Photofrin II Pharmacokinetics and Optical Dosing in Tissue: Apparatus and Clinical Measurements for the Pharynx, Esophagus, and Tracheobronchial Tree

2020 ◽  
pp. 425-444
Author(s):  
Daniel Braichotte ◽  
Roland Bays ◽  
George Wagnières ◽  
André Châtelain ◽  
Christopher W. Burckhardt ◽  
...  
Keyword(s):  
Tracheobronchial Tree ◽  
Photofrin Ii ◽  
Clinical Measurements

scholarly journals Photodynamic Therapy for 101 Early Cancers of the Upper Aerodigestive Tract, the Esophagus, and the Bronchi: A Single-Institution Experience

1999 ◽  
Vol 5 (3) ◽  
pp. 145-154 ◽  
Author(s):  
A. Radu ◽  
P. Grosjean ◽  
Ch. Fontolliet ◽  
G. Wagnieres ◽  
A. Woodtli ◽  
...  
Keyword(s):  
Photodynamic Therapy ◽  
Early Stage ◽  
Red Light ◽  
Green Light ◽  
Tracheobronchial Tree ◽  
Aerodigestive Tract ◽  
Upper Aerodigestive Tract ◽  
Photofrin Ii ◽  
Significant Difference ◽  
Radical Therapy

Cancer, when detected at an early stage, has a very good probability of being eradicated by surgery or radiotherapy. However, less aggressive treatments also tend to provide high rates of cure without the side effects of radical therapy. We report on the results of our clinical experience with photodynamic therapy (PDT) for the treatment of early carcinomas in the upper aerodigestive tract, the esophagus, and the tracheobronchial tree. Sixty-four patients with 101 squamous cell carcinomas were treated with three different photosensitizers: hematoporphyrin derivative (HPD), Photofrin II, and tetra (m-hydroxyphenyl)chlorin (mTHPC). Seventy-seven (76%) tumors showed a complete rsponse with no recurrence after a mean follow-up period of 27 months. There was no significant difference in terms of cure rates among the three dyes. However, mTHPC has a stronger phototoxicity and induces a shorter skin photosensitization than either of the other photosensitizers. There were eight major complications: three esophagotracheal fistulae after illumination with red light in the esophagus, two esophageal stenoses following 360° circumferential irradiation, and three bronchial stenoses. Illumination with the less penetrating green light and the use of a 180° or 240° windowed cylindrical light distributor render the risk of complications in the esophagus essentially impossible, without reducing the efficacy of the treatment. Therefore, PDT may be considered as a safe and effective treatment for early carcinomas of the upper aerodigestive tract, the esophagus, and the tracheobronchial tree.

Near Wall Turbulence Effects on Particle Transport and Deposition in Human Tracheobronchial Multi-Level Bifurcation Model

2015 ◽  
Author(s):  
Amir A. Mofakham ◽  
Lin Tian ◽  
Goodarz Ahmadi
Keyword(s):  
Boundary Conditions ◽  
Particle Deposition ◽  
Flow Simulation ◽  
Tracheobronchial Tree ◽  
Lung Model ◽  
Wall Turbulence ◽  
Nano Particles ◽  
Turbulent Regime ◽  
Computationally Efficient ◽  
Multi Level

Transport and deposition of micro and nano-particles in the upper tracheobronchial tree were analyzed using a multi-level asymmetric lung bifurcation model. The multi-level lung model is flexible and computationally efficient by fusing sequence of individual bifurcations with proper boundary conditions. Trachea and the first two generations of the tracheobronchial airway were included in the analysis. In these regions, the airflow is in turbulent regime due to the disturbances induced by the laryngeal jet. Anisotropic Reynolds stress transport turbulence model (RSTM) was used for mean the flow simulation, together with the enhanced two-layer model boundary conditions. Particular attention is given to evaluate the importance of the “quadratic variation of the turbulent fluctuations perpendicular to the wall” on particle deposition in the upper tracheobroncial airways.

scholarly journals Prospective Validation of Indocyanine Green Lymphangiography Staging of Breast Cancer-Related Lymphedema

Cancers ◽  
2021 ◽  
Vol 13 (7) ◽  
pp. 1540
Author(s):  
Mads Gustaf Jørgensen ◽  
Navid Mohamadpour Toyserkani ◽  
Frederik Christopher Gulmark Hansen ◽  
Jørn Bo Thomsen ◽  
Jens Ahm Sørensen
Keyword(s):  
Breast Cancer ◽  
Indocyanine Green ◽  
Clinical Severity ◽  
Serious Adverse Events ◽  
Disease Information ◽  
Grading Systems ◽  
Breast Cancer Related Lymphedema ◽  
Disease Stratification ◽  
Md Anderson ◽  
Clinical Measurements

