- Email: [email protected]
O9 Chlorin e6 photosensitizer as a fluorescence marker for fluorescence diagnostics during photodynamic therapy in ophthalmology
S8 2 months. After that he showed symptomatic effect and process stabilization. In early esophageal cancer (2 patients) complete tumour resorption was seen. No recurrences were recorded in these patients for more than 1 year; they lived for more than 3.5 years. Dysphagia in obturating tumours (stage III-IV) has reduced in all patients. In dysphagia recurrence laser recanalisation with PE PDT and Nd-YAG laser light led to longer remission (6 7 months) due to vascular PDT mechanisms when blood supply in tumour is impaired for rather long period of time. Conclusion: PDT was effectively used for palliative purposes in extended obturating esophageal cancer, in cancer recurrences with extension to lower-thoracic part of the esophagus at esophageal-intestinal and esophageal-gastric anastomoses. PE PDT considerably improves quality and duration of life in patients with obstructive esophageal cancer. Recanalisation effect lasts for 6 7 months. O8 Application of selective chronophototherapy in patients with breast cancer and skin melanoma for correction of immunological disorders V.A. Borisov1 , O.A. Guseva2 , S.S. Grigoryan2 . 1 Biochronoterapy Center, Moscow, Russia; 2 Gamaley Science Research Institute of Epidemiology and Microbiology, Moscow, Russia Introduction: Immunological studies in oncology often reveals different immune disorders, especially after radiotherapy, chemotherapy, surgical operations, which creat conditions for persistent immunodeficiency and recurrent tumor. For correction of immune system the Biochronotherapy Center applied the method of Selective Chronophototherapy (SCPT) with chlorin E6, including laser therapy. The radiation source is laser with wavelength of 662 nm, 2 W with biofeedback sensors of respiration and pulse. The expediency of SCPT method for immunocorrection was indicated by immunological study of cancer patients. Materials and Methods: The study involved 45 patients with breast cancer (BC) and 25 patients with skin melanoma (SM) before and during 4-month treatment by SCPT with 1-month intervals. Immunological investigations included: leukocyte, lymphocyte count; immunophenotyping on 10 indicators; determination of phagocytic activity, spontaneous oxygen metabolism of neutrophils and concentration of serum IgA, IgG, IgM. Processing of results was made by FoxPro. Results: Initially, all patients had pathological changes in the immune system related primarily cell-mediated immunity. In patients with BC was observed deficiency of cytotoxic T-lymphocytes (CD8) and CD56NK-cells, with MS- the suppression of T-helperlevel (CD4) and CD16NK-cells. After 1 month SCPT application in 96% of patients was observed positive changes in immunological parameters. Primarily, at BC normalized CD8 and CD56NK, and in case of SM- CD4 and CD16NK. The low level of CD54 and CD95 expression increased to the physiological norm both at BC and SM in 95% and 87% of patients respectively. This correlated with decrease in malignant inflammatory focus. Initially high expression of CD71 after 1 month normalized in 50% of patients both with BC and SM. Others had a significant trend towards reduction. Whereby was noted the decrease or (in some cases) complete absence of metastasis. Subsequent immunological investigations within 4 months observed stabilization of reduced immunological parameters that affect the clinical status of patients: improved appetite, efficiency, overall tonus, patients reported improved quality of life. Conclusion: Thus, the application of SCPT method contributes to the normalization and stabilization of reconstructed immunologic parameters, mainly cellular immunity. Achieved level of immune persists for a long time. Currently the clinical and immunological status of patients with BC and SM and with other malignant pathologies is observed.
Abstracts of Laser Helsinki 2010 Congress O9 Chlorin e6 photosensitizer as a fluorescence marker for fluorescence diagnostics during photodynamic therapy in ophthalmology Yu.Al. Belyy, A.V. Tereshchenko, P.L. Volodin. Kaluga branch of academician S.N. Fyodorov “Eye Microsurgery” Federal State Institute, Russia Purpose: To evaluate the abilities of fluorescence diagnostics (FD) using chlorin e6 photosensitizer in photodynamic therapy (PDT) in experimental and clinical ophthalmology. Materials and Methods: 6 rabbits with induced choroidal neovascularization. 12 patients with choroidal neovascularization (CNV) (9) and choroidal melanomas (3). PDT was performed under FD control with bis-N-methyl glucamine chlorin e6 photosensitizer (PS) in real time by means of ophthalmologic laser complex “ALOD-01” (Russia). Laser irradiation for FD was performed by defocused laser beam with fluency 20 40 J/cm2 at different time intervals. PS dose which was injected to rabbits was 2.5 mg/kg. The clinical dose, 0.8 mg/kg, was infused during 10 minutes. A special computer program was designed for pathologic ocular structures fluorescence intensity quantification. The software calculates a fluorescence contrast coefficient (FCC). Results: In animals FD showed contrast of the main retinal vessels and large and medium choroidal vessels one minutes after PS injection. To 15th minute gradual extinction of the fluorescence intensity of intact retinal vessels was revealed. CNV fluorescence showed tendency to intensification with surrounding tissue staining to 20th minute. In patients with CNV maximal FCC was registered 10 15 minutes after the beginning of the PS infusion. After 20th minute extravasal fluorescence with slow staining of perifocal retina was shown. In patients with choroidal melanomas maximal FCC in tumor tissue was found 1.5 2 hours after the beginning of PS infusion. Conclusions: Examination in dynamics of the PS accumulation by FD in vivo allowed to determine the optimal interval between the beginning of the PS infusion and beginning of the laser irradiation for PDT in choroidal neovascularization (10 15 minutes) and intraocular tumors (90 120 minutes).
