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1.
Medicine (Baltimore) ; 100(22): e26235, 2021 Jun 04.
Artigo em Inglês | MEDLINE | ID: mdl-34087908

RESUMO

RATIONALE: Degloving foot injuries are challenging to treat and associated with life-long sequelae for patients. An appropriate debridement of ischemic soft tissues with maximal preservation of glabrous skin is key during the reconstruction of these injuries. Indocyanine green (ICG) fluorescence angiography is an established technique for the intraoperative evaluation of tissue perfusion. PATIENT CONCERNS: Two patients sustained complex foot injuries in traffic accidents, including multiple fracture dislocations and extensive degloving of the plantar skin. DIAGNOSIS: Clinical inspection revealed significant degloving of the glabrous skin in both patients. INTERVENTIONS: After fracture fixation, ICG fluorescence angiography-assisted debridement with immediate latissimus dorsi free flap reconstruction was performed. OUTCOMES: In both cases, this technique allowed a precise debridement with maximal preservation of the glabrous skin. The healing of the remaining glabrous skin was uneventful and the 6-month follow-up was characterized by stable soft tissues and satisfying ambulation. LESSONS: ICG fluorescence angiography is a safe, user-friendly, and quick procedure with minimal risks, expanding the armamentarium of the reconstructive surgeon. It is highly useful for the debridement of extensive plantar degloving injuries and may also help to minimize the number of procedures and the risk of infection.


Assuntos
Desbridamento/métodos , Angiofluoresceinografia/métodos , Traumatismos do Pé/cirurgia , Pé/diagnóstico por imagem , Adulto , Assistência ao Convalescente , Criança , Desenluvamentos Cutâneos/cirurgia , Feminino , Pé/irrigação sanguínea , Pé/patologia , Traumatismos do Pé/complicações , Fraturas Múltiplas/cirurgia , Humanos , Verde de Indocianina/administração & dosagem , Masculino , Procedimentos Cirúrgicos Reconstrutivos/métodos , Transplante de Pele/métodos , Lesões dos Tecidos Moles/cirurgia , Retalhos Cirúrgicos/cirurgia , Resultado do Tratamento
2.
Gan To Kagaku Ryoho ; 48(4): 590-592, 2021 Apr.
Artigo em Japonês | MEDLINE | ID: mdl-33976058

RESUMO

We verified the significance of intestinal blood flow evaluation by indocyanine green(ICG)fluorescence during intracorporeal anastomosis in laparoscopic colectomy which was performed from July 2019 to December 2019 in our institute. For 11 cases of intracorporeal anastomosis, we examined the patient background, surgical results such as operation time and blood loss, evaluation of intraoperative ICG blood flow, and perioperative complications. In all cases, after the mesentery treatment in the abdominal cavity and before the intestinal incision, the blood flow of the planned anastomosis site was evaluated by ICG fluorescence observation. No cases were required to be changed the anastomosis site. The average operation time was 240 minutes and the average blood loss was 10 mL. There were no perioperative complications such as anastomotic leakage, stenosis, bleeding, nor wound infection. It was suggested that the intraoperative evaluation of ICG blood flow during intracorporeal anastomosis in laparoscopic colectomy may contribute to the suppression of complications such as anastomotic leakage.


Assuntos
Laparoscopia , Anastomose Cirúrgica , Fístula Anastomótica , Colectomia , Angiofluoresceinografia , Humanos , Verde de Indocianina
3.
Kyobu Geka ; 74(5): 343-346, 2021 May.
Artigo em Japonês | MEDLINE | ID: mdl-33980792

RESUMO

A 76-year-old man visited to the hospital with a complaint of cough. The chest computed tomography scan revealed a 20 mm part-solid nodule in the right lower lobe, which was suspected to be an early-stage lung cancer. Since the tumor was located in S8a, and was adjacent to S6b and S9a, thoracoscopic right S 6b+S 8a+S 9a combined subsegmentectomy was performed. Virtual-assisted lung mapping (VAL-MAP) with indocyanine green( ICG) was performed as the preoperative marking. After dissecting the target vessels and bronchi, the intersegmental plane was identified using intravenous ICG. The pathological diagnosis was invasive mucinous adenocarcinoma with no lymph node metastasis. Combined subsegmentectomy is a useful option for the sublober resection of small lung cancer.


