Treatment of Epithelioid angiosarcoma with Topical ALA-PDT in the course of surgery

BackgroundEpithelioid angiosarcoma is a high grade malignancy sarcoma of soft tissue, which is hard to diagnose and completely excise without causing functional and cosmetic problems. Moreover, the high rate of recurrence is hard to salvage. Photodynamic therapy is a novel treatment protocol which can selectively destroy tumor cell with good functional and cosmetic outcomes.MethodsThis is a case about a 81 years old patient with Epithelioid angiosarcoma in the right medial angle of eye, which received surgery and ALA photodynamic therapy.ResultsThere is no recurrence in one year after treatment of surgery and photodynamic therapy in the course of surgery.ConclusionsExcision combined with photodynamic therapy during operation is a promising strategy towards tumors which are hard to resect thoroughly and have a high risk of recurrence.     

Successful treatment of refractory facial acne using repeat short-cycle ALA-PDT: Case study

Acne vulgaris is a common dermatological disorder. Topical photodynamic therapy (PDT)-mediated with aminolevulinic acid (ALA) or methyl aminolevulinic acid (MAL) has been successfully used in the treatment of moderate to severe acne. The purpose of this case report is to highlight the feasibility of using a repeat weekly short-cycle ALA-PDT to treat severe facial acne lesions refractory to systemic retinoid and antibiotics.     

The in vitro effect of antimicrobial photodynamic therapy with toluidine blue and indocyanine green on microleakage of class V cavities

IntroductionConsidering the importance of disinfecting dentin and enamel after cavity preparation and the possible effect of disinfection methods on induction of various reactions in the tooth structure the aim of the present study was to evaluate microleakage of composite resin restoration after disinfecting the prepared dentin and enamel surface with antimicrobial photodynamic therapy (aPDT) with toluidine blue (TBO) and indocyanine green (ICG).Materials and methodsStandard class V cavities were prepared on buccal surface of 71 human premolar teeth. The samples were randomly divided into 3 groups based on disinfection method: Group 1: conventional disinfection method with Phosphoric acid 37% as the control; Group 2: aPDT with TBO and diode laser with wavelength of 635 nm; Group 3: aPDT with ICG and diode laser with wavelength of 808 nm. All the cavities were restored with composite resin (3M™ Filtek™ Z250). After thermocycling and immersing in 0.5% basic fuchsin, the samples were prepared for microleakage evaluation under a stereomicroscope. Data was analyzed with Kruskal-Wallis and Wilcoxon signed-rank tests at P < 0.05.ResultsThere were no significant differences in the microleakage of occlusal and gingival margins between the TBO and control groups (P > 0.05). Also, the microleackage of occlusal margins between groups was not significantly different (P > 0.05) but microleackage of gingival margins of ICG group was lower than two other groups in a meaningful way (P < 0.05).ConclusionPhotodynamic therapy with ICG as disinfecting agent in cavity preparations before composite resin restorations decreases the microleackage of gingival margins.     

ALA-PDT suppressing the cell growth and reducing the lipogenesis in human SZ95 sebocytes by mTOR signaling pathway in vitro

Background5-Aminolevulinic acid mediated −photodynamic therapy (ALA-PDT) is known to be effective in treating acne vulgaris and other sebaceous gland-related diseases. However, the therapeutic mechanisms of ALA-PDT still remain undetermined. In this study, we aimed to investigate the effects and mechanisms of ALA-PDT on the cell growth and lipogenesis of human SZ95 sebocytes.Material and methodsHuman SZ95 sebocytes were treated with different concentration of ALA-PDT.CCK-8 assay was used to detect cell proliferation activity. Fluorescence microscope and flow cytometry were used to observe the secretion of lipids in SZ95 cells after Nile red staining. Western blotting was used to detect and analyze the protein expression level of P-p70 S6 K/p70 S6 K, P-4E-BP1/4E-BP1, SREBP-1, PPARγ, P-mTOR/mTOR, and P-Raptor/Raptor. Mean while, mTOR pathway activator IGF-1 and mTORC1 inhibitor rapamycin were added to observe the interferences on the ALA-PDT treatment of SZ95 cells.ResultsALA-PDT suppressed the cell growth and reduced the secretion of lipids in a dose-dependent manner in SZ95 cells. ALA-PDT reduced the protein levels of P-p70 S6 K (T389), SREBP-1, PPARγ, P-mTOR and P-Raptor. IGF-1 had counter effects on ALA-PDT, and rapamycin enhanced the effects of ALA-PDT in SZ95 cells in suppressing the cell growth and reducing the secretion of lipids.ConclusionALA-PDT suppressed the cell growth in SZ95 cells by mTOR-p70 S6K(T389) signaling and reduced the lipogenesis in SZ95 cells by mTOR-SREBP-1/PPARγ signaling. Sebaceous glands atrophy and reduction of sebum secretion after ALA-PDT may be caused by the suppression of lipogenesis and cell growth in sebocytes.     

