bluuebunny/crossref_metadata_2025 huggingface dataset:
Bacterial behaviors on polymer surfaces with organic and inorganic antimicrobial compounds
Authors: Ji Junhui , Zhang Wei
Published: February 2008

Infection of medical polymers is often caused by bacterial adherence and bio‐film formation, and it is one of the major clinical complications causing a high rate of mortality and morbidity. In this study, it was investigated that differences of organic and inorganic antimicrobial reagents incorporated into polymers for bacterial adherence and bio‐film formation. Our experimental results show adhesion of bacteria and bio‐film (gram positive Staphylococcus aureus and gram negative Escherichia coli) are evidently reduced by adding organic antimicrobial reagents into PVC. However, inorganic antimicrobial reagents can not make much difference in bacterial bio‐film formation on their polymers' surface. Although the surface containing inorganic antimicrobial reagents has excellent ability in killing bacteria, the amount of Escherichia coli on samples surface is no less than that on the control sample during bacterial adhesion due to both various hydrophilicity and different antibacterial mechanisms on the surface. Furthermore, bacterial bio‐film formation on various hydrophilic samples is investigated, and it is observed that organic and inorganic antimicrobial compounds have much different effect on surface hydrophilicity. As a result, hydrophilicity becomes a major factor for bacterial adhesion and bio‐film. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res 2009
Biomimetic hydroxyapatite particulate nanofiber modified silicon: In vitro bioactivity
Authors: Aryal Santosh , Bajgai Madhab Prasad , Khil Myung Seob , Kang Hyung‐Sub , Kim Hak Yong
Published: February 2008

A novel particulate nanofibrous hydroxyapatite (HA), which mimics the bone matrix, is presented as a surface functional material to modify silicon wafers by the electrospinning method. The HA precursors were treated with viscous polymer solution, and then electrospun under controlled conditions. After successive calcinations, the powder X‐ray diffraction patterns of the samples revealed reflection toward the (300) HA plane that is linear with temperature. This prominent reflection suggests the crystallographic purity of the HA. Biocompatibility, cell proliferation, and microstructure were examined using AFM and FE‐SEM. Morphology showed cell spreading and penetration instead of cell aggregation. The surface roughness as well as adhesion force was calculated using contact mode AFM. The results show that the composite matrix holds promise for use as a bone implant material. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res 2009
Influence of silicone surface roughness and hydrophobicity on adhesion and colonization of Staphylococcus epidermidis
Authors: Tang Haiying , Cao Ting , Liang Xuemei , Wang Anfeng , Salley Steven O. , McAllister James , Ng K. Y. Simon
Published: February 2008

Bacterial adhesion and colonization are complicated processes that depend on many factors, including surface chemistry, hydrophobicity, and surface roughness. The contribution of each of these factors has not been fully elucidated because most previous studies used different polymeric surfaces to achieve differences in properties. The objective of this study was to modify hydrophobicity and roughness on one polymeric surface, eliminating the confounding contribution of surface chemistry. Mechanically assembled monolayer (MAM) preparation methods (both one‐ and two‐dimensional) were used to impart different degrees of hydrophobicity on fluoroalkylsilane (FAS)‐coated silicone. Surface roughness was varied by casting the silicone to templates prepared with different abrasives. Surface hydrophobicity was determined by contact angle measurement, whereas surface roughness was determined by scanning electron microscopy (SEM) and atomic force microscopy (AFM). Bacterial adhesion and colonization were analyzed using a direct colony‐counting method and SEM images. Hydrophobicity increased as a function of stretched length or width (Δx or Δy); it reached a maximum at Δx = 60% with one‐dimensional MAM and decreased as Δx further increased to 80 and 100%. The same trend was observed for the two‐dimensional MAM. After 12‐h incubation, all the FAS/silicone surfaces had significantly reduced adherence of Staphylococcus epidermidis by 42–89%, compared to untreated silicone, and the degree of which is inversely related to surface hydrophobicity. On the other hand, surface roughness had a significant effect on bacterial adhesion and colonization only when the root‐mean‐square roughness was higher than 200 nm. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res 2009
Bioactive films on metallic surfaces for osteoconduction
Authors: Zhang Qiyi , Leng Yang , Lu Xiong , Xin Renlong , Yang Xiudong , Chen Jiyong
Published: February 2008

A fast and effective electrochemical method was developed to make a dense calcium phosphate films on titanium and stainless steel for hard tissue replacement. The surfaces of titanium and stainless steel were cathodically treated in an electrochemical cell. By controlling the treatment parameters, a film of 100‐nm thickness was deposited on the metal surface in several minutes. The thin film was amorphous calcium phosphate containing octacalcium phosphate nuclei, and also dense and ductile. The treated metals were able to induce bioactive calcium phosphate deposition after immersion in simulated body fluid (SBF) for only 1 and 2 days. In vivo study was conducted by implanting the treated specimens of titanium and stainless steel in dog's femur cavity. The treated metallic surfaces showed good ability of osteoconduction. This surface treatment method can be potentially used to enhance bioactivity of any type of metallic surfaces. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res 2009
An investigation of adhesion in drug‐eluting stent layers
Authors: Wolf Kurt V. , Zong Zong , Meng Juan , Orana Argjenta , Rahbar Nima , Balss Karin M. , Papandreou George , Maryanoff Cynthia A. , Soboyejo Wole
Published: February 2008

