FUNDUS AUTOFLUORESCENCE LIFETIMES AND CENTRAL SEROUS CHORIORETINOPATHY.

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Dysli, Chantal; Berger, Lieselotte; Wolf, Sebastian; Zinkernagel, Martin S

2017-11-01

To quantify retinal fluorescence lifetimes in patients with central serous chorioretinopathy (CSC) and to identify disease specific lifetime characteristics over the course of disease. Forty-seven participants were included in this study. Patients with central serous chorioretinopathy were imaged with fundus photography, fundus autofluorescence, optical coherence tomography, and fluorescence lifetime imaging ophthalmoscopy (FLIO) and compared with age-matched controls. Retinal autofluorescence was excited using a 473-nm blue laser light and emitted fluorescence light was detected in 2 distinct wavelengths channels (498-560 nm and 560-720 nm). Clinical features, mean retinal autofluorescence lifetimes, autofluorescence intensity, and corresponding optical coherence tomography (OCT) images were further analyzed. Thirty-five central serous chorioretinopathy patients with a mean visual acuity of 78 ETDRS letters (range, 50-90; mean Snellen equivalent: 20/32) and 12 age-matched controls were included. In the acute stage of central serous chorioretinopathy, retinal fluorescence lifetimes were shortened by 15% and 17% in the respective wavelength channels. Multiple linear regression analysis showed that fluorescence lifetimes were significantly influenced by the disease duration (P autofluorescence lifetimes, particularly in eyes with retinal pigment epithelial atrophy, were associated with poor visual acuity. This study establishes that autofluorescence lifetime changes occurring in central serous chorioretinopathy exhibit explicit patterns which can be used to estimate perturbations of the outer retinal layers with a high degree of statistical significance.

Virtual Bronchoscopy for Diagnosis of Recurrent Respiratory Papillomatosis

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Chin-Hung Chang

2006-01-01

Full Text Available Virtual bronchoscopy is a new method for viewing helical/spiral computed tomography (CT images of the tracheobronchial trees. Using commercially available software to process the CT data, the tracheobronchial trees can be inspected through a series of three-dimensional images. Recently, this technique has been increasingly used to detect benign and malignant airway stenosis. We report the findings of virtual bronchoscopy in a 41-year-old man with recurrent respiratory papillomatosis (RRP. Several tiny nodules were evident in the lower trachea. Fiberoptic bronchoscopy was performed 1 month later during a planned surgery for laryngeal papillomas, and the findings were in agreement with virtual bronchoscopy. Detection of intrabronchial spreading in RRP is important since peripheral seeding of RRP can cause complications, including recurrent pneumonia, obstructive atelectasis, hemoptysis, and, rarely, may degenerate to squamous cell carcinoma. Virtual bronchoscopy is an alternative method for inspecting the tracheobronchial trees in patients with RRP when laryngeal papillomas impede fiberoptic bronchoscopy.

DISCORDANCE BETWEEN BLUE-LIGHT AUTOFLUORESCENCE AND NEAR-INFRARED AUTOFLUORESCENCE IN AGE-RELATED MACULAR DEGENERATION.

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Heiferman, Michael J; Fawzi, Amani A

2016-12-01

To identify the origin and significance of discordance between blue-light autofluorescence (BL-AF; 488 nm) and near-infrared autofluorescence (NI-AF; 787 nm) in patients with age-related macular degeneration (AMD). A total of 86 eyes of 59 patients with a diagnosis of AMD were included in this cross-sectional study conducted between March 9, 2015 and May 1, 2015. A masked observer examined the BL-AF, NI-AF, and spectral-domain optical coherence tomography images. Areas with discordance of autofluorescence patterns between NI-AF and BL-AF images were correlated with structural findings at the corresponding location in optical coherence tomography scans. Seventy-nine eyes had discordance between BL-AF and NI-AF. The most common optical coherence tomography finding accounting for these discrepancies was pigment migration accounting for 35 lesions in 21 eyes. The most clinically relevant finding was geographic atrophy missed on BL-AF in 7 eyes. Our findings indicate that variations in the distribution of lipofuscin, melanin and melanolipofuscin account for the majority of discordance between BL-AF and NI-AF. Given our finding of missed geographic atrophy lesions on BL-AF in 24% of eyes with geographic atrophy (7/29 eyes), clinicians should consider multimodal imaging, including NI-AF and optical coherence tomography, especially in clinical trials of geographic atrophy.

Flexible fiberoptic bronchoscopy service; an aid to patient management

LENUS (Irish Health Repository)

Marathe, N

2016-02-01

The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Luke’s General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Luke’s Hospital were studied. In total, 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24.8%) of suspected malignancy. The average time taken for procedure was 15 + 1 minute with overall rate of complication recorded in 1 case (0.95%). 32(30%) inpatients were referred before bronchoscopy services were started locally. Fifteen (14%) patients were referred for Endobronchial Ultrasound (EBUS) after diagnostic procedure performed at St. Luke’s Hospital. To conclude, Bronchoscopy is a safe procedure used for diagnosis of various Lung conditions. The services offered locally reduced the time and cost involved in referrals. The diagnostic bronchoscopies performed for malignancy at St. Luke’s Hospital have rightly increased references for EBUS at Tertiary care Unit

Skin autofluorescence and all-cause mortality in stage 3 CKD.

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Fraser, Simon D S; Roderick, Paul J; McIntyre, Natasha J; Harris, Scott; McIntyre, Christopher W; Fluck, Richard J; Taal, Maarten W

2014-08-07

Novel markers may help to improve risk prediction in CKD. One potential candidate is tissue advanced glycation end product accumulation, a marker of cumulative metabolic stress, which can be assessed by a simple noninvasive measurement of skin autofluorescence. Skin autofluorescence correlates with higher risk of cardiovascular events and mortality in people with diabetes or people requiring RRT, but its role in earlier CKD has not been studied. A prospective cohort of 1741 people with CKD stage 3 was recruited from primary care between August 2008 and March 2010. Participants underwent medical history, clinical assessment, blood and urine sampling for biochemistry, and measurement of skin autofluorescence. Kaplan-Meier plots and multivariate Cox proportional hazards models were used to investigate associations between skin autofluorescence (categorical in quartiles) and all-cause mortality. In total, 1707 participants had skin autofluorescence measured; 170 (10%) participants died after a median of 3.6 years of follow-up. The most common cause of death was cardiovascular disease (41%). Higher skin autofluorescence was associated significantly with poorer survival (all-cause mortality, Pskin autofluorescence was associated with all-cause mortality (hazard ratio, 2.64; 95% confidence interval, 1.71 to 4.08; PSkin autofluorescence was not independently associated with all-cause mortality in this study. Additional research is needed to clarify whether it has a role in risk prediction in CKD. Copyright © 2014 by the American Society of Nephrology.

Autofluorescence imaging of basal cell carcinoma by smartphone RGB camera

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Lihachev, Alexey; Derjabo, Alexander; Ferulova, Inesa; Lange, Marta; Lihacova, Ilze; Spigulis, Janis

2015-12-01

The feasibility of smartphones for in vivo skin autofluorescence imaging has been investigated. Filtered autofluorescence images from the same tissue area were periodically captured by a smartphone RGB camera with subsequent detection of fluorescence intensity decreasing at each image pixel for further imaging the planar distribution of those values. The proposed methodology was tested clinically with 13 basal cell carcinoma and 1 atypical nevus. Several clinical cases and potential future applications of the smartphone-based technique are discussed.

Centrifugal expansion of fundus autofluorescence patterns in Stargardt disease over time.

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Cukras, Catherine A; Wong, Wai T; Caruso, Rafael; Cunningham, Denise; Zein, Wadih; Sieving, Paul A

2012-02-01

To study the longitudinal changes in autofluorescence in Stargardt disease to reveal aspects of disease progression not previously evident. Changes in autofluorescence reflect changing fluorophore compositions of lipofuscin and melanin in retinal pigment epithelial cells, which has been hypothesized to contribute to Stargardt disease pathogenesis. We examined the temporospatial patterns of fundus autofluorescence with excitation at both 488 nm (standard fundus autofluorescence) and 795 nm (near-infrared autofluorescence) in a longitudinal case series involving 8 eyes of 4 patients (range of follow-up, 11-57 months; mean, 39 months). Image processing was performed to analyze spatial and temporal cross-modality associations. Longitudinal fundus autofluorescence imaging of fleck lesions revealed hyperautofluorescent lesions that extended in a centrifugal direction from the fovea with time. Patterns of spread were nonrandom and followed a radial path that left behind a trail of diminishing autofluorescence. Longitudinal near-infrared autofluorescence imaging also demonstrated centrifugal lesion spread but with fewer hyperautofluorescent lesions, suggestive of more transient hyperautofluorescence and more rapid decay at longer wavelengths. Fundus autofluorescence and near-infrared autofluorescence abnormalities were spatially correlated with each other, and together they reflect systematic progressions in fleck distribution and fluorophore composition occurring during the natural history of the disease. Stargardt disease fleck lesions do not evolve randomly in location but instead follow consistent patterns of radial expansion and a systematic decay of autofluorescence that reflect changing lipofuscin and melanin compositions in retinal pigment epithelial cells. These progressive foveal-to-peripheral changes are helpful in elucidating molecular and cellular mechanisms underlying Stargardt disease and may constitute potential outcome measures in clinical trials.

Autofluorescence: A screening test for mycotic infection in tissues

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Rao Shalinee

2008-04-01

Full Text Available Fungal infection is a major health concern as the clinical features are not very distinctive. Lack of rapid diagnostic techniques results in delay in diagnosis, which may even culminate in a fatal outcome. The fact that many pathogenic fungal organisms autofluoresce in hematoxylin and eosin (H and E-stained sections under ultraviolet illumination led us to evaluate the role of autofluorescence as a rapid screening technique for fungal infections. The aim of the present study was to assess the value of autofluorescence as a screening method for detecting fungi on tissue sections and to compare the results of autofluorescence with conventional histochemical stains for fungi. Hematoxylin and eosin-stained slides of mycotic lesions were examined under fluorescent microscope and the findings were compared with results of Gomori′s methenamine silver and periodic acid-Schiff stains. We found fungal autofluorescence in 63 out of 64 cases studied, with a sensitivity of 97.8% and specificity of 100% in comparison with fungal stains. This was statistically significant (P < 0.05. We conclude that autofluorescence can be used as a rapid screening method for identification of fungi in tissue sections as it does not require any other specialized staining procedure

Algorithm for Video Summarization of Bronchoscopy Procedures

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Leszczuk Mikołaj I

2011-12-01

Full Text Available Abstract Background The duration of bronchoscopy examinations varies considerably depending on the diagnostic and therapeutic procedures used. It can last more than 20 minutes if a complex diagnostic work-up is included. With wide access to videobronchoscopy, the whole procedure can be recorded as a video sequence. Common practice relies on an active attitude of the bronchoscopist who initiates the recording process and usually chooses to archive only selected views and sequences. However, it may be important to record the full bronchoscopy procedure as documentation when liability issues are at stake. Furthermore, an automatic recording of the whole procedure enables the bronchoscopist to focus solely on the performed procedures. Video recordings registered during bronchoscopies include a considerable number of frames of poor quality due to blurry or unfocused images. It seems that such frames are unavoidable due to the relatively tight endobronchial space, rapid movements of the respiratory tract due to breathing or coughing, and secretions which occur commonly in the bronchi, especially in patients suffering from pulmonary disorders. Methods The use of recorded bronchoscopy video sequences for diagnostic, reference and educational purposes could be considerably extended with efficient, flexible summarization algorithms. Thus, the authors developed a prototype system to create shortcuts (called summaries or abstracts of bronchoscopy video recordings. Such a system, based on models described in previously published papers, employs image analysis methods to exclude frames or sequences of limited diagnostic or education value. Results The algorithm for the selection or exclusion of specific frames or shots from video sequences recorded during bronchoscopy procedures is based on several criteria, including automatic detection of "non-informative", frames showing the branching of the airways and frames including pathological lesions. Conclusions

Fundus autofluorescence in serpiginouslike choroiditis.

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Gupta, Amod; Bansal, Reema; Gupta, Vishali; Sharma, Aman

2012-04-01

To report the fundus autofluorescence characteristics in serpiginouslike choroiditis. Twenty-nine patients with presumed tubercular serpiginouslike choroiditis between November 2008 and January 2010 underwent fundus autofluorescence imaging during the acute stage and at regular intervals till the lesions healed. All patients received antitubercular therapy with oral corticosteroids. The autofluorescence images were compared with color fundus photography and fundus fluorescein angiography. The main outcome measure was fundus autofluorescence characteristics of lesions during the course of the disease. The pattern of fundus autofluorescence changed as the lesions evolved from the acute to the healed stage. In acute stage, the lesions showed an ill-defined halo of increased autofluorescence (hyperautofluorescence), giving it a diffuse, amorphous appearance (Stage I, acute). As the lesions began to heal, a thin rim of decreased autofluorescence (hypoautofluorescence) surrounded the lesion, defining its edges. The lesions showed predominantly hyperautofluorescence with stippled pattern (Stage II, subacute). With further healing, the hypoautofluorescence progressed and the lesion appeared predominantly hypoautofluorescent with stippled pattern (Stage III, nearly resolved). On complete healing, the lesions became uniformly hypoautofluorescent (Stage IV, completely resolved). Fundus autofluorescence highlighted the areas of disease activity and was a quick imaging tool for monitoring the course of lesions in serpiginouslike choroiditis.

Iris autofluorescence in Fuchs' heterochromic uveitis.

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Liu, Qian; Jia, Yading; Zhang, Suhua; Xie, Juan; Chang, Xin; Hou, Jia; Li, Gaiyun; Koch, Douglas D; Wang, Li

2016-10-01

To explore the characteristic autofluorescence patterns of iris depigmentation in eyes diagnosed with Fuchs' heterochromic uveitis (FHU). Near-infrared autofluorescence images and colour images of iris were taken in 21 eyes of 21 patients with FHU, 30 eyes of 15 normal subjects, 30 eyes of 15 normal age-related iris atrophy and 33 eyes of 20 patients with uveitis other than FHU. The confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2, HRA2) was used for melanin-related autofluorescence imaging. The indocyanine green angiography mode of HRA2 was applied for near-infrared laser imaging, and the wavelength of the excitation laser was 795 nm. Iris colour images were also taken with the slit lamp. In normal iris, moderately intense autofluorescence was noted for the pigment ruff at the pupillary border, the crests in the pupillary zone and the collarette; and there was mild autofluorescence in the ciliary zone. In eyes with age-related iris atrophy and uveitis, much less autofluorescence was seen than the healthy normal irides. In eyes with FHU, there was moderate but discontinuous autofluorescence in the pigment ruff, a petaloid pattern of autofluorescence in the pupillary zone, moderate autofluorescence in the collarette and reticular pattern of autofluorescence in the ciliary zone. Characteristic autofluorescence patterns appeared in eyes diagnosed with FHU. Near-infrared autofluorescence is a promising objective technique to document the iris changes in FHU. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

On the autofluorescence of fingermarks

NARCIS (Netherlands)

Lambrechts, S. A. G.; van Dam, A. [=Annemieke; de Vos, J.; van Weert, A.; Sijen, T.; Aalders, M. C. G.

