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1.
BMJ Open ; 12(8): e063081, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35914905

RESUMO

INTRODUCTION: Viability assessment of the graft is essential to lower the risk of liver transplantation (LT) failure and need for emergency retransplantation, however, this still relies mainly on surgeon's experience. Post-LT graft function recovery assessment is also essential to aid physicians in the management of LT recipients and guide them through challenging decision making.This study aims to trial the use of indocyanine green clearance test (IGT) in the donor as an objective tool to assess graft viability and in the recipient to assess graft function recovery after LT. METHODS AND ANALYSIS: This is an observational prospective single-centre study on consecutive liver transplant donors and recipients. PRIMARY OBJECTIVE: To determine the capability of IGT of predicting graft viability at the time of organ retrieval. Indocyanine green will be administered to the donor and the plasma disappearance rate (PDR) measured using the pulsidensitometric method. Some 162 IGT donor procedures will be required (α, 5%; ß, 20%) using an IGT-PDR cut-off value of 13% to achieve a significant discrimination between viable and non-viable grafts. SECONDARY OBJECTIVE: IGT-PDR will be measured at different time-points in the LT recipient: during the anhepatic phase, after graft reperfusion, at 24 hours, on day 3 and day 7 after LT. The slope of IGT values from the donor to the recipient will be evaluated for correlation with the development of early allograft dysfunction. ETHICS AND DISSEMINATION: This research protocol was approved by Fondazione Policlinico Universitario Agostino Gemelli IRCCS Ethics Committee (reference number: 0048466/20, study ID: 3656) and by the Italian National Transplant Center (CNT) (reference number: Prot.11/CNT2021). Liver recipients will be required to provide written informed consent. Results will be published in international peer-reviewed scientific journals and presented in congresses. TRIAL REGISTRATION NUMBER: NCT05228587.


Assuntos
Transplante de Fígado , Sobrevivência de Enxerto , Humanos , Verde de Indocianina , Fígado/cirurgia , Transplante de Fígado/métodos , Estudos Observacionais como Assunto , Estudos Prospectivos , Recuperação de Função Fisiológica , Coleta de Tecidos e Órgãos
2.
BMC Gastroenterol ; 22(1): 373, 2022 Aug 05.
Artigo em Inglês | MEDLINE | ID: mdl-35931985

RESUMO

Revision surgery for the complications after repair of esophageal atresia is often complex because of previous surgeries and chest infections and thus requires surgical expertise. This study describes surgical experiences with the use of indocyanine green (ICG) fluorescence imaging localization-assisted thoracoscopy during revision surgery, including recurrent tracheoesophageal fistula (rTEF) (8 cases, one of which was esophageal-pulmonary fistula) and delayed esophageal closure (1 case). We performed fistula repair and esophageal reconstruction according to the indications of ICG. The application of this method avoids the excessive trauma caused by freeing the trachea and esophagus. Contrast imaging taken one week and one month after surgery indicated no spillover of the contrast agent from the esophagus, except in 1 case. Indocyanine green fluorescence imaging localization-assisted thoracoscopy is worth promoting for revision surgery after esophageal atresia repair.


Assuntos
Atresia Esofágica , Fístula Traqueoesofágica , Atresia Esofágica/complicações , Atresia Esofágica/diagnóstico por imagem , Atresia Esofágica/cirurgia , Humanos , Verde de Indocianina , Imagem Óptica/efeitos adversos , Reoperação/efeitos adversos , Estudos Retrospectivos , Toracoscopia/efeitos adversos , Toracoscopia/métodos , Fístula Traqueoesofágica/diagnóstico por imagem , Fístula Traqueoesofágica/etiologia , Fístula Traqueoesofágica/cirurgia
3.
Biomater Adv ; 137: 212811, 2022 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-35929250

RESUMO

As the most prevalent malignant tumor of the oral and maxillofacial regions, squamous cell carcinoma (SCC) has relatively high recurrence and low survival rates. Currently, the most common treatment strategies are surgery and chemoradiotherapy. However, incomplete removal of the tumor can allow residual tumor cells to regrow and metastasis, resulting in treatment failure. Although postoperative adjuvant radiotherapy or chemotherapy can reduce recurrence, serious adverse reactions significantly compromise patients' quality of life. Large soft tissue defects after surgery are also difficult to heal. Therefore, therapies that eliminate residual tumor cells and promote tissue regeneration post-surgery are urgently needed. Indocyanine green (ICG) can convert absorbed light into heat to ablate tumor cells. Three-dimensional (3D) scaffolds are efficient drug carriers and support cell migration and proliferation. Here, we fabricated collagen/silk fibroin encapsulated ICG (I-CS) scaffolds by combining 3D printing with freeze-drying methods. The I-CS scaffolds delayed ICG decomposition and clearance, allowing the scaffolds to be used repeatedly for photothermal therapy (PTT). With the laser positioned at 4 cm from the 1.0 I-CS scaffold and irradiation for 10 min (1.0 W/cm2), temperatures above 50 °C were achieved, which effectively killed SCC-25 cells in vitro and suppressed tumor growth in vivo. Moreover, the I-CS scaffolds supported attachment and proliferation of rat buccal mucosa fibroblasts (RBMFs) and promoted the repair of buccal mucosal wounds in rats. These results suggested that I-CS scaffolds may be useful in preventing local recurrence and support regeneration of large soft tissue defects after oral SCC surgery.