Indocyanine green lymphangiography (ICG-L) allows real-time investigation of lymphatics. Plastic surgeons performing lymphatic reconstruction use the ICG-L for patient selection and stratification using the MD Anderson (MDA) and the Arm Dermal Backflow (ADB) grading systems. However, the applicability of ICG-L in evaluating breast cancer-related lymphedema (BCRL) is sparse and not well established. This study comprehensively examines the usability of ICG-L in the assessment of BCRL. We prospectively performed ICG-L in 237 BCRL patients between January 2019 and February 2020. The aim of this study was to assess the interrater and intrarater agreement and interscale consensus of ratings made using the MDA and ADB scales. Three independent raters performed a total of 2607 ICG-L assessments. The ICG-L stage for each grading system was correlated to the lymphedema volume to assess the agreement between the ICG-L stage and clinical severity. The interrater agreement was near perfect for the MDA scale (kappa 0.82–0.90) and the ADB scale (kappa 0.80–0.91). Similarly, we found a near-perfect intrarater agreement for the MDA scale (kappa 0.84–0.94) and the ADB scale (kappa 0.88–0.89). The agreement between the MDA and the ADB scales was substantial (kappa 0.65–0.68); however, the ADB scale systematically overestimated lower ICG-L stages compared to the MDA scale. The volume of lymphedema correlated slightly with MDA stage (Spearmans rho = 0.44, p < 0.001) and ADB stage (rs = 0.35, p < 0.001). No serious adverse events occurred. The staging of BCRL with ICG-L is reliable, safe, and provides unique disease information unobtainable with clinical measurements alone. The MDA scale seems to provide better disease stratification compared to the ADB scale.

Esophagus-Like Bronchus: A Noncommunicating Bronchopulmonary Foregut Malformation

2021 ◽  
pp. 106689692110022
Author(s):  
Jenny L. Weon ◽  
Stephen Megison ◽  
Charles F. Timmons ◽  
Dinesh Rakheja
Keyword(s):  
Left Lung ◽  
Lower Lobe ◽  
Tracheobronchial Tree ◽  
Pulmonary Infections ◽  
Bronchopulmonary Foregut Malformation ◽  
Radiologic Examination ◽  
Foregut Malformation

We describe a previously unreported bronchopulmonary foregut malformation wherein a segment of a bronchus of the lower lobe of the left lung in a 4-year-old girl was entirely esophageal in structure. No communication was identified between the tracheobronchial tree and the esophagus by radiologic examination or at surgery. The esophagus-like bronchus was associated with an adjacent atretic bronchus and a downstream cavity in the lower lobe of the left lung. The child sought clinical attention because of recurrent pulmonary infections localized to the lower lobe of the lung. We posit that this esophagus-like bronchus is a novel noncommunicating bronchopulmonary foregut malformation.

scholarly journals Optical-Based Biosensors and Their Portable Healthcare Devices for Detecting and Monitoring Biomarkers in Body Fluids

Diagnostics ◽  
2021 ◽  
Vol 11 (7) ◽  
pp. 1285
Author(s):  
Anh Tran Tam Pham ◽  
Angus Wallace ◽  
Xinyi Zhang ◽  
Damian Tohl ◽  
Hao Fu ◽  
...  
Keyword(s):  
Medical Devices ◽  
Point Of Care ◽  
Body Fluids ◽  
Optical Measurements ◽  
Mobile Technologies ◽  
Detection Methods ◽  
Portable Devices ◽  
Bodily Fluids ◽  
Clinical Measurements ◽  
Distinct Features

The detection and monitoring of biomarkers in body fluids has been used to improve human healthcare activities for decades. In recent years, researchers have focused their attention on applying the point-of-care (POC) strategies into biomarker detection. The evolution of mobile technologies has allowed researchers to develop numerous portable medical devices that aim to deliver comparable results to clinical measurements. Among these, optical-based detection methods have been considered as one of the common and efficient ways to detect and monitor the presence of biomarkers in bodily fluids, and emerging aggregation-induced emission luminogens (AIEgens) with their distinct features are merging with portable medical devices. In this review, the detection methodologies that use optical measurements in the POC systems for the detection and monitoring of biomarkers in bodily fluids are compared, including colorimetry, fluorescence and chemiluminescence measurements. The current portable technologies, with or without the use of smartphones in device development, that are combined with optical biosensors for the detection and monitoring of biomarkers in body fluids, are also investigated. The review also discusses novel AIEgens used in the portable systems for the detection and monitoring of biomarkers in body fluid. Finally, the potential of future developments and the use of optical detection-based portable devices in healthcare activities are explored.