Assuntos
Neoplasias Pulmonares , Pneumonectomia , Idoso , Humanos , Verde de Indocianina , Pulmão , Neoplasias Pulmonares/diagnóstico por imagem , Neoplasias Pulmonares/cirurgia , Masculino , Tomografia Computadorizada por Raios X
4.
Int J Nanomedicine ; 16: 3457-3472, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-34045853

RESUMO

Purpose: Malignant melanoma is one of the most devastating types of cancer with rapid relapse and low survival rate. Novel strategies for melanoma treatment are currently needed to enhance therapeutic efficiency for this disease. In this study, we fabricated a multifunctional drug delivery system that incorporates dacarbazine (DTIC) and indocyanine green (ICG) into manganese-doped mesoporous silica nanoparticles (MSN(Mn)) coupled with magnetic resonance imaging (MRI) and photothermal imaging (PI), for achieving the superior antitumor effect of combined chemo-photothermal therapy. Materials and Methods: MSN(Mn) were characterized in terms of size and structural properties, and drug loading and release efficiency MSN(Mn)-ICG/DTIC were analyzed by UV spectra. Photothermal imaging effect and MR imaging effect of MSN(Mn)-ICG/DTIC were detected by thermal imaging system and 3.0 T MRI scanner, respectively. Then, the combined chemo-phototherapy was verified in vitro and in vivo by morphological evaluation, ultrasonic and pathological evaluation. Results: The as-synthesized MSN(Mn) were characterized as mesoporous spherical nanoparticles with 125.57±5.96 nm. MSN(Mn)-ICG/DTIC have the function of drug loading-release which loading ratio of ICG and DTIC could reach to 34.25±2.20% and 50.00±3.24%, and 32.68±2.10% of DTIC was released, respectively. Manganese doping content could reach up to 65.09±2.55 wt%, providing excellent imaging capability in vivo which the corresponding relaxation efficiency was 14.33 mM-1s-1. And outstanding photothermal heating ability and stability highlighted the potential biomedical applicability of MSN(Mn)-ICG/DTIC to kill cancer cells. Experiments by A375 melanoma cells and tumor-bearing mice demonstrated that the compound MSN(Mn)-ICG/DTIC have excellent biocompatibility and our combined therapy platform delivered a superior antitumor effect compared to standalone treatment in vivo and in vitro. Conclusion: Our findings demonstrate that composite MSN(Mn)-ICG/DTIC could serve as a multifunctional platform to achieve a highly effective chemo-photothermal combined therapy for melanoma treatment.


Assuntos
Imageamento por Ressonância Magnética , Melanoma/diagnóstico por imagem , Melanoma/terapia , Terapia Fototérmica , Animais , Linhagem Celular Tumoral , Terapia Combinada , Doxorrubicina/administração & dosagem , Doxorrubicina/química , Doxorrubicina/uso terapêutico , Sistemas de Liberação de Medicamentos/métodos , Liberação Controlada de Fármacos , Humanos , Verde de Indocianina/química , Melanoma/tratamento farmacológico , Melanoma/patologia , Camundongos , Nanopartículas/química , Dióxido de Silício/química
5.
Medicine (Baltimore) ; 100(20): e25872, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-34011053

RESUMO

RATIONALE: Despite significant advances in microsurgical techniques, simultaneous release of transverse carpal ligament (TCL) and lymphovenous anastomosis (LVA) surgeries may be effective for treatment of carpal tunnel syndrome (CTS) and advanced-stage lymphedema. This case report describes the successful treatment of lymphedema with LVA in a patient with CTS and advanced-stage lymphedema. PATIENT CONCERNS: A 60-year-old female patient was referred to our lymphedema clinic with a 12-year history of chronic, acquired, right upper extremity lymphedema and CTS following right mastectomy and axillary lymph node dissection and adjuvant chemoradiotherapy for treating breast cancer. DIAGNOSIS: According to the indocyanine green lymphography, magnetic resonance lymphangiography, and electromyography, the patient was diagnosed with CTS and advanced-stage lymphedema (International Society of Lymphology late stage 2). INTERVENTION: Release of the TCL was performed first, followed by LVA at the wrist, forearm, and antecubital area. The right arm was compressed and elevated immediately postoperatively and postoperative compression bandage therapy with 35 to 40 mm Hg pressure was instituted following surgery. OUTCOMES: After 2 simultaneous surgeries, the patient had significant circumference and volume reduction of the right hand. The CTS and lymphedema symptoms have decreased following synchronous TCL release and LVA surgeries. LESSONS: Simultaneous LVA and release of the TCL may be effective and safe in patients with advanced lymphedema and CTS.


