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Casper MJ, Glahn J, Evers M, Schulz-Hildebrandt H, Kositratna G, Birngruber R, Hüttmann G, Manstein D. Capillary Refill-The Key to Assessing Dermal Capillary Capacity and Pathology in Optical Coherence Tomography Angiography. Lasers Surg Med 2019; 52:653-658. [PMID: 31755127 PMCID: PMC7496142 DOI: 10.1002/lsm.23188] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/05/2019] [Indexed: 12/12/2022]
Abstract
Background/Objectives Standard optical coherence tomography angiography (OCTA) has been limited to imaging blood vessels actively undergoing perfusion, providing a temporary picture of surface microvasculature. Capillary perfusion in the skin is dynamic and changes in response to the surrounding tissue's respiratory, nutritional, and thermoregulatory needs. Hence, OCTA often represents a given perfusion state without depicting the actual extent of the vascular network. Here we present a method for obtaining a more accurate anatomic representation of the surface capillary network in human skin using OCTA, along with proposing a new parameter, the Relative Capillary Capacity (RCC), a quantifiable proxy for assessing capillary dilation potential and permeability. Methods OCTA images were captured at baseline and after compression of the skin. Baseline images display ambient capillary perfusion, while images taken upon capillary refill display the network of existing capillaries at full capacity. An optimization‐based automated vessel segmentation method was used to automatically analyze and compare OCTA image sequences obtained from two volunteers. RCC was then compared with visual impressions of capillary viability. Results Our OCTA imaging sequence provides a method for mapping cutaneous capillary networks independent of ambient perfusion. Differences between baseline and refill images clearly demonstrate the shortcomings of standard OCTA imaging and produce the RCC biometric as a quantifiable proxy for assessing capillary dilation potential and permeability. Conclusion Future dermatological OCTA diagnostic studies should implement the Capillary Refill Methods over standard imaging techniques and further explore the relevance of RCC to differential diagnosis and dermatopathology. Lasers Surg. Med. © The Authors. Lasers in Surgery and Medicine published by Wiley Periodicals, Inc.
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Affiliation(s)
- M J Casper
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129.,Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany
| | - J Glahn
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129
| | - M Evers
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129.,Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany
| | - H Schulz-Hildebrandt
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Medical Laser Center Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany
| | - G Kositratna
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129
| | - R Birngruber
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Medical Laser Center Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Wellman Center for Photomedicine, Massachusetts General Hospital, Boston, Massachusetts, 02114
| | - G Hüttmann
- Institute of Biomedical Optics, Universität zu Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Medical Laser Center Lübeck, Peter-Monnik-Weg 4, Lübeck, 23562, Germany.,Airway Research Center North (ARCN), Member of the German Center of Lung Research (DZL), Gießen, Germany
| | - D Manstein
- Harvard Medical School, Cutaneous Biology Research Center, Massachusetts General Hospital, 149 13th Street, Boston, Massachusetts, 02129
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Ourak M, Smits J, Esteveny L, Borghesan G, Gijbels A, Schoevaerdts L, Douven Y, Scholtes J, Lankenau E, Eixmann T, Schulz-Hildebrandt H, Hüttmann G, Kozlovszky M, Kronreif G, Willekens K, Stalmans P, Faridpooya K, Cereda M, Giani A, Staurenghi G, Reynaerts D, Vander Poorten EB. Combined OCT distance and FBG force sensing cannulation needle for retinal vein cannulation: in vivo animal validation. Int J Comput Assist Radiol Surg 2018; 14:301-309. [PMID: 30056592 DOI: 10.1007/s11548-018-1829-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/27/2018] [Accepted: 07/18/2018] [Indexed: 11/29/2022]
Abstract
PURPOSE Retinal vein cannulation is an experimental procedure during which a clot-dissolving drug is injected into an obstructed retinal vein. However, due to the fragility and minute size of retinal veins, such procedure is considered too risky to perform manually. With the aid of surgical robots, key limiting factors such as: unwanted eye rotations, hand tremor and instrument immobilization can be tackled. However, local instrument anatomy distance and force estimation remain unresolved issues. A reliable, real-time local interaction estimation between instrument tip and the retina could be a solution. This paper reports on the development of a combined force and distance sensing cannulation needle, and its experimental validation during in vivo animal trials. METHODS Two prototypes are reported, relying on force and distance measurements based on FBG and OCT A-scan fibres, respectively. Both instruments provide an 80 [Formula: see text] needle tip and have outer shaft diameters of 0.6 and 2.3 mm, respectively. RESULTS Both prototypes were characterized and experimentally validated ex vivo. Then, paired with a previously developed surgical robot, in vivo experimental validation was performed. The first prototype successfully demonstrated the feasibility of using a combined force and distance sensing instrument in an in vivo setting. CONCLUSION The results demonstrate the feasibility of deploying a combined sensing instrument in an in vivo setting. The performed study provides a foundation for further work on real-time local modelling of the surgical scene. This paper provides initial insights; however, additional processing remains necessary.
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Affiliation(s)
- M Ourak
- University of Leuven, Leuven, Belgium.