An atomic force microscopy (AFM) method was developed to quantify the adhesion forces between and cohesive forces within the layers of a drug‐eluting stent (DES). Surface pairs representing both the individual components and the complete chemistry of each layer within the DES were prepared. As a model, the CYPHER® Sirolimus‐eluting Coronary Stent was studied. This DES consists of a stainless steel stent substrate, a parylene C primer layer, and a drug‐eluting layer that contains poly(ethylene‐co‐vinyl acetate), poly(n‐butyl methacrylate), and sirolimus (rapamycin). Coated AFM tips and two‐dimensional substrates or coupons, which act as surrogates to the CYPHER® Stent, were prepared and characterized. The force–displacement measurements were conducted to evaluate the adhesion between the middle parylene C layer and the 316L stainless steel substrate, the adhesion between the parylene C layer and the outer drug‐eluting layer, and the cohesion between the three constituents of the drug‐eluting layer. The average adhesion forces between the parylene C to drug layer varied from 88 to 167 nN, and the drug layer‐to‐drug layer interactions were between 194 and 486 nN within the model CYPHER® Stent coating. All the adhesion forces measured were larger than those observed for gold–gold interactions, which yielded a pull of force of 19 nN (Zong et al., J Appl Phys 2006;100:104313–104323). © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2008
Comparative chronic in vitro toxicity of hexavalent chromium to osteoblasts and monocytes
Authors: Raghunathan Vijay Krishna , Tettey Justice N. A. , Ellis Elizabeth M. , Grant M. Helen
Published: February 2008

There is increasing concern regarding the long‐term biological effects of exposure to low concentrations of metal ions, particularly chromium, in patients following implantation of metal‐on‐metal hip prostheses. To investigate this, we have evaluated the chronic in vitro response to clinically relevant concentrations of chromium VI in osteoblasts and monocytes over a 4‐week period in continuous culture. The cell viability, intracellular reduced glutathione content, glutathione reductase activity and expression, and expression of glutamate cysteine ligase were monitored in both cell types. Monocytes were more susceptible to the toxicity of the metal, and at the end of 4 weeks exposure to 0.5 μM Cr VI, the protein content of cultures had declined to 23.4% ± 1.0% of control cultures. Both cell types demonstrated temporal increases in reduced glutathione levels, glutathione reductase activity, and glutamate cysteine ligase expression. Only osteoblasts showed a transcriptional increase in reductase expression. Data suggest that both cell types mount an adaptive response to chronic exposure to Cr VI, but this is more potent in osteoblasts, and results in the relative resilience of this cell type to the effects of Cr VI on cell viability. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2009
Effect of sintering on porosity, phase, and surface morphology of spray dried hydroxyapatite microspheres
Authors: Wang Ai‐Juan , Lu Yu‐Peng , Zhu Rui‐Fu , Li Shi‐Tong , Xiao Gui‐Yong , Zhao Guang‐Feng , Xu Wen‐Hua
Published: February 2008

This article deals with the effect of sintering temperature on the physical and chemical characteristics of hydroxyapatite microspheres (HAMs) obtained by spray drying method. A set of specimens were sintered in a conventional furnace at 500–1100°C. The surface morphology, phase composition, size distribution, specific surface area, and porosity were characterized by scanning electron microscope, X‐ray diffractometer, laser diffraction particle size analyzer, and specific surface area analyzer, respectively. The results indicated that at 800°C, hydroxyapatite crystals began to grow and were sintered together, which caused a drastic decrease in both the specific surface area and the pore volume. Great changes took place on the surfaces of HAMs during sintering. When the samples were sintered at the temperature of 500 and 600°C, no obvious changes can be found on the surfaces of the samples, but at 800°C, open‐micropore surfaces came forth. Besides, the dispersibility of the samples decreased at high temperature (1100°C) because small particles tended to aggregate together. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2008
Chitosan/nanohydroxyapatite composite membranes via dynamic filtration for guided bone regeneration
Authors: Teng Shu‐Hua , Lee Eun‐Jung , Yoon Byung‐Ho , Shin Du‐Sik , Kim Hyoun‐Ee , Oh Joong‐Soo
Published: February 2008

Chitosan/hydroxyapatite (HA) composite membranes were prepared by the coprecipitation method and a subsequent dynamic filtration and freeze‐drying process. The influences of the HA content of the membranes on their phase and morphology, mechanical properties, and bioactivity were investigated. FTIR analysis revealed that chitosan and HA had good miscibility over a wide range of compositions. Needle‐like HA nanocrystals with low crystallinity were uniformly embedded in the chitosan matrix. As the HA content was increased, the tensile strength of the membranes exhibited a steady decrease, while the elastic modulus increased by a factor of 2 when 20% HA was added. The results of the in vitro cell culture showed that the highest alkaline phosphatase level was achieved when 30% HA was contained in the composites. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2009
Titanium implant surface modification by cathodic reduction in hydrofluoric acid: Surface characterization and in vivo performance
Authors: Lamolle Sébastien F. , Monjo Marta , Lyngstadaas Ståle P. , Ellingsen Jan E. , Haugen Håvard J.
Published: February 2008

