Induced pathomorphism and manifestations of residual focal lesions in parenchymatous organs of patients after noninvasive procedures

Aim of investigation. To reveal principles of development residual focal lesions various type and location in parenchymatous organs of patients after different noninvasive medical manipulations.Material and methods. Overall 365 patients with focal lesions: metastases and cysts of the liver, residual foci in gallbladder area after endoscopic obliteration of organ cavity, malignant tumors and pseudo-cysts of the pancreas, chronic pancreatitis, abscesses of abdominal cavity of various localization, cysts and tumors of the spleen, cysts and tumors of kidneys, focal goiter, fibrous adenoma of breast gland were studied. Total of 1281 noninvasive medical manipulation at ultrasound guidance and X-ray navigation — installation of drainages/catheters and local treatment by antibiotics, intraportal injection of pharmaceuticals, sclerotherapy of 96% ethyl alcohol of liver and kidney cysts, metastases to the liver, interstitial laser photocoagulation of focal goiter, radio-frequency ablation of metastases in the liver, electrochemical destruction of liver metastases and fibrous adenomas of breast gland etc. was carried out. Ultrasound investigation was the basic diagnostic and control method; while helical x-ray computer tomography, X-ray fistulography, endoscopic retrograde cholangiopancreatography, scintigraphy, elastography, diagnostic punctures (aspiration biopsy, core needle biopsy, transcutaneous transhepatic cholangiography), laparoscopy, laparotomy, morphological investigation were used as methods of verification and control. Patients were followed up for 5 to 15 and more years.Conclusion. It was revealed, that residual focal lesions of various type and location in parenchymatous organs after noninvasive procedures have similar consecutive stages of development, caused by common (clinical, pathomorphological) features

Non-invasive control of influence of polyethylene glycol on transport function of fluorescent colored liposomal nanoparticles

The studies were carried out on groups of clinically healthy mice line of outbred CD-1 stock. The model animals were divided into 2 groups and received experimental liposomal formulations. Using the method of fluorescence spectroscopy, we investigated the effectiveness of penetration into the circulatory system of fluorescently stained liposomes with polyethylene glycol (PEG) and without PEG when administered orally. Fluorescence channel with a fiber probe series of multifunctional laser non-invasive diagnostic system "LAKK-M" (SPE "LAZMA" Ltd, Russia) was used as the measuring equipment

Noninvasive control of the transport function of fluorescent coloured liposomal nanoparticles

The use of liposomal nanoparticles with an incorporated active substance is an innovative and promising approach to diagnostics and therapy. The application of liposomal nanoparticle-based drugs allows for targeted localized delivery, overcomes the natural barriers within the body effectively, and minimizes possible side effects. Liposomes are able to contain a variety of ingredients with practically no limitations to their chemical composition, chemical properties, or size of constituent molecules. This study evaluated the ability to control the passage of fluorescent dye-filled liposomes through the intestinal mucosal barrier after oral administration. For this purpose, the increase in transcutaneous registered fluorescence from tetrabromofluorescein dye was recorded and analysed. Fluorescence intensity was measured at the proximal end of the tail of an animal model after oral administration of the liposomes. Measurements were taken at the excitation wavelengths of 365 and 450 nm. The fluorescence intensity in the group treated with the fluorescent contrast agent encapsulated in liposomal particles increased 140% of the initial level, but in the group treated with pure contrast agent, the increase in detected fluorescence intensity did not exceed 110%. Mice that received empty liposomes as well as the control group did not demonstrate statistically significant changes in fluorescence intensity. A potential application of our results is an express laser optical method of monitoring the transport of orally administered liposomal particles. The results can be used to help create new optical tools for use in the development of new drugs and in high-throughput screening used during their testing

Application of the fluorescence spectroscopy for the analysis of the state of abdominal cavity organs tissues in mini-invasive surgery

At present, minimally invasive interventions become more widespread for treating hepatopancreatoduodenal area pathologies. However, new methods and approaches are necessary for obtaining more diagnostic information in real time. Several methods within the framework of "optical biopsy" concept are considered. The features and areas of application of each method are reviewed to find out which of them can be used in further studies to assess the possibility of intraoperative use in minimally invasive abdominal surgery. Preliminary measurements with fluorescence spectroscopy method have been performed at excitation wavelengths 365 nm and 450 nm. Areas of interest were common bile duct, gallbladder and liver abscess. In our opinion, the obtained results can be a basis for further research and provide a deeper understanding of pathological processes of abdominal cavity organs tissues