| | - J Smits
- University of Leuven, Leuven, Belgium
| | | | | | - A Gijbels
- University of Leuven, Leuven, Belgium
| | | | - Y Douven
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - J Scholtes
- Eindhoven University of Technology, Eindhoven, The Netherlands
| | - E Lankenau
- OptoMedical Technologies GmbH, Lübeck, Germany
| | - T Eixmann
- Medical Laser Center Lübeck GmbH, Lübeck, Germany
| | | | - G Hüttmann
- Medical Laser Center Lübeck GmbH, Lübeck, Germany
| | - M Kozlovszky
- Austrian Center for Medical Innovation and Technology Gmbh, Neustadt, Austria
| | - G Kronreif
- Austrian Center for Medical Innovation and Technology Gmbh, Neustadt, Austria
| | - K Willekens
- University Hospitals Leuven, Leuven, Belgium
| | - P Stalmans
- University Hospitals Leuven, Leuven, Belgium
| | - K Faridpooya
- The Rotterdam Eye Hospital, Rotterdam, The Netherlands
| | - M Cereda
- The Eye Clinic, University of Milan, Milan, Italy
| | - A Giani
- The Eye Clinic, University of Milan, Milan, Italy
| | - G Staurenghi
- The Eye Clinic, University of Milan, Milan, Italy
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Spahr H, Hillmann D, Hain C, Pfäffle C, Sudkamp H, Franke G, Koch P, Hüttmann G. Darstellung von Blutfluss und Pulsation in retinalen Gefäßen mit Full-Field-Swept-Source-OCT. Klin Monbl Augenheilkd 2016; 233:1324-1330. [DOI: 10.1055/s-0042-120279] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- H. Spahr
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck
| | | | - C. Hain
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck
| | - C. Pfäffle
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck
| | - H. Sudkamp
- Medizinisches Laserzentrum Lübeck GmbH, Lübeck
| | - G. Franke
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck
| | - P. Koch
- Medizinisches Laserzentrum Lübeck GmbH, Lübeck
| | - G. Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck, Lübeck
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4
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Horstmann J, Siebelmann S, Schulz-Hildebrandt H, Glasunow I, Schadschneider A, Hüttmann G. [Understanding OCT - Part 2: State of the Practice]. Klin Monbl Augenheilkd 2016; 234:233-247. [PMID: 27871110 DOI: 10.1055/s-0033-1358249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - I Glasunow
- Institut für Physikdidaktik, Universität zu Köln
| | | | - G Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck
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5
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Horstmann J, Siebelmann S, Schulz-Hildebrandt H, Glasunow I, Schadschneider A, Hüttmann G. [Understanding OCT - Part 1: Basic Knowledge]. Klin Monbl Augenheilkd 2016; 234:131-143. [PMID: 27871111 DOI: 10.1055/s-0042-119126] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - I Glasunow
- Institut für Physikdidaktik, Universität zu Köln
| | | | - G Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck
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Horstmann J, Siebelmann S, Schulz-Hildebrandt H, Glasunow I, Schadschneider A, Hüttmann G. OCT verstehen – Teil 2: Praktische Aspekte und Anwendung. Augenheilkunde up2date 2016. [DOI: 10.1055/s-0042-117459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - I. Glasunow
- Institut für Physikdidaktik, Universität zu Köln
| | | | - G. Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck
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7
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Horstmann J, Siebelmann S, Schulz-Hildebrandt H, Glasunow I, Schadschneider A, Hüttmann G. OCT verstehen – Teil 1: Physikalische Grundlagen. Augenheilkunde up2date 2016. [DOI: 10.1055/s-0042-113337] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
| | | | | | - I. Glasunow
- Institut für Physikdidaktik, Universität zu Köln
| | | | - G. Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck
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Pieper M, Schulz-Hildebrandt H, Mall M, Hüttmann G, König P. Intravital microscopy of mucus transport in mice provides mechanistic insight into hypertonic saline treatment of Cystic Fibrosis. Pneumologie 2016. [DOI: 10.1055/s-0036-1584654] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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9
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Schulz-Hildebrandt H, Pieper M, Kasper J, Traulsen N, Mall M, König P, Hüttmann G. Towards automated evaluation of mucus transport measured by microscopic OCT (mOCT) during hypertonic saline treatment of Cystic Fibrosis. Pneumologie 2016. [DOI: 10.1055/s-0036-1584651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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10
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Schulz-Hildebrandt H, Pieper M, König P, Hüttmann G. Improved endoscopic optical coherence microscopy for imaging of humans airways in patients. Pneumologie 2015. [DOI: 10.1055/s-0035-1556641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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11
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Schulz-Hildebrandt H, Pieper M, König P, Hüttmann G. Influence of aberrations on the image quality in optical coherence microscopy. Pneumologie 2015. [DOI: 10.1055/s-0035-1556640] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Otte C, Otte S, Wittig L, Hüttmann G, Kugler C, Drömann D, Zell A, Schlaefer A. Investigating recurrent neural networks for OCT A-scan based tissue analysis. Methods Inf Med 2014; 53:245-9. [PMID: 24992968 DOI: 10.3414/me13-01-0135] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2013] [Accepted: 06/26/2014] [Indexed: 11/09/2022]
Abstract
OBJECTIVES Optical Coherence Tomography (OCT) has been proposed as a high resolution image modality to guide transbronchial biopsies. In this study we address the question, whether individual A-scans obtained in needle direction can contribute to the identification of pulmonary nodules. METHODS OCT A-scans from freshly resected human lung tissue specimen were recorded through a customized needle with an embedded optical fiber. Bidirectional Long Short Term Memory networks (BLSTMs) were trained on randomly distributed training and test sets of the acquired A-scans. Patient specific training and different pre-processing steps were evaluated. RESULTS Classification rates from 67.5% up to 76% were archived for different training scenarios. Sensitivity and specificity were highest for a patient specific training with 0.87 and 0.85. Low pass filtering decreased the accuracy from 73.2% on a reference distribution to 62.2% for higher cutoff frequencies and to 56% for lower cutoff frequencies. CONCLUSION The results indicate that a grey value based classification is feasible and may provide additional information for diagnosis and navigation. Furthermore, the experiments show patient specific signal properties and indicate that the lower and upper parts of the frequency spectrum contribute to the classification.
