The Smartscope is a cordless, hand-held digital imaging device that measures and documents skin lesions for use in diagnosing and monitoring skin diseases. A more accurate and user-friendly alternative to standard digital cameras, the Smartscope uses LED illumination to produce consistent, reliable images, which along with measurements and annotations, can be easily transferred to and stored in software that is compatible with electronic medical records. High-resolution images and detailed information captured with the Smartscope can also be printed for the patient or used in case studies submitted to medical journals.

Product page: Optomed Smartscope M3-1 ...

Smartscope brochure...

Press release: New Device Improves Quality of Imaging, Patient Experience

From the abstract in Journal of Medicinal Chemistry:

The high melanoma uptake and rapid body clearance displayed by our series of [¹²³I]iodonicotinamides prompted the development of [¹⁸F]N-(2-(diethylamino)ethyl)-6-fluoronicotinamide ([¹⁸F]2), a novel radiotracer for PET melanoma imaging. Significantly, unlike fluorobenzoates, [¹⁸F]fluorine incorporation on the nicotinamide ring is one step, facile, and high yielding. [¹⁸F]2 displayed high tumor uptake, rapid body clearance via predominantly renal excretion, and is currently being evaluated in preclinical studies for progression into clinical trials to assess the responsiveness of therapeutic agents.

Image: [¹⁸F]2 PET image analysis of murine melanoma. (A) Whole body and (B) transaxial PET images of a C57BL/J6 black mouse bearing a B16F0 tumor allograft (right flank) at 1 h postinjection of [¹⁸F]2. (C) Autoradiographic and (D) photographic images of [¹⁸F]2 uptake in melanotic areas of a B16F0 tumor frozen section from a 1 h autoradiographic acquisition of [¹⁸F]fluorine disintegrations.

Press statement by the American Chemical Society: A potential new imaging agent for early diagnosis of most serious skin cancer...

Full article in Journal of Medicinal Chemistry: Discovery of [18F]N-(2-(Diethylamino)ethyl)-6-fluoronicotinamide: A Melanoma Positron Emission Tomography Imaging Radiotracer with High Tumor to Body Contrast Ratio and Rapid Renal Clearance

Abstract in Dermatology Online Journal: Melanoma screening with serial whole body photographic change detection using Melanoscan® technology...

More from Connecticut Post...

Link: Melanoscan technology overview...]]> http://www.medgadget.com/archives/2009/08/melanoscan_time_lapse_total_immersion_photo_technology_helps_spot_dangerous_skin_lesions_over_time.html http://www.medgadget.com/archives/2009/08/melanoscan_time_lapse_total_immersion_photo_technology_helps_spot_dangerous_skin_lesions_over_time.html Dermatology Wed, 19 Aug 2009 00:00:06 -0800 Watch out Dermabond! The FDA has given approval to Chesson Labs out of Durham, NC for company's NUVADERM™ liquid bandage. The product, approved for marketing to healthcare professionals and directly to consumers, is either sprayed or brushed on to "to cover intact skin and minor cuts, scrapes, burns or irritations of the skin, to help keep them clean and dry and help protect them from infection." The non-toxic material keeps moisture and dirt from penetrating the applied film layer while allowing oxygen to reach the wound site.

Some technical details of the NUVADERM:

NUVADERM is a single component, poly(urea-urethane) liquid emulsion polymer that is composed of large, highly complex molecules that incorporate a broad range and distribution of hard and soft segments. The different segments are tied together with urea and urethane linkages that are formed during synthesis. NUVADERM is applied topically to form a non-toxic, hydrophobic, elastomeric coating that provides a barrier against moisture but that is permeable to oxygen. NUVADERM requires no initiator or catalyst and therefore no mixing steps. It remains liquid until released into the air and therefore is applied by spraying or with an applicator brush.

Press release: Chesson Labs Liquid Bandage Product NUVADERM® Receives FDA510(k) Market Clearance (.pdf)...

Product page: NUVADERM...

Technical Data Sheet (.pdf)...; Anti-Microbial Data (.PDF)...