Assuntos
Carcinoma de Células Escamosas , Neoplasias de Cabeça e Pescoço , Neoplasias Bucais , Animais , Carcinoma de Células Escamosas/tratamento farmacológico , Verde de Indocianina/farmacologia , Neoplasias Bucais/tratamento farmacológico , Neoplasia Residual , Qualidade de Vida , Ratos , Carcinoma de Células Escamosas de Cabeça e Pescoço , Tecidos Suporte , Cicatrização
4.
Int J Nanomedicine ; 17: 3217-3237, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35924259

RESUMO

Background: With high malignancy, retinoblastoma (RB) commonly occurs in infants and has incredible difficulty with the early diagnosis. In recent years, the integrated theranostics of multimodal imaging-guided therapy has shown promising potential for oncotherapy. Purpose: To prepare folate/magnetic dual-target theranostic nanoparticles integrating with US/PA/MR imaging and the synergistic photothermal treatment (PTT)/photodynamic treatment (PDT) for the early diagnosis and timely intervention of RB cancer. Methods: Folate/magnetic dual-target cationic nanoliposomes (CN) encapsulating indocyanine green (ICG) and perfluorohexane(PFH)(FA-CN-PFH-ICG-Fe3O4, FCNPIFE) were synthesized and characterized. Then we evaluated their targeting ability, US/PA/MR imaging effects, and the efficacy of synergistic PTT/PDT in vitro and in vivo. Finally, we explored the mechanism of synergistic PTT/PDT in Y79 tumor-bearing mice. Results: FCNPIFEs were stable and uniform in 7 days. They showed excellent in vitro targeting ability with a 95.29% cell uptake rate. The in vitro US/PA/MRI imaging results of FCNPIFEs showed a concentration-dependent manner, and in vitro therapy FCNPIFEs exhibited an enhanced anticancer efficacy against Y79 cells. In vivo analysis confirmed that FCNPIFEs enabled a targeted synergistic PTT/PDT under US/PA/MR imaging guidance in Y79 tumor-bearing mice, achieving almost complete tumor regression. Immunofluorescence results displayed weaker fluorescence intensity compared with other single treatment groups, confirming that PTT/PDT synergistic therapy effect was achieved by down-regulating the expression of HIF-1α and HSP70. Conclusion: FCNPIFEs were verified as promising theranostic nanoliposomes for RB oncotherapy and showed great potential in clinical application.


Assuntos
Nanopartículas , Fotoquimioterapia , Neoplasias da Retina , Retinoblastoma , Animais , Linhagem Celular Tumoral , Ácido Fólico , Humanos , Verde de Indocianina/farmacologia , Nanopartículas Magnéticas de Óxido de Ferro , Camundongos , Imagem Multimodal , Fotoquimioterapia/métodos , Fototerapia/métodos , Retinoblastoma/diagnóstico por imagem , Retinoblastoma/tratamento farmacológico , Nanomedicina Teranóstica/métodos
5.
Indian J Ophthalmol ; 70(8): 3102-3111, 2022 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-35918981

RESUMO

In Asians, polypoidal choroidal vasculopathy (PCV) is becoming more widely recognized as a significant cause of exudative maculopathy. The previous set of Indian guidelines on the management of PCV were published in 2018, with a literature search updated up to November 2015. As the treatment of PCV evolves, retinal physicians must constantly modify their current practice. The current guidelines are based on the most up-to-date information on PCV and are an update to the previous set of guidelines. These guidelines were developed by a panel of Indian retinal experts under the aegis of the Vitreoretinal Society of India (VRSI), based on a comprehensive search and assessment of literature up to September 2021. The final guidelines i) provide the updated nomenclature in PCV; ii) discusses the newer diagnostic imaging features of PCV, especially in the absence of indocyanine green angiography (ICGA); and iii) recommends the best possible therapeutic approach in the management of PCV, including the choice of anti-vascular endothelial growth factor (anti-VEGF) agents, treatment regimen, and the role of switching between the anti-VEGF agents. In the face of non-availability of photodynamic therapy (PDT) in India, we constructed practical recommendations on anti-VEGF monotherapy in PCV. The current updated recommendations would provide a broader framework to the treating retinal physician for the diagnosis and management of PCV for optimal therapeutic outcomes.


