***TASK*** the task is to summarize an input biomedical literature in six sentences 
    ***INPUT*** the input is a biomedical literature 
    ***OUTPUT*** the output is the summary of an input biomedical literature in six sentences 
    ***DOCUMENTATION*** 
    ***EXAMPLES*** 
    Input: Based on experimental and clinical evidence indicating that the anti-oxidant agent liposomal Cu/Zn superoxide dismutase ( Lipsod ) is an effective anti-inflammatory drug and possibly might be effective in reducing late radiation-induced tissue injury , a clinical trial using Lipsod to treat long-st and ing radiation-induced fibrosis ( RIF ) was begun at the Necker Hospital , Paris in May 1984 . Thirty-four patients presenting 42 distinct palpable zones of RIF involving the skin and underlying tissues were treated from May 1984 to January 1986 and followed for an average of 5 years ( range , 14 - 89 months ) .  Lipsod was administered over 3 weeks in twice weekly i.m . injections of 5 mg for a total of 30 mg . Patients underwent two physical examinations by independent physicians at each check-up . Parameters noted included determination of the density of the palpated fibrotic block and the dimensions of the projected cutaneous surface . The extent of change in the fibrotic zone was expressed as the ratio of the sum of the dimensions ( L + W ) and the ratio of the uncorrected areas ( L x W ) of the projected cutaneous surface before and after treatment . Changes in density were noted and scored . All patients showed some clinical regression of fibrosis . In most patients , clinical ly assessable regression begun during the third week of treatment and was maximum by 2 months . The mean decreases in the linear dimensions ( L + W ) and in the area ( L x W ) of the projected cutaneous surface were 41 + /- 30 % and 57 + /- 26 % , respectively . ( ABSTRACT TRUNCATED AT 250 WORDS PURPOSE Radiation-induced fibrosis ( RIF ) is a rare morbid complication of radiotherapy , without an established method of management . RIF treatment with a combination of pentoxifylline ( PTX ) and alpha-tocopherol ( vitamin E ; Vit E ) was recently prompted by the good results of a clinical trial and an animal study . The present double-blind , placebo-controlled , monocentric study was design ed to assess the efficacy of this combination in treating RIF sequelae . PATIENTS AND METHODS Twenty-four eligible women with 29 RIF areas involving the skin and underlying tissues were enrolled from December 1998 to April 2000 . These patients , previously irradiated for breast cancer , were r and omly assigned to four balanced treatment groups : ( A ) 800 mg/d of PTX and 1,000 U/d of Vit E ; ( B ) PTX plus placebo ; ( C ) placebo plus Vit E ; and ( D ) placebo-placebo . The main end point measure was the relative regression of measurable RIF surface after 6 months of treatment . Assessment was completed by depth ( with ultrasonography ) and associated symptom measures . RESULTS Twenty-two patients with 27 RIF areas were analyzed at 6 months . Mean RIF surface regression was significant with combined PTX/Vit E versus double placebo ( 60 % + /- 10 % v 43 % + /- 17 % ; P = .038 ) . The median slope for the speed of RIF surface area and volume regression was significantly higher for group A than groups B , C , and D. All treatments were well tolerated . CONCLUSION Six months ' treatment of combined PTX/Vit E can significantly reduce superficial RIF . Synergism between PTX and Vit E is likely , as treatment with each drug alone is ineffective , but these results require confirmation in larger series BACKGROUND / PURPOSE Quantitative measurement of skin biomechanical properties has been used effectively in the investigation of physiological changes in tissue structure and function and to determine treatment efficacy . As the methods are applied to new questions , tissue characteristics that may influence the result ant biomechanical properties are important considerations in the research design . For certain applications , variables such as dermal thickness and subdermal tissue composition , as well as age and /or solar exposure , may influence the skin biomechanics . METHODS We determined the influence of dermal thickness , tissue composition , and age on the skin biomechanical properties at the shoulder , thigh , and calf among 30 healthy females . We compared two devices , the Biomechanical Tissue Characterization System and the Cutometer SEM 575 Skin Elasticity Meter , to determine the effect of tissue sampling size . Dermal thickness was measured with 20 MHz ultrasound ( Dermascan C ) and tissue composition was inferred from anthropomorphic data . RESULTS Skin