Permanent infections recognized as oncogenic factor. STD is common concomitant diseases in early precancerous genital tract lesions. Simple optical detection of early regressive pre cancer in cervix is the aim of this study. Hereditary immunosupression most likely is risk factor for cervical cancer development. Light induced fluorescence point monitoring fitted to live cervical tissue diagnostics in 42 patients. Human papilloma virus DNR in cervix tested by means of Hybrid Capture II method. Ultraviolet (337 nm) laser excited fluorescence spectra in the live cervical tissue analyzed by Principal Component (PrC) regression method and spectra decomposition method. PCr method best discriminated pathology group "CIN I and inflammation"(AUC=75%) related to fluorescence emission in short wave region. Spectra decomposition method suggested a few possible fluorophores in a long wave region. Ultraviolet (398 nm) light excitation of live cervix proved sharp selective spectra intensity enhancement in region above 600nm for High-grade cervical lesion. Conclusion: PC analysis of UV (337 nm) light excitation fluorescence spectra gives opportunity to obtain local immunity and Low-grade cervical lesion related information. Addition of shorter and longer wavelengths is promising for multi wave LIF point monitoring method progress in cervical pre-cancer diagnostics and utility for cancer prevention especially in developing countries.
The aim of this study was to assess the feasibility of autoflorescence spectroscopy in the diagnosis of cervix maturity through cervical mucus florescence and foetal lung maturity through amniotic fluid fluorescence. LED and broadband Mercury light were used to induce fluorescence in cervical mucus and amniotic fluid respectively. Mature specimens compared to immature ones showed a significant decrease in cervical mucus fluorescence values measured at 420 nm (p = 0.0004) and in measured amniotic fluid fluorescence values at 410 nm (p = 0.0686). Probability-based classification algorithm was developed to identify samples 'maturity' through analysis of the fluorescence spectra. Employing fluorescence intensity at 420 nm for cervix maturity diagnosis rendered optimal sensitivity of 92.9%, specificity of 83.3% and area under the ROC curve of 91.1%.
We have analysed an endometrial tissue fluorescence excitation spectra with a purpose to determine the characteristic wavelength of excitation for multiwavelength diagnostics of tissue. Fluorescence excitation-emission matrices from 200 to 500 nm excitation and 200 to 800 nm emission were measured as a supplementary data for previous measurements to unambiguously characterize biochemicals quantitatively in endometrial tissue.
In this study the main interest was focused on the to investigation the photodynamic efficacy of hypericin, three other photosensitizers and 5 aminolevulinic acid-induced protopofirin IX in their ability to block the growth of rather aggressive tumor - Ehrlich ascite carcinoma in mice as well as Reh cells in humans (B-leukemia). Hypericin was found to exhibit the highest phototoxicity and antitumor activity in treating Ehrlich ascite carcinoma. The different photosensitizers were ranked as follows: Hypericin > hematoporphyrin dimethyl ether > Photofrin II > meso-tetra (para-sulfophenyl)porphin > 5-aminolevulinic acid. The most important is that just after Hyp-based photodynamic therapy 75% of mice survived a 4 month-period, and no recurrence of tumor within this period was detected in 25% of the treated mice. The clear cut correlation observed between intracellular dye concentration in the tumor cells and efficiency of photodynamic therapy, supports the idea that the intracellular accumulation of the photosensitizer is one of the most important factors in determining the benefit of photodynamic therapy. Hence, the accumulation of the photosensitizer in the tumor cells should be considered as one of the prognostic factors for the determination of the therapeutic outcome. Eventually, one of the most significant result is that hypericin is effective photosensitizer for human B-leukemia cells and induces apoptosis after photosensitization.
The use of fluorescence and reflectance spectroscopy in the analysis of cervical histopathology is a growing field of research. The majority of this research is performed with point-like probes. Typically, clinicians select probe sites visually, collecting a handful of spectral samples. An exception to this methodology is the Hyperspectral Diagnostic Imaging (HSDI) instrument developed by Science and Technology International. This non-invasive device collects contiguous hyperspectral images across the entire cervical portio. The high spatial and spectral resolution of the HSDI instruments make them uniquely well suited for addressing the issues of coupled spatial and spectral variability of tissues in vivo. Analysis of HSDI data indicates that tissue spectra vary from point to point, even within histopathologically homogeneous regions. This spectral variability exhibits both random and patterned components, implying that point monitoring may be susceptible to significant sources of noise and clutter inherent in the tissue. We have analyzed HSDI images from clinical CIN (cervical intraepithelial neoplasia) patients to quantify the spatial variability of fluorescence and reflectance spectra. This analysis shows the spatial structure of images to be fractal in nature, in both intensity and spectrum. These fractal tissue textures will limit the performance of any point-monitoring technology.
A hyperspectral imaging spectrograph has been used to measure the fluorescence and reflectance of cervical tissue in vivo. The instrument was employed in a clinical trial in Vilnius, Lithuania, where 111 patients were examined. The patients were initially screened by Pap smear, examined by colposcopy and a tissue sampling procedure was performed. Detailed histopathological assessments were performed on the biopsies, and these assessments were correlated with spectra and images. The results of the spectroscopic investigations show that different tissue types within one biopsy region exhibit different spectral signatures. A spectral analysis of the entire image localizes dysplastic regions in both fluorescence and reflectance, suggesting that the hyperspectral imaging technique is useful in the management of cervical malignancies.