Assuntos
Doenças da Coroide , Neovascularização de Coroide , Oftalmopatias , Pólipos , Inibidores da Angiogênese/uso terapêutico , Corioide/irrigação sanguínea , Doenças da Coroide/diagnóstico , Neovascularização de Coroide/diagnóstico , Neovascularização de Coroide/tratamento farmacológico , Oftalmopatias/tratamento farmacológico , Angiofluoresceinografia/métodos , Humanos , Verde de Indocianina , Pólipos/diagnóstico , Estudos Retrospectivos , Tomografia de Coerência Óptica/métodos
6.
Sensors (Basel) ; 22(15)2022 Jul 26.
Artigo em Inglês | MEDLINE | ID: mdl-35898101

RESUMO

We developed a single-camera-based near-infrared (NIR) fluorescence imaging device using indocyanine green (ICG) NIR fluorescence contrast agents for image-induced surgery. In general, a fluorescent imaging system that simultaneously provides color and NIR images uses two cameras, which is disadvantageous because it increases the imaging head of the system. Recently, a single-camera-based NIR optical imaging device with quantum efficiency partially extended to the NIR region was developed to overcome this drawback. The system used RGB_NIR filters for camera sensors to provide color and NIR images simultaneously; however, the sensitivity and resolution of the infrared images are reduced by 1/4, and the exposure time and gain cannot be set individually when acquiring color and NIR images. Thus, to overcome these shortcomings, this study developed a compact fluorescent imaging system that uses a single camera with two complementary metal-oxide semiconductor (CMOS) image sensors. Sensitivity and signal-to-background ratio were measured according to the concentrations of ICG solution, exposure time, and camera gain to evaluate the performance of the imaging system. Consequently, the clinical applicability of the system was confirmed through the toxicity analysis of the light source and in vivo testing.


Assuntos
Verde de Indocianina , Imagem Óptica , Fluorescência , Corantes Fluorescentes , Imagem Óptica/métodos , Óxidos , Semicondutores
7.
Sci Rep ; 12(1): 13120, 2022 Jul 30.
Artigo em Inglês | MEDLINE | ID: mdl-35908045

RESUMO

Tissue ischemia is a key risk factor in anastomotic leak (AL). Indocyanine green (ICG) is widely used in colorectal surgery to define the segments with the best vascularization. In an experimental model, we present a new system for quantifying ICG fluorescence intensity, the SERGREEN software. Controlled experimental study with eight pigs. In the initial control stage, ICG fluorescence intensity was analyzed at the level of two anastomoses, in the right and in the left colon. Control images of the two segments were taken after ICG administration. The images were processed with the SERGREEN program. Then, in the experimental ischemia stage, the inferior mesenteric artery was sectioned at the level of the anastomosis of the left colon. Fifteen minutes after the section, sequential images of the two anastomoses were taken every 30 min for the following 2 h. At the control stage, the mean scores were 134.2 (95% CI 116.3-152.2) for the right colon and 147 (95% CI 134.7-159.3) for the left colon (p = 0.174) (Scale RGB-Red, Green, Blue). The right colon remained stable throughout the experiment. In the left colon, intensity fell by 47.9 points with respect to the pre-ischemia value (p < 0.01). After the first post-ischemia determination, the values of the ischemic left colon remained stable throughout the experiment. The relative decrease in ICG fluorescence intensity of the ischemic left colon was 32.6%. The SERGREEN program quantifies ICG fluorescence intensity in normal and ischemic situations and detects differences between them. A reduction in ICG fluorescence intensity of 32.6% or more was correlated with complete tissue ischemia.


Assuntos
Fístula Anastomótica , Verde de Indocianina , Anastomose Cirúrgica/métodos , Fístula Anastomótica/etiologia , Animais , Fluorescência , Isquemia/complicações , Software , Suínos
8.
Front Endocrinol (Lausanne) ; 13: 897797, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35784544