Etching is used for the surface modification of titanium to improve the implant performance in bone. In this study, pure titanium implants were surface modified by a cathodic reduction process by using hydrofluoric acid (HF) at various concentrations (0.001, 0.01, and 0.1 vol %) and a constant current of 1 mA/cm2. The resulting surface microtopographies were analyzed by atomic force microscopy, scanning electron microscopy, and profilometry, while the surface chemical contents were evaluated by time of flight secondary ion mass spectrometry. The competitive forces between ionic surface implementation induced by the current direction and the HF etching effect on titanium were highlighted. The implant performance was evaluated in an in vivo rabbit model by using a pull‐out test method. The group of implants modified with 0.01% HF showed the highest retention in bone. Fluoride and hydride amounts measured in the surfaces, as well as surface skewness (Ssk), kurtosis (Sku), and core fluid retention (Sci) were positively correlated to the implant's retention in bone in vivo. Frequently used parameters for characterizing the implant, such as oxide content and the average height deviation from the mean plane (Sa), were not correlated to implant performance, suggesting that these parameters are not the most important in predicting the implant performance. © 2008 Wiley Periodicals, Inc. J Biomed Mater Res, 2009
Transfusion‐related acute lung injury: A thrombotic thrombocytopenic purpura treatment‐associated case report and concise review
Authors: Cruz Julie , Skipworth Elaine , Blue Deborah , Waxman Dan , McCarthy Leo , Smith Daniel
Published: February 2008

Blood products are frequently required immediately prior to, during, or just after an apheresis procedure. Transfusion‐related acute lung injury (TRALI) is now the leading cause of transfusion‐related mortality, surpassing ABO‐incompatible hemolytic reactions. The reported incidence of TRALI varies but is estimated at 1 in 5,000 transfusions. The true incidence could be higher because of under‐reporting and under‐diagnosis. Plasma is the most frequently implicated blood product. While the pathogenesis of TRALI appears multifactorial, one contributing factor seems to be donor antibodies to cognate recipient neutrophil antigens. Biologically active neutrophil‐priming substances may also play a role. New diagnostic criteria have recently been proposed to aid in the diagnosis of TRALI. We report a thrombotic thrombocytopenic purpura (TTP) treatment‐associated case of TRALI and review the history, pathogenesis, diagnosis and management of this syndrome. Current risk reduction strategies are also discussed. J. Clin. Apheresis, 2008. © 2008 Wiley‐Liss, Inc.
Measurement and characterization of RF nonuniformity over the heart at 3T using body coil transmission
Authors: Sung Kyunghyun , Nayak Krishna S.
Published: February 2008

Purpose

To measure and characterize variations in the transmitted radio frequency (RF) (B1+) field in cardiac magnetic resonance imaging (MRI) at 3 Tesla. Knowledge of the B1+ field is necessary for the calibration of pulse sequences, image‐based quantitation, and signal‐to‐noise ratio (SNR) and contrast‐to‐noise ratio (CNR) optimization.

Materials and Methods

A variation of the saturated double‐angle method for cardiac B1+ mapping is described. A total of eight healthy volunteers and two cardiac patients were scanned using six parallel short‐axis slices spanning the left ventricle (LV). B1+ profiles were analyzed to determine the amount of variation and dominant patterns of variation across the LV. A total of five to 10 measurements were obtained in each volunteer to determine an upper bound of measurement repeatability.

Results

The amount of flip angle variation was found to be 23% to 48% over the LV in mid‐short‐axis slices and 32% to 63% over the entire LV volume. The standard deviation (SD) of multiple flip angle measurements was <1.4° over the LV in all subjects, indicating excellent repeatability of the proposed measurement method. The pattern of in‐plane flip angle variation was found to be primarily unidirectional across the LV, with a residual variation of ≤3% in all subjects.

Conclusion

The in‐plane B1+ variation over the LV at 3T with body‐coil transmission is on the order of 32% to 63% and is predominantly unidirectional in short‐axis slices. Reproducible B1+ measurements over the whole heart can be obtained in a single breathhold of 16 heartbeats. J. Magn. Reson. Imaging 2007. © 2007 Wiley‐Liss, Inc.
Venomics: unravelling the complexity of animal venoms with mass spectrometry
Authors: Escoubas P. , Quinton L. , Nicholson G. M.
Published: February 2008

Animal venoms and toxins are now recognized as major sources of bioactive molecules that may be tomorrow's new drug leads. Their complexity and their potential as drug sources have been demonstrated by application of modern analytical technologies, which have revealed venoms to be vast peptide combinatorial libraries. Structural as well as pharmacological diversity is immense, and mass spectrometry is now one of the major investigative tools for the structural investigation of venom components. Recent advances in its use in the study of venom and toxins are reviewed. The application of mass spectrometry techniques to peptide toxin sequence determination by de novo sequencing is discussed in detail, in the light of the search for novel analgesic drugs. We also present the combined application of LC‐MALDI separation with mass fingerprinting and ISD fragmentation for the determination of structural and pharmacological classes of peptides in complex spider venoms. This approach now serves as the basis for the full investigation of complex spider venom proteomes, in combination with cDNA analysis. Copyright © 2008 John Wiley & Sons, Ltd.
Capillary electrophoretic chiral separation of Cinchona alkaloids using a cyclodextrin selector
Authors: Tsimachidis Dimitrios , Česla Petr , Hájek Tomas , Theodoridis Georgios , Jandera Pavel
Published: February 2008