2012-01-01

The autofluorescence of fingermarks is used for their detection. The components responsible for this autofluorescence are largely unknown. Thin layer chromatography and fluorescence spectroscopy were used to identify autofluorescent components and evaluate their forensic value. Based on our results,

Diagnosis of Peripheral Lung Lesions via Conventional Flexible Bronchoscopy with Multiplanar CT Planning

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Marianne Anastasia De Roza

2016-01-01

Full Text Available Background. Conventional flexible bronchoscopy has limited sensitivity in the diagnosis of peripheral lung lesions and is dependent on lesion size. However, advancement of CT imaging offers multiplanar reconstruction facilitating enhanced preprocedure planning. This study aims to report efficacy and safety while considering the impact of patient selection and multiplanar CT planning. Method. Prospective case series of patients with peripheral lung lesions suspected of having lung cancer who underwent flexible bronchoscopy (forceps biopsy and lavage. Endobronchial lesions were excluded. Patients with negative results underwent CT-guided transthoracic needle aspiration, surgical biopsy, or clinical-radiological surveillance to establish the final diagnosis. Results. 226 patients were analysed. The diagnostic yield of bronchoscopy was 80.1% (181/226 with a sensitivity of 84.2% and specificity of 100%. In patients with a positive CT-Bronchus sign, the diagnostic yield was 82.4% compared to 72.8% with negative CT-Bronchus sign (p=0.116. Diagnostic yield was 84.9% in lesions > 20 mm and 63.0% in lesions ≤ 20 mm (p=0.001. Six (2.7% patients had transient hypoxia and 2 (0.9% had pneumothorax. There were no serious adverse events. Conclusion. Flexible bronchoscopy with appropriate patient selection and preprocedure planning is more efficacious in obtaining a diagnosis in peripheral lung lesions compared to historical data. This trial is registered with ClinicalTrials.gov Identifier: NCT01374542.

Distributed practice. The more the merrier? A randomised bronchoscopy simulation study.

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Bjerrum, Anne Sofie; Eika, Berit; Charles, Peder; Hilberg, Ole

2016-01-01

The distribution of practice affects the acquisition of skills. Distributed practice has shown to be more effective for skills acquisition than massed training. However, it remains unknown as to which is the most effective distributed practice schedule for learning bronchoscopy skills through simulation training. This study compares two distributed practice schedules: One-day distributed practice and weekly distributed practice. Twenty physicians in training were randomly assigned to one-day distributed or weekly distributed bronchoscopy simulation practice. Performance was assessed with a pre-test, a post-test after each practice session, and a 4-week retention test using previously validated simulator measures. Data were analysed with repeated measures ANOVA. No interaction was found between group and test (F(4,72) 0.16), except for the measure 'percent-segments-entered', and no main effect of group was found for any of the measures (F(1,72)0.36), which indicates that there was no difference between the learning curves of the one-day distributed practice schedule and the weekly distributed practice schedule. We found no difference in effectiveness of bronchoscopy skills acquisition between the one-day distributed practice and the weekly distributed practice. This finding suggests that the choice of bronchoscopy training practice may be guided by what best suits the clinical practice.

Autofluorescence and high-definition optical coherence tomography of retinal artery occlusions

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Raeba Mathew

2010-10-01

Full Text Available Raeba Mathew, Evangelia Papavasileiou, Sobha SivaprasadLaser and Retinal Research Unit, Department of Ophthalmology, King’s College Hospital, Denmark Hill, London, UKBackground: The purpose of this study is to illustrate the fundus autofluorescence and high-definition optical coherence tomography (HD-OCT features of acute and long-standing retinal artery occlusions.Design: Retrospective case series.Participants: Patients with acute and chronic retinal and cilioretinal artery occlusions are included in this series.Methods: A detailed clinical examination, color fundus photographs, autofluorescence, and HD-OCT of the subjects were performed.Results: HD-OCT demonstrates the localized and well-demarcated thickening of the inner retina in the acute phase of arterial occlusions that correlates with the areas of blocked autofluorescence caused by the cloudy swelling of the retina. The areas of blocked autofluorescence disappear with chronicity of the disease and this corresponds to the thinning of the inner retinal layers on HD-OCT.Conclusion: Heidelberg OCT and autofluorescence are useful tools to assess retinal arterial occlusions especially in subjects with unexplained visual field loss.Keywords: autofluorescence, high definition OCT, retinal artery occlusion

Fundus autofluorescence: applications and perspectives.

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Cuba, J; Gómez-Ulla, F

2013-02-01

To describe the findings of the study of autofluorescence of the different retinal diseases included in the study. To determine in which diseases autofluorescence may be more, or just as, useful as fluorescein angiography (FAG) in terms of diagnostic information. We studied the retinal autofluorescence of 123 eyes of 93 patients, including various diseases of the eye fundus. In all cases we explored the fundus, retinal autofluorescence, and, if indicated, FAG was performed. Analysis of the autofluorescence was performed using the Heidelberg Retina angiography Angiograph 2 (HRA2) Heidelberg Engineering (Germany). The autofluorescence information provided was equal or better (than FAG) in: 68.18% of cases of macular edema, 50% of pigment epithelium detachments, 100% of pigment epithelium atrophies, 100% of central serous chorioretinopathy; 55.55% of choroidal neovascularization, 100% of retinal dystrophies with deposition of lipofuscin, 100% of hard exudates and pre-retinal hemorrhages. Autofluorescence is a quick and non-invasive examination method, comfortable for both patient and examiner, and with a very short learning curve. It provides diagnostic information about many eye fundus diseases. While more studies and more experience with its use are needed, its interest lies in the possibility of avoiding the performing of angiography in patients with these diseases, and in the additional information autofluorescence provides about the functional situation of cells and retinal pigments. Copyright © 2011 Sociedad Española de Oftalmología. Published by Elsevier Espana. All rights reserved.

Application of laser-induced autofluorescence spectra detection in human colorectal cancer screening

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Fu, Sheng; Chia, Teck-Chee; Kwek, Leong Chuan; Diong, Cheong Hoong; Tang, Choong Leong; Choen, Francis S.; Krishnan, S. M.

2003-10-01

We investigated 48 normal patients and 25 diseased patients using our laser-induced autofluorescence spectra detection system during their regular colonoscopy. The colon and rectum mucosa autofluorescence were excited by 405 nm continue wavelength laser. We observed that cancer or diseased colorectal mucosa, their autofluorescence spectra are significantly different from normal area. The autofluorescence spectra intensity at about 500 nm was been used for our intensity ratio characteristics intensity for our diagnostic algorithm. The intensity ratios of RI-680/I-500 and RI-630/I-500 were performed to identify the detection area. From experimental result we concluded that both intensity ratios of RI-680/I-500 and RI-630/I-500 as guidelines can detect cancerous and polyps disease completely. Our investigation provided some useful insight for laser induced autofluorescence spectra as a diagnosis technique for clinical application.

[Fundus autofluorescence. Has it a place in the management of diabetic macular edema?

Science.gov (United States)

Zbiba, W; Baba, A; Bouayed, E; Daldoul, A

2016-11-01

Analyze the characteristics of fundus autofluorescence of diabetic macular edema and study the association between these characteristics and visual function. Our study included 18 patients (28 eyes) with clinically significant diabetic macular edema. All patients had a complete eye examination with a fundus autofluorescence imaging and optical coherence tomography. The central macular thickness and central macular volume were measured. The integrity of the inner segment-outer segment junction and the integrity of the external limiting membrane were also evaluated in the same area. Among the 28 eyes studied, 8 had normal autofluorescence. The remaining 20 eyes had abnormal autofluorescence: a hyper-cystoid autofluorescence in 5 eyes (25%), hyper-spot autofluorescence in 8 eyes (40%), and hypo-irregular autofluorescence in 5 eyes (25%). Best corrected visual acuity was significantly better in patients with normal autofluorescence and those with hyper-cystoid autofluorescence. There was no significant difference in central macular thickness (P=0.186) and central macular volume (P=0.191) between the four groups. The autofluorescence is a simple, fast, and non-invasive technique for the study of diabetic macular edema with good correlation to the visual function as well as to the extent of damage to the retina. It is, therefore, a possible alternative to other invasive imaging techniques in particular in the long term monitoring of diabetic macular edema. Copyright © 2016 Elsevier Masson SAS. All rights reserved.

Relevance of wide-field autofluorescence imaging in Birdshot retinochoroidopathy: descriptive analysis of 76 eyes.

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Piffer, Anne-Laure Le; Boissonnot, Michèle; Gobert, Frédéric; Zenger, Anita; Wolf, Sebastian; Wolf, Ute; Korobelnik, Jean-François; Rougier, Marie-Bénédicte

2014-09-01

To study and classify retinal lesions in patients with birdshot disease using wide-field autofluorescence imaging and correlate them according to patients' visual status. A multicentre study was carried out on 76 eyes of 39 patients with birdshot disease, analysing colour images and under autofluorescence using the wide-field Optomap(®) imaging system. This was combined with a complete clinical exam and analysis of the macula with OCT. In over 80% of the eyes, a chorioretinal lesion has been observed under autofluorescence with a direct correlation between the extent of the lesion and visual status. The presence of macular hypo-autofluorescence was correlated with a decreased visual acuity, due to the presence of a macular oedema, active clinical inflammation or an epiretinal membrane. The hypo-autofluorescence observed correlated with the duration of the disease and the degree of inflammation in the affected eye, indicating a secondary lesion in the pigment epithelium in relation to the choroid. The pigment epithelium was affected in a diffuse manner, as in almost 50% of the eyes the wider peripheral retina was affected. Wide-field autofluorescence imaging could appear to be a useful examination when monitoring patients, to look for areas of macular hypo-autofluorescence responsible for an irreversible loss of vision. © 2013 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.

Quantitative Fundus Autofluorescence in Recessive Stargardt Disease

OpenAIRE

Burke, Tomas R.; Duncker, Tobias; Woods, Russell L.; Greenberg, Jonathan P.; Zernant, Jana; Tsang, Stephen H.; Smith, R. Theodore; Allikmets, Rando; Sparrow, Janet R.; Delori, François C.

2014-01-01

Quantitative fundus autofluorescence (qAF) is significantly increased in Stargardt disease, consistent with previous reports of increased RPE lipofuscin. QAF will help to establish genotype-phenotype correlations and may serve as an outcome measure in clinical trials.

A review of fundus autofluorescence imaging

OpenAIRE

D. J. Booysen

2013-01-01

Autofluorscence photography of the retina provides important diagnostic information about diseases that affect the outer retina; more specifically the retinal pigment epithelium and photoreceptors. Fundus autofluorescence can alsobe used to evaluate macular pigment density and other diseases of the retina and choroid. It is a non-invasive clinical tool which has the potential to revolutionise clinical retina practice. (S Afr Optom 2013 72(1) 46-53)

The Role of Fundus Autofluorescence in Late-Onset Retinitis Pigmentosa (LORP) Diagnosis

Science.gov (United States)

Lee, Tamara J.; Hwang, John C.; Chen, Royce W. S.; Lima, Luiz H.; Wang, Nan-Kai; Tosi, Joaquin; Freund, K. Bailey; Yannuzzi, Lawrence A.; Tsang, Stephen H.

2015-01-01

Purpose To demonstrate the utility and characteristics of fundus autofluorescence in late-onset retinitis pigmentosa. Methods Observational case series. Patients diagnosed with late-onset retinitis pigmentosa were identified retrospectively in an institutional setting. Twelve eyes of six patients were identified and medical records were reviewed. Results All patients presented with slowly progressive peripheral field loss and initial clinical examination revealed only subtle retinal changes. There was a notable lack of intraretinal pigment migration in all patients. Five out of six patients underwent magnetic resonance imaging of the brain to rule out intracranial processes and all were referred from another ophthalmologist for further evaluation. Fundus autofluorescence was ultimately employed in all patients and revealed more extensive retinal pathology than initially appreciated on clinical examination. Fundus autofluorescence directed the workup toward a retinal etiology in all cases and led to the eventual diagnosis of late-onset retinitis pigmentosa through electroretinogram testing. Conclusion Fundus autofluorescence may be a more sensitive marker for retinal pathology than stereo fundus biomicroscopy alone in late-onset retinitis pigmentosa. Early use of fundus autofluorescence imaging in the evaluation of patients with subtle retinal lesions and complaints of peripheral field loss may be an effective strategy for timely and cost-efficient diagnosis. PMID:23899229

Fundus Autofluorescence Features of Optic Disc Pit Related ...

African Journals Online (AJOL)

chorioretinopathy, retina telangiectasia and diffuse and macula retina dystrophies.[1,3‑8] These features give useful clinical and prognostic information, making FAF a desired day‑to‑day clinical tool. Fundus autoflorescence signals can be detected using 3 different systems, the Delori's fundus. Fundus Autofluorescence ...

Autofluorescence lifetime imaging during transoral robotic surgery: a clinical validation study of tumor detection (Conference Presentation)

Science.gov (United States)

Lagarto, João. L.; Phipps, Jennifer E.; Unger, Jakob; Faller, Leta M.; Gorpas, Dimitris; Ma, Dinglong M.; Bec, Julien; Moore, Michael G.; Bewley, Arnaud F.; Yankelevich, Diego R.; Sorger, Jonathan M.; Farwell, Gregory D.; Marcu, Laura

2017-02-01

Autofluorescence lifetime spectroscopy is a promising non-invasive label-free tool for characterization of biological tissues and shows potential to report structural and biochemical alterations in tissue owing to pathological transformations. In particular, when combined with fiber-optic based instruments, autofluorescence lifetime measurements can enhance intraoperative diagnosis and provide guidance in surgical procedures. We investigate the potential of a fiber-optic based multi-spectral time-resolved fluorescence spectroscopy instrument to characterize the autofluorescence fingerprint associated with histologic, morphologic and metabolic changes in tissue that can provide real-time contrast between healthy and tumor regions in vivo and guide clinicians during resection of diseased areas during transoral robotic surgery. To provide immediate feedback to the surgeons, we employ tracking of an aiming beam that co-registers our point measurements with the robot camera images and allows visualization of the surgical area augmented with autofluorescence lifetime data in the surgeon's console in real-time. For each patient, autofluorescence lifetime measurements were acquired from normal, diseased and surgically altered tissue, both in vivo (pre- and post-resection) and ex vivo. Initial results indicate tumor and normal regions can be distinguished based on changes in lifetime parameters measured in vivo, when the tumor is located superficially. In particular, results show that autofluorescence lifetime of tumor is shorter than that of normal tissue (p robot assisted cancer removal interventions.