RESUMO

Background and objectives: Accurate identification and evaluation of the parathyroid glands (PGs) intraoperatively is critical to reduce the incidence of postoperative hypoparathyroidism after total thyroidectomy. Near-infrared fluorescence imaging (NIFI), including the autofluorescence (AF) and indocyanine green fluorescence (ICGF) imaging, is a promising technique to protect PGs. This study aimed to assess whether the combined use of AF and ICGF could reduce the incidence of postoperative hypoparathyroidism and improve the identification and evaluation of PGs during total thyroidectomy. Methods: This randomized controlled trial enrolled 180 patients who were randomized into two groups and underwent total thyroidectomy with unilateral or bilateral central lymph node dissection. In the control group, the PGs were identified and evaluated by the naked eye. In the NIFI group, AF was used to identify the PGs and ICGF was applied to assess the blood perfusion of the PGs in situ. The primary outcome was the incidence of postoperative hypoparathyroidism. The secondary outcomes included the number of identified PGs, autotransplanted PGs, and known preserved PGs in situ. Results: The incidence of postoperative transient hypoparathyroidism was significantly lower in the NIFI group than in the control group (27.8% vs. 43.3%, P = 0.029). More PGs were identified in the NIFI group than in the control group (3.6 ± 0.5 vs. 3.2 ± 0.4, P < 0.001). No significant difference was observed in the number of autotransplanted PGs between the two groups (P = 0.134). Compared with the control group, a greater number of known PGs were preserved in situ in the NIFI group (1.3 ± 0.6 vs. 1.0 ± 0.5, P < 0.001). In the NIFI group, only 4.5% of the patients with at least one well-perfused PG (ICG score of 2) developed postoperative hypoparathyroidism, which was significantly lower than that of the control group (34.6%, P < 0.001). Conclusion: Combined use of AF and ICGF during total thyroidectomy reduces the risk of transient postoperative hypoparathyroidism, enhances the ability to identify and preserve PGs, and improves the accuracy of evaluating the perfusion of PGs during surgery. Clinical Trial Registration: Chinese Clinical Trial Register (www.chictr.org.cn), identifier ChiCTR2100045320. Registered on April 12, 2021.


Assuntos
Hipoparatireoidismo , Glândulas Paratireoides , Humanos , Hipoparatireoidismo/diagnóstico , Hipoparatireoidismo/epidemiologia , Hipoparatireoidismo/etiologia , Verde de Indocianina , Imagem Óptica/efeitos adversos , Imagem Óptica/métodos , Glândulas Paratireoides/diagnóstico por imagem , Tireoidectomia/efeitos adversos , Tireoidectomia/métodos
9.
J Biomed Opt ; 27(7)2022 07.
Artigo em Inglês | MEDLINE | ID: mdl-35810324

RESUMO

SIGNIFICANCE: Pharmacokinetic parametric images in dynamic fluorescence molecular tomography (FMT) can describe three-dimensional (3D) physiological and pathological information inside biological tissues, potentially providing quantitative assessment tools for biological research and drug development. AIM: In vivo imaging of the liver tumor with pharmacokinetic parametric images from dynamic FMT based on the differences in metabolic properties of indocyanine green (ICG) between normal liver cells and tumor liver cells inside biological tissues. APPROACH: First, an orthotopic liver tumor mouse model was constructed. Then, with the help of the FMT/computer tomography (CT) dual-modality imaging system and the direct reconstruction algorithm, 3D imaging of liver metabolic parameters in nude mice was achieved to distinguish liver tumors from normal tissues. Finally, pharmacokinetic parametric imaging results were validated against in vitro anatomical results. RESULTS: This letter demonstrates the ability of dynamic FMT to monitor the pharmacokinetic delivery of the fluorescent dye ICG in vivo, thus, enabling the distinction between normal and tumor tissues based on the pharmacokinetic parametric images derived from dynamic FMT. CONCLUSIONS: Compared with CT structural imaging technology, dynamic FMT combined with compartmental modeling as an analytical method can obtain quantitative images of pharmacokinetic parameters, thus providing a more powerful research tool for organ function assessment, disease diagnosis and new drug development.


Assuntos
Neoplasias Hepáticas , Tomografia , Animais , Fluorescência , Verde de Indocianina/farmacocinética , Neoplasias Hepáticas/diagnóstico por imagem , Camundongos , Camundongos Nus , Imagem Óptica/métodos , Tomografia/métodos , Tomografia Computadorizada por Raios X
11.
J Vis Exp ; (184)2022 06 24.
Artigo em Inglês | MEDLINE | ID: mdl-35815955

RESUMO

Biliary cysts (BC) are rare congenital dilatations of intra- and extrahepatic parts of the biliary tract and bear a significant risk of carcinogenesis. Surgery is the cornerstone treatment for patients with BC. While total BC excision and Roux-Y hepaticojejunostomy is the treatment method of the choice in patients with extrahepatic BC (i.e., Todani I-IV), patients with intrahepatic BC (i.e., Todani V) benefit the most from a surgical liver resection. In recent years, minimally invasive liver surgery (MILS) including robotic MILS has gained more acceptance as a feasible, safe, and effective procedure for the treatment of both benign and malignant indications. Robotic major MILS is still considered technically demanding and a detailed description of the technical approach during robotic major MILS has only been limitedly discussed in the literature. The current article describes the main steps for a robotic left hepatectomy in a patient with a large BC Todani Type V. The patient is in French position with 5 trocars placed (4 robotic, 1 laparoscopic assistant). After mobilizing the left hemiliver, the left and right hepatic artery are dissected carefully followed by a cholecystectomy. Intraoperative ultrasound is performed to confirm localization and margins of the BC. The Left hepatic artery and left portal vein are isolated, clipped, and divided. Indocyanine green (ICG) fluorescence imaging is used regularly during the entire procedure to visualize and confirm biliary tract anatomy and the BC. Parenchymal transection is performed with robotic cautery hook for the superficial part and robotic cautery spatula, bipolar cautery, and vessel sealer for the deeper parenchyma. The postoperative course was uncomplicated. A robotic left hepatectomy is technically demanding, yet a feasible and safe procedure. ICG-fluorescence imaging aids in delineating the BC and bile duct anatomy. Further, comparative studies are needed to confirm clinical benefits of robotic MILS for benign and malignant indications.