ALA-induced porphyrin formation and fluorescence in synovitis tissue: In-vitro and in vivo studies

The synovial inflammatory process in rheumatoid arthritis (RA) is accompanied by massive tumor-like proliferation and activation of the connective stroma. These abnormal cells actively invade and destroy the peri-articular bone and cartilage at the margins of joints where synovium and bone are attached. There is still a lack of minimally invasive synovectomy methods, which might be suitable for the smaller joints. Unfortunately, these joints are usually involved in the disease. Photodynamic therapy has been evaluated as a possible treatment modality for RA synovitis. The present study describes the differences of 5-aminolevulinic acid (5-ALA) and 5-ALA ester-induced protoporphyrin IX (PpIX) production in cell cultures obtained from patients with RA, osteoarthritis (OA) and human sarcoma cell line (HS 192.T) and in a collagen-induced arthritis model in rats. The incubation of cells with hexyl aminolevulinate (HAL) induced the same amount of fluorescence as 5-ALA and methyl aminolevulinate (MAL) at about a 100-fold lower concentration. Incubation with HAL-induced accumulation of at least twice as much porphyrins in RA- and HS 192.T-cells than 5-ALA and MAL in OA-cells. Similar levels of porphyrins were accumulated in RA and the malignant cells. In vivo, intra-articular application of 5-ALA induced a significant porphyrin accumulation in synovitis tissue as measured by in situ fluorescence spectroscopy. In contrast to our in vitro results and other reports, we could not detect enhanced fluorescence after application of up to 0.1 mg HAL.     

重视老龄化对创面愈合影响的研究

机体老龄化将带来一系列病理生理变化,其中也将对创面愈合产生影响。本文从营养、免疫调控、激素与内分泌多个方面综述老龄化对创面愈合产生的影响。     

局部5-氨基酮戊酸-光动力疗法治疗中重度痤疮疗效分析

目的探讨局部5-氨基酮戊酸-光动力疗法治疗中重度痤疮的安全性及有效性。方法将60例中重度面部痤疮患者随机分为两组。治疗组30例,给予ALA-PDT治疗,每2周治疗1次,共治疗2～4次;对照组30例,单纯红光治疗,每周1次,共8次。在治疗后第2、4、6和8周对两组患者进行疗效判断和比较,同时观察治疗过程中出现的不良反应。结果治疗组和对照组治疗后第8周总有效率分别为96.7%和76.7%,治疗组疗效明显优于对照组(P0.05)。治疗组个别患者出现红斑、少许色素沉着,但无瘢痕形成。结论局部5-氨基酮戊酸-光动力疗法治疗中重度痤疮疗效高、复发率低,不良反应小,优于单纯红光治疗。     

放射损伤对创面愈合的影响

放射损伤合并创伤称为"放创复合伤",主要见于核爆炸、核事故和核恐怖活动,也可见于临床放疗等病例,其中创面或伤口愈合显著延缓是一个突出的医学问题。电离辐射延缓创面愈合的机制是"以细胞损害为关键环节的愈合诸因素调控失调",其中"细胞"同时包括造血细胞和修复细胞,而"损害"则同时包括数量和功能的损害。对放创复合伤创面促愈的一个重要原则是要同时考虑增加创伤局部造血细胞和修复细胞的数量,促进其功能。已经筛选获得了数种对放创复合伤具有促愈作用的药物和生长因子。成体多能干细胞的应用为放创复合伤等严重创伤的救治提供了新的思路和途径     

