Mid-Career Investigator in Patient-Oriented Research

描述(由申请人提供)：建议书由J.Stuart提交 Nelson，医学博士，K-24职业生涯中期研究人员奖获得者 面向研究。纳尔逊博士的医学博士，博士培训，学术背景，以及 对激光基础科学和临床应用的参与使他 独一无二的资历和经验，以病人为中心 研究。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指导 对新兴领域感兴趣的年轻医生和 生物医学光学。在任何给定的时间，至少有两名研究员将得到指导。它 预计4-6名研究员将在课程期间接受指导 提议五年。绝大多数口岸的治疗成功率 酒渍(PWS)患者非常低(&lt；10%)，如果需要的最终标准 是病变完全变白了。激光治疗红斑狼疮 PWS是为了最大限度地对靶血管造成热损伤，同时 防止对正常的覆盖表皮的损伤。不幸的是，对许多人来说 皮损，表皮损伤的阈值低于永久性损伤的阈值 对PWS进行漂白，从而排除使用更高和更有效的 激光剂量。克服上述问题的重要方法 有选择地冷却皮肤最浅的一层。虽然 黑色素吸收会导致激光曝光时产生热量， 给表皮降温可以防止其温度超过阈值。 用于治疗热损伤。空间选择性冷却可以通过主动实现 使用制冷剂喷雾冷却(CSQ.当冷冻剂喷洒到 皮肤表面在适当短的时间内(几十 毫秒)，CSC促进快速和空间选择性的表皮冷却 在不影响目标血管温度的情况下进行低温 激光脉冲被传送。CSC的成功发展应该是。1) 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 在针对PWS患者的综合1期、11期和III期临床试验中， CSC联合个体化激光治疗的疗效和安全性 每名患者；目标登记人数为225人。我们还建议 启动对色素性皮肤病患者的几项试验性研究，例如 先天性毛痣、贝克痣、溢出痣、蓝痣或太田痣； 目标招生人数为200门。

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.