In this Medical Physics M.Sc. project, a near-infrared (NIR) fluorescence imaging system was built for in-vivo diagnosis and evaluation of pigmented skin abnormalities and diseases. Light coming from a 785 nm diode laser is coupled into a ring light guide to uniformly illuminate the skin surface with a field-of-view (FOV) of 25 mm diameter. The diffuse reflectance and emitted fluorescence photons are collected by an NIR-sensitive CCD camera, with computer-controlled filter switch to select between reflectance mode and fluorescence mode. Both reflectance and fluorescence images of skin disorders were obtained with an exposure time of 2 seconds. The results show that cutaneous melanin in pigmented skin disorders emits higher NIR autofluorescence (AF) than surrounding normal tissue. This finding challanged the conventional concept that melanin is a non-fluorescence substance. The developed NIR autofluorescence imaging method also provided a new and direct way to characterize cutaneous melanin and can potentially be used for evaluation and diagnosis of pigmented skin diseases and skin cancers, such as melanoma.

In this Medical Physics M.Sc. project, a near-infrared (NIR) fluorescence imaging system was built for in-vivo diagnosis and evaluation of pigmented skin abnormalities and diseases. Light coming from a 785 nm diode laser is coupled into a ring light guide to uniformly illuminate the skin surface with a field-of-view (FOV) of 25 mm diameter. The diffuse reflectance and emitted fluorescence photons are collected by an NIR-sensitive CCD camera, with computer-controlled filter switch to select between reflectance mode and fluorescence mode. Both reflectance and fluorescence images of skin disorders were obtained with an exposure time of 2 seconds. The results show that cutaneous melanin in pigmented skin disorders emits higher NIR autofluorescence (AF) than surrounding normal tissue. This finding challanged the conventional concept that melanin is a non-fluorescence substance. The developed NIR autofluorescence imaging method also provided a new and direct way to characterize cutaneous melanin and can potentially be used for evaluation and diagnosis of pigmented skin diseases and skin cancers, such as melanoma.

ABSTRACT Background Cutaneous melanoma is a potentially lethal cancer for which incidence rates have risen dramatically in white-skinned populations worldwide over the past decades. While some risk factors for melanoma have been clearly established, such as pigmentary characteristics, sun exposure, and familial history of the disease, emerging evidence suggests that other factors, such as hormonal and genetic factors, may play a role in the aetiology of this cancer. The present work aimed at 1) examining the relationships between hormonal factors, benign gynaecological conditions, and the risk of melanoma, and 2) to explore shared risk factors for endometriosis and melanoma in a large French prospective cohort; and 3) to study the potential associations between novel naevus-associated gene variants and the risk of melanoma in a large Australian population-based study. Methods The E3N prospective cohort includes 98,995 French women insured by a national scheme mostly covering teachers, and aged 40-65 years at inclusion. Women were followed-up approximately every two years starting in 1990 through self-administered questionnaires. A first investigation focused on the potential association between a personal history of endometriosis or of other benign gynaecological conditions and the risk of melanoma, which was examined in the E3N cohort using Cox proportional hazards regression models. A second study explored the potential relationships between cutaneous phenotypic factors associated with melanoma and the risk of endometriosis in the E3N cohort, using unconditional logistic regression models. A third investigation used data from the Q-MEGA (an Australian study that followed-up four population-based samples of melanoma patients in Queensland, diagnosed between 1987 and 1995), as well as from the BTNS (a study including adolescent twins and their parents), from which the parents of the twins served as healthy controls in the present investigation. The association between novel naevus-associated gene variants and the site- and subtype-specific risk of melanoma was assessed using unconditional multinomial logistic regression models. Results A significantly positive association was observed between a personal history of endometriosis and the risk of melanoma in the E3N cohort, as well as a significantly positive association between a personal history of uterine fibroma and melanoma risk. The association between endometriosis and melanoma was even stronger when restricting to endometriosis reported as treated or diagnosed by laparoscopic surgery. However, a history of ovarian cyst, uterine polyp, breast adenoma/fibro-adenoma or breast fibrocystic disease was not significantly associated with the risk of melanoma. Also, significantly positive dose-effect relationships were found in the E3N cohort between the risk of endometriosis and skin sensitivity to sun exposure, number of naevi, and number of freckles, while no significant associations were found with hair or skin colour. Finally, variants of MTAP, PLA2G6 and IRF4 were significantly associated with the propensity to develop naevi in the Q-MEGA study. There was also a statistically significant association between MTAP rs10757257 and the risk of melanoma. Although there was no evidence that this association varied according to anatomical site of the tumour, the risk alleles of this polymorphism were more common in patients with superficial spreading melanoma or nodular melanoma than in controls, while patients with melanoma of the lentigo maligna type were no more likely than controls to carry these alleles. In contrast, no association was found between PLA2G6 and IRF4 variants and the risk of melanoma, globally or by site or type of melanoma. Conclusion The present findings suggest a positive association between endometriosis and melanoma, for which they constitute the strongest evidence to date. This finding may reflect the existence of shared risk factors between endometriosis and melanoma, which is supported by the finding of significant associations between endometriosis and some cutaneous phenotypic traits that are established risk factors for melanoma. Because these traits are mostly genetically determined, it can be speculated that endometriosis and melanoma share similar genetic characteristics. More research will be needed in order to clarify common pathways between endometriosis and melanoma. The finding of a positive association between uterine fibroma and melanoma risk had not been previously reported and warrants further investigation. The presented results also confirm an association between MTAP, PLA2G6 and IRF4 variants and naevus propensity, as well as an association between MTAP and melanoma. The findings suggest that the relationship is subtype-specific, which confirms and further refines the overarching “divergent pathways” model. Since MTAP is located at the same locus as CDKN2A, which has also been associated with naevus counts, further research will be necessary to determine whether these results can be attributed to MTAP independently of CDKN2A.