Argon Plasma Coagulation: Elucidation of the Mechanism of Gas Embolism

Respiration ◽  
2021 ◽  
pp. 1-5
Author(s):  
Erik E. Folch ◽  
Catherine L. Oberg ◽  
Atul C. Mehta ◽  
Adnan Majid ◽  
Colleen Keyes ◽  
...  
Keyword(s):  
Direct Contact ◽  
Gas Flow ◽  
Argon Plasma Coagulation ◽  
Argon Plasma ◽  
Tracheobronchial Tree ◽  
Bleeding Complications ◽  
Gas Transfer ◽  
Gas Embolism ◽  
Associated Gas ◽  
Plasma Coagulation

<b><i>Background:</i></b> Argon plasma coagulation (APC) is a tool used in the management of tracheobronchial obstruction or bleeding. Complications include gas embolism which can cause devastating effects including hemodynamic instability, cardiac arrest, and stroke. Multiple theories as to how gas embolism occurs with APC have been postulated; however, none have identified the exact mechanism. <b><i>Objectives:</i></b> To identify the mechanism by which APC causes gas embolism in the tracheobronchial tree. <b><i>Methods:</i></b> Using an explanted porcine tracheobronchial tree with lung parenchyma, the APC catheter was applied through noncontact and direct contact to the endobronchial airway mucosa via flexible bronchoscopy. This was done at multiple gas flow settings and pulse durations. Visual changes in the mucosa were photographed, videoed, and described. <b><i>Results:</i></b> Gross evidence of submucosal gas transfer occurred when the APC catheter was in direct contact with the mucosa at all gas flow settings in all applications, despite using shorter pulse durations. Whenever the catheter was not in contact with the mucosa, there was no transfer of gas at any gas flow setting or pulse duration. <b><i>Conclusions:</i></b> Direct mucosal contact with the APC probe leads to submucosal gas deposition and is a likely mechanism for gas entry into the intravascular space. In reported cases of APC-associated gas embolism, presence of a vascularized endobronchial tumor may have increased the risk of gas tracking into the intravascular space. Care should be taken when applying APC during brisk bleeding or limited vision, as inadvertent mucosal contact may occur and could increase the risk of gas embolism.

scholarly journals Volumetric changes in edentulous alveolar ridge sites utilizing guided bone regeneration and a custom titanium ridge augmentation matrix (CTRAM): a case series study

2020 ◽  
Vol 6 (1) ◽  
Author(s):  
Craig E. Hofferber ◽  
J. Cameron Beck ◽  
Peter C. Liacouras ◽  
Jeffrey R. Wessel ◽  
Thu P. Getka
Keyword(s):  
Case Series ◽  
Bone Allograft ◽  
Volumetric Analysis ◽  
Collagen Membrane ◽  
Ridge Augmentation ◽  
Implant Placement ◽  
Case Series Study ◽  
Freeze Dried ◽  
Clinical Measurements ◽  
Bone Gain

Abstract Background The purpose of this study was to evaluate the volumetric changes in partially edentulous alveolar ridges augmented with customized titanium ridge augmentation matrices (CTRAM), freeze-dried bone allograft, and a resorbable collagen membrane. Methods A pre-surgical cone beam computed tomography (CBCT) scan was obtained for CTRAM design/fabrication and to evaluate pre-surgical ridge dimensions. Ridge augmentation surgery using CTRAM, freeze-dried bone allograft, and a resorbable collagen membrane was performed at each deficient site. Clinical measurements of the area of augmentation were made at the time of CTRAM placement and re-entry, and a 2nd CBCT scan 7 months after graft placement was used for volumetric analysis. Locations of each CTRAM in situ were also compared to their planned positions. Re-entry surgery and implant placement was performed 8 months after CTRAM placement. Results Nine subjects were treated with CTRAM and freeze-dried bone allograft. Four out of the nine patients enrolled (44.4%) experienced premature CTRAM exposure during healing, and in two of these cases, CTRAM were removed early. Early exposure did not result in total graft failure in any case. Mean volumetric bone gain was 85.5 ± 30.9% of planned augmentation volume (61.3 ± 33.6% in subjects with premature CTRAM exposure vs. 104.9% for subjects without premature exposure, p = 0.03). Mean horizontal augmentation (measured clinically) was 3.02 mm, and vertical augmentation 2.86 mm. Mean surgical positional deviation of CTRAM from the planned location was 1.09 mm. Conclusion The use of CTRAM in conjunction with bone graft and a collagen membrane resulted in vertical and horizontal bone gain suitable for implant placement.

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