Assuntos
Síndrome do Túnel Carpal/cirurgia , Descompressão Cirúrgica/métodos , Linfedema/cirurgia , Complicações Pós-Operatórias/cirurgia , Anastomose Cirúrgica/métodos , Neoplasias da Mama/terapia , Síndrome do Túnel Carpal/etiologia , Doença Crônica/terapia , Feminino , Humanos , Verde de Indocianina/administração & dosagem , Excisão de Linfonodo/efeitos adversos , Vasos Linfáticos/diagnóstico por imagem , Vasos Linfáticos/cirurgia , Linfedema/diagnóstico , Linfedema/etiologia , Linfografia , Mastectomia/efeitos adversos , Pessoa de Meia-Idade , Complicações Pós-Operatórias/diagnóstico , Complicações Pós-Operatórias/etiologia , Resultado do Tratamento , Extremidade Superior/irrigação sanguínea , Extremidade Superior/cirurgia , Veias/cirurgia
6.
Nanoscale ; 13(19): 8909-8921, 2021 May 21.
Artigo em Inglês | MEDLINE | ID: mdl-33954311

RESUMO

After several decades of development in the field of near-infrared (NIR) dyes for photothermal therapy (PTT), indocyanine green (ICG) still remains the only FDA-approved NIR contrast agent. However, upon NIR light irradiation ICG can react with molecular oxygen to form reactive oxygen species and degrade the ICG core, losing the convenient dye properties. In this work, we introduce a new approach for expanding the application of ICG in nanotheranostics, which relies on the confinement of self-organized J-type aggregates in hydrophobic protein domains acting as monomer depots. Upon the fast photobleaching, while the dye is irradiated, this strategy permits the equilibrium-driven monomer replacement after each irradiation cycle that radically increases the systems' effectivity and applicability. Gadolinium-doped casein micelles were designed to prove this novel concept at the same time as endowing the nanosystems with further magnetic resonance imaging (MRI) ability for dual-modal imaging-guided PTT. By teaching a new trick to a very old dog, the clinical prospect of ICG will undoubtedly be boosted laying the foundation for novel therapeutics. It is anticipated that future research could be expanded to other relevant J-aggregates-forming cyanine dyes or nanocrystal formulations of poorly water-soluble photosensitizers.


Assuntos
Corantes , Nanopartículas , Verde de Indocianina , Fototerapia , Nanomedicina Teranóstica
7.
Int J Nanomedicine ; 16: 2897-2915, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33907399

RESUMO

Background: Surgery is considered to be a potentially curative approach for gastric cancer. However, most cases are diagnosed at a very advanced stage for the lack of typical symptoms in the initial stage, which makes it difficult to completely surgical resect of tumors. Early diagnosis and precise personalized intervention are urgent issues to be solved for improving the prognosis of gastric cancer. Herein, we developed an RGD-modified ROS-responsive multifunctional nanosystem for near-infrared (NIR) imaging and photothermal therapy (PTT) against gastric cancer. Methods: Firstly, the amphiphilic polymer was synthesized by bromination reaction and nucleophilic substitution reaction of carboxymethyl chitosan (CMCh) and 4-hydroxymethyl-pinacol phenylborate (BAPE). Then, it was used to encapsulate indocyanine green (ICG) and modified with RGD to form a smart multifunctional nanoparticle targeted to gastric cancer (CMCh-BAPE-RGD@ICG). The characteristics were determined, and the targeting capacity and biosafety were evaluated both in vitro and in vivo. Furthermore, CMCh-BAPE-RGD@ICG mediated photothermal therapy (PTT) effect was studied using gastric cancer cells (SGC7901) and SGC7901 tumor model. Results: The nanoparticle exhibited suitable size (≈ 120 nm), improved aqueous stability, ROS-responsive drug release, excellent photothermal conversion efficiency, enhanced cellular uptake, and targeting capacity to tumors. Remarkably, in vivo studies suggested that CMCh-BAPE-RGD@ICG could accurately illustrate the location and margin of the SGC7901 tumor through NIR imaging in comparison with non-targeted nanoparticles. Moreover, the antitumor activity of CMCh-BAPE-RGD@ICG-mediated PTT could effectively suppress tumor growth by inducing necrosis and apoptosis in cancer cells. Additionally, CMCh-BAPE-RGD@ICG demonstrated excellent biosafety both in vitro and in vivo. Conclusion: Overall, our study provides a biocompatible theranostic nanoparticle with enhanced tumor-targeting ability and accumulation to realize NIR image-guided PTT in gastric cancer.