Assuntos
Cistos , Laparoscopia , Procedimentos Cirúrgicos Robóticos , Ductos Biliares/cirurgia , Hepatectomia/métodos , Humanos , Verde de Indocianina , Laparoscopia/métodos , Imagem Óptica/métodos , Procedimentos Cirúrgicos Robóticos/métodos
12.
ACS Appl Mater Interfaces ; 14(27): 30523-30532, 2022 Jul 13.
Artigo em Inglês | MEDLINE | ID: mdl-35775188

RESUMO

Accurate diagnosis and highly effective treatment of glioblastoma are still challenges in clinic. Near-infrared (NIR) light triggered fluorescence imaging and photodynamic therapy (PDT) showed the potential for theranostics of glioblastoma, but the presence of blood-brain barrier (BBB) and hypoxia limited treatment effect. Herein, the novel theranostic nanoagents with YOF:Nd3+ as core, MnO2 as shell, and further loading photosensitizer (indocyanine green, ICG) and glucose oxidase (GOx) were successfully constructed, and further modified with lactoferrin to endow them with BBB penetration and target abilities (YOF:Nd3+@MnO2-ICG-GOx-LF, YMIGL). The YOF:Nd3+ core with good fluorescence performances makes YMIGL act as promising probes for fluorescence imaging in the second biowindow (NIR-II FL). The combination of GOx and MnO2 shell significantly increased the O2 generation from the cascade reactions and consumed glucose, improving the treatment effect of PDT and achieving starvation treatment (ST). These theranostic nanoagents exhibit a highly efficient inhibition effect on orthotopic gliomas by cascade reactions, which improved PDT and ST.


Assuntos
Glioblastoma , Nanopartículas , Fotoquimioterapia , Linhagem Celular Tumoral , Glioblastoma/diagnóstico por imagem , Glioblastoma/tratamento farmacológico , Humanos , Verde de Indocianina , Compostos de Manganês/farmacologia , Imagem Óptica , Óxidos/farmacologia , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , Fármacos Fotossensibilizantes/uso terapêutico , Medicina de Precisão , Nanomedicina Teranóstica/métodos
13.
Comput Math Methods Med ; 2022: 2182931, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35860187

RESUMO

This research was to investigate the value of indocyanine green angiography (ICGA) based on maximum interclass variance (Otsu) method in the nursing plan of intracranial aneurysm clipping (ICAC) for intracranial aneurysm patients. An Otsu algorithm was selected to optimize the original images with the optimal threshold. In addition, the algorithm was applied to ICGA images of 86 patients with intracranial aneurysms, who were randomly divided into an experimental group (using ICGA + ICAC+ perioperative nursing) and a control group (ICAC + conventional nursing), to observe the clinical indicators, treatment, complications, nursing satisfaction, and quality of life of patients in two groups. The results showed that the mean square error (MSE), structural similarity (SSIM), and shape error (SE) were 3.71, 0.84, and 0.47, respectively. The length of hospital stay in the experimental group (19.9 ± 3.5 days) was significantly shorter than that in the control group (23.2 ± 3.0 days), the rate of excellent treatment was significantly higher than that in the control group, and the incidence of complications was lower. WHOQOL-BREF scores of the two groups after nursing intervention were higher than before, and the score in the experimental group was higher than the control group. In addition, the nursing satisfaction was also significantly higher in the experimental group, and the difference was statistically significant (P < 0.05). In conclusion, ICGA based on the Otsu method could effectively evaluate the cerebrovascular morphology during craniotomy and ICAP and improve the surgical efficacy. Combined with perioperative nursing intervention, it could greatly reduce the incidence of postoperative complications, improve the treatment effect and quality of life, and enhance the long-term prognosis.


