Michael D. Colvard

Natural Products and Traditional Medicine: Turning on a Paradigm

Paradigm shifts in the strategies and the sciences that would enhance the quality, safety, and efficacy of traditional medicines and dietary supplements in global health care are discussed. Some of the challenges facing traditional medicine in health care are described, and the importance of defining clear goals and directions for the information systems, botany, chemistry, and biology related to plants and health care, including for drug discovery and quality control, is indicated.

An assessment of the occupational hazards related to medical lasers.

Objective:Occupational hazards associated with medical laser applications remain poorly understood and uncharacterized. Methods:A literature search was performed using PubMed, and all articles relevant to beam and nonbeam medical laser hazards were reviewed. The Rockwell Laser Industries Laser Accident Database was searched for medical laser injuries and abstracted. Results:Eye injuries, skin burns, injuries related to the onset of fires, and electric shock have been reported in relation to medical laser use. It is probable that both acute and chronic health effects have been experienced by medical personnel as the result of exposure to laser generated air contaminants. Conclusions:Because of the clinical benefits they provide, the growth of laser technologies and applications are anticipated to result in an increase in the number and type of medical personnel with future exposure to laser hazards.

Photodynamic therapy: Occupational hazards and preventative recommendations for clinical administration by healthcare providers

OBJECTIVE Photodynamic therapy (PDT) as a medical treatment for cancers is an increasing practice in clinical settings, as new photosensitizing chemicals and light source technologies are developed and applied. PDT involves dosing patients with photosensitizing drugs, and then exposing them to light using a directed energy device in order to manifest a therapeutic effect. Healthcare professionals providing PDT should be aware of potential occupational health and safety hazards posed by these treatment devices and photosensitizing agents administered to patients. MATERIALS AND METHODS Here we outline and identify pertinent health and safety considerations to be taken by healthcare staff during PDT procedures. RESULTS Physical hazards (for example, non-ionizing radiation generated by the light-emitting device, with potential for skin and eye exposure) and chemical hazards (including the photosensitizing agents administered to patients that have the potential for exposure via skin, subcutaneous, ingestion, or inhalation routes) must be considered for safe use of PDT by the healthcare professional. CONCLUSIONS Engineering, administrative, and personal protective equipment controls are recommendations for the safe use and handling of PDT agents and light-emitting technologies.

Application of Immunohistochemical Staining to Detect Antigen Destruction as a Measure of Tissue Damage

Electrocautery and directed energy devices (DEDs) such as lasers, which are used in surgery, result in tissue damage that cannot be readily detected by traditional histological methods, such as hematoxylin and eosin staining. Alternative staining methods, including 3-(4,5-dimethyl-thiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT) to stain live tissue, have been reported. Despite providing superior detection of damaged tissue relative to the hematoxylin and eosin (H&E) method, the MTT method possesses a number of drawbacks, most notably that it must be carried out on live tissue samples. Herein, we report the development of a novel staining method, “antigen destruction immunohistochemistry” (ADI), which can be carried out on paraffin-embedded tissue. The ADI method takes advantage of epitope loss to define the area of tissue damage and provides many of the benefits of live tissue MTT staining without the drawbacks inherent to that method. In addition, the authors provide data to support the use of antibodies directed at a number of gene products for use in animal tissue for which there are no species-specific antibodies commercially available, as well as an example of a species-specific direct antibody. Data are provided that support the use of this method in many tissue models, as well as evidence that ADI is comparable to the live tissue MTT method.

Handheld directed energy sensor for environmental monitoring and clinician safety

INTRODUCTION Directed energy (DE) research and development is generating more powerful portable devices designed to support operational, environmental, clinical, point detection, and remote-sensing applications. These same DE devices present potential for injury, thereby impacting medical operations. The environmental surveillance and clinical communities require handheld sensor platforms that afford preemptive detection and monitoring of potentially hazardous exposures to DE and other electromagnetic (EM) frequencies. METHODS A personal digital assistant (PDA) was interfaced with a wavelength sensor board via a multifunction data acquisition card to passively detect wavelengths in the 480-950 nm range. A 9V DC battery coupled to a voltage up-converter with a manual ON/OFF switch powered the sensor board. The sensor board was integrated with a standard operating system-based PDA. Graphical programming software integrated the data acquisition card with the PDA. RESULTS The DE wavelength sensor/PDA platform detected and relayed laser radiation information from 480 to 950 nm ranges, with graphical data output to the PDA screen. DISCUSSION This project demonstrated the technical ability to detect anthropogenic DE frequency signatures using a handheld, battery-driven DE sensor platform. Laboratory and field assessment studies are underway to validate operational applications. This DE-sensing prototype is designed explicitly for DE medical measurement and signatures intelligence (MED MASINT) to meet the protection needs of environmental and clinical operators.