Assuntos
Nanopartículas Multifuncionais/química , Nanopartículas Multifuncionais/uso terapêutico , Neoplasias Gástricas/diagnóstico por imagem , Neoplasias Gástricas/terapia , Animais , Ácidos Borônicos/química , Linhagem Celular Tumoral , Quitosana/análogos & derivados , Quitosana/química , Feminino , Humanos , Verde de Indocianina/química , Verde de Indocianina/farmacocinética , Camundongos Endogâmicos BALB C , Oligopeptídeos/química , Fototerapia/métodos , Polímeros/química , Espécies Reativas de Oxigênio/metabolismo , Ensaios Antitumorais Modelo de Xenoenxerto
8.
Zhong Nan Da Xue Xue Bao Yi Xue Ban ; 46(3): 316-321, 2021 Mar 28.
Artigo em Inglês, Chinês | MEDLINE | ID: mdl-33927080

RESUMO

The preliminary screening of oral cancer mostly depends on the experience of clinicians, The surgical margin of tumor is mostly based on physical examination and preoperative imaging examination. It lacks real-time and objective intraoperative evaluation methods. Indocyanine green (ICG), as a safe and pollution-free organic fluorescent pigments, combined with near-infrared fluorescence imaging can be applied in the screening of early oral cancer, the determination of tumor resection margins, sentinel lymph node biopsy, cervical lymph node dissection, targeted chemotherapy, and other aspects. Near-infrared fluorescence imaging may become a key link in the early diagnosis and accurate treatment for oral cancer in the future.


Assuntos
Linfonodos , Neoplasias Bucais , Humanos , Verde de Indocianina , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/terapia , Imagem Óptica , Biópsia de Linfonodo Sentinela
9.
Medicine (Baltimore) ; 100(15): e25365, 2021 Apr 16.
Artigo em Inglês | MEDLINE | ID: mdl-33847634

RESUMO

OBJECTIVE: This study aims to investigate the feasibility of combined application of indocyanine green (ICG) and methylene blue (MB) for sentinel lymph node biopsy (SLNB) in patients with early breast cancer. METHODS: A total of 415 patients who underwent SLNB and axillary lymph node dissection were enrolled. Sentinel lymph node (SLN) was assessed in 197 patients with ICG and MB combination method, while, the other 218 patients were detected by MB method alone. During surgery, all SLNs were harvested for pathological examination. Then the detection rate and false negative rate of SLNs were comparatively analyzed between the 2 groups. RESULTS: In the combined ICG and MB group, the detection rate of SLNs was 96.9%, significantly higher than that of MB group, which was 89.7% (P < .05). Similarly, in combined group, the average number of SLNs per patient was 3.0, much higher than that of MB group, which was 2.1 (P < .05). There was no statistically significant difference in false negative rate between combined group and MB alone group, which was 7.3% and 10.5%, respectively (P = .791). CONCLUSION: The combined application of ICG and MB for SLNB is much more effective than MB alone in detecting SLNs.


Assuntos
Neoplasias da Mama/patologia , Verde de Indocianina/administração & dosagem , Azul de Metileno/administração & dosagem , Biópsia de Linfonodo Sentinela/métodos , Adulto , Idoso , Corantes , Reações Falso-Negativas , Feminino , Humanos , Pessoa de Meia-Idade , Estadiamento de Neoplasias , Sensibilidade e Especificidade , Linfonodo Sentinela/patologia , Carga Tumoral
10.
Int J Nanomedicine ; 16: 2775-2787, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33880023

RESUMO

Purpose: With the advance of screening techniques, there is a growing number of low-risk or intermediate-risk prostate cancer (PCa) cases, remaining a serious threat to men's health. To obtain better efficacy, a growing interest has been attracted to develop such emerging treatments as immunotherapy and focal therapy. However, few studies offer guidance on whether and how to combine these modalities against PCa. This study was designed to develop dual-functional nanoparticles (NPs) which combined photothermal therapy (PTT) with immunotherapy and determine the anti-tumor efficacy for PCa treatment. Methods: By a double emulsion technique, the drug nanocarrier, poly(lactic-co-glycolic acid) or PLGA, was applied for co-loading of a fluorescent dye, indocyanine green (ICG) and a toll-like receptor 7/8 (TLR7/8) agonist resiquimod (R848) to synthesize PLGA-ICG-R848 NPs. Next, we determined their characteristic features and evaluated whether they inhibited the cell viability in multiple PCa cell lines. After treatment with PLGA-ICG-R848, the maturation markers of bone marrow-derived dendritic cells (BMDCs) were detected by flow cytometry. By establishing a subcutaneous xenograft model of mouse PCa, we explored both the anti-tumor effect and immune response following the NPs-based laser ablation. Results: With a mean diameter of 157.7 nm, PLGA-ICG-R848 exhibited no cytotoxic effect in PCa cells, but they significantly decreased RM9 cell viability to (3.9±1.0)% after laser irradiation. Moreover, PLGA-ICG-R848 promoted BMDCs maturation with the significantly elevated proportions of CD11c+CD86+ and CD11c+CD80+ cells. Following PLGA-ICG-R848-based laser ablation in vivo, the decreased bioluminescent signals indicated a significant inhibition of PCa growth, while the ratio of splenic natural killer (NK) cells in PLGA-ICG-R848 was (3.96±1.88)% compared with (0.99±0.10)% in PBS group, revealing the enhanced immune response against PCa. Conclusion: The dual-functional PLGA-ICG-R848 NPs under laser irradiation exhibit the anti-tumor efficacy for PCa treatment by combining PTT with immunotherapy.