Assuntos
Aneurisma Intracraniano , Algoritmos , Inteligência Artificial , Angiografia Cerebral/métodos , Craniotomia , Humanos , Verde de Indocianina , Aneurisma Intracraniano/diagnóstico por imagem , Aneurisma Intracraniano/cirurgia , Qualidade de Vida , Resultado do Tratamento
14.
Drug Deliv ; 29(1): 2177-2189, 2022 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-35815688

RESUMO

We fabricated an ultrasound activated 'nanobomb' as a noninvasive and targeted physical therapeutic strategy for sonodynamic therapy and priming cancer immunotherapy. This 'nanobomb' was rationally designed via the encapsulation of indocyanine green (ICG) and perfluoropentane (PFP) into cRGD peptide-functionalized nano-liposome. The resulting Lip-ICG-PFP-cRGD nanoparticle linked with cRGD peptide could actively targeted ID8 and TC-1 cells and elicits ROS-mediated apoptosis after triggered by low-intensity focused ultrasound (LIFU). Moreover, the phase change of PFP (from droplets to microbubbles) under LIFU irradiation can produce a large number of microbubbles, which act as intra-tumoral bomber and can detonate explode tumor cells by acoustic cavitation effect. Instant necrosis of tumor cells further induces the release of biologically active damage-associated molecular patterns (DAMPs) to facilitate antitumor immunity. More important, the 'nanobomb' in combination with anti-PD-1checkpoint blockade therapy can significantly improve the antitumor efficacy in a subcutaneous model. In addition, the liposomes may also be used as an imaging probe for ultrasound (US) imaging after being irradiated with LIFU. In summary, the US imaging-guided, LIFU activated ROS production and explosion 'nanobomb' might significantly improve the antitumor efficacy and overcome drug resistance through combination of SDT and immunotherapy, we believe that this is a promising approach for targeted therapy of solid tumor including ovarian cancer.


Assuntos
Nanopartículas , Neoplasias Ovarianas , Acústica , Linhagem Celular Tumoral , Feminino , Humanos , Verde de Indocianina/química , Lipossomos/química , Microbolhas , Nanopartículas/química , Neoplasias Ovarianas/tratamento farmacológico , Espécies Reativas de Oxigênio , Ultrassonografia
15.
Front Endocrinol (Lausanne) ; 13: 916557, 2022.
Artigo em Inglês | MEDLINE | ID: mdl-35813620

RESUMO

Background: Indocyanine green angiography (ICGA) has been used to identify and preserve the parathyroid glands (PGs), and to evaluate PGs viability and function during thyroid surgery. However, evidence on the utilization of IGCA in thyroid cancer and robotic surgery is lacking. The efficacy of IGCA remains to be evaluated in PTC patients undergoing bilateral axillo-breast approach robotic thyroidectomy (BABA RT) and central neck dissection (CND). Methods: From March 2020 to August 2021, 81 papillary thyroid cancer (PTC) patients receiving total thyroidectomy and CND were enrolled in this retrospective analysis. An intravenous bolus of 7.5 mg ICG was administrated three times in the ICGA group (n=34). Medical records were reviewed and analyzed, including the baseline characteristics, surgical parameters, PGs-related parameters, and perioperative PTH and calcium levels. Results: The mean number of total identified PGs and preserved PGs were significantly more in the ICG group than in the control group (3.74 ± 0.45 vs. 3.15 ± 0.55, P<0.001; 3.12 ± 0.64 vs. 2.74 ± 0.57, P=0.007, respectively), as were PTH and calcium levels on POD 1 (23.16 ± 18.32 vs. 6.06 ± 7.74, P=0.039; 2.13 ± 0.11 vs. 2.08 ± 0.08, P=0.024, respectively). While there were no differences in PTH levels on POD 30. Additionally, patients with at least one well vascularized PG had higher ioPTH 3 and PTH on POD 1, which significantly suggested the absence of postoperative hypocalcemia. Although not statistically significant, ICGA seemed superior to relative ioPTH decline and ioPTH 3 in predicting postoperative hypocalcemia. Conclusion: In PTC patients undergoing BABA RT and CND, ICGA is a simple, safe, effective, and cost-effective tool in better identification and preservation of PGs as well as evaluation of PGs viability and function, with the potential to preserve more PGs, guide more appropriate autotransplantation, and accurately predict postoperative hypocalcemia.


Assuntos
Hipocalcemia , Procedimentos Cirúrgicos Robóticos , Neoplasias da Glândula Tireoide , Angiografia , Cálcio , Humanos , Hipocalcemia/cirurgia , Verde de Indocianina , Estudos Retrospectivos , Câncer Papilífero da Tireoide/cirurgia , Neoplasias da Glândula Tireoide/diagnóstico por imagem , Neoplasias da Glândula Tireoide/cirurgia , Tireoidectomia
16.
Retina ; 42(8): 1520-1528, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35877973