The engineers attached compact microscope lenses to a holder fitted to a cell phone. Using samples of infected blood and sputum, the researchers were able to use the camera phone to capture bright field images of Plasmodium falciparum, the parasite that causes malaria in humans, and sickle-shaped red blood cells. They were also able to take fluorescent images of Mycobacterium tuberculosis, the bacterial culprit that causes TB in humans. Moreover, the researchers showed that the TB bacteria could be automatically counted using image analysis software.

The engineers had previously shown that a portable microscope mounted on a mobile phone could be used for bright field microscopy, which uses simple white light — such as from a bulb or sunlight — to illuminate samples. The latest development adds to the repertoire fluorescent microscopy, in which a special dye emits a specific fluorescent wavelength to tag a target - such as a parasite, bacteria or cell - in the sample.

The researchers used filters to block out background light and to restrict the light source, a simple light-emitting diode (LED), to the 460 nanometer wavelength necessary to excite the green fluorescent dye in the TB-infected blood. Using an off-the-shelf phone with a 3.2 megapixel camera, they were able to achieve a spatial resolution of 1.2 micrometers. In comparison, a human red blood cell is about 7 micrometers in diameter.

The researchers pointed out that while fluorescent microscopes include additional parts, less training is needed to interpret fluorescent images. Instead of sorting out pathogens from normal cells in the images from standard light microscopes, health workers simply need to look for something the right size and shape to light up on the screen.

Article in PLoS ONE: Mobile Phone Based Clinical Microscopy for Global Health Applications...

Press release with video of the microscope in action: UC Berkeley researchers bring fluorescent imaging to mobile phones for low-cost screening in the field...

Side image: Fluorescent image of TB bacteria taken by the CellScope.

Flashback: CellScope for Rural Microscopy On The Go

From the press release:

The HairDX (RxR) Genetic Test for Finasteride Response will help doctors predetermine if patients will have a subtle, moderate, or great treatment response to Finasteride, allowing the physician to provide patients with the best treatment regimen to save their hair...

[The test] provides doctors with a patient score, called the CAG repeat score. “A smaller CAG test score is associated with an increased response to Finasteride for treatment of Androgenetic Alopecia,” says Dr. Sharon Keene, HairDX Chief Medical Officer. “Scientists discovered that among men that had the best response to Finasteride approximately 70% had a CAG score below 22 while among men that had a subtle response to Finasteride approximately 70% had a CAG score above 22.”

Press release: HairDX Introduces Genetic Test For Finasteride Response (.pdf)...

Product page: HairDX...

NOTE: Please say big hello to our new editor. Sean Duffy is a graduate of Columbia in neuroscience, who is starting Harvard Medical School this August. For now he will be blogging with us. This is his first post.

From the University of Texas M. D. Anderson Cancer Center:

With hollow gold nanospheres inside melanoma cells, photothermal ablation destroyed tumors in mice with a laser light dose that was 12 percent of the dose required when the nanospheres aren't applied, Li [Chun Li, Ph.D., professor in M. D. Anderson's Department of Experimental Diagnostic Imaging] and colleagues report. Such a low dose is more likely to spare surrounding tissue.

Injected, untargeted nanoparticles accumulate in tumors because they are so small that they fit through the larger pores of abnormal blood vessels that nourish cancer, Li said. This "passive targeting" delivers a low dose of nanoparticles and concentrates them near the cell's vasculature.

The researchers packaged hollow, spherical gold nanospheres with a peptide - a small compound composed of amino acids - that binds to the melanocortin type 1 receptor, which is overly abundant in melanoma cells. They first treated melanoma cells in culture and later injected both targeted and untargeted nanospheres into mice with melanoma, then applied near-infrared light.

Fluorescent tagging of the targeted nanospheres showed that they were embedded in cultured melanoma cells, while hollow gold nanospheres without the targeting peptide were not. The targeted nanospheres were actively drawn into the cells through the cell membrane.

When the researchers beamed near-infrared light onto treated cultures, most cells with targeted nanospheres died, and almost all of those left were irreparably damaged. Only a small fraction of cells treated with untargeted nanospheres died. Cells treated only with near-infrared light or only with the nanospheres were undamaged.

Most of the targeted nanospheres in the treated mice gathered in the tumor, with smaller amounts found in the liver and spleen. Most of the untargeted nanospheres gathered in the spleen, then in the liver and then the tumor, demonstrating the selectivity and importance of targeting.