Evaluation of skin pathologies by RGB autofluorescence imaging

Science.gov (United States)

Lihachev, Alexey; Plorina, Emilija V.; Derjabo, Alexander; Lange, Marta; Lihacova, Ilze

2017-12-01

A clinical trial on autofluorescence imaging of malignant and non-malignant skin pathologies comprising 32 basal cell carcinomas (BCC), 4 malignant melanomas (MM), 1 squamous cell carcinoma (SCC), 89 nevi, 14 dysplastic nevi, 20 hemangiomas, 23 seborrheic keratoses, 4 hyperkeratoses, 3 actinic keratoses, 3 psoriasis, 1 dematitis, 2 dermatofibromas, 5 papillofibromas, 12 lupus erythematosus, 7 purpura, 6 bruises, 5 freckles, 3 fungal infections, 1 burn, 1 tattoo, 1 age spot, 1 vitiligo, 32 postoperative scars, 8 post cream therapy BCCs, 4 post radiation therapy scars, 2 post laser therapy scars, 1 post freezing scar as well as 114 reference images of healthy skin was performed. The sequence of autofluorescence images of skin pathologies were recorded by smartphone RGB camera under continuous 405 nm LED excitation during 20 seconds with 0.5 fps. Obtained image sequences further were processed with subsequent extraction of autofluorescence intensity and photobleaching parameters.

A review of fundus autofluorescence imaging

Directory of Open Access Journals (Sweden)

D. J. Booysen

2013-12-01

Full Text Available Autofluorscence photography of the retina provides important diagnostic information about diseases that affect the outer retina; more specifically the retinal pigment epithelium and photoreceptors. Fundus autofluorescence can alsobe used to evaluate macular pigment density and other diseases of the retina and choroid. It is a non-invasive clinical tool which has the potential to revolutionise clinical retina practice. (S Afr Optom 2013 72(1 46-53

Application of the Virtual Bronchoscopy in Children with Suspected Aspiration of the Foreign Body - Case Report

Directory of Open Access Journals (Sweden)

Kostic Gordana

2016-12-01

Full Text Available In diagnosing the aspiration of the foreign body (AFB in children most important are: medical history, clinical signs and positive radiography of the lungs. Common dilemmas in the diff erential diagnosis are life-threatening asthma attacks or difficult pneumonia. Conventional rigid bronchoscopy (RB is not recommended as a routine method. Virtual bronchoscopy (VB can be a diagnostic tool for solving dilemmas. Fiber-optic bronchoscopy (FOB has a therapeutic stake in severe cases. Herein, we describe a girl, at the age of 6, who was hospitalized due to rapid bronchoconstriction and based on the anamnesis, clinical symptoms and physical fi ndings the suspicion was that she aspirated the foreign body. Due to the poor general condition and possible sequel, the idea of RB was dropped out. Multidetector computed tomography of the chest and VB was performed and AFB was not found. Due to positive epidemiological situation, virus H1N1 was excluded. FOB established that the foreign body does not exist in the airways. During bronchoscopy numerous castings are aspirated from the peripheral airways which lead to faster final recovery. With additional procedures, the diagnosis of asthma was confirmed and for girl that was the first attack. Along with inhaled corticosteroids as prevention she feels well.

Bronchoscopy for the diagnosis of pulmonary tuberculosis in patients with negative sputum smear microscopy results.

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Jacomelli, Márcia; Silva, Priscila Regina Alves Araújo; Rodrigues, Ascedio Jose; Demarzo, Sergio Eduardo; Seicento, Márcia; Figueiredo, Viviane Rossi

2012-01-01

To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to bronchoscopy-BAL and transbronchial biopsy (TBB). The BAL specimens were submitted to direct testing and culture for AFB and fungi, whereas the TBB specimens were submitted to histopathological examination. Of the 286 patients studied, 225 (79%) were diagnosed on the basis of bronchoscopic findings, as follows: pulmonary tuberculosis, in 127 (44%); nonspecific chronic inflammation, in 51 (18%); pneumocystis, fungal infections, or nocardiosis, in 20 (7%); bronchiolitis obliterans organizing pneumonia, alveolites, or pneumoconiosis, in 14 (5%); lung or metastatic neoplasms, in 7 (2%); and nontuberculous mycobacterium infections, in 6 (2%). For the diagnosis of tuberculosis, BAL showed a sensitivity and a specificity of 60% and 100%, respectively. Adding the TBB findings significantly increased this sensitivity (to 84%), as did adding the post-bronchoscopy sputum smear microscopy results (total sensitivity, 94%). Minor post-procedure complications occurred in 5.6% of the cases. Bronchoscopy is a reliable method for the diagnosis of pulmonary tuberculosis, with low complication rates. The combination of TBB and BAL increases the sensitivity of the method and facilitates the differential diagnosis with other diseases.

Post-bronchoscopy pneumonia in patients suffering from lung cancer: Development and validation of a risk prediction score.

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Takiguchi, Hiroto; Hayama, Naoki; Oguma, Tsuyoshi; Harada, Kazuki; Sato, Masako; Horio, Yukihiro; Tanaka, Jun; Tomomatsu, Hiromi; Tomomatsu, Katsuyoshi; Takihara, Takahisa; Niimi, Kyoko; Nakagawa, Tomoki; Masuda, Ryota; Aoki, Takuya; Urano, Tetsuya; Iwazaki, Masayuki; Asano, Koichiro

2017-05-01

The incidence, risk factors, and consequences of pneumonia after flexible bronchoscopy in patients with lung cancer have not been studied in detail. We retrospectively analyzed the data from 237 patients with lung cancer who underwent diagnostic bronchoscopy between April 2012 and July 2013 (derivation sample) and 241 patients diagnosed between August 2013 and July 2014 (validation sample) in a tertiary referral hospital in Japan. A score predictive of post-bronchoscopy pneumonia was developed in the derivation sample and tested in the validation sample. Pneumonia developed after bronchoscopy in 6.3% and 4.1% of patients in the derivation and validation samples, respectively. Patients who developed post-bronchoscopy pneumonia needed to change or cancel their planned cancer therapy more frequently than those without pneumonia (56% vs. 6%, ppneumonia, which we added to develop our predictive score. The incidence of pneumonia associated with scores=0, 1, and ≥2 was 0, 3.7, and 13.4% respectively in the derivation sample (p=0.003), and 0, 2.9, and 9.7% respectively in the validation sample (p=0.016). The incidence of post-bronchoscopy pneumonia in patients with lung cancer was not rare and associated with adverse effects on the clinical course. A simple 3-point predictive score identified patients with lung cancer at high risk of post-bronchoscopy pneumonia prior to the procedure. Copyright © 2017 The Japanese Respiratory Society. Published by Elsevier B.V. All rights reserved.

Computer-based route-definition system for peripheral bronchoscopy.

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Graham, Michael W; Gibbs, Jason D; Higgins, William E

2012-04-01

Multi-detector computed tomography (MDCT) scanners produce high-resolution images of the chest. Given a patient's MDCT scan, a physician can use an image-guided intervention system to first plan and later perform bronchoscopy to diagnostic sites situated deep in the lung periphery. An accurate definition of complete routes through the airway tree leading to the diagnostic sites, however, is vital for avoiding navigation errors during image-guided bronchoscopy. We present a system for the robust definition of complete airway routes suitable for image-guided bronchoscopy. The system incorporates both automatic and semiautomatic MDCT analysis methods for this purpose. Using an intuitive graphical user interface, the user invokes automatic analysis on a patient's MDCT scan to produce a series of preliminary routes. Next, the user visually inspects each route and quickly corrects the observed route defects using the built-in semiautomatic methods. Application of the system to a human study for the planning and guidance of peripheral bronchoscopy demonstrates the efficacy of the system.

Subinterlobular Pleural Location Is a Risk Factor for Pneumothorax After Bronchoscopy.

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Chino, Haruka; Iikura, Motoyasu; Saito, Nayuta; Sato, Nahoko; Suzuki, Manabu; Ishii, Satoru; Morino, Eriko; Naka, Go; Takasaki, Jin; Izumi, Shinyu; Hojo, Masayuki; Takeda, Yuichiro; Sugiyama, Haruhito

2016-12-01

Pneumothorax is one of the most important complications after bronchoscopy. This study was conducted to determine the risk factors for post-bronchoscopy pneumothorax. We retrospectively reviewed the medical records of 23 consecutive subjects who were diagnosed with iatrogenic pneumothorax after bronchoscopy between August 2010 and February 2014. Forty-six control subjects who did not develop pneumothorax after bronchoscopy were randomly selected. The factors affecting the occurrence of pneumothorax were determined by univariate and multivariate analyses. Among 991 patients who underwent bronchoscopy during the study period, 23 (2.3%) developed pneumothorax after bronchoscopy. Among these 23 subjects, 13 (57%) required chest tube drainage. Compared with the control group (46 randomly selected from 968 subjects who did not develop pneumothorax), the group that developed pneumothorax had a preponderance of women and had more target lesions located in the subpleural area (odds ratio [OR] 7.8, 95% CI 0.9-64), especially those that were close to the interlobular pleura (OR 5.1, 95% CI 1.6-16.1) and the left lung (OR 3.2, 95% CI 1.1-9.5). Multivariate analysis revealed that a subinterlobular pleural location of a lesion was a risk factor for pneumothorax (OR 4.8, 95% CI 1.1-20.4). Pneumothorax occurred significantly more frequently when bronchoscopy was performed for subinterlobular pleural lesions. Close attention and care should be taken during bronchoscopy, especially when target lesions are abutting the interlobular pleura. Copyright © 2016 by Daedalus Enterprises.

Quantitative fundus autofluorescence in recessive Stargardt disease.

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Burke, Tomas R; Duncker, Tobias; Woods, Russell L; Greenberg, Jonathan P; Zernant, Jana; Tsang, Stephen H; Smith, R Theodore; Allikmets, Rando; Sparrow, Janet R; Delori, François C

2014-05-01

To quantify fundus autofluorescence (qAF) in patients with recessive Stargardt disease (STGD1). A total of 42 STGD1 patients (ages: 7-52 years) with at least one confirmed disease-associated ABCA4 mutation were studied. Fundus AF images (488-nm excitation) were acquired with a confocal scanning laser ophthalmoscope equipped with an internal fluorescent reference to account for variable laser power and detector sensitivity. The gray levels (GLs) of each image were calibrated to the reference, zero GL, magnification, and normative optical media density to yield qAF. Texture factor (TF) was calculated to characterize inhomogeneities in the AF image and patients were assigned to the phenotypes of Fishman I through III. Quantified fundus autofluorescence in 36 of 42 patients and TF in 27 of 42 patients were above normal limits for age. Young patients exhibited the relatively highest qAF, with levels up to 8-fold higher than healthy eyes. Quantified fundus autofluorescence and TF were higher in Fishman II and III than Fishman I, who had higher qAF and TF than healthy eyes. Patients carrying the G1916E mutation had lower qAF and TF than most other patients, even in the presence of a second allele associated with severe disease. Quantified fundus autofluorescence is an indirect approach to measuring RPE lipofuscin in vivo. We report that ABCA4 mutations cause significantly elevated qAF, consistent with previous reports indicating that increased RPE lipofuscin is a hallmark of STGD1. Even when qualitative differences in fundus AF images are not evident, qAF can elucidate phenotypic variation. Quantified fundus autofluorescence will serve to establish genotype-phenotype correlations and as an outcome measure in clinical trials.

Quantitative Fundus Autofluorescence in Recessive Stargardt Disease

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Burke, Tomas R.; Duncker, Tobias; Woods, Russell L.; Greenberg, Jonathan P.; Zernant, Jana; Tsang, Stephen H.; Smith, R. Theodore; Allikmets, Rando; Sparrow, Janet R.; Delori, François C.

2014-01-01

Purpose. To quantify fundus autofluorescence (qAF) in patients with recessive Stargardt disease (STGD1). Methods. A total of 42 STGD1 patients (ages: 7–52 years) with at least one confirmed disease-associated ABCA4 mutation were studied. Fundus AF images (488-nm excitation) were acquired with a confocal scanning laser ophthalmoscope equipped with an internal fluorescent reference to account for variable laser power and detector sensitivity. The gray levels (GLs) of each image were calibrated to the reference, zero GL, magnification, and normative optical media density to yield qAF. Texture factor (TF) was calculated to characterize inhomogeneities in the AF image and patients were assigned to the phenotypes of Fishman I through III. Results. Quantified fundus autofluorescence in 36 of 42 patients and TF in 27 of 42 patients were above normal limits for age. Young patients exhibited the relatively highest qAF, with levels up to 8-fold higher than healthy eyes. Quantified fundus autofluorescence and TF were higher in Fishman II and III than Fishman I, who had higher qAF and TF than healthy eyes. Patients carrying the G1916E mutation had lower qAF and TF than most other patients, even in the presence of a second allele associated with severe disease. Conclusions. Quantified fundus autofluorescence is an indirect approach to measuring RPE lipofuscin in vivo. We report that ABCA4 mutations cause significantly elevated qAF, consistent with previous reports indicating that increased RPE lipofuscin is a hallmark of STGD1. Even when qualitative differences in fundus AF images are not evident, qAF can elucidate phenotypic variation. Quantified fundus autofluorescence will serve to establish genotype-phenotype correlations and as an outcome measure in clinical trials. PMID:24677105

[Virtual bronchoscopy: the correlation between endoscopic simulation and bronchoscopic findings].