RESUMO

PURPOSE: Age-related scattered hypofluorescent spots on late-phase indocyanine green angiography (ASHS-LIA) might represent hydrophobic neutral lipid deposits in the Bruch membrane. This study aimed to report retentional avascular pigment epithelial detachment (PED) associated with ASHS-LIA. METHODS: Patients aged ≥50 years who presented a single avascular serous PED without soft drusen or any other retinal or choroidal diseases were retrospectively included. Pigment epithelial detachment was classified as retentional, effusional, or mixed PED based on indocyanine green angiography. Multimodal images were qualitatively and quantitatively evaluated. RESULTS: This study included 74 eyes of 57 patients. Retentional PED, effusional PED, and mixed PED accounted for 91.9%, 4.1%, and 4.1%, respectively. All PEDs were located in the macular region. Seventeen (29.8%) included patients had bilateral PEDs and all were retentional PEDs with a high level of bilateral consistency in the characteristics of PED and ASHS-LIA. All retentional PEDs were within the bounds of ASHS-LIA. The area of retentional PED increased with the ASHS-LIA grade ( P = 0.030). CONCLUSION: Most age-related avascular serous PEDs are retentional PEDs. The location and area of retentional PEDs are consistent with the distribution of ASHS-LIA. These findings suggest that the hydrophobic neutral lipid deposits in the Bruch membrane might be involved in the pathogenesis and be a therapeutic target in age-related retentional avascular PED.


Assuntos
Verde de Indocianina , Descolamento Retiniano , Angiofluoresceinografia/métodos , Humanos , Lipídeos/uso terapêutico , Descolamento Retiniano/tratamento farmacológico , Epitélio Pigmentado da Retina/patologia , Estudos Retrospectivos , Tomografia de Coerência Óptica , Acuidade Visual
17.
Curr Opin Obstet Gynecol ; 34(4): 237-243, 2022 08 01.
Artigo em Inglês | MEDLINE | ID: mdl-35895966

RESUMO

PURPOSE OF REVIEW: We review the literature regarding the use of dyes and fluorescence-guided visualization techniques in gynaecological surgery. We also discuss advances in imaging that may enhance surgery by incorporating real-time visual feedback through augmented reality and preoperative planning with patient-specific, three-dimensional printed surgical fields. RECENT FINDINGS: Methylene blue is one of the most commonly used dyes, while indocyanine green is the most used agent in fluorescence-guided surgery. Augmented reality and three-dimensional printing are also being increasingly used in gynaecology. SUMMARY: Dyes and fluorescence-based surgeries are commonly utilized to improve anatomic identification, preservation of healthy tissue and excision of disease. In addition, we explore how augmented reality and three-dimensional printing are used in gynaecology.


Assuntos
Corantes , Cirurgia Assistida por Computador , Feminino , Fluorescência , Procedimentos Cirúrgicos em Ginecologia , Humanos , Imageamento Tridimensional/métodos , Verde de Indocianina , Cirurgia Assistida por Computador/métodos
18.
Zhonghua Yan Ke Za Zhi ; 58(7): 535-541, 2022 Jul 11.
Artigo em Chinês | MEDLINE | ID: mdl-35796127

RESUMO

Objective: To evaluate the perfusion features of the anterior segment in patients with different types of strabismus. Methods: A cross-sectional study. Sixteen strabismus patients (16 eyes) who received the examination of iris indocyanine green angiography (ICGA) in Tianjin Eye Hospital from November 2016 to December 2021 were enrolled and divided into two groups according to whether they had a history of extraocular muscle injury/rectus muscle surgery. All patients underwent routine ophthalmic examinations. Angiographic images were obtained by the anterior segment camera, and indicators such as arm to iris circulation time, whole iris filling time, regression onset time, and complete regression time were recorded. The independent sample t test or Mann-Whitney U test was used to compare iris perfusion aspects of the two groups, and the Pearson/Spearman correlation tests was used to analyze the correlation of arm to iris circulation time and whole iris filling time with age and course of strabismus. Results: Among the 16 patients, there were 10 males and 6 females. The mean age was (49.2±13.2) years, and the course of strabismus ranged from 2 to 31 months. There were 7 patients in the group of without extraocualr muscle injury and 9 patients in the extraocular muscle injury/surgery group. There was no significant difference in age and course of strabismus between the two groups (both P>0.05). The arm to iris circulation time [M (Q1, Q3)] of the group without extraocular muscle injury and the group with extraocular muscle injury/surgery were 18 (18, 21) and 22 (20, 24) s, respectively. The average whole iris filling time was (13.86±1.95) and (12.22±3.60) s, respectively. There was no statistical significance between the two groups (both P>0.05). Correlation analysis showed that arm to iris circulation time was not correlated with age and course of strabismus (r=-0.033, -0.079; both P>0.05). And the whole iris filling time was not correlated with age and course of disease (r=0.057, -0.119; both P>0.05). The matrix scatter plots showed that in the group of extraocular muscle injury/surgery, there were three patients who were older than the average (49.2 years) and above the median of arm to iris circulation time (20 s) (two cases with the vertical muscle involved), meanwhile, there were three patients (all with the vertical muscle involved) whose course of strabismus was longer than 6 months and above the median of arm to iris circulation time, which were more than those in the group of without extraocular muscle injury (1 case, respectively). Conclusions: ICGA in patients with strabismus show that a history of injury to the extraocular muscle or surgical treatment beyond 2 months had no effect on iris perfusion. Age and course have no correlation with iris reperfusion. The vertical muscle involvement has more effects on the blood supply to the anterior segment.