thickness was significantly correlated with stiffness , energy absorption , and U(r)/U(f ) for the shoulder . Body mass index ( BMI ) was significantly correlated with stiffness ( negative correlation ) , energy absorption ( positive ) , and skin thickness ( negative ) for the shoulder . Significant differences across body sites were observed . The calf was significantly different from the thigh and shoulders for all parameters ( P<0.05 , one-way anova ) . The calf had significantly lower laxity , laxity% , elastic deformation , energy absorption , elasticity , elasticity % , U(r ) , U(f ) , and U(r)/U(f ) and significantly higher stiffness compared with the thighs and shoulders . sites . The thigh and shoulder sites were significantly different for all parameters except U(r)/U(f ) , elasticity % , laxity% , and stiffness . The dominant and non-dominant sides were significantly different . The dominant side ( right for 90 % of the subjects ) had increased stiffness and decreased energy absorption ( tissue softness , compliance ) compared with the left side . A significant ( P < or = 0.02 ) negative relationship with age was seen for all biomechanical measures except stiffness at the shoulder . For the thigh and calf sites , significant negative correlations with age were found for elasticity % , U(r ) , and U(r)/U(f ) . Age and skin thickness were not correlated in this population . Skin thickness and age influenced the energy absorption at the shoulder site . The biological elasticity at the calf site could be predicted by age and BMI . The biological activity at the thigh site could be predicted by skin thickness and BMI . CONCLUSIONS Significant regional variations in biomechanical properties and dominant side effects were observed . The biomechanical properties were significantly influenced by age . Certain properties varied with dermal thickness and tissue composition . The parameters were well correlated between the two instruments . The Cutometer , with its smaller aperture , was found to be more sensitive to age relationships Intraoperative evaluation of skin flap viability has primarily been dependent on clinical judgment . The purpose of this study was to determine whether an orthogonal polarization spectral imaging device could be used to accurately predict viability of r and om-pattern skin flaps .  Orthogonal polarization spectral imaging is a newly developed technique that visualizes the microcirculation using reflected light without the use of fluorescent dyes and allows for noninvasive real-time observation of functional microvascular networks . In Sprague-Dawley rats ( n = 24 ) , three types of r and om skin flaps were design ed with unknown zones of viability ( n = 8 per group ) . After flap elevation , the skin flaps were evaluated by both clinical examination and orthogonal polarization spectral imaging . Areas of the flap determined to be nonviable by clinical examination were measured and marked . Orthogonal polarization spectral imaging was subsequently performed , and areas of the skin flap with stasis ( i.e. , cessation of red blood cell movement ) in the dermal microcirculation on orthogonal polarization spectral imaging were measured and marked . The skin flaps were then secured in place . Flaps were evaluated on a daily basis for clinical signs of ischemia and necrosis . On postoperative day 7 , the total amount of r and om skin flap necrosis was measured and recorded . Clinical examination of the r and om skin flaps significantly underestimated the actual amount of eventual flap necrosis , and as result was a very poor predictor of flap necrosis . By contrast , assessment of microcirculatory stasis using the orthogonal polarization spectral imaging device correlated well with the subsequent development of necrosis in all groups . In the three groups , the average amount of flap necrosis predicted by clinical examination deviated from actual necrosis by approximately 2 to 4 cm . However , the amount that orthogonal polarization spectral imaging differed from actual necrosis was 0.1 to 0.3 cm . Therefore , orthogonal polarization spectral imaging was an excellent predictor of eventual flap necrosis and much more accurate than clinical observation ( p < 0.001 ) . Intraoperative evaluation of axial and r and om pattern flap viability has traditionally been based on clinical examination as no other reliable , convenient test currently exists . The authors demonstrated that an orthogonal polarization spectral imaging device accurately predicts zones of necrosis in r and om pattern flaps by directly visualizing cessation of microcirculatory flow . Intraoperative stasis in the dermal