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Affiliation(s)
- C Otte
- C. Otte, TU Hamburg-Harburg, Schwarzenbergstr. 95 E, room 3.088, 21073 Hamburg, Germany, E-mail:
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Schulz-Hildebrandt H, Pieper M, König P, Hüttmann G. Imaging cilial motion by endoscopic optical coherence microscopy. Pneumologie 2014. [DOI: 10.1055/s-0034-1376791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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14
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Pieper M, Schulz-Hildebrandt H, Myrtus C, Abdul RAM, Hüttmann G, König P. Untersuchung der Atemwege der Maus mit zellulärer Auflösung durch optische Kohärenz-Mikroskopie. Pneumologie 2014. [DOI: 10.1055/s-0034-1367794] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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15
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Koinzer S, Müller HH, Ptaszynski L, Schlott K, Birngruber R, Brinkmann R, Roider J, Hüttmann G. Detektion molekularer Gewebeveränderungen durch Vergleich von high-speed Fourier-Domain- und phasenkontrastsensitiver optischer Kohärenztomografie (OCT). ROFO-FORTSCHR RONTG 2012. [DOI: 10.1055/s-0032-1329774] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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16
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Hüttmann G, Lankenau E, Schulz-Wackerbarth C, Müller M, Steven P, Birngruber R. [Optical coherence tomography: from retina imaging to intraoperative use - a review]. Klin Monbl Augenheilkd 2009; 226:958-64. [PMID: 20108189 DOI: 10.1055/s-0028-1109939] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
BACKGROUND Optical coherence tomography (OCT) is new diagnostic procedure that has rapidly evolved in the last years. The recently developed spectral domain OCT allows one to increase the imaging speed by a hundred times compared to the first generation time domain OCT and enables three-dimensional imaging as well as real-time imaging of fast moving structures. Volumetric imaging improves the quantitative measurement of morphology and the evaluation of temporal changes. In addition, an exact correlation with images acquired with other imaging modalities is possible. Real-time imaging enables also the use of OCT during examinations with the slit-lamp and during ophthalmological surgery. METHODS A spectral domain OCT was adapted to a slit lamp. 70 patients (91 eyes) were examined at the anterior or posterior segment of the eye. Images of healthy structures and different pathologies were compared to OCT images obtained with Stratus 3, Spectralis, and the SL-OCT. To demonstrate the feasibility of OCT during surgery, spectral domain OCT devices working with 20,000 and 210,000 A scans per second were coupled by specially developed optics to the camera port of a surgical microscope. The device was tested with phantoms and enucleated pig eyes. RESULTS AND CONCLUSIONS A 5 kHz spectral domain OCT can image the retina during slit lamp-based indirect ophthalmoscopy with a quality similar to that of the Stratus 3. In addition, relevant structures of the anterior segment were imaged. Here, compared to commercially available devices, the imaged field was smaller and the angle of the anterior chamber was not directly visible due to the 830 nm wavelength, which had to be used for retinal imaging. Through the surgical microscope, a volumetric imaging of epithelium, Bowman's, Descemet's membranes, limbus, iris, lens, conjunctiva and sclera was demonstrated with several tens of centimetre working distance. Instruments and incisions in the cornea were visualised with 20 microm precision. Real-time imaging and visualisation of volumetric OCT data were also demonstrated. In principle, all technical problems of an intraoperative use of OCT have been solved and a clinical trial will start in the near future. OCT has the potential to improve the precision of surgical interventions and may even enable new interventions.
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Affiliation(s)
- G Hüttmann
- Institut für Biomedizinische Optik, Universität zu Lübeck.
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Böhringer HJ, Lankenau E, Stellmacher F, Reusche E, Hüttmann G, Giese A. Imaging of human brain tumor tissue by near-infrared laser coherence tomography. Acta Neurochir (Wien) 2009; 151:507-17; discussion 517. [PMID: 19343270 PMCID: PMC3085760 DOI: 10.1007/s00701-009-0248-y] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2008] [Accepted: 02/19/2009] [Indexed: 12/22/2022]
Abstract
INTRODUCTION Intraoperative detection of residual tumor remains an important challenge in surgery to treat gliomas. New developments in optical techniques offer non-invasive high-resolution imaging that may integrate well into the workflow of neurosurgical operations. Using an intracranial glioma model, we have recently shown that time domain optical coherence tomography (OCT) allows discrimination of normal brain, diffusely invaded brain tissue, and solid tumor. OCT imaging allowed acquisition of 2D and 3D data arrays for multiplanar analysis of the tumor to brain interface. In this study we have analyzed biopsy specimens of human brain tumors and we present the first feasibility study of intraoperative OCT and post-image acquisition processing for non-invasive imaging of the brain and brain tumor. METHODS We used a Sirius 713 Tomograph with a superluminescence diode emitting light at a near infrared central wavelength of 1,310 nm and a coherence length of 15 microm. The light is passed through an optical mono mode fiber to a modified OCT adapter containing a lens system with a working distance of 10 cm and an integrated pilot laser. Navigation-registered tumor biopsies were imaged ex vivo and the intraoperative site of optical tissue analysis was registered by marker acquisition using a neuronavigation system. RESULTS Optical coherence tomography non-contact measurements of brain and brain tumor tissue produced B-scan images of 4 mm in width and 1.5-2.0 mm in depth at an axial and lateral optical resolution of 15 microm. OCT imaging demonstrated a different microstructure and characteristic signal attenuation profiles of tumor versus normal brain. Post-image acquisition processing and automated detection of the tissue to air interface was used to realign A-scans to compensate for image distortions caused by pulse- and respiration-induced movements of the target volume. Realigned images allowed monitoring of intensity changes within the scan line and facilitated selection of areas for the averaging of A-scans and the calculation of attenuation coefficients for specific regions of interest. CONCLUSION This feasibility study has demonstrated that OCT analysis of the tissue microstructure and light attenuation characteristics discriminate normal brain, areas of tumor infiltrated brain, solid tumor, and necrosis. The working distance of the OCT adapter and the A-scan acquisition rate conceptually allows integration of the OCT applicator into the optical path of the operating microscopes. This would allow a continuous analysis of the resection plain, providing optical tomography, thereby adding a third dimension to the microscopic view and information on the light attenuation characteristics of the tissue.