A new capillary electrophoretic method for the chiral separation of four major Cinchona alkaloids (quinine/quinidine and cinchonine/cinchonidine) was developed using heptakis‐(2,6‐di‐O‐methyl)‐β‐cyclodextrin as the chiral selector. The inner walls of the separation capillary were modified with a thin polyacrylamide layer, which substantially reduced the electroosmotic flow and improved the chiral resolution and the reproducibility of the migration time of the analytes. Various operation parameters were optimised, including the pH, the capillary temperature, the concentration of the background electrolyte, and the concentration of the chiral selector. Baseline separation of the two diastereomer pairs was achieved in 12 minutes in ammonium acetate background electrolyte pH 5.0 with addition of cyclodextrin in a concentration of 3 mM or higher.
A simple method to optimize the HSCCC two‐phase solvent system by predicting the partition coefficient for target compound
Authors: Han Quan‐Bin , Wong Lina , Yang Nian‐Yun , Song Jing‐Zheng , Qiao Chun‐Feng , Yiu Hillary , Ito Yoichiro , Xu Hong‐Xi
Published: February 2008

A simple method was developed to optimize the solvent ratio of the two‐phase solvent system used in the high‐speed counter‐current chromatography (HSCCC) separation. Some mathematic equations, such as the exponential and the power equations, were established to describe the relationship between the solvent ratio and the partition coefficient. Using this new method, the two‐phase solvent system was easily optimized to obtain a proper partition coefficient for the CCC separation of the target compound. Furthermore, this method was satisfactorily applied in determining the two‐phase solvent system for the HSCCC preparation of pseudolaric acid B from the Chinese herb Pseudolarix kaempferi Gordon (Pinaceae). The two‐phase solvent system of n‐hexane/EtOAc/MeOH/H2O (5:5:5:5 by volume) was used with a good partition coefficient K = 1.08. As a result, 232.05 mg of pseudolaric acid B was yielded from 0.5 g of the crude extract with a purity of 97.26% by HPLC analysis.
Tourist satisfaction and beyond: tourist migrants in Mallorca
Authors: Bowen David , Schouten Alexander F.
Published: February 2008

This exploratory study analyses the role of tourist experience, especially tourist satisfaction, in subsequent migration from the UK to the municipality of Calviá, Mallorca, Spain. An overview and commentary is provided of theory relating to both tourist satisfaction and migration. Through a series of elite interviews, in‐depth micro‐studies and a questionnaire, which provides a small quantitative component, it is established that the motivation given by tourist satisfaction can be recognised as a key catalyst for migration. Classic migration motivations cannot be entirely discounted, and the migration decisions are multi‐stage through time. But tourist satisfaction—and particularly the two satisfaction components of performance and emotion—is especially relevant in the micro‐perspective of migration decision‐making. Copyright © 2008 John Wiley & Sons, Ltd.
A histopathologic evaluation of the plasma skin regeneration system (PSR) versus a standard carbon dioxide resurfacing laser in an animal model
Authors: Fitzpatrick R. , Bernstein E. , Iyer S. , Brown D. , Andrews P. , Penny K.
Published: February 2008

Background and Objectives

A variety of high energy, pulsed, and scanned carbon dioxide lasers are available to perform cutaneous resurfacing. Rhytec has developed a device for skin regeneration that utilizes energy delivered via a burst of nitrogen plasma. This study was undertaken to benchmark the energy outputs of the plasma skin regeneration device as compared to an ultra‐short pulsed carbon dioxide laser (the control device). The two systems were compared for time to complete healing, and the healing response post‐treatment.

Materials and Methods

Three Yucatan mini‐pigs were utilized for this study. Following anesthesia, five experimental sites were marked along the skin atop the psoas muscle on each side of the spine. Treatment was applied using either the plasma skin regeneration system or the carbon dioxide laser, with one site remaining untreated as a control. Biopsies were taken from all treatment sites 0, 2, 7, 14, 30, and 60 days following treatment and processed to hematoxylin‐eosin staining. Histopathologic examination was performed by observers blinded as to the treatment conditions.

Results

Skin treated with the plasma skin regeneration device showed a wider range of tissue effects across the energy settings used as compared to the laser treatment. All treatment sites had clinically regenerated epidermis by 7 days after treatment, with active cellular response below the D/E junction noted at the day 30 time‐point at energies ranging from 2 to 4 J.

Conclusion

The Rhytec PSR system provides an attractive alternative to standard CO2 laser with good remodeling of tissue architecture. Epidermis regenerated after PSR treatment shows a smoother surface profile than adjacent untreated tissue. Lesers Surg. Med. 40:93–99, 2008. © 2008 Wiley‐Liss, Inc.
Histologic and ultrastructural analysis of melasma after fractional resurfacing
Authors: Goldberg David J. , Berlin Alexander L. , Phelps Robert
Published: February 2008

Background and Objective

Fractional photothermolysis is a popular treatment option for photodamaged skin and other cutaneous conditions. Recently, successful improvement in melasma has been achieved with this laser system. We undertook this study to evaluate the ultrastructural changes associated with fractional laser treatment of melasma.