Assuntos
Imidazóis/uso terapêutico , Verde de Indocianina/uso terapêutico , Copolímero de Ácido Poliláctico e Ácido Poliglicólico/química , Neoplasias da Próstata/tratamento farmacológico , Animais , Antineoplásicos/farmacologia , Antineoplásicos/uso terapêutico , Células da Medula Óssea/efeitos dos fármacos , Células da Medula Óssea/metabolismo , Linhagem Celular Tumoral , Sobrevivência Celular/efeitos dos fármacos , Células Dendríticas/efeitos dos fármacos , Células Dendríticas/metabolismo , Endocitose/efeitos dos fármacos , Humanos , Verde de Indocianina/administração & dosagem , Lasers , Masculino , Camundongos Endogâmicos C57BL , Nanopartículas/administração & dosagem , Nanopartículas/ultraestrutura , Neoplasias da Próstata/patologia
11.
Arq Gastroenterol ; 58(1): 61-70, 2021.
Artigo em Inglês | MEDLINE | ID: mdl-33909799

RESUMO

BACKGROUND: Fluorescent imaging with indocyanine green is an emerging technology whose benefits are put in perspective. OBJECTIVE: This article reports essential principles and approaches of intraoperative fluorescence in general surgery bringing familiarity to its practical usage. Our group describes possible pitfalls and provides tips and tricks for training surgeons making their attempts easier and reproducible during practice. METHODS: This study overviews the most structured concepts, practical applications and its tricks in robotic fluorescence guided imaging surgery with indocyanine green. Possible pitfalls are emphasized and emerging fields of application are put in a perspective. RESULTS: Guided information and practical applications in several surgical fields are described for a safe and reproducible indocyanine green fluorescence imaging use. CONCLUSION: Robotic assisted surgery combined to fluorescence imaging technology represents a logical evolution in image guided surgery and technology familiarity with guided information may represent a wider and safer spectrum of use in surgeons' hands.


Assuntos
Procedimentos Cirúrgicos Robóticos , Corantes , Humanos , Verde de Indocianina , Imagem Óptica
12.
BMC Gastroenterol ; 21(1): 142, 2021 Mar 31.
Artigo em Inglês | MEDLINE | ID: mdl-33789567

RESUMO

BACKGROUND: The preoperative prediction of post hepatectomy liver failure (PHLF) is essential, but there is no gold standard for the prediction at present, and the efficacy of different methods for the prediction has not been compared systematically. In this study, we aimed to compare the efficacy of preoperative two-dimensional shear wave elastography (2D-SWE), indocyanine green (ICG) clearance test and biomarkers for PHLF prediction in patients with hepatocellular carcinoma (HCC). METHODS: We retrospectively studied 215 patients with HCC, who had undergone major liver resection in our hospital. Preoperative data of each patient, including liver stiffness value (LSV) of underlying hepatic parenchyma measured by 2D-SWE, ICG retention rate at 15 min (ICG-R15) measured by ICG clearance test, albumin-bilirubin (ALBI) scores, aspartate aminotransferase-platelet ratio index (APRI), and Fibrosis-4 (FIB-4) were collected for analysis. Post hepatectomy outcomes of study patients were also recorded for assessment of PHLF. The study patients were divided into development cohort (133 patients without PHLF, and 17 patients with PHLF) and validation cohort (59 patients without PHLF, and 6 patients with PHLF) randomly. RESULTS: In the development cohort, LSV, ICG-R15 and ALBI scores were significantly different between patients with and without PHLF, while no significant difference of APRI and FIB-4 scores was found. LSV had higher AUC (the area under the receiver operating characteristic curve) (AUC = 0.795) for PHLF prediction than ICG-R15 (AUC = 0.619) and ALBI scores (AUC = 0.686) (p < 0.05 for all comparisons). In the validation cohort, the cutoff value of LSV obtained from the development cohort, 10.35 kPa,  revealed higher specificity (76.3%) for PHLF prediction than ICG-R15 (specificity: 66.1%) and ALBI scores (specificity: 69.5%) (p < 0.0001). CONCLUSIONS: Compared with ICG-R15, ALBI scores, APRI and FIB-4, LSV measured by 2D-SWE may demonstrate better efficacy for preoperative PHLF prediction in patients with HCC.


