Mid-Career Investigator in Patient-Oriented Research

描述（由申请人提供）：该提案由J. Stuart提交 纳尔逊，医学博士，博士获得K-24职业中期研究者奖 导向研究。纳尔逊医生的医学博士博士培训，学术联系，以及 参与激光的基础科学和临床应用， 独特的资格和经验，追求以病人为导向的职业生涯 research.此应用程序提供的请求保护时间将允许 他有机会最大限度地利用他的时间来指导 对新兴的光医学领域感兴趣的年轻医生， 生物医学光学在任何时候至少有两名研究员将得到指导。它 预计将有4-6名研究员在研究期间接受指导， 建议五年。绝大多数港口的治疗成功率 葡萄酒色斑（PWS）患者的比例很低（< 10%），如果最终标准要求 是完全的白化激光治疗的目的是 PWS是为了最大限度地对目标血管造成热损伤， 防止损伤正常的上覆表皮。不幸的是，对许多人来说， 损伤时，表皮损伤的阈值低于永久性损伤的阈值。 PWS的漂白，从而排除了使用更高和更有效的 激光剂量克服上述问题的一个重要方法是 是有选择地冷却皮肤的最表层。虽然 黑色素吸收将导致激光照射期间的热产生， 冷却表皮可以防止其温度超过阈值 用于热损伤。空间选择性冷却可以通过主动冷却来实现。 使用冷冻剂喷雾冷却（CSQ.当冷冻剂喷射被施加到 皮肤表面持续适当短的时间段（数十 CSC促进快速和空间选择性表皮冷却， 低温不影响目标血管温度之前， 传送激光脉冲。成功的发展CSC应该.第一章 改善治疗结果; 2）减少治疗次数; 3） 缩短治疗方案;（4）提高安全性。我们打算确定 在PWS患者的全面1期、11期和III期临床试验中， CSC联合激光个体化治疗有效性和安全性 每例患者;目标入组225例受试者。我们亦建议 对色素性皮肤病患者开展了几项试点研究， 先天性毛痣、贝克痣、斑痣、蓝痣或太田痣; 目标入组人数为200名受试者。

DESCRIPTION (provided by applicant): The proposal is submitted by J. Stuart Nelson, M.D., Ph.D. for a K-24 Mid-Career Investigator Award in Patient Oriented Research. Dr. Nelson's M.D., Ph.D. training, academic affiliation, and involvement in the basic science and clinical applications of lasers make him uniquely qualified and experienced to pursue a career in patient oriented research. The requested protected time provided by this application will allow him the opportunity to maximize his time availability for the mentoring of young physicians interested in the emerging fields of photomedicine and biomedical optics. At least two fellows will be mentored at any given time. It is anticipated that 4-6 fellows will be mentored over the course of the proposed five years. The treatment success rate for the vast majority of port wine stain (PWS) patients is very low (< 10%) if the ultimate standard required is complete blanching of the lesion. The objective in the laser treatment of PWS is to maximize thermal damage to the targeted blood vessels while preventing injury to the normal overlying epidermis. Unfortunately, for many lesions, the threshold for epidermal damage is lower than that for permanent blanching of the PWS thereby precluding the use of higher and more effective laser light dosages. An important method to overcome the aforementioned problem is to cool selectively the most superficial layers of the skin. Although melanin absorption will result in heat production during laser exposure, cooling the epidermis can prevent its temperature from exceeding the threshold for thermal injury. Spatially selective cooling can be achieved by active cooling using cryogen spray cooling (CSQ. When a cryogen spurt is applied to the skin surface for an appropriately short period of time (tens of milliseconds), CSC promotes rapid and spatially selective epidermal cooling to low temperatures without affecting the targeted blood vessel temperature before the laser pulse is delivered. The successful development of CSC should. 1) improve therapeutic outcome; 2) reduce the number of treatment sessions; 3) shorten therapeutic protocols; and (4) improve safety. We intend to determine in comprehensive Phase 1, 11 and III clinical trials on PWS patients, the efficacy and safety of CSC in conjunction with laser treatment individualized for each patient; target enrollment is 225 subjects. We also propose to initiate several pilot studies on patients with pigmented dermatoses such as congenital hairy nevi, Becker's nevus, nevus spilus, blue nevus or nevi of Ota; target enrollment is 200 subjects.