Thesis (Ph. D.)--Ohio State University, 2008. / Title from first page of PDF file. Includes bibliographical references (p. 199-211).

目的: 通過搜索有關天灸治療過敏性鼻炎的臨床研究文獻，以系統評價及數據挖掘技術提取其干預措施的細節，包括敷貼藥物的組成、選用的穴位、治療時間點、治療頻率, 敷貼時長及治療次數等，並且基於此研究，從循證醫學角度提供天灸治療過敏性鼻炎干預措施的建議性方案，為進一步的臨床實踐和研究提供循證醫學依據。 方法: 選取包括中國期刊全文數據庫（ CNKI ）、中國科技期刊數據庫（ VIP ）和萬方數據庫（ Wanfang Database ）在內的中文文獻數據庫及包括EMBASE 數據庫和MEDLINE數據庫在內的英文文獻數據庫進行文獻檢索，檢索範圍為各數據庫已知收錄時間至20 1 6 年2 月的全部期刊，檢索對象為所有有關天灸治療過敏性鼻炎的臨床研究文獻，制定文獻納人和排除標準進行篩選，對所納人的文獻進行數據挖掘，並通過計算比例、百分數、平均數、中位數等數據處理方法列出相應圖表進行報告。 結果：根據檢索以及對符合納入標準的文獻進行統計、最終符合納人標準的文獻為88篇。通過干預措施數據提取分析，可知目前臨床使用率最高的四種藥物分別是白芥子（ n=85, 93 . 41 % ），緬辛（ n=85, 93 . 41 % ），甘遂（ n=72, 79.12% ）和延胡索（ n = 7 0, 76.92% ），通過將上述藥物比例換算為百分數，再計算中位數之比，得出結果為白芥子（ 28. 60% ），延胡索（ 2 0.00 % ），名田辛（ 16. 70% ），甘遂（ 16.70%) , 即白芥子： 延胡索：細辛：甘遂三7:5:4:4 的組方比例。最常用的五個穴位分別為肺俞(n=85, 96 . 5 9% ） ，大椎（ n =67, 76 . 14% ） ， 腎俞（ n =64, 72.7 3% ），脾俞( n= 56, 63 . 64 % ）和風門（ n=56, 63. 6 4% ） 。治療時間點一般分為三伏天（ n 49，53. 26% ） 與常日（ n=32 , 34. 78% ） 兩類，治療頻次及次數多為10 天貼1 次， 共 貼3次為一療程。貼敷時間一般為成人3-4h ，小兒l. 5 -2 h ， 貼藥時間以皮膚可耐受為度。 結論：通過以上數據挖掘，得出天灸治療過敏性鼻炎的建議干預措施方案為： 將白芥子、延胡索、細辛、甘遂按7: 5 : 4 : 4 的比例研組末混合，以新鮮生薑汁調成糊狀, 保鮮備用。取大椎、風門、肺俞、脾俞和腎俞，將配制好的藥物取約2 g 藥量, 置於專用敷貼繆布中央， 貼在上述穴位上。除大惟穴外，其余穴位均取雙側。 預約患者於當年三伏天當天進行治療, 1 0 天貼l 次，共貼3 次為一療程。成人一般貼敷3-4h，小兒一般貼敷1. 5-2h ， 貼藥時間可視患者具體情況而定。如發癢、灼痛感不明顯者可貼敷較長時間，如發癢、灼痛戚非常明顯者宜適當縮短貼敷時間。

No description available.

Nitric oxide (NO) has been shown to be lethal for a variety of intracellular pathogens including Leishmania. In murine models, the inducible nitric oxide synthase gene (iNOS) is expressed in activated macrophages and is involved in the synthesis of NO. Because the role of NO and iNOS in human leishmaniasis was less clear, we examined the expression of the iNOS gene in human macrophages infected with Leishmania in vitro and in biopsy tissue from subjects with cutaneous leishmaniasis. / Pentavalent antimony (Sb5+) in the form of Pentostam(TM) or Glucantime(TM) is still the treatment of choice despite its toxicity. Aldara(TM) (5% imiquimod) is an immune-response modifying agent that has been approved by the Food and Drug Administration in the USA for treating genital warts caused by papillomaviruses. We conducted an open-label, prospective study of combined Glucantime(TM) + Aldara(TM) therapy in subjects with CL who had previously failed a complete course of Glucantime(TM) treatment at regular doses. (Abstract shortened by UMI.)

Diss. (sammanfattning) Stockholm : Karolinska institutet, 2007. / Härtill 6 uppsatser.

Diss. (sammanfattning) Stockholm : Karol. inst., 2006. / Härtill 4 uppsatser.

No description available.