Возможности применения пероральной внутрипросветной лазерной литотрипсии при крупном конкременте общего желчного протока (клиническое наблюдение)

There is a clinical report of successful oral intraluminal laser lithotripsy with subsequent lithoextraction of a large concretion of the common bile duct in a patient with choledocholithiasis and mechanical jaundice. For the intraluminar lithotripsy a tulium laser "Urolaz" was used with energy modes 0,025-0,05-0,1 J, up to a maximum of 0.5 J. The average power is 6-10 W. Laser exposure was carried out by pulses in an aqueous medium in order to prevent carbonation of the light guide and smoke. The effect of exposure to the concretion was manifested in its fragmentation and the formation of small particles without damage of the mucous membrane of the common bile duct. The total duration of the intervention was 45 minutes. The method is effective and safe, thus it avoids the need of endoscopic papillosphincterotomy and violation of the anatomical integrity and physiological function of the Oddi sphincter. Представлено клиническое наблюдение успешного выполнения пероральной внутрипросветной лазерной литотрипсии с последующей литоэкстракцией крупного конкремента общего желчного протока у пациентки с холедохолитиазом и механической желтухой. Для проведения внутрипротоковой литотрипсии использовали тулиевый лазер «Уролаз» в следующих режимах: энергия – 0,025-0,05-0,1 Дж, максимум до 0,5 Дж. Средняя мощность 6-10 Вт. Лазерное воздействие проводили импульсами в водной среде с целью профилактики карбонизации волокна световода и задымления. Эффект воздействия на конкремент проявлялся в его фрагментации и образовании мелких частиц без повреждения слизистой оболочки общего желчного протока. Общая продолжительность вмешательства составила 45 мин. Метод является эффективным и безопасным, позволяет избежать необходимости выполнения эндоскопической папиллосфинктеротомии и нарушения анатомической целостности и физиологической функции сфинктера Одди

Optical diagnostics of bile duct tissues state with tumor compression

The paper presents the results of in vivo experimental measurements of the endogenous fluorescence and blood perfusion in common bile duct tissues in obstructive jaundice patients during minimally invasive surgical operations. Nowadays the type of interventions become more widespread for treating hepatopancreatobiliary pathologies. An effective feedback which can be established by one or more optical diagnostic channels integrated into the standard instruments for minimally invasive manipulations would be of particular value to practical surgeons. To collect reference data, an experimental study has been conducted using a fiber optical probe with fluorescence spectroscopy and laser Doppler flowmetry channels. For every measurement, the areas of interest were different areas of common bile duct obstructed by a malignant tumor. Obtained results demonstrated significant variety registered intensities of fluorescence spectra and values of blood perfusion. Tested fiber optical endoscopic system showed sensitivity to the tissue state in the investigated area, so the two modal approach seems to be promising for further research and implementation in clinical practice

Fluorescence lifetime needle optical biopsy discriminates hepatocellular carcinoma

This work presents results of in vivo and in situ measurements of hepatocellular carcinoma by a developed optical biopsy system. Here, we describe the technical details of the implementation of fluorescence lifetime and diffuse reflectance measurements by the system, equipped with an original needle optical probe, compatible with the 17.5G biopsy needle standard. The fluorescence lifetime measurements observed by the setup were verified in fresh solutions of NADH and FAD++, and then applied in a murine model for the characterisation of inoculated hepatocellular carcinoma (HCC) and adjacent liver tissue. The technique, applied in vivo and in situ and supplemented by measurements of blood oxygen saturation, made it possible to reveal statistically significant transformation in the set of measured parameters linked with the cellular pools of NADH and NADPH. In the animal model, we demonstrate that the characteristic changes in registered fluorescent parameters can be used to reliably distinguish the HCC tissue, liver tissue in the control, and the metabolically changed liver tissues of animals with the developed HCC tumour. For further transition to clinical applications, the optical biopsy system was tested during the routing procedure of the PNB in humans with suspected HCC. The comparison of the data from murine and human HCC tissues suggests that the tested animal model is generally representative in the sense of the registered fluorescence lifetime parameters, while statistically significant differences between their absolute values can still be observed