Assuntos
Carcinoma Hepatocelular , Técnicas de Imagem por Elasticidade , Falência Hepática , Neoplasias Hepáticas , Biomarcadores , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Hepatectomia , Humanos , Verde de Indocianina , Falência Hepática/diagnóstico por imagem , Falência Hepática/etiologia , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Estudos Retrospectivos
13.
J Int Med Res ; 49(4): 3000605211004025, 2021 Apr.
Artigo em Inglês | MEDLINE | ID: mdl-33845602

RESUMO

Constitutional indocyanine green (ICG) excretory defect is rare. However, ICG excretory defect concomitant with hepatocellular carcinoma (HCC) is extremely rare, and only six reports of hepatectomy in patients with constitutional ICG excretory defect have been published in the English language literature through 2020. In this study, we report a case of combined HCC and ICG excretory defect and discuss its clinicopathological features and outcomes. The case featured a 68-year-old man who was admitted to the hospital with a diagnosis of resectable HCC. The preoperative ICG retention rate at 15 minutes was 82.9%. Despite this finding, the Child-Pugh assessment and hepatobiliary-specific magnetic resonance imaging (MRI) did not reveal any abnormal findings. Therefore, we diagnosed the patient with constitutional ICG excretory defect and performed partial hepatectomy. For patients requiring hepatectomy, the indications and procedure for surgery should be considered. These should be based on liver function tests such as gadolinium ethoxybenzyl diethylenetriamine pentaacetic acid-enhanced MRI.


Assuntos
Carcinoma Hepatocelular , Neoplasias Hepáticas , Idoso , Carcinoma Hepatocelular/diagnóstico por imagem , Carcinoma Hepatocelular/cirurgia , Meios de Contraste , Gadolínio DTPA , Hepatectomia , Humanos , Verde de Indocianina , Neoplasias Hepáticas/diagnóstico por imagem , Neoplasias Hepáticas/cirurgia , Imageamento por Ressonância Magnética , Masculino
14.
Nat Commun ; 12(1): 2390, 2021 04 22.
Artigo em Inglês | MEDLINE | ID: mdl-33888699

RESUMO

The mitochondrion is an important sub-cellular organelle responsible for the cellular energetic source and processes. Owing to its unique sensitivity to heat and reactive oxygen species, the mitochondrion is an appropriate target for photothermal and photodynamic treatment for cancer. However, targeted delivery of therapeutics to mitochondria remains a great challenge due to their location in the sub-cellular compartment and complexity of the intracellular environment. Herein, we report a class of the mitochondrion-targeted liposomal delivery platform consisting of a guanidinium-based dendritic peptide moiety mimicking mitochondrion protein transmembrane signaling to exert mitochondrion-targeted delivery with pH sensitive and charge-reversible functions to enhance tumor accumulation and cell penetration. Compared to the current triphenylphosphonium (TPP)-based mitochondrion targeting system, this dendritic lipopeptide (DLP) liposomal delivery platform exhibits about 3.7-fold higher mitochondrion-targeted delivery efficacy. Complete tumor eradication is demonstrated in mice bearing 4T1 mammary tumors after combined photothermal and photodynamic therapies delivered by the reported DLP platform.


Assuntos
Sistemas de Liberação de Medicamentos/métodos , Lipopeptídeos/química , Neoplasias Mamárias Experimentais/tratamento farmacológico , Mitocôndrias/metabolismo , Fármacos Fotossensibilizantes/administração & dosagem , Amidoidrolases , Animais , Linhagem Celular Tumoral/transplante , Feminino , Guanidina/química , Humanos , Concentração de Íons de Hidrogênio , Verde de Indocianina/administração & dosagem , Verde de Indocianina/farmacocinética , Lipossomos , Neoplasias Mamárias Experimentais/patologia , Camundongos , Membranas Mitocondriais/efeitos dos fármacos , Membranas Mitocondriais/metabolismo , Compostos Organofosforados/química , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacocinética , Distribuição Tecidual
15.
Zhonghua Wai Ke Za Zhi ; 59(5): 338-342, 2021 May 01.
Artigo em Chinês | MEDLINE | ID: mdl-33915622