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Affiliation(s)
| | - E. Lankenau
- Institute for Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - F. Stellmacher
- Department of Neuropathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - E. Reusche
- Department of Neuropathology, University Hospital Schleswig-Holstein, Lübeck, Germany
| | - G. Hüttmann
- Institute for Biomedical Optics, University of Lübeck, Lübeck, Germany
| | - A. Giese
- Department of Neurosurgery, Georg-August-University of Göttingen, Robert-Koch-Strasse 40, 37075 Göttingen, Germany
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Pau H, Lankenau E, Just T, Hüttmann G. Darstellung cochleärer Binnenstrukturen durch Optische Kohärenz-Tomografie (OCT). Laryngorhinootologie 2008; 87:641-6. [DOI: 10.1055/s-2007-995725] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Just T, Lankenau E, Hüttmann G, Pau H. Intraoperative Anwendung der Optischen Kohärenz-Tomografie (OCT) zur Darstellung der ovalen Fensternische. Laryngorhinootologie 2008; 88:168-73. [DOI: 10.1055/s-2008-1077530] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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20
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Garwe F, Bauerschäfer U, Csaki A, Steinbrück A, Ritter K, Bochmann A, Bergmann J, Weise A, Akimov D, Maubach G, König K, Hüttmann G, Paa W, Popp J, Fritzsche W. Optically controlled thermal management on the nanometer length scale. Nanotechnology 2008; 19:055207. [PMID: 21817605 DOI: 10.1088/0957-4484/19/05/055207] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
The manipulation of polymers and biological molecules or the control of chemical reactions on a nanometer scale by means of laser pulses shows great promise for applications in modern nanotechnology, biotechnology, molecular medicine or chemistry. A controllable, parallel, highly efficient and very local heat conversion of the incident laser light into metal nanoparticles without ablation or fragmentation provides the means for a tool like a 'nanoreactor', a 'nanowelder', a 'nanocrystallizer' or a 'nanodesorber'. In this paper we explain theoretically and show experimentally the interaction of laser radiation with gold nanoparticles on a polymethylmethacrylate (PMMA) layer (one-photon excitation) by means of different laser pulse lengths, wavelengths and pulse repetition rates. To the best of our knowledge this is the first report showing the possibility of highly local (in a 40 nm range) regulated heat insertion into the nanoparticle and its surroundings without ablation of the gold nanoparticles. In an earlier paper we showed that near-infrared femtosecond irradiation can cut labeled DNA sequences in metaphase chromosomes below the diffraction-limited spot size. Now, we use gold as well as silver-enhanced gold nanoparticles on DNA (also within chromosomes) as energy coupling objects for femtosecond laser irradiation with single-and two-photon excitation. We show the results of highly localized destruction effects on DNA that occur only nearby the nanoparticles.
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Affiliation(s)
- F Garwe
- Institute of Photonic Technology (IPHT) Jena, PO Box 100239, D-07745 Jena, Germany
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Rahmanzadeh R, Hüttmann G, Gerdes J, Scholzen T. Chromophore-assisted light inactivation of pKi-67 leads to inhibition of ribosomal RNA synthesis. Cell Prolif 2007; 40:422-30. [PMID: 17531085 PMCID: PMC6496591 DOI: 10.1111/j.1365-2184.2007.00433.x] [Citation(s) in RCA: 101] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
OBJECTIVES Expression of the nuclear Ki-67 protein (pKi-67) is strongly associated with cell proliferation. For this reason, antibodies against this protein are widely used as prognostic tools for the assessment of cell proliferation in biopsies from cancer patients. Despite this broad application in histopathology, functional evidence for the physiological role of pKi-67 is still missing. Recently, we proposed a function of pKi-67 in the early steps of ribosomal RNA (rRNA) synthesis. Here, we have examined the involvement of pKi-67 in this process by photochemical inhibition using chromophore-assisted light inactivation (CALI). MATERIALS AND METHODS Anti-pKi-67 antibodies were labelled with the fluorochrome fluorescein 5(6)-isothiocyanate and were irradiated after binding to their target protein. RESULTS Performing CALI in vitro on cell lysates led to specific cross-linking of pKi-67. Moreover, the upstream binding factor (UBF) necessary for rRNA transcription was also partly subjected to cross-link formation, indicating a close spatial proximity of UBF and pKi-67. CALI in living cells, using micro-injected antibody, caused a striking relocalization of UBF from foci within the nucleoli to spots located at the nucleolar rim or within the nucleoplasm. pKi-67-CALI resulted in dramatic inhibition of RNA polymerase I-dependent nucleolar rRNA synthesis, whereas RNA polymerase II-dependent nucleoplasmic RNA synthesis remained almost unaltered. CONCLUSIONS Our data presented here argue for a crucial role of pKi-67 in RNA polymerase I-dependent nucleolar rRNA synthesis.
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Affiliation(s)
- R Rahmanzadeh
- Research Center Borstel, Department of Immunology and Cell Biology, Division of Tumour Biology, Borstel, Germany
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Abstract
PURPOSE The aim of this pilot study was to evaluate whether contact optical coherence tomography (OCT) allows visualization of the effects of cyclophotocoagulation. METHODS In this pilot study, transscleral contact OCT images (1310-nm wavelength) were generated prior to and immediately after conventional transscleral diode laser cyclophotocoagulation in three eyes of three patients who were suffering from uncontrolled glaucoma. RESULTS In the region of the ciliary body, transscleral contact OCT revealed two layers: (i) a superficial thick hyperreflective complex representing conjunctiva, the Tenon capsule, episclera, and sclera; and (ii) a thinner hyporeflective layer representing the ciliary body. The ciliary body could be differentiated from the overlying sclera by its marked drop in reflectivity. After cyclophotocoagulation, a marked increase of reflectivity in the treated area of the ciliary body was identifiable. After treatment, the distinct border between the hyperreflective scleral complex disappeared, and the region of the ciliary body appeared hyperreflective. The optical properties of the overlying sclera remained unchanged. On corresponding averaged A-scan images, scleral thickness appeared to be slightly increased, whereas ciliary body thickness remained unchanged. CONCLUSIONS This pilot study demonstrates the capability of contact OCT for allowing visualization of changes in the ciliary body after transscleral cyclophotocoagulation (TSCPC). Further investigations are planned to clarify the complete significance of these data.
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Affiliation(s)
- M Müller
- Department of Ophthalmology, Medical University of Lübeck, University Eye Clinic, Campus Lübeck, Ratzeburger Allee 160, 23538 Lübeck, Germany.