Background and Objective: The detailed multivariate analysis of endometrial tissue fluorescence spectra was done. Spectra underlying features and classification algorithm were analyzed. An effort has been made to determine the importance of neopterin component in endometrial premalignization.
Study Design/Materials and Methods: Biomedical tissue fluorescence was measured by excitation with the Nd YAG laser third harmonic. Multivariate analysis techniques were used to analyze fluorescence spectra. Biomedical optics group at Vilnius University analyzed the neopterin substance supplied by the Institute of Medical Chemistry and Biochemistry of Innsbruck University.
Results: Seven statistically significant spectral compounds were found. The classification algorithm classifying samples to histopathological categories was developed and resulted in sensitivity of 80% and specificity 93% for malignant vs. hyperplastic and normal.
Conclusions: Fluorescence spectra could be classified with high accuracy. Spectral variation underlying features can be extracted.
Neopterin component might play an important role in endometrial hyperplasia development.
An effort has been made to detect neopterin spectrum in fluorescence of premalignant endometrial tissue and to estimate the number of fluorophores naturally existing in the tissue with fluorescence present above the noise level. Endometrial Tissue fluorescence was measured in vitro by excitation with the third harmonic of Nd YAG laser. Multivariate curve resolution was used for testing neopterin presence in endometrial tissue. Fluorescence spectra ofneopterin was measured and used as a target spectrum for testing. Seven factors -fluorescence ofnatural fluorophores ofendometrial tissue were found to be present above the noise level in the overall autofluorescence. Neopterin concentration may be too low in endometrial tissue
to make its fluorescence above the noise level because neopterin spectrum was not found to be among the spectra resolved by multivariate curve resolution. An intensity increase in the neopterin spectrum spectral region in hyperplastic endometrial samples might be associated with neopterin concentration increase.
The detailed statistical analysis of the tissue fluorescence spectra was proposed for the investigation of tissue biochemical changes. The method is based on the decomposition of the autofluorescence spectrum into the spectra of natural components of cells. The human tissues with different physiological activity or affected by sickness were investigated. The tissue spectra changes are grouped by the histology data. The observed correlation of fluorescence spectra structure changes for cancer and other 'normal' phases of the tissue are observed from multivariate statistical analysis.
Laser-induced fluorescence (LIF) was studied in vivo from premalignant and benign lesions in the female genital tract, in particular the cervix. The aim of the study was to investigate the possibilities to differentiate cervical intraepithelial neoplasia (CIN) from normal tissue by means of two different fluorescence modalities. Most of the patients were given a low dose (5 mg/kg bw) of (delta) -amino levulinic acid (ALA). The ALA was orally administered 2 - 4 hours prior to the investigation. During this time, the ALA is transformed to the strongly fluorescent protoporphyrin IX (PpIX) via the haem cycle. Excitation light with a wavelength of 405 nm was used to excite the PpIX fluorescence. Excess amounts of PpIX were accumulated preferentially in diseased tissue. However, the variability in the PpIX accumulation from patient to patient was large. By using excitation light at 337 nm, the endogenous fluorophores are more efficiently excited. Therefore, this excitation modality was exploited for studying spectral characteristics of the autofluorescence in different tissue types. The spectra obtained were evaluated by forming fluorescence intensity ratios. The tissue types were grouped according to the histopathological examination. A correlation with the fluorescence ratios was performed. Some problems with the classification remain, mostly due to the difficulties in obtaining histopathologic evaluation of the biopsies at the exact location of the LIF measurements.
Laparoscopic cholecystectomy (LC) is a minimally invasive method of removing the diseased gallbladder. It was introduced into Lithuania in December 1992 and has gained wide acceptance. While LC offers many advantages over the conventional laparotomy procedure one of its drawbacks is delayed biliary complications. Those complications may be avoided with appropriate precautions. The aim of this research is to maximize the safety of LC. The potential way to solve this problem is to minimize the possible heat damage and electrical injury remote from the site of surgery during dissection of the cystic duct, cystic artery, and the gallbladder. Neodymium:YAG laser applications with endoscopic fiber have been investigated. The possibilities to use it as a scalpel and as coagulator to release the gallbladder from all its peritoneal attachments during LC have been investigated. The controversy over optimal sources for thermal dissection of the gallbladder has been performed. The potential benefits of Nd:YAG laser in surgery -- precise cutting, limited collateral tissue damage, and improved capillary and arteriole hemostasis -- have been found.
The surgical properties of pulsed 0.53 m Nd:YAG laser have been investigated. The tissues of genitals have been treated with 0.53 mm laser beam and investigated microscopically, injury depth to width ratio was established. The spectrophotometry of the same tissues was performed and optical densities were compared. The advantages of 0.53 micrometers , 1.06 micrometers , 1.32 micrometers Nd:YAG lasers used for gynecological operations have been discussed.
The properties of surgical Nd:YAG laser (1.06 micrometers and 1.36 micrometers wavelength) with endoscopic fiber have been investigated. The possibilities of using it as a scalpel and as a coagulator suitable for the endoscopic gynecological operations have been established. The tissues of myometrium, endometrium and ovary have been treated with different output profile quartz fibers. The most efficient wavelength of laser light and the profile of fiber for cutting and coagulation of different structure tissue have been found.
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