Study Design/Materials and Methods

Ten subjects with skin types III and IV and a clinical diagnosis of epidermal melasma were treated with a 1,550‐nm erbium:glass laser delivering light in a fractional manner (Fraxel SR 750, Reliant Technologies, Inc., Mountain View, CA) every 2 weeks for a total of four sessions. Biopsies were obtained from all subjects both before treatment and at 3 months following the final treatment. All biopsies were analyzed by light and electron microscopy for treatment‐induced changes. In addition, a secondary endpoint of the study was to assess for clinical improvement in melasma following fractional resurfacing. This assessment was performed by the investigator using pre‐ and post‐treatment photographs.

Results

Light microscopy on post‐treatment specimens showed a relative decrease in melanocytes compared to the pre‐treatment ones. Post‐treatment electron microscopy revealed fewer melanocytes and a relative absence of melanin in the surrounding keratinocytes compared to pre‐treatment specimens. In addition, six subjects with skin type III were determined to have good improvement, whereas four subjects with skin type IV had fair improvement, as assessed by the investigator.

Conclusion

Post‐treatment ultrastructural changes are consistent with an elimination process and may help to explain clinical improvement following laser treatment. Lesers Surg. Med. 40:134–138, 2008. © 2008 Wiley‐Liss, Inc.
Relevance of the structure of time‐resolved spectral output to light‐tissue interaction using intense pulsed light (IPL)
Authors: Ash Caerwyn , Town Godfrey , Bjerring Peter
Published: February 2008

Background and Objectives

High quality IPLs can offer simple, safe and effective treatments for long‐term hair removal, removal of benign vascular and pigmented skin abnormalities, skin rejuvenation and acne treatments. Significant differences in clinical outcome have been recorded among different free‐discharge and constant current IPLs despite identical settings. We investigated the differences in optical output of 19 IPLs in normal clinical use in the UK to evaluate spectral output, energy density values and pulse structure and propose a correlation between light‐tissue interaction and spectral output as measured by time‐resolved photo‐spectrometry.

Study Design/Materials and Methods

Using a fast spectrometer, generating 1,000 full spectral scans per second, time resolved spectral data of IPL outputs was captured with a resolution of 0.035 nm. IPL spectral outputs were calculated and graphically modelled using MathCAD™ software for comparison.

Results

Several IPLs, which professed matching of pulse durations to the thermal relaxation times of specific follicular or vascular targets were shown to have effective pulse durations that were vastly shorter than those claimed. Some IPLs claiming ‘square pulse’ characteristics failed to show constant spectral output across the duration of the pulse or sub‐pulses.

Conclusions

This study provides a suitable method to determine accurately key parameters of the emitted light pulses from IPLs and confirms the direct correlation between the electrical discharge current profile and the output energy profile. The differences measured between first generation free discharge systems and modern square pulse systems may have important clinical consequences in terms of different light‐tissue interactions and hence clinical efficacy and safety. IPL manufacturers should provide time‐resolved spectroscopy graphs to users. Lesers Surg. Med. 40:83–92, 2008. © 2008 Wiley‐Liss, Inc.
Micro‐fractional ablative skin resurfacing with two novel erbium laser systems
Authors: Dierickx Christine C. , Khatri Khalil A. , Tannous Zeina S. , Childs James J. , Cohen Richard H. , Erofeev Andrei , Tabatadze David , Yaroslavsky Ilya V. , Altshuler Gregory B.
Published: February 2008

Background and Objectives

Fractional ablation offers the potential benefits of full‐surface ablative skin resurfacing while minimizing adverse effects. The purpose of this study was to evaluate the safety, damage profile, and efficacy of erbium fractional lasers.

Materials and Methods

Histology from animal and human skin as well as clinical evaluations were conducted with erbium YAG (2,940 nm) and erbium YSGG (2,790 nm) fractional lasers varying pulse width, microbeam (µb) energy, number of passes, and stacking of pulses.

Results

Single‐pulse treatment parameters from 1 to 12 mJ per 50–70 µm diameter microbeam and 0.25–5 milliseconds pulse widths produced microcolumns of ablation with border coagulation of up to 100 µm width and 450 µm depth. Stacking of pulses generated deeper microcolumns. Clinical observations and in vivo histology demonstrate rapid re‐epithelization and limited adverse side effects. Facial treatments were performed in the periorbital and perioral areas using 1–8 passes of single and stacked pulses. Treatments were well‐tolerated and subjects could resume their normal routine in 4 days. A statistically significant reduction in wrinkle scores at 3 months was observed for both periorbital and perioral wrinkles using blinded grading. For periorbital treatments of four passes or more, over 90% had ≥1 score wrinkle reduction (0–9 scale) and 42% had ≥2. For perioral wrinkles, over 50% had substantial improvements (≥2).

Conclusion

The clinical observations and histology findings demonstrate that micro‐fractional ablative treatment with 2,790 and 2,940 nm erbium lasers resulted in safe and effective wrinkle reduction with minimal patient downtime. The depth and width of the ablated microcolumns and varying extent of surrounding coagulation can be controlled and used to design new treatment procedures targeted for specific indications and areas such as moderate to severe rhytides and photodamaged skin. Lesers Surg. Med. 40:113–123, 2008. © 2008 Wiley‐Liss, Inc.
Ablative targeting of fatty‐tissue using a high‐powered diode laser
Authors: O'Dey Dan mon , Prescher Andreas , Poprawe Reinhart , Gaus Sebastian , Stanzel Sven , Pallua Norbert
Published: February 2008

Background and Objective

Concerning current clinical practice, laser‐assisted lipoplasty is still secondary to other procedures. In order to evaluate effects of thermal interaction with fatty‐tissue, a near infrared diode laser was examined under reproducible conditions.