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Böhringer HJ, Boller D, Leppert J, Knopp U, Lankenau E, Reusche E, Hüttmann G, Giese A. Time-domain and spectral-domain optical coherence tomography in the analysis of brain tumor tissue. Lasers Surg Med 2007; 38:588-97. [PMID: 16736504 DOI: 10.1002/lsm.20353] [Citation(s) in RCA: 48] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
Abstract
INTRODUCTION Detection of residual tumor during resection of glial brain tumors remains a challenge because of a low inherent contrast of adjacent edematous brain, the surrounding infiltration zone, and the solid tumor. Therefore, new technologies that may facilitate an intraoperative analysis of the tissue at the resection edge are of great interest to neurosurgeons. MATERIALS AND METHODS For ex vivo imaging of gliomas in a mouse model and human biopsy specimens of brain tumors and nervous system tissue we have used a time-domain Sirius 713 Tomograph with a central wavelength of 1,310 nm and a coherence length of 15 microm equipped with a mono mode fiber and a modified optical coherence tomography (OCT) adapter containing a lens system for imaging at a working distance of 2.5 cm. A spectral-domain tomograph using 840 nm and 930 nm superluminescence diodes (SLD) with a central wavelength of 900 nm was used as a second imaging modelity. RESULTS Both time-domain and spectral-domain coherence tomography delineated normal brain, the infiltration zone and solid tumor in murine intracerebral gliomas. Histological evaluation of H&E sections parallel to the optical plain demonstrated that tumor areas of less than a millimeter could be detected and that not only solid tumor, but also brain invaded by a low-density single tumor cells produced an OCT signal different from normal brain. Spectral-domain OCT (SD-OCT) demonstrated a significantly more detailed microstructure of tumor and normal brain up to a tissue depth of 1.5-2.0 mm, whereas the interpretation of time-domain OCT (TD-OCT) was difficult at a tissue depth >1.0 mm. Because of rapid scanning times SD-OCT data could be acquired as 3D data maps, which allowed a multi-planar analysis of the tumor to brain interface. Similar to our findings in experimental gliomas, images of human nervous system tissue acquired using SD-OCT showed a characteristic signal of normal brain tissue and a detailed microstructure of tumor parenchyma. CONCLUSION Spectral-domain OCT of experimental gliomas and human brain tumor specimens differentiates solid tumor, diffusely invaded brain tissue, and adjacent normal brain based on microstructure and B-scan signal characteristics. In conjunction with the rapid image acquisition rates of SD-OCT, this technology carries the potential of a novel intraoperative imaging tool for the detection of residual tumor and guidance of neurosurgical tumor resections.
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Affiliation(s)
- H J Böhringer
- Department of Neurosurgery, University Hospital Schleswig-Holstein, Campus Luebeck, Luebeck, Germany
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24
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Abstract
Optical coherence tomography (OCT) is a non-invasive and non-contact imaging technology that has been applied to several biomedical applications. We have recently demonstrated that OCT allows discrimination of tumor adjacent brain, diffuse and solid tumor tissue and that this technology may be used to detect residual tumor within the resection cavity during resection of intrinsic brain tumors. Here we show that an OCT integrated endoscope can image the endoventricular anatomy and other endoscopically accessible structures in a human brain specimen. A Sirius 713 optical coherence tomography device was mounted to a modified rigid endoscope. A formalin-fixed human brain specimen was used to simulate endoscopic visualization of brain anatomy and two specimens of fixed malignant tumors with endoventricular growth patterns. Simultaneous OCT imaging and endoscopic video imaging of the visible spectrum was possible using a graded index rod endoscope. OCT imaging of a human brain specimen in water allowed an in-depth view into structures like the walls of the ventricular system, the choroid plexus or the thalamostriatal vein. OCT further allowed imaging of structures beyond tissue barriers or opaque media. In this fixed specimen OCT allowed discrimination of vascular structures down to a diameter of 50 mum. In vessels larger that 100 mum the lumen could be discriminated and within larger blood vessels a layered structure of the vascular wall as well as endovascular plaques could be visualized. This in vitro pilot study has demonstrated that OCT integrated into neuroendoscopes may add information that cannot be obtained by the video imaging alone. This technology may provide an extra margin of safety by providing cross-sectional images of tissue barriers within optically opaque conditions.
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Affiliation(s)
- H J Böhringer
- Department of Neurosurgery, Georg-August-University of Göttingen, Göttingen, Germany
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25
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Löning M, Diddens H, Friedrich M, Altgassen C, Diedrich K, Hüttmann G. Fluoreszenzdiagnostik und photodynamische Therapie mit 5-Aminolävulinsäure induziertem Protoporphyrin IX in der Gynäkologie: eine Übersicht. ACTA ACUST UNITED AC 2006; 128:311-7. [PMID: 17213968 DOI: 10.1055/s-2005-836915] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Fluorescence diagnosis and photodynamic therapy with 5-aminolevulinic acid induced protoporphyrin IX are promising new options in the diagnosis and therapy of diseases in a wide spectrum of medical disciplines such as urology, dermatology, gastroenterology, surgery, neurosurgery and gynecology. The techniques are based on the application of the heme biomolecule precursor 5-aminolevulinic acid which induces the endogenous accumulation of the photosensitizer protoporphyrin IX in designated tissues. After external excitation with blue light a strong red fluorescence can be initiated particularly in tumorous tissues. In gynecology many studies have been performed evaluating the usefulness of fluorescence based detection of cervical dysplasias, breast cancer, endometrial diseases, ovarian cancer and endometriosis. This work aims on the principles of fluorescence detection as an important tool in biomedical optical imaging and its current status in gynecology.
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Affiliation(s)
- M Löning
- Klinik für Frauenheilkunde und Geburtshilfe, Universitätsklinikum Schleswig-Holstein Campus Lübeck, Lübeck, Germany.
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Hoerauf H, Müller M, Hüttmann G, Winter C, Schlote T. Real-time imaging of transscleral diode laser cyclophotocoagulation by optical coherence tomography. Graefes Arch Clin Exp Ophthalmol 2006; 245:385-90. [PMID: 17006680 DOI: 10.1007/s00417-006-0421-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2006] [Revised: 06/20/2006] [Accepted: 07/13/2006] [Indexed: 11/26/2022] Open
Abstract
PURPOSE To present optical coherence tomography (OCT) for real-time imaging of cyclophotocoagulation effects. METHODS In a pilot study, real-time transscleral OCT images were generated during diode laser cyclophotocoagulation in four eyes of four patients suffering from uncontrolled glaucoma using a specially designed contact applicator containing the OCT fiber, a focussing fiber optic and the fiber of the diode laser. RESULTS When the contact system was used, two layers could be differentiated: a superficial thick hyperreflective complex representing conjunctiva, Tenon's capsule, episclera and sclera, and a thinner hyporeflective layer representing the ciliary body. During cyclophotocoagulation, real-time OCT showed a clear and sudden thickening of the ciliary body in the treated area. CONCLUSION This new OCT device represents a first step towards visual, real-time imaging of cyclophotocoagulation. After further adaptation of the delivery system, further trials are needed to correlate OCT findings with aqueous production and intraocular pressure.