microcirculation correlated precisely with subsequent flap necrosis . Orthogonal polarization spectral imaging was significantly more accurate than clinical examination , which consistently underestimated flap necrosis . The orthogonal polarization spectral imaging technique may have value in the intraoperative assessment of skin flap perfusion such as that required after skin-sparing mastectomy PURPOSE Significant regression of radiation ( RT ) -induced fibrosis ( RIF ) has been achieved after treatment combining pentoxifylline ( PTX ) and alpha-tocopherol ( vitE ) . In this study , we focus on the maximum response , how long it takes to achieve response , and changes after treatment discontinuation . PATIENTS AND METHODS Measurable superficial RIF was assessed in patients treated by RT for breast cancer in a long-treatment ( 24 to 48 months ) PTX-vitE ( LPE ) group of 37 patients ( 47 RIFs ) and in a short-treatment ( 6 to 12 months ) PTX-vitE ( SPE ) group of seven patients ( eight RIFs ) . Between April 1995 and April 2000 , women were treated with a daily combination of PTX ( 800 mg ) and VitE ( 1,000 IU ) . RESULTS Combined PTX-vitE was continuously effective and result ed in exponential RIF surface area regression ( -46 % for LPE and -68 % for SPE at 6 months , -58 % for LPE and -69 % for SPE at 12 months , -63 % for LPE and -62 % for SPE at 18 months , and -68 % for LPE at 24 and 36 months ) . The mean estimated maximal treatment effect was 68 % RIF surface area regression . The mean time to this effect was 24 months and was shorter ( 16 months ) in more recent RIF ( < 6 years since RT ) than in older RIF ( 28 months ; P = .0003 ) . Symptom severity ( Subjective Objective Medical Management and Analytic Evaluation score ) was halved in both groups . After treatment discontinuation , mean RIF surface area at 1 year had increased by + 40 % in the SPE group ( rebound ) and + 8.5 % in the LPE group . CONCLUSION Under combined PTX-vitE treatment , RIF regression was exponential , with a two-thirds maximum response after a mean of 2 years . There was a risk of a rebound effect if treatment was too short . Long treatment ( > /= 3 years ) is recommended in patients with severe RIF This is the first report of an evaluation of the use of a laser Doppler imager ( LDI ) scanner in the assessment of  burn depth in patients . It is based on a 6-month , prospect i ve audit of 76 burns of intermediate depth . Clinical and LDI assessment s of burn wound depth were recorded at 48 - 72 h post-injury . Histological confirmation of depth was obtained from those burns requiring surgery . A healing time of less than 21 days was taken as confirmation of the injury being an superficial dermal burn . The accuracy of LDI  in the assessment of burn depth was 97 % , compared with 60 - 80 % for established clinical methods . This audit confirms that LDI is a very accurate measurement tool for the assessment of burn wound depth . We recommend that all burns of intermediate depth should be analysed in this way in order to ensure appropriate management of the burn , to avoid unnecessary surgery and to reduce hospital stay and costs OBJECTIVE Microcirculatory visualization has already been used to investigate buccal and cutaneous microcirculatory alterations in neonates . Still , the reproducibility of these microvascular measurements has never been studied in ( premature ) neonates . This study aim ed to determine the reproducibility of microvascular vessel density in cutaneous and buccal SDF clips in one-day-old term newborns . METHODS Buccal and cutaneous microcirculations were measured using SDF imaging .  Vessel density was independently assessed by two investigators . Reproducibility was assessed from the ICC and Bl and -Altman analysis . RESULTS Reproducibility of vessel density assessment in the buccal area was good , with ICCs for total and PVD of 0.93 ( 0.88 - 0.97 ) and 0.93 ( 95 % CI 0.85 - 0.97 ) , respectively , and a near zero bias and acceptable limits of agreement in the Bl and -Altman analysis . Reproducibility of assessment of the cutaneous microcirculation was poor with ICCs for total and PVD of 0.31 ( 0 - 0.70 ) and 0.37 ( 0 - 0.74 ) , respectively , and large biases ( 3.09 and 2.53 ) in the Bl and -Altman analysis . CONCLUSIONS Evaluation of buccal microvascular vessel density in SDF-derived images in term newborns is reproducible in contrary to the cutaneous vessel density BACKGROUND Autologous fat grafting is increasingly used in reconstructive surgery . However , res 
    Output:
    
Purified autologous fat grafts contain cellular and non-cellular properties that potentially interact with these processes .