Methods

Based on optical spectroscopy of fatty‐tissue, a high‐powered diode laser (λ = 940 nm) was used to irradiate n = 59 fat samples of fresh corpses in non‐contact mode. Thermal effects were histologically evaluated by computer based metric measurements. Calculated values included ablation rate (AR) and the ratio of cavity diameter to diameter of collateral damage (CCDratio). Pearson's correlation and analysis of covariance (ANCOVA) were used for statistical evaluation. P values of less than 0.05 were considered to indicate statistical significance.

Results

Regarding the conditions examined, irradiances from 250 to 400 W/cm2 revealed both increased ablation capacities and decreased collateral damages. An average irradiance of 370±0 W/cm2 shows an average CCDratio of 2:1 and an average AR of 9.98±7.65 mm3/second.

Conclusion

Near infrared high‐powered diode laser energy proved to be eligible for tissue protective ablation of fat in vitro. Further studies are necessary to improve efficiency and safety of this procedure. Lesers Surg. Med. 40:100–105, 2008. © 2008 Wiley‐Liss, Inc.
The short pulse carbon dioxide laser versus the colorado needle tip with electrocautery for upper and lower eyelid blepharoplasty
Authors: Rokhsar Cameron K. , Ciocon David H. , Detweiler Susan , Fitzpatrick Richard E.
Published: February 2008

Background/Objective

Various techniques for blepharoplasty have been described, including those performed with the assistance of the short pulse carbon dioxide laser and those performed with the assistance of the Colorado microdissection needle attached to an electrocautery unit. Although the superiority of the carbon dioxide laser to cold steel has been demonstrated for the performance of eyelid blepharoplasty, no studies have ever compared the carbon dioxide laser to the Colorado needle.

Study Design/Materials and Methods

This is a paired comparison study in which 12 healthy patients underwent bilateral blepharoplasty of their upper and/or lower eyelids by a single surgeon. For each patient, a short pulse carbon dioxide laser was used on one side, and a Colorado needle attached to an electrocautery unit was used on the other. Intraoperative times were recorded. At five post‐operative visits patients were evaluated for post‐operative healing parameters including edema, erythema, scar width, and bruising. Finally, excised tissue was assessed histologically for thermal damage.

Results

Comparing both techniques, no difference in patient or physician‐measured parameters of healing were noted up to 1 month post‐operatively. However, Colorado needle assisted blepharoplasty resulted in slightly shorter intraoperative times. It also resulted in less thermal damage on a histologic level, although these differences were not clinically significant.

Conclusions

For the performance of blepharoplasty, the Colorado needle tip with electrocautery offers benefits equivalent to those of the short pulsed CO2 laser but has the advantage of shorter intraoperative times and lower cost. Lesers Surg. Med. 40:159–164, 2008. © 2008 Wiley‐Liss, Inc.
Selective transcutaneous delivery of energy to porcine soft tissues using intense ultrasound (IUS)
Authors: White W. Matthew , Makin Inder Raj S. , Slayton Michael H. , Barthe Peter G. , Gliklich Richard
Published: February 2008

Objective

Various energy delivery systems have been utilized to treat superficial rhytids in the aging face. The Intense Ultrasound System (IUS) is a novel modality capable of transcutaneously delivering controlled thermal energy at various depths while sparing the overlying tissues. The purpose of this feasibility study was to evaluate the response of porcine tissues to various IUS energy source conditions. Further evaluation was performed of the built‐in imaging capabilities of the device.

Materials and Methods

Simulations were performed on ex vivo porcine tissues to estimate the thermal dose distribution in tissues after IUS exposures to determine the unique source settings that would produce thermal injury zones (TIZs) at given depths. Exposures were performed at escalating power settings and different exposure times (in the range of 1–7.6 J) using three IUS handpieces with unique frequencies and focal depths. Ultrasound imaging was performed before and after IUS exposures to detect changes in tissue consistency. Porcine tissues were examined using nitro‐blue tetrazolium chloride (NBTC) staining sensitive for thermal lesions, both grossly and histologically. The dimensions and depth of the TIZs were measured from digital photographs and compared.

Results

IUS can reliably achieve discrete, TIZ at various depths within tissue without surface disruption. Changes in the TIZ dimensions and shape were observed as source settings were varied. As the source energy was increased, the thermal lesions became larger by growing proximally towards the tissue surface. Maximum lesion depth closely approximated the pre‐set focal depth of a given handpiece. Ultrasound imaging detected well‐demarcated TIZ at depths within the porcine muscle tissue.