Parallel Session: Laser aesthetic surgery O10 How can ISO international standards help you? P. Fryda. European Medical Laser Association (EMLA), Czech Republic Laser treatment and laser surgery are highly effective specialties of medicine, utilizing high-tech devices, however, bringing high risks, too. Apart from laser safety rules and standards every laser clinic must conform to many legal, administrative and other obligations and responsibilities. Even though ISO standards are considered mainly an industrial category they can also help in building and maintaining an efficent private clinic. Some clinics have already been certified under ISO 9001 Quality Management System. The ISO family also offers ISO 27001 Information Safety Management System for protection of patients data, ISO 14001 Environmental Management Standard to provide evidence of environmentally responsible behavior, or ISO OHSAS 18001 Occupational Health Safety Management System.
Abstracts of Laser Helsinki 2010 Congress O9 Chlorin e6 photosensitizer as a fluorescence marker for fluorescence diagnostics during photodynamic therapy in ophthalmology Yu.Al. Belyy, A.V. Tereshchenko, P.L. Volodin. Kaluga branch of academician S.N. Fyodorov “Eye Microsurgery” Federal State Institute, Russia Purpose: To evaluate the abilities of fluorescence diagnostics (FD) using chlorin e6 photosensitizer in photodynamic therapy (PDT) in experimental and clinical ophthalmology. Materials and Methods: 6 rabbits with induced choroidal neovascularization. 12 patients with choroidal neovascularization (CNV) (9) and choroidal melanomas (3). PDT was performed under FD control with bis-N-methyl glucamine chlorin e6 photosensitizer (PS) in real time by means of ophthalmologic laser complex “ALOD-01” (Russia). Laser irradiation for FD was performed by defocused laser beam with fluency 20 40 J/cm2 at different time intervals. PS dose which was injected to rabbits was 2.5 mg/kg. The clinical dose, 0.8 mg/kg, was infused during 10 minutes. A special computer program was designed for pathologic ocular structures fluorescence intensity quantification. The software calculates a fluorescence contrast coefficient (FCC). Results: In animals FD showed contrast of the main retinal vessels and large and medium choroidal vessels one minutes after PS injection. To 15th minute gradual extinction of the fluorescence intensity of intact retinal vessels was revealed. CNV fluorescence showed tendency to intensification with surrounding tissue staining to 20th minute. In patients with CNV maximal FCC was registered 10 15 minutes after the beginning of the PS infusion. After 20th minute extravasal fluorescence with slow staining of perifocal retina was shown. In patients with choroidal melanomas maximal FCC in tumor tissue was found 1.5 2 hours after the beginning of PS infusion. Conclusions: Examination in dynamics of the PS accumulation by FD in vivo allowed to determine the optimal interval between the beginning of the PS infusion and beginning of the laser irradiation for PDT in choroidal neovascularization (10 15 minutes) and intraocular tumors (90 120 minutes).
Parallel Session: Laser aesthetic surgery O10 How can ISO international standards help you? P. Fryda. European Medical Laser Association (EMLA), Czech Republic Laser treatment and laser surgery are highly effective specialties of medicine, utilizing high-tech devices, however, bringing high risks, too. Apart from laser safety rules and standards every laser clinic must conform to many legal, administrative and other obligations and responsibilities. Even though ISO standards are considered mainly an industrial category they can also help in building and maintaining an efficent private clinic. Some clinics have already been certified under ISO 9001 Quality Management System. The ISO family also offers ISO 27001 Information Safety Management System for protection of patients data, ISO 14001 Environmental Management Standard to provide evidence of environmentally responsible behavior, or ISO OHSAS 18001 Occupational Health Safety Management System.