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Affiliation(s)
- H Hoerauf
- Department of Ophthalmology, Medical University Lübeck, Ratzeburger Allee 160, 23538, Lübeck, Germany.
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27
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Löning M, Dawson A, Diedrich K, Hüttmann G, Küpker W. Laparoskopisch Optische Diagnostik der Endometriose mit Hilfe der Gewebeautofluoreszenzdetektion. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952209] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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28
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Löning M, Lankenau E, Hillbricht S, Diedrich K, Hüttmann G. Optische Kohärenztomographie (OCT)–ein neues Verfahren der hochauflösenden optischen Diagnostik bei Dysplasien der Zervix. Geburtshilfe Frauenheilkd 2006. [DOI: 10.1055/s-2006-952810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Hoell T, Huschak G, Beier A, Hüttmann G, Minkus Y, Holzhausen HJ, Meisel HJ. Auto fluorescence of intervertebral disc tissue: a new diagnostic tool. Eur Spine J 2006; 15 Suppl 3:S345-53. [PMID: 16896842 PMCID: PMC2335379 DOI: 10.1007/s00586-006-0157-1] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/20/2006] [Revised: 05/29/2006] [Accepted: 06/06/2006] [Indexed: 11/28/2022]
Abstract
The paper reports on auto fluorescence phenomena of inter-vertebral human discs. It systematically investigates the auto fluorescence effects of ex vivo disc specimen and reports on surgical cases to demonstrate the potential value of the new method. The paper offers biologic explanations of the phenomenon and discusses the potential value of the UV auto fluorescence technique as a diagnostic tool. Intra- and postoperative observations are made by a surgical microscope with an integrated UV light source. Quantitative measurements were carried out using a photon counter and a spectrometer ex vivo. The auto fluorescence phenomenon allows the differentiation of traumatized and degenerated disc tissue intraoperatively in some cases, it allows the differentiation of bony and collagen endplate in cervical disc surgery. The source of the auto fluorescent light emission are amino acids of the collagen molecules. The proteoglycan components and the liquid components of the disc do not show relevant auto fluorescence. Emission wavelength of disc material is equivalent to color perception. It differs due to different collagen composition of the intervertebral disc components from yellow-green to blue-green and can be visualized in situ by naked eye.UV-auto fluorescence of inter-vertebral discs is a new clinical tool that has the potential to differentiate disc material from the anatomical surrounding, to distinguish between different fractions of the disc and to give information on the quality and status of the disc material. Since the technology has just emerged, it needs further investigations to quantify the clinical observations reported in this paper.
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Affiliation(s)
- T Hoell
- Department of Spine Surgery, Mittelbaden Hospital, Robert-Koch-Strasse 70, 77815, Bühl, Baden-Baden, Germany.
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Sommer KD, Gehrking E, Lankenau E, Hüttmann G. Die optische Kohärenztomographie (OCT) eine neue qualitative nicht-invasive Methode zur Diagnostik von Karzinomen im Kopf- und Halsbereich? Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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31
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Raap M, Koop N, Brandt R, Hüttmann G, Birngruber R, Schönweiler R. Quantitative Autofluoreszenz-Laryngoskopie (QAF) bei benignen und malignen Stimmlippenveränderungen. Laryngorhinootologie 2004. [DOI: 10.1055/s-2004-823377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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32
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Löning M, Lankenau E, Strunck C, Diedrich K, Hüttmann G. Optische Kohärenztomographie (OCT) bei zervikalen und vulvären Dysplasien. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-815196] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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33
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Löning M, Lankenau E, Strunck C, Krokowski M, Hillbricht S, Diedrich K, Hüttmann G. Optische Kohärenztomographie - ein neues hochauflösendes Schnittbildverfahren als Ergänzung zur Kolposkopie. Geburtshilfe Frauenheilkd 2003. [DOI: 10.1055/s-2003-43459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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34
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Brinkmann R, Hüttmann G, Rögener J, Roider J, Birngruber R, Lin CP. Origin of retinal pigment epithelium cell damage by pulsed laser irradiance in the nanosecond to microsecond time regimen. Lasers Surg Med 2001; 27:451-64. [PMID: 11126439 DOI: 10.1002/1096-9101(2000)27:5<451::aid-lsm1006>3.0.co;2-1] [Citation(s) in RCA: 103] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
BACKGROUND AND OBJECTIVE Selective photodamage of the retinal pigment epithelium (RPE) is a new technique to treat a variety of retinal diseases without causing adverse effects to surrounding tissues such as the neural retina including the photoreceptors and the choroid. In this study, the mechanism of cell damage after laser irradiation was investigated. STUDY DESIGN/MATERIALS AND METHODS Single porcine RPE-melanosomes and RPE cells were irradiated with a Nd:YLF laser (wavelength lambda = 527 nm, adjustable pulse duration tau = 250 nsec-3 microsec) and a Nd:YAG laser (lambda = 532 nm, tau = 8 nsec). Fast flash photography was applied to observe vaporization at melanosomes in suspension. A fluorescence viability assay was used to probe the cells vitality. RESULTS The threshold radiant exposures for vaporization around individual melanosomes and for ED50 cell damage are similar at 8-nsec pulse duration. Both thresholds increase with pulse duration; however, the ED50 cell damage radiant exposure is 40% lower at 3 microsec. Temperature calculations to model the onset of vaporization around the melanosomes are in good agreement with the experimental results when assuming a surface temperature of 150 degrees C to initiate vaporization and a homogeneous melanosome absorption coefficient of 8,000 cm(-1). Increasing the number of pulses delivered to RPE cells at a repetition rate of 500 Hz, the ED50 value decreases for all pulse durations. However, the behavior does not obey scaling laws such as the N 1/4 equation. CONCLUSION The origin of RPE cell damage for single pulse irradiation up to pulse durations of 3 microsec can be described by a damage mechanism in which microbubbles around the melanosomes cause a rupture of the cell structure. The threshold radiant exposure for RPE damage decreases with increasing number of pulses applied.