Conclusion

This study demonstrates the response of porcine tissue to various energy dose levels of Intense Ultrasound. Further study, especially on human facial tissue, is necessary in order to understand the utility of this modality in treating the aging face and potentially, other cosmetic applications. Lesers Surg. Med. 40:67–75, 2008. © 2008 Wiley‐Liss, Inc.
Treatment of acne scars using the plasma skin regeneration (PSR) system
Authors: Gonzalez Michele J. , Sturgill William H. , Ross E. Victor , Uebelhoer Nathan S.
Published: February 2008

Background and Objectives

Acne scarring is a common and difficult to treat condition. The plasma skin regeneration (PSR) system is a novel device that causes delayed ablation of the epidermis and controlled thermal modification to the underlying dermis. PSR has previously been shown to be a safe and effective treatment for facial rhytides and benign skin lesions. In this study, we investigated the safety and efficacy of single‐treatment, high‐energy, double‐pass PSR for the treatment of acne scarring.

Study Design/Materials and Methods

Ten patients with acne scarring and Fitzpatrick skin types I–III were included in the study. All patients underwent a single PSR treatment with two high‐energy passes (3.5–4.0 J). Treatments were performed in an outpatient clinic setting. Nine patients completed 6 months of follow‐up. Improvement was determined by patient questionnaires and physician evaluation of digital photographs taken prior to treatment and at 3 and 6 months post‐treatment.

Results

On average, patients reported 34% improvement in their acne scarring at 3 months and 33% improvement at 6 months. Blinded physician ratings of patient photos demonstrated 19% improvement at 3 months and 34% at 6 months. Re‐epithelialization was complete by 4–6 days after treatment, and no serious adverse events were encountered.

Conclusion

PSR appears to provide a safe and effective single treatment, minimal downtime alternative for the treatment of acne scarring. Additional studies are warranted to further demonstrate the safety and efficacy of this device. Lesers Surg. Med. 40:124–127, 2008. © 2008 Wiley‐Liss, Inc.
Structures of the chain metaphosphates NaM(PO3)3 (M = Ca or Sr)
Authors: Abrahams I. , Hawkes G. E. , Ahmed A. , Di Cristina T. , Demetriou D. Z. , Ivanova G. I.
Published: February 2008

Solid‐state 23Na and 31P magic‐angle spinning nuclear magnetic resonance spectroscopy and X‐ray crystallography have been used to study the structures of the chain metaphosphates NaCa(PO3)3 and NaSr(PO3)3. The compounds are isostructural and crystallise in space group P−1 with the following parameters: NaCa(PO3)3, a = 6.711 Å, b = 6.934 Å, c = 7.619 Å, α = 83.44° , β = 81.41° , γ = 82.80° ; NaSr(PO3)3a = 6.805 Å, b = 7.133 Å, c = 7.720 Å and α = 83.71° , β = 80.48° , γ = 82.87° . Both structures contain anionic metaphosphate chains of (PO3)nn with ionic contacts to Na+ ions in distorted octahedral sites and Ca2+ (or Sr2+) in distorted dodecahedral sites. 31P and 23Na NMR are entirely consistent with the crystallographic data and an empirical method for assigning 31P resonances to particular crystallographically unique P atoms is described. Copyright © 2008 John Wiley & Sons, Ltd.
Understanding reasons for underuse: An approach to improve quality and reduce disparities in breast cancer treatmentrr
Authors: Bickell Nina A. , Cohen Alicia
Published: February 2008

Objective: Effective adjuvant treatments proven to prolong survival for breast cancer exist, yet many women, particularly minority women, do not receive them. Little work has focused on improving the quality of, and reducing racial disparities in, cancer treatment. We describe the application of a conceptual model to direct, design, and implement trials to reduce underuse of effective adjuvant breast cancer treatments.

Methods: Content analysis of extensive interviews and focus groups was used to construct a framework of patient, physician, and system‐level reasons for underuse. Use of the model then directed development of targeted interventions aimed at ameliorating underlying causes.

Results: The process of identifying patient, physician, and system‐level reasons for underuse involved patients, surgeons, surgeon's office staff, and providers of patient assistance. Engaging these individuals both informed the design of our multi‐focused interventions and generated interest in trial participation. All 38 surgeons in six unaffiliated institutions and all 25 patient assistance programs approached agreed to participate in the intervention trials.

Interpretation: Identifying reasons for underuse by interviewing patients, physicians, physician office staff, and allied care providers about episodes in which needed care failed to occur helps engage key individuals, and can inform the design and implementation of interventions targeting barriers to delivering high quality breast cancer care to all. Mt Sinai J Med 75:23–30, 2008. © 2008 Mount Sinai School of Medicine
The success of recruiting minorities, women, and elderly into a randomized controlled effectiveness trial
Authors: Sisk Jane E. , Horowitz Carol R. , Wang Jason J. , McLaughlin Mary Ann , Hebert Paul L. , Tuzzio Leah
Published: February 2008

Background: Heart failure, a leading cause of hospitalization among elderly people, disproportionately afflicts African‐American and other non‐White populations. Studies of health care interventions often do not include these groups in proportion to numbers in the patient population. Our objective was to assess whether a randomized controlled effectiveness trial enrolled patients by ethnicity/race, gender, and age in proportion to those eligible.

Methods: We conducted a randomized controlled trial comparing nurse management and usual care among ambulatory heart failure patients at the four hospitals in East and Central Harlem, New York. We incorporated culturally sensitive and age‐appropriate strategies to enroll a demographically representative group into the trial. Recruitment proceeded in several steps: identifying patients with billing code and visit criteria, documenting systolic dysfunction, obtaining clinician permission and correct addresses, contacting patients, and enrolling eligible patients. We assessed differences by ethnicity/race and gender at successive steps in the recruitment process, and differences between enrollees and refusals regarding overall health, evaluation of medical care, and difficulty receiving care.