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Salvolini, L; Gasparini, S; Baldelli, S; Bichi Secchi, E; Amici, F

1997-11-01

We carried out a preliminary clinical validation of 3D spiral CT virtual endoscopic reconstructions of the tracheobronchial tree, by comparing virtual bronchoscopic images with actual endoscopic findings. Twenty-two patients with tracheobronchial disease suspected at preliminary clinical, cytopathological and plain chest film findings were submitted to spiral CT of the chest and bronchoscopy. CT was repeated after endobronchial therapy in 2 cases. Virtual endoscopic shaded-surface-display views of the tracheobronchial tree were reconstructed from reformatted CT data with an Advantage Navigator software. Virtual bronchoscopic images were preliminarily evaluated with a semi-quantitative quality score (excellent/good/fair/poor). The depiction of consecutive airway branches was then considered. Virtual bronchoscopies were finally submitted to double-blind comparison with actual endoscopies. Virtual image quality was considered excellent in 8 cases, good in 14 and fair in 2. Virtual exploration was stopped at the lobar bronchi in one case only; the origin of segmental bronchi was depicted in 23 cases and that of some subsegmental branches in 2 cases. Agreement between actual and virtual bronchoscopic findings was good in all cases but 3 where it was nevertheless considered satisfactory. The yield of clinically useful information differed in 8/24 cases: virtual reconstructions provided more information than bronchoscopy in 5 cases and vice versa in 3. Virtual reconstructions are limited in that the procedure is long and difficult and needing a strictly standardized threshold value not to alter virtual findings. Moreover, the reconstructed surface lacks transparency, there is the partial volume effect and the branches < or = 4 pixels phi and/or meandering ones are difficult to explore. Our preliminary data are encouraging. Segmental bronchi were depicted in nearly all cases, except for the branches involved by disease. Obstructing lesions could be bypassed in some cases

Autofluorescence of choroidal nevus in 64 cases.

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Shields, Carol L; Pirondini, Cesare; Bianciotto, Carlos; Materin, Miguel A; Harmon, Sarah A; Shields, Jerry A

2008-10-01

To describe the autofluorescence features of choroidal nevi. Noncomparative case series. Sixty-four consecutive patients. Correlation of fundus photography with autofluorescence photography. Autofluorescence features of choroidal nevus and overlying retinal pigment epithelium (RPE). The mean patient age was 62 years. The choroidal nevus was a mean of 5 mm from the optic disk and foveola. The mean tumor basal dimension was 5.0 mm and mean tumor thickness was 1.0 mm. The choroidal nevus showed hypoautofluorescence in 56%, isoautofluorescence in 19%, and hyperautofluorescence in 25%. The autofluorescence features appeared unaffected by tumor thickness, but increasing tumor base and disrupted overlying RPE appeared to produce slightly brighter autofluorescence. Nevi located in the macular region showed darker hypoautofluorescence than those outside the macular region. Overlying RPE hyperplasia, atrophy, and fibrous metaplasia were generally hypoautofluorescent. Drusen, subretinal fluid, and orange pigment were generally hyperautofluorescent. The brightest hyperautofluorescence was found with orange pigment. Choroidal nevus shows little intrinsic autofluorescence. Overlying RPE alterations show dramatic autofluorescence ranging from dark hypoautofluorescence of RPE atrophy to bright hyperautofluorescence of orange pigment.

Bronchoscopy Simulation Training as a Tool in Medical School Education.

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Gopal, Mallika; Skobodzinski, Alexus A; Sterbling, Helene M; Rao, Sowmya R; LaChapelle, Christopher; Suzuki, Kei; Litle, Virginia R

2018-07-01

Procedural simulation training is rare at the medical school level and little is known about its usefulness in improving anatomic understanding and procedural confidence in students. Our aim is to assess the impact of bronchoscopy simulation training on bronchial anatomy knowledge and technical skills in medical students. Medical students were recruited by email, consented, and asked to fill out a survey regarding their baseline experience. Two thoracic surgeons measured their knowledge of bronchoscopy on a virtual reality bronchoscopy simulator using the Bronchoscopy Skills and Tasks Assessment Tool (BSTAT), a validated 65-point checklist (46 for anatomy, 19 for simulation). Students performed four self-directed training sessions of 15 minutes per week. A posttraining survey and BSTAT were completed afterward. Differences between pretraining and posttraining scores were analyzed with paired Student's t tests and random intercept linear regression models accounting for baseline BSTAT score, total training time, and training year. The study was completed by 47 medical students with a mean training time of 81.5 ± 26.8 minutes. Mean total BSTAT score increased significantly from 12.3 ± 5.9 to 48.0 ± 12.9 (p training time and frequency of training did not have a significant impact on level of improvement. Self-driven bronchoscopy simulation training in medical students led to improvements in bronchial anatomy knowledge and bronchoscopy skills. Further investigation is under way to determine the impact of bronchoscopy simulation training on future specialty interest and long-term skills retention. Copyright © 2018 The Society of Thoracic Surgeons. Published by Elsevier Inc. All rights reserved.

Inexpensive anatomical trainer for bronchoscopy.

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Di Domenico, Stefano; Simonassi, Claudio; Chessa, Leonardo

2007-08-01

Flexible fiberoptic bronchoscopy is an indispensable tool for optimal management of intensive care unit patients. However, the acquisition of sufficient training in bronchoscopy is not straightforward during residency, because of technical and ethical problems. Moreover, the use of commercial simulators is limited by their high cost. In order to overcome these limitations, we realized a low-cost anatomical simulator to acquire and maintain the basic skill to perform bronchoscopy in ventilated patients. We used 1.5 mm diameter iron wire to construct the bronchial tree scaffold; glazier-putty was applied to create the anatomical model. The model was covered by several layers of newspaper strips previously immersed in water and vinilic glue. When the model completely dried up, it was detached from the scaffold by cutting it into six pieces, it was reassembled, painted and fitted with an endotracheal tube. We used very cheap material and the final cost was euro16. The trainer resulted in real-scale and anatomically accurate, with appropriate correspondence on endoscopic view between model and patients. All bronchial segments can be explored and easily identified by endoscopic and external vision. This cheap simulator is a valuable tool for practicing, particularly in a hospital with limited resources for medical training.

Fundus autofluorescence applications in retinal imaging

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Gabai, Andrea; Veritti, Daniele; Lanzetta, Paolo

2015-01-01

Fundus autofluorescence (FAF) is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications. PMID:26139802

Fundus autofluorescence applications in retinal imaging

Directory of Open Access Journals (Sweden)

Andrea Gabai

2015-01-01

Full Text Available Fundus autofluorescence (FAF is a relatively new imaging technique that can be used to study retinal diseases. It provides information on retinal metabolism and health. Several different pathologies can be detected. Peculiar AF alterations can help the clinician to monitor disease progression and to better understand its pathogenesis. In the present article, we review FAF principles and clinical applications.

Assessment of competence in simulated flexible bronchoscopy using motion analysis

DEFF Research Database (Denmark)

Collela, Sara; Svendsen, Morten Bo Søndergaard; Konge, Lars

2015-01-01

Background: Flexible bronchoscopy should be performed with a correct posture and a straight scope to optimize bronchoscopy performance and at the same time minimize the risk of work-related injuries and endoscope damage. Objectives: We aimed to test whether an automatic motion analysis system could...... intermediates and 9 experienced bronchoscopy operators performed 3 procedures each on a bronchoscopy simulator. The Microsoft Kinect system was used to automatically measure the total deviation of the scope from a perfectly straight, vertical line. Results: The low-cost motion analysis system could measure...... with the performance on the simulator (virtual-reality simulator score; p analysis system could discriminate between different levels of experience. Automatic feedback on correct movements during self-directed training on simulators might help new bronchoscopists learn how to handle...

Evaluation of a low-cost, 3D-printed model for bronchoscopy training.

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Parotto, Matteo; Jiansen, Joshua Qua; AboTaiban, Ahmed; Ioukhova, Svetlana; Agzamov, Alisher; Cooper, Richard; O'Leary, Gerald; Meineri, Massimiliano

2017-01-01

Flexible bronchoscopy is a fundamental procedure in anaesthesia and critical care medicine. Although learning this procedure is a complex task, the use of simulation-based training provides significant advantages, such as enhanced patient safety. Access to bronchoscopy simulators may be limited in low-resource settings. We have developed a low-cost 3D-printed bronchoscopy training model. A parametric airway model was obtained from an online medical model repository and fabricated using a low-cost 3D printer. The participating physicians had no prior bronchoscopy experience. Participants received a 30-minute lecture on flexible bronchoscopy and were administered a 15-item pre-test questionnaire on bronchoscopy. Afterwards, participants were instructed to perform a series of predetermined bronchoscopy tasks on the 3D printed simulator on 4 consecutive occasions. The time needed to perform the tasks and the quality of task performance (identification of bronchial anatomy, technique, dexterity, lack of trauma) were recorded. Upon completion of the simulator tests, participants were administered the 15-item questionnaire (post-test) once again. Participant satisfaction data on the perceived usefulness and accuracy of the 3D model were collected. A statistical analysis was performed using the t-test. Data are reported as mean values (± standard deviation). The time needed to complete all tasks was 152.9 ± 71.5 sec on the 1st attempt vs. 98.7 ± 40.3 sec on the 4th attempt (P = 0.03). Likewise, the quality of performance score improved from 8.3 ± 6.7 to 18.2 ± 2.5 (P 3D-printed model for bronchoscopy training. This model improved trainee performance and may represent a valid, low-cost bronchoscopy training tool.

Fundus autofluorescence and the bisretinoids of retina.

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Sparrow, Janet R; Wu, Yalin; Nagasaki, Takayuki; Yoon, Kee Dong; Yamamoto, Kazunori; Zhou, Jilin

2010-11-01

Imaging of the human fundus of the eye with excitation wavelengths in the visible spectrum reveals a natural autofluorescence, that in a healthy retina originates primarily from the bisretinoids that constitute the lipofuscin of retinal pigment epithelial (RPE) cells. Since the intensity and distribution of fundus autofluorescence is altered in the presence of retinal disease, we have examined the fluorescence properties of the retinal bisretinoids with a view to aiding clinical interpretations. As is also observed for fundus autofluorescence, fluorescence emission from RPE lipofuscin was generated with a wide range of exciting wavelengths; with increasing excitation wavelength, the emission maximum shifted towards longer wavelengths and spectral width was decreased. These features are consistent with fluorescence generation from a mixture of compounds. While the bisretinoids that constitute RPE lipofuscin all fluoresced with maxima that were centered around 600 nm, fluorescence intensities varied when excited at 488 nm, the excitation wavelength utilized for fundus autofuorescence imaging. For instance the fluorescence efficiency of the bisretinoid A2-dihydropyridine-phosphatidylethanolamine (A2-DHP-PE) was greater than A2E and relative to both of the latter, all-trans-retinal dimer-phosphatidylethanolamine was weakly fluorescent. On the other hand, certain photooxidized forms of the bisretinoids present in both RPE and photoreceptor cells were more strongly fluorescent than the parent compound. We also sought to evaluate whether diffuse puncta of autofluorescence observed in some retinal disorders of monogenic origin are attributable to retinoid accumulation. However, two retinoids of the visual cycle, all-trans-retinyl ester and all-trans-retinal, did not exhibit fluorescence at 488 nm excitation.

Skin autofluorescence is associated with renal function and cardiovascular diseases in pre-dialysis chronic kidney disease patients.

Science.gov (United States)

Tanaka, Kenichi; Tani, Yoshihiro; Asai, Jun; Nemoto, Fumihiko; Kusano, Yuki; Suzuki, Hodaka; Hayashi, Yoshimitsu; Asahi, Koichi; Katoh, Tetsuo; Miyata, Toshio; Watanabe, Tsuyoshi

2011-01-01

Tissue accumulation of advanced glycation end-products (AGE) is thought to be a contributing factor to the progression of cardiovascular disease (CVD). Skin autofluorescence, a non-invasive measure of AGE accumulation using autofluorescence of the skin under ultraviolet light, has shown associations with CVD in haemodialysis patients. The present study aimed to evaluate relationships of skin autofluorescence to renal function as well as CVD in pre-dialysis patients with chronic kidney disease (CKD). Subjects in this cross-sectional analysis comprised 304 pre-dialysis CKD patients [median age, 62.0 years; median estimated glomerular filtration rate (eGFR), 54.3 mL/min/1.73 m(2); diabetes, n = 81 (26.6%)]. AGE accumulation in skin was assessed by skin autofluorescence using an autofluorescence reader. Relationships between skin autofluorescence, eGFR, CVD history and other parameters were evaluated. Skin autofluorescence correlated negatively with eGFR (r = -0.42, P skin autofluorescence with age, presence of diabetes, eGFR and CVD history in CKD patients (R(2) = 30%). Age, male gender, smoking history, skin autofluorescence and eGFR were significantly correlated with CVD history, and multiple logistic regression analysis identified age [odds ratio (OR), 1.09; 95% confidence interval (CI), 1.03-1.15; P skin autofluorescence (OR, 3.74; 95%CI, 1.54-9.24; P skin autofluorescence increased as GFR decreased and was related to CVD history in CKD patients. Non-invasive autofluorescence readers may provide potential markers for clinical risk assessment in pre-dialysis CKD patients.

Issues in quantifying atrophic macular disease using retinal autofluorescence.

Science.gov (United States)

Sunness, Janet S; Ziegler, Matthias D; Applegate, Carol A

2006-01-01

To demonstrate the potential and limits of autofluorescence imaging in identifying and delineating areas of atrophy. Fundus photographs and infrared scanning laser ophthalmoscope (SLO) imaging, SLO macular perimetry, and SLO autofluorescence imaging results were compared for two patients with geographic atrophy (GA) from age-related macular degeneration, one patient with pigmentary alteration of the retina, and two patients with Stargardt disease. The main outcome measure in this case series was the presence of reduced autofluorescence. Drusen may become undetectable during autofluorescence imaging for some patients, allowing simple identification of areas of GA with areas of reduced autofluorescence. In other patients, drusen themselves have decreased autofluorescence, despite having intact retinal function in the retina overlying them. Some patients may have areas of reduced autofluorescence that persist for many years, without evidence of the development of atrophy. In Stargardt disease, decreased autofluorescence can easily detect and delineate areas of scotoma. Areas with mottled autofluorescence may have overlying function, but the function may not be adequate to support a fixation locus in that area. Using decreased autofluorescence to delineate areas of atrophy may be helpful in atrophic macular disorders. For GA, correlation with fundus photographs or macular perimetry findings may be necessary to differentiate between drusen and atrophy. For Stargardt disease, the nature of areas of decreased autofluorescence may help explain visual function of those areas.

[Fundus autofluorescence in dry AMD - impact on disease progression].