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Hendrich C, Hüttmann G, Vispo-Seara JL, Houserek S, Siebert WE. Experimental photodynamic laser therapy for rheumatoid arthritis with a second generation photosensitizer. Knee Surg Sports Traumatol Arthrosc 2000; 8:190-4. [PMID: 10883433 DOI: 10.1007/s001670050213] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Photodynamic laser therapy has been shown to be a new method for the treatment of synovitis in various animal models. Its principle is the accumulation of a photosensitizing drug in the inflamed synovium which is destroyed by photoactivation of the drug. In the present animal study we demonstrate the effect of a second-generation photosensitizer and suggest a concept for light dosimetry within the joint. We used 38 inbred rabbits for the IgG-induced arthritis model; 2 mg/kg of the benzoporphyrin derivative monoacid ring-A (BPD-MA) Verteporfin were administered 3 h before irradiation, which was performed using a 690-nm diode laser coupled to quartz glass fiber with a cylinder diffusor tip at a total light energy of either 180 or 470 J. During irradiation specific fluorescence of BPD-MA was monitored using a spectroscopy unit. The effect of the photodynamic laser therapy was documented grossly and histologically after 1 week. Within the 470 J-group a complete necrosis of the inflamed synovium was observed. The bradytrophic structures of the joint, however, remained unchanged. Throughout the 180 J-group the extent of necrosis was minor. During irradiation the tissue fluorescence of BPD-MA showed a dose-dependent decrease. Using BPD-MA as a photosensitizer a highly selective and minimal invasive synoviorthesis can be performed. At a dose of 2 mg/kg the histological effect depends on the light dose. For optimum efficacy a total energy of 470 J seems favorable. Online fluorescence detection can be used to monitor the effect of light administration. For dosimetry therefore an online tissue fluorescence detection may represent a technical solution.
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Affiliation(s)
- C Hendrich
- Department of Orthopedics, König-Ludwig-Haus, Würzburg University, Germany.
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36
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Hüttmann G, Birngruber R. Laserinduzierte thermische Gewebseffekte mit mikroskopischer und makromolekularer Präzision? Z Med Phys 2000. [DOI: 10.1016/s0939-3889(15)70301-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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37
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Brinkmann R, Rögener J, Hüttmann G, Lin C, Roider J, Birngruber R. MECHANISM OF RPE CELL DAMAGE FOR μs - LASER IRRADIATION. BIOMED ENG-BIOMED TE 2000. [DOI: 10.1515/bmte.2000.45.s1.322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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38
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Vispo Seara JL, Hüttmann G, Hendrich C, Housarek S, Lehnert C, Siebert WE. Experimentelle photodynamische Lasertherapie für die chronische Polyarthritis mit verschiedenen Photosensibilisatoren. Arthroskopie 1999. [DOI: 10.1007/s001420050070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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39
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Hendrich C, Hüttmann G, Lehnert C, Diddens H, Siebert WE. Photodynamic laser therapy for rheumatoid arthritis. Cell culture studies and animal experiments. Knee Surg Sports Traumatol Arthrosc 1997; 5:58-63. [PMID: 9127856 DOI: 10.1007/s001670050026] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
The introduction of arthroscopic techniques has improved the surgical therapy of rheumatoid arthritis. The additional application of the holmium:yttrium aluminum garnet (Ho:YAG) laser likewise holds great promise by providing complete hemorrhagic control. Unfortunately, a minimally invasive solution for use in smaller joints has not yet emerged. The present study describes the possible treatment of these joints by means of photodynamic laser therapy. Cell culture studies with human synovial fibroblasts obtained from patients with rheumatoid arthritis have demonstrated a cytotoxic effect after administration of Photosan-3 as a photosensitizer and subsequent laser irradiation at 630 nm. for the in vivo studies, IgG-induced arthritis in rabbits, which is histologically consistent with the proliferative phase of rheumatoid arthritis, was used as the animal model. The histologic picture following photodynamic laser therapy with Photosan-3 revealed complete synovial destruction which also extended to the border of the subjacent joint capsule. In contrast, bradytrophic structures, e.g. cartilage. menisci, and ligaments, remained unchanged at both the macroscopic and microscopic levels. Therefore, photodynamic laser therapy can be considered a new method in the surgical treatment of inflammatory disease of the synovial membrane. It has the advantage of being minimally invasive, while offering a high degree of efficacy and selectivity.
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Affiliation(s)
- C Hendrich
- Department of Orthopaedics, Würzburg University, Germany
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Novo M, Hüttmann G, Diddens H. Chemical instability of 5-aminolevulinic acid used in the fluorescence diagnosis of bladder tumours. J Photochem Photobiol B 1996; 34:143-8. [PMID: 8810532 DOI: 10.1016/1011-1344(96)07285-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Aqueous solutions of 5-aminolevulinic acid (ALA) prepared for intravesical instillation in the framework of a clinical study on the fluorescence diagnosis of urothelial bladder cancer were found to be unstable. This chemical instability of ALA was studied in aqueous solution of 37 degrees C as a function of concentration, pH and reaction time. Our investigations showed that the reaction of ALA is an irreversible process, which yields at least two reaction products in the pH range studied (pH lower than 8): the 2,5-(beta-carboxyethyl)dihydropyrazine and the 2,5-(beta-carboxyethyl)pyrazine. As a result of these studies, the conditions for the preparation of ALA solutions to be used for intravesical instillation were optimized: solution of ALA in phosphate-buffered saline at a concentration of 0.18 M (3 g of ALA in 100 ml) neutralized to pH 5, were prepared and stored on ice until use. Solutions prepared under these conditions were stable and were used for fluorescence diagnosis of bladder tumours with successful results. The effect of the pH and the composition of the urine on the extent of the reaction of ALA and on the nature of its reaction products formed during instillation was investigated by comparing the urine of patients before and immediately after instillation of ALA.
