Methylene Blue Near-Infrared Fluorescence Imaging in Breast Cancer Sentinel Node Biopsy

Introduction: Fluorescence-based navigation for breast cancer sentinel node biopsy is a novel method that uses indocyanine green as a fluorophore. However, methylene blue (MB) also has some fluorescent properties. This study is the first in a clinical series presenting the possible use of MB as a fluorescent dye for the identification of sentinel nodes in breast sentinel node biopsy. Material and methods: Forty-nine patients with breast cancer who underwent sentinel node biopsy procedures were enrolled in the study. All patients underwent standard simultaneous injection of nanocolloid and MB. We visualized and assessed the sentinel nodes and the lymphatic channels transcutaneously, with and without fluorescence, and calculated the signal-to-background ratio (SBR). We also analyzed the corresponding fluorescence intensity of various dilutions of MB. Results: In twenty-three patients (46.9%), the location of the sentinel node, or the end of the lymphatic path, was visible transcutaneously. The median SBR for transcutaneous sentinel node location was 1.69 (range 1.66–4.35). Lymphatic channels were visible under fluorescence in 14 patients (28.6%) prior to visualization by the naked eye, with an average SBR of 2.01 (range 1.14–5.6). The sentinel node was visible under fluorescence in 25 patients (51%). The median SBR for sentinel node visualization with MB fluorescence was 2.54 (range 1.34–6.86). Sentinel nodes were visualized faster under fluorescence during sentinel node preparation. Factors associated with the rate of visualization included diabetes (p = 0.001), neoadjuvant chemotherapy (p = 0.003), and multifocality (p = 0.004). The best fluorescence was obtained using 40 µM (0.0128 mg/mL) MB, but we also observed a clinically relevant dilution range between 20 µM (0.0064 mg/mL) and 100 µM (0.032 mg/mL). Conclusions: For the first time, we propose the clinical usage of MB as a fluorophore for fluorescence-guided sentinel node biopsy in breast cancer patients. The quenching effect of the dye may be the reason for its poor detection rate. Our analysis of different concentrations of MB suggests a need for a detailed clinical analysis to highlight the practical usefulness of the dye

A new strategy to prevent biofilm and clot formation in medical devices: the use of atmospheric non-thermal plasma assisted deposition of silver-based nanostructured coatings

In industrialized countries, health care associated infections, the fourth leading cause of dis- ease, are a major health issue. At least half of all cases of nosocomial infections are associ- ated with medical devices. Antibacterial coatings arise as an important approach to restrict the nosocomial infection rate without side effects and the development of antibiotic resis- tance. Beside nosocomial infections, clot formation affects cardiovascular medical devices and central venous catheters implants. In order to reduce and prevent such infection, we develop a plasma-assisted process for the deposition of nanostructured functional coatings on flat substrates and mini catheters. Silver nanoparticles (Ag NPs) are synthesized exploit- ing in-flight plasma-droplet reactions and are embedded in an organic coating deposited through hexamethyldisiloxane (HMDSO) plasma assisted polymerization. Coating stability upon liquid immersion and ethylene oxide (EtO) sterilization is assessed through chemical and morphological analysis carried out by means of Fourier transform infrared spectroscopy (FTIR) and scanning electron microscopy (SEM). In the perspective of future clinical appli- cation, an in vitro analysis of anti-biofilm effect has been done. Moreover, we employed a murine model of catheter-associated infection which further highlighted the performance of Ag nanostructured films in counteract biofilm formation. The anti-clot performances coupled by haemo- and cytocompatibility assays have also been performed

Ceramic Industry Air Quality. Emissions Into the Atmosphere From Ceramic Tile Processes

The subject of this chapter, air quality associated to the ceramic tile industry, represents a very interesting \u2018real scenario\u2019 in the framework of the whole volume. The reasons can be summarised in this way: (1) the ceramic tile technology includes several significant pollutant emissions into the atmosphere and (2) ceramic industry has generated \u2013 although many years ago and in rather small industrial areas, characterised by large concentrations of factories \u2013 some air quality problems. The Ceramic District of Sassuolo, Italy, can be considered as a significant example of such industrial areas and represents the main reference adopted in this chapter. Another \u2018ceramic district\u2019 is that of Castell\uf3n, Spain, which however is quite different as regards significant factors influencing air quality: factors such as territory, orography, climate, meteorological conditions, urban and industrial settlements and density, road system and traffic, etc. With reference to the Italian ceramic tile industry, this chapter deals with the description and quantification of emissions into the atmosphere from ceramic industries and aims to document the approach adopted, the resources used and the knowledge developed, to drastically reduce the environmental impact of these emissions on air quality. This objective has been successfully achieved, at the point that, in particular, the Italian ceramic tile sector is still working, in the framework of a continuous improvement approach, on its environmental performances, as well as on the exploitation of the results achieved as competitiveness factors