Rationalizing the Study of Plants for the Treatment of Oral Pain

Oral and maxillofacial pain, inflammation, and associated pathologies have been documented since the begin- ning of recorded human history, and the use of plant materials from certain families for the relief of these disorders has paralleled this health care need. Humans discovered, through personal experimentation, that numerous plants and plant- based products placed into the oral cavity had the capacity to deliver diverse secondary metabolites and thereby elicit a variety of stimulant, medicinal, and hallucinogenic effects. Recent pharmacognostic research has confirmed the presence of medicinal compounds in several of these plants. Contemporary neurobiological and pathophysiologic research has il- luminated the mechanisms and actions of numerous tissues, cell structures, TRP channels, mammalian peripheral and CNS receptors, actions responsive to plant-based and other natural compounds. Consequently, theories have emerged that propose a co-evolutionary relationship and functionality between natural products and the various mammalian cell mem- brane channels, receptors, and tissues. In this brief review, we will indicate some of the background relating to the contemporary views of the use of various plant-based products as analgesic and anesthetic agents for oral pain and inflammations and briefly discuss their mecha- nisms of action. An overview of the need for new, plant-based oral analgesic agents and for new experimental models for the discovery process from plant extracts will be described and some discussion will be offered regarding the potential for future research developments in this area of pharmacognosy.

The Evolving Role of Dental Responders on Interprofessional Emergency Response Teams

Disaster and pandemic response events require an interprofessional team of health care responders to organize and work together in high-pressure, time-critical situations. Civilian oral health care professionals have traditionally been limited to forensic identification of human remains. However, after the bombing of the Twin Towers in New York, federal agencies realized that dentists can play significant roles in disaster and immunization response, especially on interprofessional responder teams. Several states have begun to incorporate dentists into the first responder community. This article discusses the roles of dental responders and highlights legislative advancements and advocacy efforts supporting the dental responder.

A Disease Without History? Evidence for the Antiquity of Head and Neck Cancers

There has been a long-running debate in anthropological, archaeological, and medical literature regarding the prevalence of cancer in various ancient human populations. At one extreme, some scholars have claimed that past human societies had rates of cancer roughly equivalent to those seen among modern peoples; at the other extreme, some researchers have effectively claimed that cancer is a disease of modernity. The present study aims to shed further light on this topic, at least insofar as cancers of the head and neck are concerned. A review of ancient art, medical texts, and paleopathological reports revealed somewhat discordant accounts of the age, geographical distribution, and prevalence of head and neck cancers. While representations of these neoplastic conditions in art are relatively rare and patchy in geographic distribution, descriptions of suspect lesions in ancient medical texts are rather more widespread, if unevenly distributed geographically, and the paleopathological record was found to contain surprisingly abundant evidence for cancers of the head and neck, especially as compared to what are, in modern societies, more ubiquitous cancers of the breast, lung, or prostate. While establishing the absolute prevalence of any of these conditions in antiquity is impossible, the present work establishes that cancers of the head and neck have long been present, and perhaps even prevalent, in human societies.

Age estimation of Hispanic children using the London Atlas

PURPOSE To test the accuracy of the London Atlas for age estimation of Hispanic children and to determine if there is any difference in age accuracy between Hispanic males and females. METHODS The London Atlas was used to estimate age from panoramic radiographs of 17 males and 17 females for each year of age from six to 15.99 years, using the electronic patient database of a dental school. Exclusion criteria included gross pathology, hypodontia, hyperdontia, and previous orthodontic treatment. RESULTS There were 332 panoramic radiographs evaluated. In all age groups, 34 radiographs (from 17 males and 17 females) were reviewed, except for the age bracket 6-6.99 years, for which only 26 radiographs were available. The mean age estimated of the entire sample by the London Atlas (11.44 years) was greater than the mean chronological age (11.09 years), which was statistically significant (P<.001). The mean difference between chronological and estimated ages for males was .30 years and for females was .40 years, but the difference between sexes was not significant (P=.324). One hundred sixty-two radiographs (49%) were estimated to the exact age interval while 45 (14%) were under-estimated and 125 (38%) were over-estimated. Two hundred and forty radiographs (72%) were estimated to a value within one year of the actual age. CONCLUSION There was no difference in age estimation prediction accuracy between Hispanic males and females but an age overestimation of three percent in the cohort was seen. The London Atlas accuracy is suitable for use in forensic investigation.

Photodynamic Therapy (PDT): An Evolving Therapeutic Technique in Head and Neck Cancer Treatment

Photodynamic therapy (PDT) is a non-invasive therapeutic technique used in the treatment of many cancers, including head and neck cancers. PDT is a two-step process: the patient is first given a drug (“photosensitizing agent”) that preferentially accumulates in the tumor. Light is then applied to the treatment site in order to active the drug, in turn leading to tumor destruction. A number of photosensitizing agents and light sources are used clinically for treating head and neck cancers. The PDT technique has been shown to be effective for treating premalignant lesions, early stage malignant tumors, and secondary or recurrent head and neck squamous cell carcinomas, as well as for aesthetic and cosmetic purposes. Additionally, a number of different head and neck tumor subtypes (larynx, oral cavity, neck, pharynx, etc.) have been successfully treated with PDT. This chapter serves to provide a general background of the PDT technique and discusses how PDT is currently used clinically to treat head and neck cancers. The future prospects of PDT in the treatment of head and neck cancers will also be discussed.