RESUMO

Objective: To examine the safety and feasibility of using fusion indocyanine green fluorescence imaging (FIGFI) technique for intraoperative evaluation of colorectal perfusion in the totally laparoscopic left colectomy. Methods: A retrospective cohort study was conducted to collect the clinical data of 58 patients with left colon cancer who underwent totally laparoscopic surgery at the Colorectal Surgery Department, Cancer Hospital, Chinese Academy of Medical Sciences from October 2016 to December 2019. There were 39 males and 19 females, aging (57.0±10.1)years(range:28 to 75 years). According to whether the FIGFI was used during the operation, they were divided into 36 cases in the study group and 22 cases in the control group. The clinical pathological characteristics, operative and postoperative recovery of the two groups were compared by t test, χ2 test, and Fisher exact test. Results: All the 58 patients underwent R0 resection with totally laparoscopic surgery. In the study group, due to poor bowel blood flow after cutting the mesentery (Sherwinter score = 1), 1 patient had to be expanded the resection range until the blood flow was rich(Sherwinter score≥3), and 1 patient in the control group had the complication of postoperative anastomotic leakage of grade A. Compared with the control group, the operation time in the study group was shorter ((156.3±43.5) minutes vs. (180.4±41.3) minutes, t=-2.083, P=0.042). However, there were no significant differences in the amount of blood loss, postoperative hospital stay, postoperative time of anal exhaust, length of bowel resection, number of lymph nodes dissected, and in the incidence of postoperative complications between the two groups. Median follow-up period was 23 months (range: 18 to 37 months). There were no long-term postoperative complications such as ischemic enteritis and anastomotic stenosis in both groups. Conclusions: The FIGFI is safe and feasible to assess the blood supply of intestinal segment and anastomosis during totally laparoscopic left hemicolectomy, and is easy to operate. It is expected to reduce the incidence of anastomotic leakage.


Assuntos
Verde de Indocianina , Laparoscopia , Anastomose Cirúrgica , Colectomia , Feminino , Humanos , Masculino , Imagem Óptica , Perfusão , Estudos Retrospectivos , Resultado do Tratamento
16.
Am J Case Rep ; 22: e929549, 2021 Apr 30.
Artigo em Inglês | MEDLINE | ID: mdl-33927177

RESUMO

BACKGROUND Superior mesenteric vein thrombosis (SMVT) is a relatively rare form of acute abdominal disease; less than 0.1% of laparotomy surgeries are performed for SMVT. In the presence of severe intestinal ischemia or necrosis caused by SMVT, immediate surgical intervention is required. Macroscopic diagnosis of intestinal viability is sometimes difficult; its over-resection may carry the risk of short bowel syndrome. A near-infrared fluorescence imaging system with indocyanine green (ICG) has recently been developed for intraoperative, real-time evaluation of intestinal perfusion. This is the first report on the use of ICG fluorescence imaging during surgery for intestinal ischemia caused by venous thrombosis. CASE REPORT A 70-year-old man presented with a general feeling of weariness. On examination, he was diagnosed with intravascular large B cell lymphoma. R-CHOP therapy was initiated. On day 3 of initial R-CHOP therapy, the patient experienced sudden severe abdominal pain while in the hospital. Contrast-enhanced computed tomography revealed SMVT and loss of contrast effect in the small intestine. We diagnosed small bowel necrosis caused by SMVT, and exploratory laparotomy was performed, which revealed a continuous ischemia of 150 cm. Intraoperative ICG fluorescence imaging was utilized, and the color boundary was consistent with the ischemic area detected by visualization. The necrotic small intestine was excised and anastomosed. The patient was transferred to the hematology department on postoperative day 10 with no severe complications such as anastomotic leakage or re-thrombosis, and re-embolization was not observed 6 months later. CONCLUSIONS Venous thrombosis should be listed as a differential diagnosis when acute abdominal disease presents during chemotherapy for malignant lymphoma. ICG fluorescence imaging may be useful in the evaluation of intestinal blood flow for venous thrombosis.


