Head & neck optical diagnostics: vision of the future of surgery

Review paper and Proceedings of the Inaugural Meeting of the Head and Neck Optical Diagnostics Society (HNODS) on March 14th 2009 at University College London

In search of the authentic nation: landscape and national identity in Canada and Switzerland

While the study of nationalism and national identity has flourished in the last decade, little attention has been devoted to the conditions under which natural environments acquire significance in definitions of nationhood. This article examines the identity-forming role of landscape depictions in two polyethnic nation-states: Canada and Switzerland. Two types of geographical national identity are identified. The first – what we call the ‘nationalisation of nature’– portrays zarticular landscapes as expressions of national authenticity. The second pattern – what we refer to as the ‘naturalisation of the nation’– rests upon a notion of geographical determinism that depicts specific landscapes as forces capable of determining national identity. The authors offer two reasons why the second pattern came to prevail in the cases under consideration: (1) the affinity between wild landscape and the Romantic ideal of pure, rugged nature, and (2) a divergence between the nationalist ideal of ethnic homogeneity and the polyethnic composition of the two societies under consideration

The future of medical diagnostics: Review paper

While histopathology of excised tissue remains the gold standard for diagnosis, several new, non-invasive diagnostic techniques are being developed. They rely on physical and biochemical changes that precede and mirror malignant change within tissue. The basic principle involves simple optical techniques of tissue interrogation. Their accuracy, expressed as sensitivity and specificity, are reported in a number of studies suggests that they have a potential for cost effective, real-time, in situ diagnosis. We review the Third Scientific Meeting of the Head and Neck Optical Diagnostics Society held in Congress Innsbruck, Innsbruck, Austria on the 11th May 2011. For the first time the HNODS Annual Scientific Meeting was held in association with the International Photodynamic Association (IPA) and the European Platform for Photodynamic Medicine (EPPM). The aim was to enhance the interdisciplinary aspects of optical diagnostics and other photodynamic applications. The meeting included 2 sections: oral communication sessions running in parallel to the IPA programme and poster presentation sessions combined with the IPA and EPPM posters sessions. © 2011 Jerjes et al; licensee BioMed Central Ltd

Devices to Assist the Insertion of Colonoscopes

The thesis starts by describing the colon and the history and workings of the endoscope. It then suggests that the fundamental problem when inserting a colonoscope is that as one flexible tube (the colonoscope) is pushed along another poorly supported flexible tube (the colon), it tends to catch and push and form loops. The literature concerning devices for overcoming this problem is reviewed and the first phase of the thesis ends with an investigation of the forces applied by clinicians to the colonoscope during routine clinical procedures. The body of the thesis describes the following four novel devices intended to minimise this fundamental problem.1) Water is pumped through an array of backward facing nozzles mounted onto the endoscope tip. As water accelerates through the nozzles, the reaction force propels the endoscope. The forces and pressures are analysed theoretically and compared with experimental results. Prototypes, some incorporating atomisers to 'blunt' the jets, are described and results are presented from live pigs and models using excised porcine colon. 2) A "crawler" has two suction feet that can be moved together or apart using concertina bellows or a Bowden cable. To take a step, one foot advances while the other grips the colon wall with suction, then the suction is switched over, so that the first foot grips whilst the other advances. Results with model colons are presented. 3) Electrodes placed at the tapering end of a lozenge shaped piece of acrylic stimulate the bowel to contract, squeezing the taper forward, which in turn brings the electrodes into contact with new tissues. In vivo results are presented. 4) A disposable sleeve with a lubricious hydrogel coating is attached to the endoscope to minimize friction. Results from bench tests are presented. The thesis ends with some concluding comments and suggestions for future work

Photodynamic Therapy in Primary Breast Cancer

Photodynamic therapy (PDT) is a technique for producing localized necrosis with light after prior administration of a photosensitizing agent. This study investigates the nature, safety, and efficacy of PDT for image-guided treatment of primary breast cancer. We performed a phase I/IIa dose escalation study in 12 female patients with a new diagnosis of invasive ductal breast cancer and scheduled to undergo mastectomy as a first treatment. The photosensitizer verteporfin (0.4 mg/kg) was administered intravenously followed by exposure to escalating light doses (20, 30, 40, 50 J; 3 patients per dose) delivered via a laser fiber positioned interstitially under ultrasound guidance. MRI (magnetic resonance imaging) scans were performed prior to and 4 days after PDT. Histological examination of the excised tissue was performed. PDT was well tolerated, with no adverse events. PDT effects were detected by MRI in 7 patients and histology in 8 patients, increasing in extent with the delivered light dose, with good correlation between the 2 modalities. Histologically, there were distinctive features of PDT necrosis, in contrast to spontaneous necrosis. Apoptosis was detected in adjacent normal tissue. Median follow-up of 50 months revealed no adverse effects and outcomes no worse than a comparable control population. This study confirms a potential role for PDT in the management of early breast cancer