基因治疗在创面愈合中的应用

伤口愈合是一系列代谢和复杂分子间相互作用的过程，在细胞增殖、迁移和分化中生长因子充当了重要角色，被用于临床创面修复的治疗。然而，大多数生长因子不能有效地传递到靶细胞、发挥明显的促创面愈合的作用。随着基因传递技术的发展和对人类基因组认识的提高，创面愈合的基因治疗已经取得飞速的发展。基因治疗在伤口病理性愈合过程中将发挥积极有效的作用。     

三阶段光动力疗法治疗男性尖锐湿疣

目的评价外用盐酸氨酮戊酸散剂三阶段光动力疗法治疗男性生殖器疣的临床疗效和安全性。方法 102例男性尖锐湿疣患者接受三阶段光动力疗法治疗:第一阶段主要是清除疣体,第二个阶段主要是治疗亚临床感染,第三个阶段使用免疫调节剂和食疗法预防尖锐湿疣的复发。结果经过三阶段3～6次的光动力治疗,疣体清除率100.0%,6个月随访的复发率仅为2.9%。治愈率97.1%。结论三阶段光动力疗法是治疗尖锐湿疣、预防复发的安全有效的好方法。     

创面修复中生长因子研究及临床干预新进展

创面修复是一个多因素参与的复杂而精细的生物学过程。创面局部生长因子及其受体活性下降和数量的相对和绝对缺乏是其难愈的重要病理生理基础。创面修复过程中生长因子不仅可以促进角质细胞增殖分化使创面再上皮化,还可改变细胞外基质,促进蛋白质、DNA和RNA的合成以及糖酵解,促进新生肉芽组织形成。因此,局部外用生长因子可以显著促进创面修复。在临床实践中,生长因子的应用方式也不断改善,同时与其相关的治疗方案也不断涌现,应用前景广泛。     

负压封闭引流技术联合局部氧疗对创面愈合的影响

目的：探讨负压封闭引流技术联合局部氧疗对创面愈合的影响,为临床应用提供实验依据。方法以新西兰大白兔为研究对象,建立皮肤切除伤口动物模型,并随机分为4组,分别对创面施加负压封闭引流治疗（负压值－60mmHg）、局部氧疗（氧流量1L／min）、负压封闭引流技术＋局部氧疗（负压值－60mmHg,氧流量1L／min）3种治疗,而对照组采用常规包扎治疗。观察创面愈合情况28d,记录各组伤口愈合数目和愈合天数并计算平均愈合时间。结果结合治疗组（即负压封闭＋局部氧疗组）中10个创面全部愈合,平均愈合天数为（18.6±2.4）d,分别与负压封闭治疗组、局部氧疗组、对照组存在显著性差异。结论负压封闭引流技术与局部氧疗相结合能促进创面愈合,是一种新的治疗创面的方式。     

热休克蛋白70与创伤愈合的相关性研究

目的探讨热休克蛋白70(HSP70)在创伤愈合及细胞增殖中的作用.方法建立小鼠创伤模型,利用免疫组织化学及细胞学方法检测HSP70在创伤愈合及细胞增殖过程中的表达变化.结果在创伤后组织增生活跃期及细胞增殖期HSP70呈高表达,热诱导组创伤后细胞的增殖活性明显高于非热诱导组.结论创伤愈合及细胞增殖可诱导HSP70的表达,其表达强度与组织增生活性密切相关.热诱导引起的细胞增殖活性升高可能与HSP70的功能有关.     

Topical ALA-PDT as alternative therapeutic option in treatment-recalcitrant dermatosis: Report of 4 cases

BackgroundTopical Photodynamic therapy (PDT) is widely acknowledged for its safety and effectiveness in treating oncologic skin diseases such as basal cell carcinoma, actinic keratosis and squamous cell carcinoma in situ. Despite its broad applications in dermatology, this method is a relatively new therapeutic option for treating inflammatory/infectious skin diseases.ObjectivesTo determine whether topical PDT is a safe and effective treatment option in treating treatment-recalcitrant dermatosis.ObservationsWe presented one of each case of Acne Vulgaris, facial flat warts, urethral meatus Condyloma Acuminatum and extramammary Paget’s disease, where other treatment options were either ineffective or not feasible, then those patients underwent topical PDT and showed significant improvement with minimal side effects.ConclusionsTopical PDT therapy may be applied in cases of Acne Vulgaris, facial flat warts, urethral meatus Condyloma Acuminatum and extramammary Paget’s disease, where other treatment has shown no or minimal improvement, or in whom ablative or invasive procedure is to be avoided or not well tolerated.