Science.gov (United States)

Vidinova, C N; Gouguchkova, P T; Vidinov, K N

2013-11-01

Fundus autofluorescence is a novel technique that gives us information about the RPE cells by evaluating the distribution of lipofuscin in the retina. The purpose of our study was to evaluate the diagnostic abilities of OCT, RTVue and fundus autofluorescence in predicting the progression of dry AMD. In our study 37 dry AMD patients were enrolled: 22 of them with druses and 15 with developed geographic atrophy. They all underwent complete ophthalmological examinations including OCT and autofluorescence. We used the RTVue OCT programmes HD line, Cross line, EMM5 and EMM5 progression in all cases. The autofluorescence was recorded with the help of the Canon CX1 fundus camera. OCT images in the AMD patients with dry AMD and large druses showed typical undulations in the RPE/choroid line and occasionally drusenoid detachment of the RPE. Autofluorescence showed different patterns. The confluent reticular autofluorescence was associated with the development of neovascular membranes. In geographic atrophy patient OCTs showed diminished retinal thickness measured with EMM5. On autofluorescence the findings at the border zone atrophic/normal retina were of particular importance. The diffuse increased autofluorescence in that area was considered to be a sign for further atrophy progression. Our results point out that OCT in combination with autofluorescence is important in following the progression of dry AMD. Pathological autofluorescence at the border of atrophic lesions is an important sign for disease activity. Although both OCT and autofluorescence visualise the changes in RPE, autofluorescence is of key importance in predicting the development of the disease. Georg Thieme Verlag KG Stuttgart · New York.

Centrifugal Expansion of Fundus Autofluorescence Patterns in Stargardt Disease Over Time

Science.gov (United States)

Cukras, Catherine A.; Wong, Wai T.; Caruso, Rafael; Cunningham, Denise; Zein, Wadih; Sieving, Paul

2012-01-01

Objective Changing lipofuscin and melanin content in RPE cells has been hypothesized to contribute to Stargardt disease pathogenesis. Longitudinal study of autofluorescence in Stargardt disease which reflect changing fluorophore compositions can reveal aspects of disease progression not previously evident. Method We examined the temporal-spatial patterns of fundus autofluorescence with excitation at both 488 nm (standard fundus autofluorescence, FAF) and 795nm (near infrared autofluorescence, NIA) in a longitudinal case series involving 8 eyes of 4 patients (range of follow-up = 11 to 57 months; mean = 39 months). Image processing was performed to analyze spatial and temporal cross-modality associations. Results Longitudinal FAF imaging of fleck lesions revealed hyperautofluorescent lesions that extended in a centrifugal direction from the fovea with time. Patterns of spread were non-random and followed a radial path that leaves behind a trail of diminishing autofluorescence. Longitudinal NIA imaging also demonstrated centrifugal lesion spread, but with fewer hyperautofluorescent lesions, suggestive of more transient hyperautofluorescence and more rapid decay at longer wavelengths. FAF and NIA abnormalities were spatially correlated to each other, and together reflect systematic progressions in fleck distribution and fluorophore composition occurring during the natural history of the disease. Conclusion Stargardt disease fleck lesions do not evolve randomly in location but instead follow consistent patterns of radial expansion and a systematic decay of autofluorescence that reflect changing lipofuscin and melanin compositions in RPE cells. These progressive foveal-to-peripheral changes are helpful in elucidating molecular and cellular mechanisms underlying Stargardt disease and may constitute potential outcome measures in clinical trials. PMID:21987580

Establishing Pass/Fail Criteria for Bronchoscopy Performance

DEFF Research Database (Denmark)

Konge, Lars; Clementsen, Paul; Larsen, Klaus Richter

2012-01-01

Background: Several tools have been created to assess competence in bronchoscopy. However, educational guidelines still use an arbitrary number of performed procedures to decide when basic competency is acquired. Objectives: The purpose of this study was to define pass/fail scores for two...... method. In the first we compared bronchoscopy performance scores of 14 novices with the scores of 14 experienced consultants to find the score that best discriminated between the two groups. In the second we asked an expert group of 7 experienced bronchoscopists to judge how a borderline trainee would...

[Application of bispectral index monitoring in sedation and analgesia for flexible bronchoscopy].

Science.gov (United States)

Fang, S R; Liu, Y J; Su, N J; Shu, Y; Gu, W

2017-12-12

Objective: To investigate the feasibility of using bispectral index monitoring in sedation and analgesia for bronchoscopy. Methods: Totally 285 patients admitted to the Respiratory Medicine Department of Nanjing First Hospital for bronchoscopy between June 2016 and December 2016 were assigned, according to their own wishes, into a conscious sedation group (171 cases receiving local anesthesia and conscious sedation, 89 males, 82 females, mean age 59±10 years) and a control group (114 cases undergoing local anesthesia, 59 males, 55 females, average age 61±12 years). The 2 groups were compared in terms of operation time, blood pressure, heart rate and other indicators during bronchoscopy including incidence of adverse events, memory of the procedure, willingness to be re-examined, safety of sedation and analgesia for bronchoscopy under bispectral index monitoring, and patient satisfaction in the postoperative follow-up. Results: The conscious sedation group and the control group had no difference in age and sex ratio( P >0.05). Compared with the patients in the control group(operation time 16±5 min and systolic blood pressure 153±21 mmHg, 1 mmHg=0.133 kPa), those in the conscious sedation group had a shorter operation time(14±5 min) and a lower systolic blood pressure(144±22 mmHg), with statistically significant difference ( P sedation group and 92±12 mmHg and 87±14 times/min in the control group, P >0.05). Adverse events, overall intraoperative cough and bleeding were found to be significantly reduced in the conscious sedation group (27%, 4% and 13% and 60%, 13% and 35% in the control group, P sedation group, and 14% in the control group, P =0.72). Patient satisfaction and willingness to be re-examined were markedly higher in the conscious sedation group (97%) than in the controls (4%, P sedation and analgesia for bronchoscopy and has higher patient satisfaction, suggesting that it is a potential tool for use in clinical practice.

Flexible bronchoscopy and mechanical ventilation in managing Mounier-Kuhn syndrome: a case report

Directory of Open Access Journals (Sweden)

Aslihan Gürün Kaya

2017-04-01

Full Text Available ABSTRACT CONTEXT: Mounier-Kuhn syndrome is a rare congenital condition with distinct dilatation and diverticulation of the tracheal wall. The symptoms may vary and the treatment usually consists of support. CASE REPORT: The patient was a 60-year-old male with recurrent hospital admission. He was admitted in this case due to dyspnea, cough and sputum production. An arterial blood sample revealed decompensated respiratory acidosis with moderate hypoxemia. A chest computed tomography (CT scan showed dilatation of the trachea and bronchi, tracheal diverticula and bronchiectasis. Flexible bronchoscopy was performed, which revealed enlarged airways with expiratory collapse. Furthermore, orifices of tracheal diverticulosis were also detected. Non-invasive positive pressure ventilation (NPPV was added, along with long-term oxygen therapy. At control visits, the patient’s clinical and laboratory findings were found to have improved. CONCLUSION: Flexible bronchoscopy can be advocated for establishing the diagnosis and non-invasive mechanical ventilation can be used with a high success rate, for clinical wellbeing in Mounier-Kuhn syndrome.

[Application of electric coagulation treatment via bronchoscopy in the management of congenital vallecular cyst in children].

Science.gov (United States)

Liu, Xia; Ma, Jing; Zhao, Feng-mei; Zhang, Zhong-xiao; Niu, Tie-huan; Yan, Xiu-li; Wang, Chao; Meng, Chen

2013-11-01

To discuss the effect of electric coagulation through bronchoscopy in diagnosis and treatment of congenital vallecular cyst in children. Ten cases of congenital vallecular cyst in the study with age ranged from 21 days to 4 years and 10 months were treated with electric coagulation through bronchoscopy. The therapeutic effect was evaluated by endoscopic and clinical manifestation. And all the patients were followed-up for 6-12 months. All the patients obtained 3-5 times electric coagulation. After the operation, the cyst decreased in size, epiglottis softening was subsided, uplift uncompression, dyspnea and laryngeal stridor were improved obviously. After follow-up periods of 6-12 months, no capsule wall were left, and the activity of the epiglottis resumed.No severe complication was found in any patient. Electric coagulation through bronchoscopy is a simple, effective and safe method to treat congenital vallecular cyst in children.

On the autofluorescence of aged fingermarks

NARCIS (Netherlands)

van Dam, Annemieke; Aalders, Maurice C. G.; Todorovski, Toni; van Leeuwen, Ton G.; Lambrechts, Saskia A. G.

2016-01-01

Fingermark autofluorescence changes with time, both spectrally and in total intensity. In this study we investigate which components in the aged fingermarks cause this change in autofluorescent signal. Thin layer chromatography combined with fluorescence spectroscopy was used to identify fluorescent

Therapeutic flexible bronchoscopy in child with cystic fibrosis

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Amina Selimović

2008-05-01

Full Text Available The report deals with the case of a 10-year-old girl with chronic cystic fibrosis. She has been repeatedly treated at the hospital. She has been hospitalized due to respiratory deterioration. Cystic fibrosis is a rare disease, inherited autosomaly recessively, but is very complex in terms of diagnostic and treatment (2. The diagnosis is confirmed based on a clinical picture of the child, measure of Chloride in the sweat, chest X-ray, CT thorax, laboratory findings--genetic confirmation CFTR ( cystic fibrosis transmembrane conductance regulator genes (3, which result in the production of hyper-viscous mucus and chloride malabsorption in the sweat glands ducts (5,6. Bronchial thickening and plugging and ring shadows suggesting bronchiectasis, segmental or lobar atelectasis are often. Computer tomography of the chest can be used to detect and localize thickening of bronchial airways walls, mucus plugging, hyperinflation and early bronchieactasiae. Pulmonary therapy: the object is to clear secretions from airways and to control infection (7. The diagnosis is originally set when she was 4 years old. She is now admitted due to a deterioration of the main disease. Day before admission in the hospital had a higher bodily temperature, cough and difficult breathing. She already treated conservatively (Ceftazidim, Ceftriakson, Kloksacillin Since the girl is a chronic patient with bronchiectasie chronic walls of bronchi changes full of the mucus, who is not responding to conservative treatment (antibiotics, therapeutic and diagnostic flexible bronchoscopy had to be performed, resulting in a gram-negative bacteria pseudomonas aeruginosa--a typical bacteria for chronically sick C. F.PATIENT:A pseudomonas therapy was prescribed according to the sensitive antibiogram, during which bronchoscopy was given locally on changes mucous pulmozyme and garamycin. Flexible bronchoscopy was performed as therapeutic. Local bronchoscopy

Management of antithrombotic agents in patients undergoing flexible bronchoscopy

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Sami Abuqayyas

2017-07-01

Full Text Available Bleeding is one of the most feared complications of flexible bronchoscopy. Although infrequent, it can be catastrophic and result in fatal outcomes. Compared to other endoscopic procedures, the risk of morbidity and mortality from the bleeding is increased, as even a small amount of blood can fill the tracheobronchial tree and lead to respiratory failure. Patients using antithrombotic agents (ATAs have higher bleeding risk. A thorough understanding of the different ATAs is critical to manage patients during the peri-procedural period. A decision to stop an ATA before bronchoscopy should take into account a variety of factors, including indication for its use and the type of procedure. This article serves as a detailed review on the different ATAs, their pharmacokinetics and the pre- and post-bronchoscopy management of patients receiving these medications.

Spectral-domain optical coherence tomography staging and autofluorescence imaging in achromatopsia.

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Greenberg, Jonathan P; Sherman, Jerome; Zweifel, Sandrine A; Chen, Royce W S; Duncker, Tobias; Kohl, Susanne; Baumann, Britta; Wissinger, Bernd; Yannuzzi, Lawrence A; Tsang, Stephen H

2014-04-01

IMPORTANCE Evidence is mounting that achromatopsia is a progressive retinal degeneration, and treatments for this condition are on the horizon. OBJECTIVES To categorize achromatopsia into clinically identifiable stages using spectral-domain optical coherence tomography and to describe fundus autofluorescence imaging in this condition. DESIGN, SETTING, AND PARTICIPANTS A prospective observational study was performed between 2010 and 2012 at the Edward S. Harkness Eye Institute, New York-Presbyterian Hospital. Participants included 17 patients (aged 10-62 years) with full-field electroretinography-confirmed achromatopsia. MAIN OUTCOMES AND MEASURES Spectral-domain optical coherence tomography features and staging system, fundus autofluorescence and near-infrared reflectance features and their correlation to optical coherence tomography, and genetic mutations served as the outcomes and measures. RESULTS Achromatopsia was categorized into 5 stages on spectral-domain optical coherence tomography: stage 1 (2 patients [12%]), intact outer retina; stage 2 (2 patients [12%]), inner segment ellipsoid line disruption; stage 3 (5 patients [29%]), presence of an optically empty space; stage 4 (5 patients [29%]), optically empty space with partial retinal pigment epithelium disruption; and stage 5 (3 patients [18%]), complete retinal pigment epithelium disruption and/or loss of the outer nuclear layer. Stage 1 patients showed isolated hyperreflectivity of the external limiting membrane in the fovea, and the external limiting membrane was hyperreflective above each optically empty space. On near infrared reflectance imaging, the fovea was normal, hyporeflective, or showed both hyporeflective and hyperreflective features. All patients demonstrated autofluorescence abnormalities in the fovea and/or parafovea: 9 participants (53%) had reduced or absent autofluorescence surrounded by increased autofluorescence, 4 individuals (24%) showed only reduced or absent autofluorescence, 3

Descriptive data on cancerous lung lesions detected by auto-fluorescence bronchoscope: A five-year study

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Asmitananda Thakur

2012-01-01

Full Text Available Background: Auto-fluorescence bronchoscopy (AFB has been used for the identification and localization of intra-epithelial pre-neoplastic and neoplastic lesions within the bronchus. Objectives: To determine the applicability of AFB for the detection and localization of precancerous and cancerous lesions, in addition to analyzing the morphologic presentation, their association to histological type and the variation between genders. Methods: A five-year study involving 4983 patients, who underwent routine bronchoscopy [B] examination in a local tertiary teaching hospital, was done. The B examination was performed under intratracheal lidocaine, and samples were obtained using suitable approach. One thousand four hundred and eighty-five pathologically confirmed lung cancer patients were included in the study. The following parameters were studied: Morphological presentation, biopsy sites, histology. Differences between the groups were analyzed using Chi square test. Result: One thousand four hundred and eighty-five patients who had hyperplasia or neoplastic lesions were further confirmed as lung cancer pathologically. Lung cancer was more commonly found in the right lung (51.58% vs. 42.82%. The lesion occurred more frequently in the upper lobe than the lower lobe (44.17% vs. 22.42%. Male patients with squamous cell carcinoma showed upper lobe involvement more commonly, while the left main bronchus was more commonly involved in female patients. Adenocarcinoma mostly involved lesion of the upper lobe. Squamous cell carcinoma and small cell carcinoma were the major proliferative types (80.15% and 76.16% respectively. Conclusion: AFB is efficient in the detection of pre-invasive and invasive lung lesions. The morphological presentation is associated to the histological type. There is variation in the presentation and histology of cancerous lung lesions between genders.