Assuntos
Verde de Indocianina , Estrabismo , Segmento Anterior do Olho , Pré-Escolar , Estudos Transversais , Feminino , Angiofluoresceinografia/métodos , Humanos , Lactente , Iris/diagnóstico por imagem , Isquemia , Masculino , Estrabismo/cirurgia
19.
Artigo em Inglês | MEDLINE | ID: mdl-35742629

RESUMO

OBJECTIVES: Sentinel lymph node biopsy is considered a crucial step in endometrial cancer staging. Cervical injection has become the most favored technique and indocyanine green has been demonstrated to be more accurate than other tracers. Different near-infrared camera systems are currently being used to detect indocyanine green in sentinel lymph nodes and have been compared in different patients. The present study aimed to determine the number and site of sentinel lymph nodes detected in the same patients with two different near-infrared technologies. METHODS: This is a prospective, single-center, observational, non-sponsored study. Patients with presumed uterine-confined endometrial cancer were prospectively enrolled. After cervical injection, two different near-infrared cameras were used to detect sentinel lymph nodes at the same time: Olympus, Tokyo, Japan-considered the standard (SNIR); and Medtronic, Minneapolis, MN, USA with VISION SENSE® which is a new laser near-infrared (LNIR) fluorescence laparoscope. The two cameras were alternatively switched on to detect sentinel lymph nodes in the same patients. RESULTS: Seventy-four consecutive patients were included in the study. Most of the patients were diagnosed with endometrioid histology (62, 83.8%), FIGO stage IA (48, 64.9%), grade 2 (43, 58.1%), and underwent surgery with laparoscopic approach (70, 94.0%). The bilateral detection rate was 56/74 (75.7%) with SNIR and 63/74 (85.1%) with LNIR (p = 0.214). The total number of sentinel lymph nodes identified in the left hemipelvis was 65 and 70 with SNIR and LNIR, respectively; while in the right hemipelvis, there were 74 and 76, respectively. The median number of sentinel lymph nodes identified with SNIR and LNIR was 2 (range, 0-4) and 2 (range, 0-4), respectively (p = 0.370). No difference in site of sentinel lymph node detection was evident between the two technologies (p = 0.994). Twelve patients (16.2%) had sentinel lymph node metastasis: in all cases metastatic sentinel lymph nodes were detected both with Olympus and LNIR. CONCLUSIONS: No difference in bilateral detection rate and number or site of sentinel lymph node detection was evident comparing two different technologies of near-infrared camera for ICG detection in endometrial cancer patients. No difference in sentinel lymph node metastases identification was detected between the two technologies.


Assuntos
Neoplasias do Endométrio , Linfonodo Sentinela , Neoplasias Uterinas , Estudos de Coortes , Corantes , Neoplasias do Endométrio/diagnóstico por imagem , Neoplasias do Endométrio/patologia , Feminino , Humanos , Verde de Indocianina , Excisão de Linfonodo , Metástase Linfática/patologia , Estadiamento de Neoplasias , Estudos Prospectivos , Linfonodo Sentinela/diagnóstico por imagem , Linfonodo Sentinela/patologia , Linfonodo Sentinela/cirurgia
20.
J Mater Chem B ; 10(27): 5154-5164, 2022 07 13.
Artigo em Inglês | MEDLINE | ID: mdl-35666635

RESUMO

Tumor-triggered targeting ammonium bicarbonate (TTABC) liposomes were proposed to improve the uptake of ammonium bicarbonate (ABC) liposomes in tumor cells and retain their long circulation in vivo in our previous study. However, it must be solved how to precisely release the loaded drugs of the TTABC liposomes into tumor cells. In addition, synergistic multimodal therapy could result in better tumor treatment outcomes than monomodal chemotherapy. In the research, we prepared indocyanine green (ICG) and doxorubicin (DOX) encapsulated TTABC liposomes (ICG&DOX@TTABC) to achieve near-infrared (NIR) light-controlled chemo/photothermal/photodynamic multimodal therapy guided by fluorescence and photothermal imaging. In vitro and vivo studies show that ICG&DOX@TTABC can specifically accumulate in tumor tissues, effectively transform NIR light into local thermo-therapy, and have excellent anti-tumor ability without obvious side effects. ICG&DOX@TTABC could be promising for fluorescence and photothermal imaging-guided chemo/photothermal/photodynamic tumor treatment.


Assuntos
Lipossomos , Neoplasias , Bicarbonatos , Terapia Combinada , Doxorrubicina , Humanos , Verde de Indocianina/farmacologia , Verde de Indocianina/uso terapêutico , Lipossomos/uso terapêutico , Neoplasias/tratamento farmacológico , Fototerapia/métodos
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