Results: We enrolled 406 ambulatory patients by ethnicity/race and gender in proportion to the numbers eligible to be contacted (46% African‐American/Black, 33% Hispanic, and 47% female). Among patients contacted, however, those 18 through 74 years were 2.0 to 3.3 times more likely than those ≥ 75 years to enroll (p < 0.001).

Conclusions: The recruitment strategy successfully enrolled patients by ethnicity/race, gender, and age through 74 years, but not those ≥ 75 years. Registries of patients who refuse to enroll in trials could provide guidance for clinical and public policy. Mt Sinai J Med 75:37–43, 2008. © 2008 Mount Sinai School of Medicine
Racial disparities in infant mortality: A quality of care perspective
Authors: Howell Elizabeth A.
Published: February 2008

Black infants in the United States are more than twice as likely to die as White infants in the first year of life. Reducing the existing racial disparity in infant mortality rates is a major health policy focus. Despite decades of research aimed at reducing preterm births, our efforts have been largely unsuccessful. Much greater success has been achieved in reducing the morbidity and mortality of premature infants, largely through improvements in obstetrical and neonatal care. However, it is an open question whether such improvements have reduced racial disparities in infant mortality. In this article, we recommend a new framework for addressing infant mortality disparities. We suggest that a quality of care problem may partially underlie racial disparities in infant mortality rates. Mt Sinai J Med 75:31–35, 2008. © 2008 Mount Sinai School of Medicine
Evidence of artificial cranial deformation from the later prehistory of the Acacus Mts. (southwestern Libya, Central Sahara)
Authors: Ricci F. , Fornai C. , Blos V. Tiesler , Rickards O. , di Lernia S. , Manzi G.
Published: February 2008

The 1999–2001 Italian–Libyan Archaeological Mission in the Acacus and Messak, southwestern Libya, resulted in the discovery of human specimens from the Wadi Tanezzuft Valley belonging to the Final Pastoral horizon (i.e. late Neolithic, about 3000 years bp). Some of these show clear traces of artificial cranial deformation. This practice, hitherto unrecorded in the central Sahara, is described and analysed in this paper. It represents an additional source of information about population movements and cultural connections in the area. It does not appear to be gender‐related, and neither does it involve all individuals in the sample, suggesting some kind of social and/or cultural differentiation within the group. The pattern of cranial deformation described here is not directly related to types most commonly encountered among recent African populations and elsewhere. It may be considered a combination of antero‐posterior and circumferential deformation and thus is referred to as a ‘pseudo‐circular type’. Archaeological and ethnographic literature related to Africa and southwestern Asia is investigated in order to identify a possible origin of such a custom and its pattern of diffusion. The evidence, according to other sources of information, contributes to interpret this area at the centre of the Sahara as a focal point of population movements and circulation of cultural traditions across North Africa in the latest phases of the Pastoral Neolithic. Copyright © 2008 John Wiley & Sons, Ltd.
Most multifocal papillary thyroid carcinomas acquire genetic and morphotype diversity through subclonal evolution following the intra‐glandular spread of the initial neoplastic clone
Authors: Jovanovic L , Delahunt B , McIver B , Eberhardt NL , Grebe SKG
Published: February 2008

Papillary thyroid carcinoma (PTC) is frequently multifocal (mPTC), with synchronous tumour foci often showing varied morphology. The genetic mechanisms underlying the development of multiple and histologically diverse tumour foci remain uncertain. Different tumour foci might develop either through intrathyroidal dissemination of a single malignant clone, with morphotype differentiation occurring as a result of subclonal progression, or they may stem from independent transformational events involving multiple progenitor clones. To determine the clonal derivation of multiple tumour foci and to map their clonal relationships and genetic progression in mPTC, we evaluated genome‐wide allelic imbalances (AI) and BRAFV600E mutation status in 55 synchronous tumour foci from 18 mPTC patients. For apparently monoclonal tumours, we calculated the probabilities of monoclonal derivation and used phylogenetic analysis to model clonal evolution. Genome‐wide allelotyping and BRAF mutation analysis showed genetic alterations consistent with monoclonal origin in 83% of cases, mostly with evidence of subclonal evolution. BRAFV600E mutations were early events during clonal evolution of most, but not all cases. MPTC with morphologically diverse tumour foci also arose through monoclonal derivation in 75% of cases, demonstrating that morphotype‐determining genetic changes can be acquired during clonal diversification, subsequent to the spread of the original malignant progenitor clone. In 17% of patients, discordant AI or BRAFV600E profiles implied that mPTCs can occasionally develop from distinct transformation events. This study suggests that mPTC originates usually from neoplastic transformation and subsequent intrathyroidal spread of a single malignant progenitor clone. Clonal progression and morphotype differentiation occur through progressive acquisition of genetic alterations subsequent to the initial intra‐glandular spread. In monoclonal BRAFV600E‐positive mPTCs, BRAFV600E is not always present in all tumour foci, indicating that other tumour‐genetic factors in the primary progenitor clone can also trigger PTC neoplastic transformation. Copyright © 2008 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.