Electromagnetic navigation diagnostic bronchoscopy for small peripheral lung lesions.

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Makris, D; Scherpereel, A; Leroy, S; Bouchindhomme, B; Faivre, J-B; Remy, J; Ramon, P; Marquette, C-H

2007-06-01

The present study prospectively evaluated the diagnostic yield and safety of electromagnetic navigation-guided bronchoscopy biopsy, for small peripheral lung lesions in patients where standard techniques were nondiagnostic. The study was conducted in a tertiary medical centre on 40 consecutive patients considered unsuitable for straightforward surgery or computed tomography (CT)-guided transthoracic needle aspiration biopsy, due to comorbidities. The lung lesion diameter was mean+/-sem 23.5+/-1.5 mm and the depth from the visceral-costal pleura was 14.9+/-2 mm. Navigation was facilitated by an electromagnetic tracking system which could detect a position sensor incorporated into a flexible catheter advanced through a bronchoscope. Information obtained during bronchoscopy was superimposed on previously acquired CT data. Divergence between CT data and data obtained during bronchoscopy was calculated by the system's software as a measure of navigational accuracy. All but one of the target lesions was reached and the overall diagnostic yield was 62.5% (25-40). Diagnostic yield was significantly affected by CT-to-body divergence; yield was 77.2% when estimated divergence was drainage was required in one case. Electromagnetic navigation-guided bronchoscopy has the potential to improve the diagnostic yield of transbronchial biopsies without additional fluoroscopic guidance, and may be useful in the early diagnosis of lung cancer, particularly in nonoperable patients.

High-Flow Nasal Interface Improves Oxygenation in Patients Undergoing Bronchoscopy

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Umberto Lucangelo

2012-01-01

Full Text Available During bronchoscopy hypoxemia is commonly found and oxygen supply can be delivered by interfaces fed with high gas flows. Recently, the high-flow nasal cannula (HFNC has been introduced for oxygen therapy in adults, but they have not been used so far during bronchoscopy in adults. Forty-five patients were randomly assigned to 3 groups receiving oxygen: 40 L/min through a Venturi mask (V40, N=15, nasal cannula (N40, N=15, and 60 L/min through a nasal cannula (N60, N=15 during bronchoscopy. Gas exchange and circulatory variables were sampled before (FiO2 = 0.21, at the end of bronchoscopy (FiO2 = 0.5, and thereafter (V40, FiO2 = 0.35. In 8 healthy volunteers oxygen was randomly delivered according to V40, N40, and N60 settings, and airway pressure was measured. At the end of bronchoscopy, N60 presented higher PaO2, PaO2/FiO2, and SpO2 than V40 and N40 that did not differ between them. In the volunteers (N60 median airway pressure amounted to 3.6 cmH2O. Under a flow rate of 40 L/min both the Venturi mask and HFNC behaved similarly, but nasal cannula associated with a 60 L/min flow produced the better results, thus indicating its use in mild respiratory dysfunctions.

The reduction of retinal autofluorescence caused by light exposure.

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Morgan, Jessica I W; Hunter, Jennifer J; Merigan, William H; Williams, David R

2009-12-01

A prior study showed that long exposure to 568-nm light at levels below the maximum permissible exposure safety limit produces retinal damage preceded by a transient reduction in the autofluorescence of retinal pigment epithelial (RPE) cells in vivo. The present study shows how the effects of exposure power and duration combine to produce this autofluorescence reduction and find the minimum exposure causing a detectable autofluorescence reduction. Macaque retinas were imaged using a fluorescence adaptive optics scanning laser ophthalmoscope to resolve individual RPE cells in vivo. The retina was exposed to 568-nm light over a square subtending 0.5 degrees with energies ranging from 1 to 788 J/cm(2), where power and duration were independently varied. In vivo exposures of 5 J/cm(2) and higher caused an immediate decrease in autofluorescence followed by either full autofluorescence recovery (exposures or= 247 J/cm(2)). No significant autofluorescence reduction was observed for exposures of 2 J/cm(2) and lower. Reciprocity of exposure power and duration held for the exposures tested, implying that the total energy delivered to the retina, rather than its distribution in time, determines the amount of autofluorescence reduction. That reciprocity held is consistent with a photochemical origin, which may or may not cause retinal degeneration. The implementation of safe methods for delivering light to the retina requires a better understanding of the mechanism causing autofluorescence reduction. Finally, RPE imaging was demonstrated using light levels that do not cause a detectable reduction in autofluorescence.

Fundus autofluorescence in chronic essential hypertension.

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Ramezani, Alireza; Saberian, Peyman; Soheilian, Masoud; Parsa, Saeed Alipour; Kamali, Homayoun Koohi; Entezari, Morteza; Shahbazi, Mohammad-Mehdi; Yaseri, Mehdi

2014-01-01

To evaluate fundus autofluorescence (FAF) changes in patients with chronic essential hypertension (HTN). In this case-control study, 35 eyes of 35 patients with chronic essential HTN (lasting >5 years) and 31 eyes of 31 volunteers without history of HTN were included. FAF pictures were taken from right eyes of all cases with the Heidelberg retina angiography and then were assessed by two masked retinal specialists. In total, FAF images including 35 images of hypertensive patients and 31 pictures of volunteers, three apparently abnormal patterns were detected. A ring of hyper-autofluorescence in the central macula (doughnut-shaped) was observed in 9 (25.7%) eyes of the hypertensive group but only in 2 (6.5%) eyes of the control group. This difference was statistically significant (P = 0.036) between two groups. Hypo- and/or hyper-autofluorescence patches outside the fovea were the other sign found more in the hypertensive group (22.9%) than in the control group (6.5%); however, the difference was not statistically significant (P = 0.089). The third feature was hypo-autofluorescence around the disk noticed in 11 (31.4%) eyes of hypertensive patients compared to 8 (25.8%) eyes of the controls (P = 0.615). A ring of hyper-autofluorescence in the central macula forming a doughnut-shaped feature may be a FAF sign in patients with chronic essential HTN.

Fundus Autofluorescence in Chronic Essential Hypertension

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Alireza Ramezani

2014-01-01

Full Text Available Purpose: To evaluate fundus autofluorescence (FAF changes in patients with chronic essential hypertension (HTN. Methods: In this case-control study, 35 eyes of 35 patients with chronic essential HTN (lasting >5 years and 31 eyes of 31 volunteers without history of HTN were included. FAF pictures were taken from right eyes of all cases with the Heidelberg retina angiography and then were assessed by two masked retinal specialists. Results: In total, FAF images including 35 images of hypertensive patients and 31 pictures of volunteers, three apparently abnormal patterns were detected. A ring of hyper-autofluorescence in the central macula (doughnut-shaped was observed in 9 (25.7% eyes of the hypertensive group but only in 2 (6.5% eyes of the control group. This difference was statistically significant (P = 0.036 between two groups. Hypo- and/or hyper-autofluorescence patches outside the fovea were the other sign found more in the hypertensive group (22.9% than in the control group (6.5%; however, the difference was not statistically significant (P = 0.089. The third feature was hypo-autofluorescence around the disk noticed in 11 (31.4% eyes of hypertensive patients compared to 8 (25.8% eyes of the controls (P = 0.615. Conclusion: A ring of hyper-autofluorescence in the central macula forming a doughnut-shaped feature may be a FAF sign in patients with chronic essential HTN.

Bronchoscopy Simulation: A Brief Review

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Davoudi, Mohsen; Colt, Henri G.

2009-01-01

More than 500,000 flexible bronchoscopies are performed annually by chest physicians in the United States (Ernst et al., Chest 123:1693-1717, 2003). Indications include diagnosis of lung cancer and airway tumors, benign strictures, pulmonary infections, and treatment of central airway obstruction, emphysema, and intraepithelial lesions such as…

Low auto-fluorescence fabrication methods for plastic nanoslits.

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Yin, Zhifu; Qi, Liping; Zou, Helin; Sun, Lei; Xu, Shenbo

2016-04-01

Plastic nanofluidic devices are becoming increasingly important for biological and chemical applications. However, they suffer from high auto-fluorescence when used for on-chip optical detection. In this study, the auto-fluorescence problem of plastic nanofluidic devices was remedied by newly developed fabrication methods that minimise their auto-fluorescence: one by depositing a gold (Au) layer on them, the other by making them ultra-thin. In the first method, the Au layer [minimum thickness is 40 nm on 150 μm SU-8, 50 nm on 1 mm polyethylene terephthalate (PET), and 40 on 2 nm polymethyl methacrylate (PMMA)] blocks the auto-fluorescence of the polymer; in the second method, auto-fluorescence is minimised by making the chips ultra-thin, selected operating thickness of SU-8 is 20 μm, for PET it is 150 μm, and for PMMA it is 0.8 mm.

Fundus autofluorescence patterns in primary intraocular lymphoma.

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Casady, Megan; Faia, Lisa; Nazemzadeh, Maryam; Nussenblatt, Robert; Chan, Chi-Chao; Sen, H Nida

2014-02-01

To evaluate fundus autofluorescence (FAF) patterns in patients with primary intraocular (vitreoretinal) lymphoma. Records of all patients with primary intraocular lymphoma who underwent FAF imaging at the National Eye Institute were reviewed. Fundus autofluorescence patterns were evaluated with respect to clinical disease status and the findings on fluorescein angiography and spectral-domain optical coherence tomography. There were 18 eyes (10 patients) with primary intraocular lymphoma that underwent FAF imaging. Abnormal autofluorescence in the form of granular hyperautofluorescence and hypoautofluorescence was seen in 11 eyes (61%), and blockage by mass lesion was seen in 2 eyes (11%). All eyes with granular pattern on FAF had active primary intraocular lymphoma at the time of imaging, but there were 5 eyes with unremarkable FAF, which were found to have active lymphoma. The most common pattern on fluorescein angiography was hypofluorescent round spots with a "leopard spot" appearance (43%). These hypofluorescent spots on fluorescein angiography correlated with hyperautofluorescent spots on FAF in 5 eyes (36%) (inversion of FAF). Nodular hyperreflective spots at the level of retinal pigment epithelium on optical coherence tomography were noted in 43% of eyes. The hyperautofluorescent spots on FAF correlated with nodular hyperreflective spots on optical coherence tomography in 6 eyes (43%). Granularity on FAF was associated with active lymphoma in majority of the cases. An inversion of FAF (hyperautofluorescent spots on FAF corresponding to hypofluorescent spots on fluorescein angiography) was observed in less than half of the eyes.

Lifestyle and clinical determinants of skin autofluorescence in a population-based cohort study

NARCIS (Netherlands)

van Waateringe, Robert P; Slagter, Sandra N; van der Klauw, Melanie M; van Vliet-Ostaptchouk, Jana V; Graaff, Reindert; Paterson, Andrew D; Lutgers, Helen L; Wolffenbuttel, Bruce H R

BACKGROUND: Skin autofluorescence (SAF) is a non-invasive marker of advanced glycation end products (AGEs). In diabetes, higher SAF levels has been positively associated with long-term complications, cardiovascular morbidity and mortality. Because little is known about the factors that influence SAF

Commentary on “Music Does Not Alter Anxiety in Patients with Suspected Lung Cancer Undergoing Bronchoscopy: A Randomised Controlled Trial” – European Clinical Respiratory Journal

DEFF Research Database (Denmark)

Jeppesen, Elisabeth; Pedersen, Carsten Michel

2016-01-01

Introduction Not only may the prognosis of lung cancer provoke fear in patients with suspected lung cancer undergoing bronchoscopy, but also the thought of undergoing bronchoscopy may provoke fear [1]. This can be fear of pain, of shortness of breath and also fear of death in connection with the ...

Progressive Retinal Degeneration and Accumulation of Autofluorescent Lipopigments in Progranulin Deficient Mice

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Hafler, Brian P.; Klein, Zoe A.; Zhou, Z. Jimmy; Strittmatter, Stephen M.

2014-01-01

Prior investigations have shown that patients with neuronal ceroid lipofuscinosis (NCL) develop neurodegeneration characterized by vision loss, motor dysfunction, seizures, and often early death. Neuropathological analysis of patients with NCL shows accumulation of intracellular autofluorescent storage material, lipopigment, throughout neurons in the central nervous system including in the retina. A recent study of a sibling pair with adult onset NCL and retinal degeneration showed linkage to the region of the progranulin (GRN) locus and a homozygous mutation was demonstrated in GRN. In particular, the sibling pair with a mutation in GRN developed retinal degeneration and optic atrophy. This locus for this form of adult onset neuronal ceroid lipofuscinosis was designated neuronal ceroid lipofuscinosis-11 (CLN11). Based on these clinical observations, we wished to determine whether Grn-null mice develop accumulation of autofluorescent particles and retinal degeneration. Retinas of both wild-type and Progranulin deficient mice were examined by immunostaining and autofluorescence. Accumulation of autofluorescent material was present in Progranulin deficient mice at 12 months. Degeneration of multiple classes of neurons including photoreceptors and retinal ganglion cells was noted in mice at 12 and 18 months. Our data shows that Grn−/− mice develop degenerative pathology similar to features of human CLN11. PMID:25234724

Autofluorescence in eleocytes of some earthworm species.

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Barbara Płytycz

2006-04-01

Full Text Available Immunocompetent cells of earthworms, coelomocytes, comprise adherent amoebocytes and granular eleocytes (chloragocytes. Both cell populations can be expelled via dorsal pores of adult earthworms by exposure to an electric current (4.5 V for 1 min. Analysis by phase contrast/fluorescence microscopy and flow cytometry demonstrated that eleocyte population of several species exhibits a strong autofluorescence. A high percentage (11-35% of autofluorescent eleocytes was recorded in Allolobophora chlorotica, Dendrodrilus rubidus, Eisenia fetida, and Octolasion sp. (O. cyaneum, O. tyrtaeum tyrtaeum and O. tyrtaeum lacteum. In contrast, autofluorescent coelomocytes were exceptionally scarce (less than 1% in representative Aporrectodea sp. (A. caliginosa and A. longa and Lumbricus sp. (L. castaneus, L. festivus, L. rubellus, L. terrestris. Thus, this paper for the first time describes profound intrinsic fluorescence of eleocytes in some--but not all--earthworm species. The function (if any and inter-species differences of the autofluorescent coelomocytes still remain elusive.