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Affiliation(s)
- M Novo
- Medizinisches Laserzentrum Lübeck, Germany
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41
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Hendrich C, Hüttmann G, Diddens H, Seara J, Siebert WE. [Experimental bases for photodynamic laser therapy in chronic polyarthritis]. Orthopade 1996; 25:30-6. [PMID: 8622843] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/31/2023]
Abstract
The principle of photodynamic laser therapy (PDT) for chronic polyarthritis consists in specifically concentrating a drug (photosensitizer) in the synovium. Subsequent activation of the photosensitizer by means of laser leads to a cytotoxic effect. The practicability of PDT was first shown in cell cultures of human synovial fibroblasts. For further tests an animal model consisting of IgG-induced arthritis in rabbits was used. In this model, concentration of the photosensitizer in the synovial lining cells, in the media of arteries and in the lymphoid infiltrate was seen. After laser irradiation there was total selective demarcation of the synovium. In contrast, bradytrophic tissues such as cartilage, meniscus and ligament structures were changed neither macroscopically nor microscopically. In the animal model PDT combines high selectivity with minimal invasiveness and can be used in small joints. PDT thus offers ideal preconditions for future minimal invasive treatment of chronic inflammatory joint diseases.
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Affiliation(s)
- C Hendrich
- Orthopädische Universitätsklinik, König-Ludwig-Haus, Würzburg
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42
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Hoerauf H, Hüttmann G, Diddens H, Thiele B, Laqua H. [Photodynamic therapy of eyelid basalioma after topical administration of delta-aminolevulinic acid]. Ophthalmologe 1994; 91:824-9. [PMID: 7849439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/27/2023]
Abstract
Delta-aminolevulinic acid (ALA) induced Protoporphyring IX photodynamic therapy (PDT) is a new method in the therapy of cutaneous malignancies. Topical application prevents photosensibilization of normal skin. Promising results in the treatment of superficial basal cell carcinomas have been reported. To evaluate the efficiency of this method in the therapy of basal cell carcinomas of the lid, 10 patients were treated by PDT 5 h after application of ALA. The lesions were irradiated by an argon-ion-laser-pumped dye laser at a wavelength of 630 or 635 nm and at cumulative radiant exposures of 50 and 100 J/cm2. After 5-8 weeks follow-up, the basal cell carcinomas were excised to assess histologic changes. In the first few days after PDT the lesions seemed clinically to regress, due to erythematous swelling, but after a few weeks all tumours showed the same configuration they had before irradiation. Histological examination revealed small areas of necrotic cells in all irradiated basal cell carcinomas, surrounded by residual tumour formations. The reason for the poor results may be limited penetration of ALA or light. Although ALA-induced Protoporphyrin-IX PDT is a promising approach in the therapy of dermal lesions, it is not yet an acceptable alternative method in the treatment of basal cell carcinomas of the lid.
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Hüttmann G, Kühnle W, Staerk H. Photoinduced ion and ketyl radical formation in covalently linked benzophenone—dimethylaniline studied by time-resolved transient absorption spectroscopy with picosecond resolution. J Photochem Photobiol A Chem 1993. [DOI: 10.1016/1010-6030(93)80012-x] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Pieper K, Hüttmann G. [Caries and gingivitis prevention in handicapped children and youth. Part 3. Five-year results]. Dtsch Zahnarztl Z 1989; 44:521-4. [PMID: 2534294] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
In schools for handicapped children in Göttingen 104 mentally and physically handicapped and 150 learning disabled pupils participated in an intensive care preventive program. Their teeth were examined before beginning the prevention, after 6 months, and subsequently at annual intervals. The examinations consisted of caries diagnosis and assessment of periodontal health. Five years after the onset of the prevention program the incidence of caries in the various age groups and institutions was 23% to 64% lower than 1982. Results were best in mentally and physically handicapped children aged 9 to 11 years (mean DMF-S 1987: 2.4 versus 1982: 6.6). In the same period of observation the degree of oral health in mentally and physically handicapped children improved from 43% to 73%, in learning disabled from 32% to 63%. Mean SBI values were reduced by 60%.
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Pieper K, Dirks G, Evers W, Hüttmann G. [Caries incidence and oral hygiene level in young school children in Gottingen]. Oralprophylaxe 1989; 11:50-6. [PMID: 2635962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
669 school beginners and 739 fourth-year pupils in Göttingen were examined for caries prevalence and dental hygienic measures. 28% of first-year pupils examined had naturally healthy primary teeth; the average DFS was 6.8. Only 12% of the carious primary tooth surfaces had intact fillings. Carious defects in permanent teeth were restricted to sixth-year molars. Among the fourth-year pupils 26.8% had no caries on their permanent teeth; the average DMFS was 3.9. In this age group 60% of the carious tooth surfaces had been treated and the M components observed were minimal. A total of only 16 sixth-year molars were missing because of caries in all the children examined. A comparison of prevalence rates among different schools revealed considerable differences: Average DMFS values at the various schools ranged from 2.0 to 5.5.
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Pieper K, Hüttmann G, Evers W, Gehring F. [A selective, need-oriented prevention program for primary schoolchildren - results after two years]. Dtsch Zahnarztl Z 1989; 44:130-2. [PMID: 2598871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/01/2023]
Abstract
427 first grade pupils from primary schools in Göttingen participated in a selective, need-oriented preventive program. Following a clinical examination and an additional saliva test the children were assigned to three risk groups, according to the severity of the initial findings. Each group received preventive care of varying intensity. Two years later the children of risk group 1 ("minor caries risk") showed a mean 0.5 and those of risk group 2 ("medium caries risk") a mean 1.0 new DF surfaces. In the children of the high caries risk group the average caries increment was 1.8 DF surfaces. The degree of sanation of the deciduous teeth could be improved from 10% to 47% within the two years' test period. The saliva tests revealed that the number of cariogenic organisms was markedly reduced in the course of the preventive program.
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