Background and Objective Chronic and infected leg ulcers (LUs) are painful, debilitating, resistant to antibiotics, immensely reducing patient's quality of life. The purpose of the new clinical research project was to demonstrate the the efficacy of photodynamic therapy (PDT) as an alternative to antibiotic therapy for the treatment of infected chronic LUs.
Patients and Methods PDT using irradiation at fluency 80 J / cm2 and 20% 5-aminolevulinic acid topically applied for 4 hrs, was performed during 10 days of hospitalization in 10 patients both sexes aged 40-85, with chronic leg ulcers, who had not responded well to conventional treatment. This was a randomized, placebo-controlled trial (local Octenidine dihydrochloride). The numerical scale of pain was used. Treatments were carried out at 3-week intervals.
Result During 8 months follow up, complete remission (CR) was obtained in 4 patients (40%), partial response (>50% reduction in ulcer diameter), in 3 patients (30%), no response in 1 patients (10%). In two patients (20%) was observed deterioration of the local condition, with swelling, erythema and inflammation.
Conclusion PDT allowed healing of chronic leg ulcers through the antimicrobial effect, modulation of inflammatory process and improving the oxygenation of ulcer tissue with a reduction in healing time and improving scarring results with the reduction of pathological bacterial culture. Further studies on the larger group of patients are needed to confirm the benefit role of PDT in the treatment of LUs.
The aim of this study was to determine the immune effect of PDT with 5-aminolevulinic acid (ALA-PDT) used in sublethal doses on the secretion of growth factors: VEGF, GM-CSF, G-CSF, FGF, Interleukin 6,8 and 10 and S100 protein secretion by experimental models of residual colon cancer cells in vitro.
Background and objective The search for new diagnostic and therapeutic procedures is an essential task in contemporary oncology. The purpose of our study was the evaluation of the practical usefulness of endoscopic autofluorescence assessment (AFE) using the Onco-LIFE system, and the estimation of the correlation between the histopathological evaluation with the degree of lesions’ Numerical Color Value (NCV index) and the method’s sensitivity and specificity valuation.
Material 67 patients were analyzed and had previously a tumor of the gastrointestinal tract which appeared malignant, but without histopathological confirmation. We measured NCV, estimated the correlation of the clinical diagnosis based on histopathological evaluation with the degree of NCV index from gastrointestinal lesions, and calculated the sensitivity and specificity of this method.
Results In the group of 67 patients, we found 44 cases of primary or secondary cancers and 7 cases of non-epithelial malignancies. In this group (51 patients) we identified 13 colorectal cancers and 38 upper gastrointestinal cancers. Based on the NCV index at NCV>1.0, we can show that the sensitivity for malignant neoplastic lesions was 100% and the specificity was 73%, while for NCV>1.5, the sensitivity for malignant neoplastic lesions was 86% and the specificity 100%.
Conclusion AFE using the Onco-LIFE system is a helpful tool to perform targeted biopsies at the outset. A significant correlation was found between lesions’ NCV index and the grade of dysplasia or tumor malignancy. AFE sensitivity and specificity is higher than WLE. Further studies are needed, especially performed by expert endoscopists.
Background. This study assessed the efficacy of autofluorescence endoscopy (AFE) using the Onco-LIFE system and numerical color value (NCV) estimation in comparison to white light endoscopy (WLE) in endoscopic surveillance for identification of early dysplasia in Barrett’s esophagus (BE). In the case of dysplasia photodynamic treatment (PDT) was carried out.
Methods. AFE, performed simultaneously during WLE, with biopsy was performed in 24 patients with BE. None of these patients had any obvious mucosal abnormalities in WLE. A total of 376 biopsies were taken, include 325 randomly collected according to Seattle Protocol (SP) and 51 additional biopsies, taken from the sites with pathological AF and NCV, and then compared to histological examinations. The PDT was performed using 5-aminolevulinic acid (ALA) and DIOMED 630nm light source.
Results. In the case of 248 biopsies taken from sites with NCV below 1.0, two cases of unspecified dysplasia were recognized; in 14 biopsies with NCV above 2.0 in all cases the various grades of dysplasia were documented. Dysplasia was found in 42% of AFE+NCV- guided biopsy specimens, and in 7.1% of WLE-guided biopsy specimens. AFE+NCV detected high-grade dysplasia in 7 patients, 6 more than according to SP in WLE. In the group patients with dysplasia, PDT was successfully carried out.
Conclusion: The results indicate that AFE+NCV using the Onco-LIFE system leads to improved BE lesion visualization for targeted biopsy with accurate histologic correlation compared to WLE and SP guided biopsy, and can serve to minimize additional biopsies. PDT is an effective therapeutic method in BE.
Aim of the study was to determine the immune effect of PDT with hypericin (HY-PDT) used in sublethal doses on the secretion of Interleukin 8 and 10 by experimental models of residual colon cancer cells in vitro.
Results HY-PDT amplified the secretion of IL-8 by SW620 cell line, but the decrease of IL-8 secreted by the SW480 cell line. The increase in secretion of IL-10 was noticed in the SW480 cell line, but the changes of secretion IL-10 by SW 620 was not noted. SW480 cell line without PDT secreted higher levels of IL-8 and IL-10 than SW620 cells.
Based on these research findings it could be told, that PDT both eliminates and control primary tumors using cytotoxic effect while HY-PDT at lower doses can modulate function of tumor microenvironment by releasing interleukins depended on metastatic activity of tumor cells.
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