Virtual reality bronchoscopy simulation: a revolution in procedural training.

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Colt, H G; Crawford, S W; Galbraith, O

2001-10-01

In the airline industry, training is costly and operator error must be avoided. Therefore, virtual reality (VR) is routinely used to learn manual and technical skills through simulation before pilots assume flight responsibilities. In the field of medicine, manual and technical skills must also be acquired to competently perform invasive procedures such as flexible fiberoptic bronchoscopy (FFB). Until recently, training in FFB and other endoscopic procedures has occurred on the job in real patients. We hypothesized that novice trainees using a VR skill center could rapidly acquire basic skills, and that results would compare favorably with those of senior trainees trained in the conventional manner. We prospectively studied five novice bronchoscopists entering a pulmonary and critical care medicine training program. They were taught to perform inspection flexible bronchoscopy using a VR bronchoscopy skill center; dexterity, speed, and accuracy were tested using the skill center and an inanimate airway model before and after 4 h of group instruction and 4 h of individual unsupervised practice. Results were compared to those of a control group of four skilled physicians who had performed at least 200 bronchoscopies during 2 years of training. Student's t tests were used to compare mean scores of study and control groups for the inanimate model and VR bronchoscopy simulator. Before-training and after-training test scores were compared using paired t tests. For comparisons between after-training novice and skilled physician scores, unpaired two-sample t tests were used. Novices significantly improved their dexterity and accuracy in both models. They missed fewer segments after training than before training, and had fewer contacts with the bronchial wall. There was no statistically significant improvement in speed or total time spent not visualizing airway anatomy. After training, novice performance equaled or surpassed that of the skilled physicians. Novices performed

Autofluorescence Lifetimes in Geographic Atrophy in Patients With Age-Related Macular Degeneration.

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Dysli, Chantal; Wolf, Sebastian; Zinkernagel, Martin S

2016-05-01

To investigate fluorescence lifetime characteristics in patients with geographic atrophy (GA) in eyes with age-related macular degeneration and to correlate the measurements with clinical data and optical coherence tomography (OCT) findings. Patients with GA were imaged with a fluorescence lifetime imaging ophthalmoscope. Retinal autofluorescence lifetimes were measured in a short and a long spectral channel (498-560 nm and 560-720 nm). Mean retinal fluorescence lifetimes were analyzed within GA and the surrounding retina, and data were correlated with best corrected visual acuity and OCT measurements. Fluorescence lifetime maps of 41 eyes of 41 patients (80 ± 7 years) with GA were analyzed. Mean lifetimes within areas of atrophy were prolonged by 624 ± 276 ps (+152%) in the short spectral channel and 418 ± 186 ps (+83%) in the long spectral channel compared to the surrounding tissue. Autofluorescence lifetime abnormalities in GA occurred with particular patterns, similar to those seen in fundus autofluorescence intensity images. Within the fovea short mean autofluorescence lifetimes were observed, presumably representing macular pigment. Short lifetimes were preserved even in the absence of foveal sparing but were decreased in patients with advanced retinal atrophy in OCT. Short lifetimes in the fovea correlated with better best corrected visual acuity in both spectral channels. This study established that autofluorescence lifetime changes in GA present with explicit patterns. We hypothesize that the short lifetimes seen within the atrophy may be used to estimate damage induced by atrophy and to monitor disease progression in the context of natural history or interventional therapeutic studies.

Two-photon excited autofluorescence imaging of freshly isolated frog retinas.

Science.gov (United States)

Lu, Rong-Wen; Li, Yi-Chao; Ye, Tong; Strang, Christianne; Keyser, Kent; Curcio, Christine A; Yao, Xin-Cheng

2011-06-01

The purpose of this study was to investigate cellular sources of autofluorescence signals in freshly isolated frog (Rana pipiens) retinas. Equipped with an ultrafast laser, a laser scanning two-photon excitation fluorescence microscope was employed for sub-cellular resolution examination of both sliced and flat-mounted retinas. Two-photon imaging of retinal slices revealed autofluorescence signals over multiple functional layers, including the photoreceptor layer (PRL), outer nuclear layer (ONL), outer plexiform layer (OPL), inner nuclear layer (INL), inner plexiform layer (IPL), and ganglion cell layer (GCL). Using flat-mounted retinas, depth-resolved imaging of individual retinal layers further confirmed multiple sources of autofluorescence signals. Cellular structures were clearly observed at the PRL, ONL, INL, and GCL. At the PRL, the autofluorescence was dominantly recorded from the intracellular compartment of the photoreceptors; while mixed intracellular and extracellular autofluorescence signals were observed at the ONL, INL, and GCL. High resolution autofluorescence imaging clearly revealed mosaic organization of rod and cone photoreceptors; and sub-cellular bright autofluorescence spots, which might relate to connecting cilium, was observed in the cone photoreceptors only. Moreover, single-cone and double-cone outer segments could be directly differentiated.

Value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules.

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Schwarz, Carsten; Schönfeld, Nicolas; Bittner, Roland C; Mairinger, Thomas; Rüssmann, Holger; Bauer, Torsten T; Kaiser, Dirk; Loddenkemper, Robert

2013-01-01

The diagnostic value of flexible bronchoscopy in the pre-operative work-up of solitary pulmonary nodules (SPN) is still under debate among pneumologists, radiologists and thoracic surgeons. In a prospective observational manner, flexible bronchoscopy was routinely performed in 225 patients with SPN of unknown origin. Of the 225 patients, 80.5% had lung cancer, 7.6% had metastasis of an extrapulmonary primary tumour and 12% had benign aetiology. Unsuspected endobronchial involvement was found in 4.4% of all 225 patients (or in 5.5% of patients with lung cancer). In addition, flexible bronchoscopy clarified the underlying aetiology in 41% of the cases. The bronchoscopic biopsy results from the SPN were positive in 84 (46.5%) patients with lung cancer. Surgery was cancelled due to the results of flexible bronchoscopy in four cases (involvement of the right main bronchus (impaired pulmonary function did not allow pneumonectomy) n=1, small cell lung cancer n=1, bacterial pneumonia n=2), and the surgical strategy had to be modified to bilobectomy in one patient. Flexible bronchoscopy changed the planned surgical approach in five cases substantially. These results suggest that routine flexible bronchoscopy should be included in the regular pre-operative work-up of patients with SPN.

Fundus autofluorescence and optical coherence tomography of congenital grouped albinotic spots.

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Kim, David Y; Hwang, John C; Moore, Anthony T; Bird, Alan C; Tsang, Stephen H

2010-09-01

The purpose of this study was to describe the findings of fundus autofluores-cence (FAF) and optical coherence tomography in a series of patients with congenital grouped albinotic spots. Three eyes of three patients with congenital grouped albinotic spots were evaluated with FAF and optical coherence tomography imaging to evaluate the nature of the albinotic spots. In all three eyes with congenital grouped albinotic spots, FAF imaging showed autofluorescent spots corresponding to the albinotic spots seen on stereo biomicroscopy. One eye also had additional spots detected on FAF imaging that were not visible on stereo biomicroscopy or color fundus photographs. Fundus autofluorescence imaging of the spots showed decreased general autofluorescence and decreased peripheral autofluorescence surrounding central areas of retained or increased autofluorescence. Optical coherence tomography showed a disruption in signal from the hyperreflective layer corresponding to the inner and outer segment junction and increased signal backscattering from the choroid in the area of the spots. Fluorescein angiography showed early and stable hyperfluorescence of the spots without leakage. In this case series, FAF showed decreased autofluorescence of the spots consistent with focal retinal pigment epithelium atrophy or abnormal material blocking normal autofluorescence and areas of increased autofluorescence suggesting retinal pigment epithelium dysfunction. The findings of optical coherence tomography and fluorescein angiography suggest photoreceptor and retinal pigment epithelium layer abnormalities. Fundus autofluorescence and optical coherence tomography are useful noninvasive diagnostic adjuncts that can aid in the diagnosis of congenital grouped albinotic spots, help determine extent of disease, and contribute to our understanding of its pathophysiology.

Interactive navigation and bronchial tube tracking in virtual bronchoscopy.

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Heng, P A; Fung, P F; Wong, T T; Siu, Y H; Sun, H

1999-01-01

An interactive virtual environment for simulation of bronchoscopy is developed. Medical doctor can safely plan their surgical bronchoscopy using the virtual environment without any invasive diagnosis which may risk the patient's health. The 3D pen input device of the system allows the doctor to navigate and visualize the bronchial tree of the patient naturally and interactively. To navigate the patient's bronchial tree, a vessel tracking process is required. While manual tracking is tedious and labor-intensive, fully automatic tracking may not be reliable. We propose a semi-automatic tracking technique called Intelligent Path Tracker which provides automation and enough user control during the vessel tracking. To support an interactive frame rate, we also introduce a new volume rendering acceleration technique, named as IsoRegion Leaping. The volume rendering is further accelerated by distributed rendering on a TCP/IP-based network of low-cost PCs. With these approaches, a 256 x 256 x 256 volume data of human lung, can be navigated and visualized at a frame rate of over 10 Hz in our virtual bronchoscopy system.

Riboflavin content in autofluorescent earthworm coelomocytes is species-specific.

Directory of Open Access Journals (Sweden)

Joanna Homa

2007-01-01

Full Text Available We have recently shown that a large proproportion of earthworm coelomocytes exhibit strong autofluorescence in some species (Dendrobaena veneta, Allolobophora chlorotica, Dendrodrilus rubidus, Eisenia fetida, and Octolasion spp., while autofluorescent coelomocytes are very scarce in representatives of Lumbricus spp. and Aporrectodea spp. Riboflavin (vitamin B2 was identified as a major fluorophore in Eisenia jetida coelomocytes. The main aim of the present experiments was to quantify riboflavin content in autofluorescent coelomocytes (eleocytes from several earthworm species through a combination of flow cytometric and spectrofluorometric measurements. Spectrofluorometry of coelomocyte lysates showed that riboflavin was non-detectable in the coelomocytes of Aporrectodea spp. and Lumbricus spp., but was a prominent constituent of lysates from species with autofluorescent eleocytes. In the latter case, riboflavin content was the highest in E. fetida, followed by Octolasion spp. > A. chlorotica > D. rubidus. The riboflavin content of coelomocytes correlates positively with eleocyte autofluorescence intensity measured by flow cytometry and visible with fluorescence microscopy.

Role of bronchoscopy in evaluation of cases with sputum smear negative pulmonary tuberculosis, interstitial lung disease and lung malignancy: A retrospective study of 712 cases.

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Kumar, Raj; Gupta, Nitesh

2015-01-01

The introduction of flexible bronchoscope has revolutionized the field of pulmonary medicine and is a standard instrument used for diagnostic purpose. A retrospective analysis of the clinico-radiological profile, indication, biopsy procedure and complications, for patients undergoing bronchoscopy at one of the respiratory unit at a tertiary care center in India. Retrospective analysis of 712 bronchoscopies was done in regard to demographic profile, clinical and radiological presentation and diagnostic indication. The results were analyzed on basis of bronchoscopy inspection and histopathological specimen obtained from transbronchial (TBLB), endobronchial biopsy (EBLB) and cytology specimen by transbronchial needle aspiration (TBNA). Furthermore, diagnostic yield of each biopsy procedure and their combination was evaluated. Of 712 patients undergoing bronchoscopy, the pathological diagnosis was achieved in 384 (53.93%). Of 384 diagnosed cases, the clinic-radio-pathological diagnosis of pulmonary tuberculosis in 88 (22.19%), interstitial lung disease (ILDs) in 226 (58.85%), and lung cancer in 70 (18.22%) cases. Of 116 sputum smear negative tuberculosis patients, 88 (75.86%) were diagnosed to be pulmonary tuberculosis; the contribution of BAL being 71.59%. Of 226 ILDs, sarcoidosis was most common 148/226 (65.48%). Among 70 lung cancer diagnosed cases, squamous cell carcinoma was most common (54.28%). The results from current study reemphasizes on the diagnostic utility as well as safety of the bronchoscopy procedure. Copyright © 2015 Tuberculosis Association of India. Published by Elsevier B.V. All rights reserved.

Risks and recommendations to perform flexible bronchoscopy in pregnant woman

International Nuclear Information System (INIS)

Majid, Adnan; Ernst, Armin; Begolli, Melissa; Canas, Alejandra

2008-01-01

If possible, it is advisable to postpone Flexible Bronchoscopy until after delivery, or at least until after the twenty eighth week of pregnancy. Bronchoscopy should be carried out by the most experienced pulmonologist and in a hospital facility where anesthesiology, obstetrics and neonatology departments are available. Consultation with these specialists is recommended. A pharmacologist should be consulted with regard to the teratogenic potential of the drugs that are to be used during bronchoscopy. The lowest possible doses of drugs should be used for sedation, and drugs of the D and X categories should not be used. During the procedure, it is advisable to carry out continual monitoring of cardiac rhythm and pulse oximetry, as well as intermittent measurements of arterial blood pressure. If possible, fetal monitoring should be carried out. The patient should be placed in the left lateral decubitus position. If this is not possible, the procedure should be carried out with the patient in the sitting position. The duration of the procedure should be minimized, and it should be terminated if the patient does not tolerate it well. The convenience of using fluoroscopy has to be considered separately in each case, taking into consideration its potential risks and benefits. Technological advances for the diagnosis and treatment of pulmonary and airway diseases, such as endobronchial ultrasound, CT scanning with fluoroscopy and bronchoscopy

Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and mIP?

International Nuclear Information System (INIS)

Rapp-Bernhardt, U.; Doehring, W.; Bernhardt, T.M.; Welte, T.; Kropf, S.

2000-01-01

The aim of this study was to evaluate the diagnostic potential of virtual endoscopy (VE) and to compare it with axial CT slices, multiplanar reconstructions (MPR), minimal intensity projections (mIP), and bronchoscopy in patients diagnosed with bronchogenic carcinoma. Thirty patients underwent a spiral CT. Axial CT images were transferred to an Onyx workstation (Silicon Graphics, Sun Microsystems, Mountain View, Calif.) for performing virtual endoscopy. Accuracy for this procedure was tested by three radiologists on a monitor in comparison with axial CT slices, MPR, mIP, and bronchoscopy concerning the localization and degree of stenoses. Endoluminal tumors were identified by virtual bronchoscopy with no statistically significant difference of localization or grading of stenosis in comparison with bronchoscopy, axial CT slices, MPR and mIP. Axial CT slices, MPR, and mIP showed poorer results with over- or underestimation of stenoses compared with VE and bronchoscopy. Passing of stenoses was only possible with VE in 5 patients. Virtual endoscopy is a non-invasive method for identification of endoluminal tumors and is comparable to real bronchoscopy. (orig.)

