59 research outputs found
Optimising the management of dysplastic lesions in the oesophagus with photodynamic therapy
The outcome of patients suffering from adeno and squamous carcinoma of the oesophagus remains poor. In the west, the incidence of adenocarcinoma has increased dramatically, with most cases occurring in association with Barrett's oesophagus (BE). Both adeno and squamous carcinoma are believed to progress through worsening degrees of dysplasia. This thesis assesses the role of Elastic Scattering Spectroscopy (ESS) as an objective diagnostic test for dysplasia and Photodynamic Therapy (PDT) with 5-aminolevulinic acid (ALA) as a less invasive treatment option. It also looks for a better understanding of the factors influencing mucosal healing after PDT. Using ESS, the sensitivity and specificity was 83% for distinguishing HGD/cancer from LGD/non dysplastic BE. Low dose ALA (30mg/kg) PDT eradicated 38% of HGD in BE compared with 67% eradication with a higher dose (60mg/kg). The higher dose also decreased the length of BE. In a study comparing red with green light (fixed light doses) for treating HGD, at 30 mg/kg ALA, 63% and 13 % of patients were clear of HGD with red and green laser respectively. At 60 mg/kg, the corresponding figures were 78% and 33% for the same light dose. 5 of 5 patients with LGD in BE and 4 of 5 patients with HGD in squamous mucosa had their dysplasia eradicated with ALA PDT. Successful PDT involves healing by regeneration of normal squamous mucosa. My in vitro studies created a PDT wound model using malignant oesophageal cell lines to assess the role of different cytokines in healing. Keratinocyte Growth Factor (KGF) was found to promote wound healing after PDT and significantly encouraged (p 0.001) the development of squamous cell lines. In conclusion: 1. ESS can differentiate dysplasia and early cancer from non-dysplastic and normal mucosa (sensitivity and specificity 83%). 2. PDT using high dose (60mg/kg) ALA (but not low dose) is effective in eradicating HGD in BE using red light. 3. The cytokine, KGF may promote healing with squamous mucosa after PDT. 4. Larger scale clinical trials are now required to confirm these results
Active pulmonary tuberculosis and latent tuberculosis infection among homeless people in Seoul, South Korea: a cross-sectional study
Enhancing Coenzyme B12 Detection with Modular and Titratable Toehold Switches for Signal Amplification in Riboswitch-Based Hybrid Inputs Optimization
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โDevelopment of Systematic Strategies for Optimizing L-Tryptophan Riboswitches for Versatile Applications in Escherichia coli
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Development of improved coenzyme B12 sensor by integrating riboswitch and transcription repressor
Enhancing Signal Amplification of Hybrid Inputs in Riboswitch-based Systems Using Modular and Titratable Toehold Switches
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Development of signal amplifier using toehold switches modulator to riboswitch-based coenzyme B12 sensor
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Development of Novel Hybrid Input Part Using Coenzyme B12 Riboswitch and Transcriptional Repressors for Signal Inverting Amplifier
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Novel Coenzyme B12 riboswitch-based sensor integrates with transcriptional repressor for signal inverting and amplify
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Development of signal amplified riboswitch-based coenzyme B12 sensor by toehold switches modulator
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