In another group of mice, near-infrared light beamed into tumors with targeted nanospheres destroyed 66 percent of the tumors, but only destroyed 7.9 percent of tumors treated with untargeted nanospheres.

The researchers used F-18-labeled glucose to monitor tumor activity by observing how much glucose it metabolized. This action "lights up" the tumor for positron emission tomography (PET) imaging. Tumors treated with targeted shells largely went dark.

Press release: Targeted Nanospheres Find, Penetrate, then Fuel Burning of Melanoma

Image: Gold nanoparticles from an unrelated project. Credit Annie Cavanagh, Wellcome Images

Here's a video report from Vanderbilt:

Press release: Diagnosing Skin Cancer Without Biopsy

From the press release:

President and CEO Richard Burtt commented, “The granting of this 510(k) approval is another significant milestone in Nomir’s regulatory process, which we have been pursuing rigorously, and paves the way for future 510(k) multi-site, disease-specific applications. The Noveon is a light-based system that photo-biologically targets the elimination of bacterial and fungal infections through a unique, near-infrared, photo-inactivation effect, while preserving healthy tissue and promoting recovery. This new FDA clearance highlights the continued success of the Nomir team and its implementation of our regulatory plans for commercialization of our unique photo-biological, anti-infective Noveon system.”

Nomir’s Chief Scientific Officer, Dr. Eric Bornstein, added, “Noveon has also demonstrated its success in the clinic, eliminating MRSA infection in the nose, reversing microbial resistance to common antibiotics, and effecting complete photo-inactivation of toe nail fungus, all at safe energy densities and temperatures. We believe these positive results, combined with our successful regulatory strategy, will make Noveon a potentially attractive option in the future to clinicians treating an array of infections.”

Nomir has completed two IRB human studies with Noveon against methicillin-resistant Staphylococcus aureus (MRSA) carriage and infection in the nares (nose). Based on positive data from these studies, Nomir is initiating a pilot study with Noveon for the reduction of bioburden in diabetic foot ulcers.

After multiple IRB human pilot studies with Noveon against onychomycosis (toe nail fungus), Nomir initiated an FDA pivotal study of its Noveon device for this indication in May 2008, an integral step for FDA clearance of the application.

Press release: Nomir Medical Announces Second FDA 510(k) Clearance of its Noveon® Dual-Wavelength Device...

Nomir technology page...

Flashback: A Bright Light Against Dark Matter: A New Device to Fight Toe Nail Fungus

BAD has dubbed the rash "mobile phone dermatitis" but we think MedGadgetitis is not only easier to remember, but it's catchier and shamelessly promotes our website. We hope this catches on before the dermatologists lobby for "BAD Rash", as this could lead to all kinds of problems when trying to explain it to your partner.

Lionel Bercovitch, MD, and John Luo of Brown's Warren Alpert Medical School noticed a pattern with phones containing nickel and published their work in the January 2008 edition of the CMAJ (Canadian Medical Association Journal).

Picture and case from the CMAJ (January 1, 2008)

The case:

An 18-year-old male presented with pruritic lichenified dermatitis on his lower abdomen and eczematous dermatitis on his extremities, flanks and face that had lasted several weeks. We suspected his belt buckle had led to allergic contact dermatitis with subsequent autoeczematization. Patch testing using the expanded North American Contact Dermatitis Group allergen battery of 65 allergens1 disclosed an edematous and papulovesicular reaction to nickel at 72 hours. The patient had no other positive reactions, nor did he react to other metals tested, including gold, cobalt, chromium, copper and palladium.

The patient suspected that his recurrent facial dermatitis was related to contact with the headset of his cellphone. We spot tested both the antenna and the headset for free nickel. The test of the antenna, which was plastic coated with metallic paint, was negative. The test of the headset was strongly positive for free nickel. The patient began using a cellphone that contained no nickel, and his facial dermatitis cleared. He decided to resume using his old cellphone to confirm that it had caused his dermatitis and the eruption recurred.

CMAJ Article: Cellphone contact dermatitis with nickel allergy; CMAJ • January 1, 2008; 178 (1)

Press Release: British Association of Dermatologists