Assuntos
Linfoma , Trombose , Idoso , Fluorescência , Humanos , Verde de Indocianina , Masculino , Veias Mesentéricas/diagnóstico por imagem , Veias Mesentéricas/cirurgia
18.
Eur J Obstet Gynecol Reprod Biol ; 261: 59-64, 2021 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-33892210

RESUMO

OBJECTIVE: The aim of this study was to describe our latest results using dual cervical and fundal indocyanine green injection for detection of sentinel lymph node (SLN) in endometrial cancer. METHODS: A prospective observational study was conducted between 26 June 2014 and 31 December 2019 with 278 patients that underwent laparoscopic surgery for endometrial cancer at our institution. In all cases, we performed SLN biopsy with dual cervical and fundal indocyanine green injection. All SLNs were processed with an ultrastaging technique. A total of 128 patients also underwent total pelvic and paraaortic lymphadenectomy. RESULTS: The detection rates were as follows: 93.5 % (260/278) overall for SLNs; 90.7 % (252/278) overall for pelvic SLNs; 68.0 % (189/278) for bilateral SLNs; 66.9 % (186/278) for paraaortic SLNs, and 2.9 % (8/278) for isolated paraaortic SLNs. We found macroscopic lymph node metastasis in 26 patients (10.0 %) and microdisease in lymph nodes in another 48 patients, raising the overall rate of lymph node involvement to 16.2 %. There was one false negative (negative SLN biopsy but positive lymphadenectomy). Applying the SLN algorithm, the sensitivity of detection was 97.9 % (95 % CI 89.1-99.6), specificity 100 % (95 % CI 98.2-100), negative predictive value 99.5 % (95 % CI 97.4-99.9), and positive predictive value 100 % (95 % CI 92.4-100). CONCLUSIONS: Dual sentinel node injection is a feasible technique that achieves adequate detection rates. Additionally, this technique allows a high rate of aortic detection, identifying a non-negligible percentage of isolated aortic metastases. Aortic metastases in endometrial cancer are possible and we should not give up actively looking for them.


Assuntos
Neoplasias do Endométrio , Linfonodo Sentinela , Neoplasias do Endométrio/patologia , Feminino , Humanos , Verde de Indocianina , Excisão de Linfonodo , Linfonodos/diagnóstico por imagem , Linfonodos/patologia , Estadiamento de Neoplasias , Estudos Prospectivos , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/patologia , Biópsia de Linfonodo Sentinela
20.
BMC Surg ; 21(1): 190, 2021 Apr 10.
Artigo em Inglês | MEDLINE | ID: mdl-33838677

RESUMO

BACKGROUND: Fluorescence-guided visualization is a recently proposed technology in colorectal surgery. Possible uses include evaluating perfusion, navigating lymph nodes and searching for hepatic metastases and peritoneal spread. Despite the absence of high-level evidence, this technique has gained considerable popularity among colorectal surgeons due to its significant reliability, safety, ease of use and relatively low cost. However, the actual use of this technique in daily clinical practice has not been reported to date. METHODS: This survey was conducted on April 2020 among 44 centers dealing with colorectal diseases and participating in the Italian ColoRectal Anastomotic Leakage (iCral) study group. Surgeons were approximately equally divided based on geographical criteria from multiple Italian regions, with a large proportion based in public (89.1%) and nonacademic (75.7%) centers. They were invited to answer an online survey to snapshot their current behaviors regarding the use of fluorescence-guided visualization in colorectal surgery. Questions regarding technological availability, indications and techniques, personal approaches and feelings were collected in a 23-item questionnaire. RESULTS: Questionnaire replies were received from 37 institutions and partially answered by 8, as this latter group of centers do not implement fluorescence technology (21.6%). Out of the remaining 29 centers (78,4%), fluorescence is utilized in all laparoscopic colorectal resections by 72.4% of surgeons and only for selected cases by the remaining 27.6%, while 62.1% of respondents do not use fluorescence in open surgery (unless the perfusion is macroscopically uncertain with the naked eye, in which case 41.4% of them do). The survey also suggests that there is no agreement on dilution, dosing and timing, as many different practices are adopted based on personal judgment. Only approximately half of the surgeons reported a reduced leak rate with fluorescence perfusion assessment, but 65.5% of them strongly believe that this technique will become a minimum requirement for colorectal surgery in the future. CONCLUSION: The survey confirms that fluorescence is becoming a widely used technique in colorectal surgery. However, both the indications and methods still vary considerably; furthermore, the surgeons' perceptions of the results are insufficient to consider this technology essential. This survey emphasizes the need for further research to reach recommendations based on solid scientific evidence.


Assuntos
Neoplasias Colorretais , Cirurgia Colorretal , Neoplasias Colorretais/diagnóstico por imagem , Neoplasias Colorretais/cirurgia , Cirurgia Colorretal/métodos , Humanos , Verde de Indocianina , Itália , Imagem Óptica
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