Diagnostic potential of virtual bronchoscopy: advantages in comparison with axial CT slices, MPR and mIP?

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Rapp-Bernhardt, U.; Doehring, W.; Bernhardt, T.M. [Department of Diagnostic Radiology, Otto-von-Guericke University, Magdeburg (Germany); Welte, T. [Department of Cardiology, Angiology, and Pneumology, Otto-von-Guericke University, Magdeburg (Germany); Kropf, S. [Department of Biometrics and Medical Informatics, Otto-von-Guericke University, Magdeburg (Germany)

2000-06-01

The aim of this study was to evaluate the diagnostic potential of virtual endoscopy (VE) and to compare it with axial CT slices, multiplanar reconstructions (MPR), minimal intensity projections (mIP), and bronchoscopy in patients diagnosed with bronchogenic carcinoma. Thirty patients underwent a spiral CT. Axial CT images were transferred to an Onyx workstation (Silicon Graphics, Sun Microsystems, Mountain View, Calif.) for performing virtual endoscopy. Accuracy for this procedure was tested by three radiologists on a monitor in comparison with axial CT slices, MPR, mIP, and bronchoscopy concerning the localization and degree of stenoses. Endoluminal tumors were identified by virtual bronchoscopy with no statistically significant difference of localization or grading of stenosis in comparison with bronchoscopy, axial CT slices, MPR and mIP. Axial CT slices, MPR, and mIP showed poorer results with over- or underestimation of stenoses compared with VE and bronchoscopy. Passing of stenoses was only possible with VE in 5 patients. Virtual endoscopy is a non-invasive method for identification of endoluminal tumors and is comparable to real bronchoscopy. (orig.)

[Evaluation of fundus autofluorescence in hereditary retinal diseases using Heidelberg Retina Angiograph2].

Science.gov (United States)

Côco, Monique; Baba, Natalia Tamie; Sallum, Juliana Maria Ferraz

2007-01-01

To define characteristics of the fundus autofluorescence examination, verifying usefulness in the diagnosis and care of hereditary retinal diseases. 28 patients, adults, divided equally into four groups with diagnoses of Stargardt macular dystrophy, cone dystrophy, retinitis pigmentosa and healthy volunteers for the establishment of the normality pattern. An average of nine images with the filter for fluorescein angiography was obtained for the formation of the image autofluorescence using Heidelberg Retina Angiograph2. The images of each group of patients were analyzed to verify common characteristics. The fundus autofluorescence of healthy volunteers showed the foveal area darker than the surrounding retina. The images of Stargardt macular dystrophy, in general, presented an oval central lesion, with reduced autofluorescence. The main alterations of the autofluorescence in patients with cone dystrophy were reduced foveal autofluorescence with a parafoveal ring of increased autofluorescence. In general, the images of retinitis pigmentosa showed outlying pigments with reduced autofluorescence, and of the foveal area, in some cases disorganization or reduced autofluorescence. The study showed the existence of patterns of fundus autofluorescence in the hereditary retinal diseases that allow the diagnosis and better interpretation of the pathogenesis of these diseases.

Retro-mode imaging and fundus autofluorescence with scanning laser ophthalmoscope of retinal dystrophies

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Maurizio Battaglia

2012-05-01

Full Text Available Abstract Background Retinal dystrophies display a considerably wide range of phenotypic variability, which can make diagnosis and clinical staging difficult. The aim of the study is to analyze the contribution of retro-mode imaging (RMI and fundus autofluorescence (FAF to the characterization of retinal dystrophies. Methods Eighteen consecutive patients affected by retinal dystrophies underwent a complete ophthalmological examination, including best corrected visual acuity with ETDRS charts, blue-light fundus autofluorescence, (BL-FAF, near-infrared fundus autofluorescence (NIR-FAF, and RMI. The primary outcome was the identification of abnormal patterns on RMI. The secondary outcome was the correlation with the findings on BL-FAF and NIR-FAF. Results Overall, the main feature of RMI is represented by a pseudo-3D pattern of all the lesions at the posterior pole. More specifically, any accumulation of material within the retina appears as an area of elevation of different shape and size, displaying irregular and darker borders. No precise correlations between RMI, BL-AF, and NIR-AF imaging was found. Conclusions RMI and FAF appear to be useful tools for characterizing retinal dystrophies. Non-invasive diagnostic tools may yield additional information on the clinical setting and the monitoring of the patients.

Fundus autofluorescence in the diagnosis and monitoring of acute retinal necrosis

OpenAIRE

Ward, Tyson SJ; Reddy, Ashvini K

2015-01-01

Background Acute retinal necrosis (ARN), a vision threatening viral retinitis, is often diagnosed and treated based on clinical findings. These clinical features have been well characterized by various imaging modalities, but not using fundus autofluorescence (FAF), a noninvasive method of evaluating the neurosensory retina and retinal pigment epithelium (RPE) based on the detection of endogenous fluorophores. Findings A patient diagnosed with ARN was followed over a 10-month period to identi...

Autofluorescence Imaging for Diagnosis and Follow-up of Cystoid Macular Edema

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Nazanin Ebrahimiadib

2012-01-01

Full Text Available Lipofuscin results from digestion of photoreceptor outer segments by the retinal pigment epithelium (RPE and is the principal compound that causes RPE fluorescence during autofluorescence imaging. Absorption of the 488-nanometer blue light by macular pigments, especially by the carotenoids lutein and zeaxanthin, causes normal macular hypo-autofluorescence. Fundus autofluorescence imaging is being increasingly employed in ophthalmic practice to diagnose and monitor patients with a variety of retinal disorders. In macular edema for example, areas of hyper-autofluorescence are usually present which are postulated to be due to dispersion of macular pigments by pockets of intraretinal fluid. For this reason, the masking effect of macular pigments is reduced and the natural autofluorescence of lipofuscin can be observed without interference. In cystic types of macular edema, e.g. cystoid macular edema due to retinal vein occlusion, diabetic macular edema and post cataract surgery, hyperautofluorescent regions corresponding to cystic spaces of fluid accumulation can be identified. In addition, the amount of hyper-autofluorescence seems to correspond to the severity of edema. Hence, autofluorescence imaging, as a noninvasive technique, can provide valuable information on cystoid macular edema in terms of diagnosis, followup and efficacy of treatment.

Autofluorescence-Free Live-Cell Imaging Using Terbium Nanoparticles.

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Cardoso Dos Santos, M; Goetz, J; Bartenlian, H; Wong, K-L; Charbonnière, L J; Hildebrandt, N

2018-04-18

Fluorescent nanoparticles (NPs) have become irreplaceable tools for advanced cellular and subcellular imaging. While very bright NPs require excitation with UV or visible light, which can create strong autofluorescence of biological components, NIR-excitable NPs without autofluorescence issues exhibit much lower brightness. Here, we show the application of a new type of surface-photosensitized terbium NPs (Tb-NPs) for autofluorescence-free intracellular imaging in live HeLa cells. The combination of exceptionally high brightness, high photostability, and long photoluminecence (PL) lifetimes for highly efficient suppression of the short-lived autofluorescence allowed for time-gated PL imaging of intracellular vesicles over 72 h without toxicity and at extremely low Tb-NP concentrations down to 12 pM. Detection of highly resolved long-lifetime (ms) PL decay curves from small (∼10 μm 2 ) areas within single cells within a few seconds emphasized the unprecedented photophysical properties of Tb-NPs for live-cell imaging that extend well beyond currently available nanometric imaging agents.

Multimodal system for the planning and guidance of bronchoscopy

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Higgins, William E.; Cheirsilp, Ronnarit; Zang, Xiaonan; Byrnes, Patrick

2015-03-01

Many technical innovations in multimodal radiologic imaging and bronchoscopy have emerged recently in the effort against lung cancer. Modern X-ray computed-tomography (CT) scanners provide three-dimensional (3D) high-resolution chest images, positron emission tomography (PET) scanners give complementary molecular imaging data, and new integrated PET/CT scanners combine the strengths of both modalities. State-of-the-art bronchoscopes permit minimally invasive tissue sampling, with vivid endobronchial video enabling navigation deep into the airway-tree periphery, while complementary endobronchial ultrasound (EBUS) reveals local views of anatomical structures outside the airways. In addition, image-guided intervention (IGI) systems have proven their utility for CT-based planning and guidance of bronchoscopy. Unfortunately, no IGI system exists that integrates all sources effectively through the complete lung-cancer staging work flow. This paper presents a prototype of a computer-based multimodal IGI system that strives to fill this need. The system combines a wide range of automatic and semi-automatic image-processing tools for multimodal data fusion and procedure planning. It also provides a flexible graphical user interface for follow-on guidance of bronchoscopy/EBUS. Human-study results demonstrate the system's potential.

Fluoroscence bronhoscopy

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Tomić Ilija

2003-01-01

Full Text Available Background. Fluorescence bronchoscopy is one of the methods of the early detection of lung cancer that involves the large airways. The method is based on the detection of the altered autofluorescence of malignantly transformed tissue, and confirmed by biopsy and histopathologic examination. Method. Fluorescence bronchoscopy was performed in 18 patients, mean age of 51.2 years (male n=12, female n=6 due to the suspected lung cancer. Fluorescence bronchoscopy was performed using the Xillix LIFE-Lung System Vancouver, Canada. After conventional white-light bronchoscopy, the tracheobronchial tree was illuminated by blue light (442 nm using helium-cadmium laser, and the results of autofluorescence were classified into three classes. Normal mucosa was of green fluorescence (Class I abnormal mucosa was red or dark brown fluorescence (Class II and II, which was the indication for performing biopsy. Results. Normal endoscopy findings were established in 15 patients by conventional bronchoscopy. In the same group, by fluorescence bronchoscopy, Class I of fluorescence (normal finding was found in 9 patients, while Class II changes occured in 6 patients. Histopathologic analysis of bronchial mucosa with Class II changes was performed detecting planocellular carcinoma in situ in one patient. Tumor-like changes were detected in 3 patients by conventional bronchoscopy and were determined as Class III changes by fluorescence bronchoscopy. By the biopsy of these chages carcinoma was documented in 2 patients while in one patient metaplasia of epithelium and granulation tissue around aspirated foreign body was detected. Conclusion. Fluorescence bronchoscopy is one of the methods for detecting metaplasia, carcinoma in situ and cancerous changes of bronchial epithelium in the large airways. However, the high rate of falsely positive findings represents a limitation of this method.

Skin autofluorescence associates with vascular calcification in chronic kidney disease.

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Wang, Angela Yee-Moon; Wong, Chun-Kwok; Yau, Yat-Yin; Wong, Sharon; Chan, Iris Hiu-Shuen; Lam, Christopher Wai-Kei

2014-08-01

This study aims to evaluate the relationship between tissue advanced glycation end products, as reflected by skin autofluorescence, and vascular calcification in chronic kidney disease. Three hundred patients with stage 3 to 5 chronic kidney disease underwent multislice computed tomography to estimate total coronary artery calcium score (CACS) and had tissue advanced glycation end product assessed using a skin autofluorescence reader. Intact parathyroid hormone (Pskin autofluorescence after age (Pskin autofluorescence was associated with a 7.43-fold (95% confidence intervals, 3.59-15.37; PSkin autofluorescence retained significance in predicting CACS ≥400 (odds ratio, 3.63; 95% confidence intervals, 1.44-9.18; P=0.006) when adjusting for age, sex, serum calcium, phosphate, albumin, C-reactive protein, lipids, blood pressure, estimated glomerular filtration rate, and intact parathyroid hormone but marginally lost significance when additionally adjusting for diabetes mellitus (odds ratio, 2.23; 95% confidence intervals, 0.81-6.14; P=0.1). Combination of diabetes mellitus and higher intact parathyroid hormone was associated with greater skin autofluorescence and CACS versus those without diabetes mellitus and having lower intact parathyroid hormone. Tissue advanced glycation end product, as reflected by skin autofluorescence, showed a significant novel association with vascular calcification in chronic kidney disease. These data suggest that increased tissue advanced glycation end product may contribute to vascular calcification in chronic kidney disease and diabetes mellitus and warrant further experimental investigation. © 2014 American Heart Association, Inc.

Autofluorescence Imaging and Spectroscopy of Human Lung Cancer

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Mengyan Wang

2016-12-01

Full Text Available Lung cancer is one of the most common cancers, with high mortality rate worldwide. Autofluorescence imaging and spectroscopy is a non-invasive, label-free, real-time technique for cancer detection. In this study, lung tissue sections excised from patients were detected by laser scan confocal microscopy and spectroscopy. The autofluorescence images demonstrated the cellular morphology and tissue structure, as well as the pathology of stained images. Based on the spectra study, it was found that the majority of the patients showed discriminating fluorescence in tumor tissues from normal tissues. Therefore, autofluorescence imaging and spectroscopy may be a potential method for aiding the diagnosis of lung cancer.

Remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy: comparison of adjuvant propofol and ketamine

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Mefkur Bakan

2014-06-01

Full Text Available OBJECTIVE:Laryngoscopy and stimuli inside the trachea cause an intense sympatho-adrenal response. Remifentanil seems to be the optimal opioid for rigid bronchoscopy due to its potent and short-acting properties. The purpose of this study was to compare bolus propofol and ketamine as an adjuvant to remifentanil-based total intravenous anesthesia for pediatric rigid bronchoscopy.MATERIALS AND METHODS:Forty children under 12 years of age who had been scheduled for a rigid bronchoscopy were included in this study. After midazolam premedication, a 1 µg/kg/min remifentanil infusion was started, and patients were randomly allocated to receive either propofol (Group P or ketamine (Group K as well as mivacurium for muscle relaxation. Anesthesia was maintained with a 1 µg/kg/min remifentanil infusion and bolus doses of propofol or ketamine. After the rigid bronchoscopy, 0.05 µg/kg/min of remifentanil was maintained until extubation. Hemodynamic parameters, emergence characteristics, and adverse events were evaluated.RESULTS:The demographic variables were comparable between the two groups. The decrease in mean arterial pressure from baseline values to the lowest values during rigid bronchoscopy was greater in Group P (p= 0.049, while the reduction in the other parameters and the incidence of adverse events were comparable between the two groups. The need for assisted or controlled mask ventilation after extubation was higher in Group K.CONCLUSION:Remifentanil-based total intravenous anesthesia with propofol or ketamine as an adjuvant drug along with controlled ventilation is a viable technique for pediatric rigid bronchoscopy. Ketamine does not provide a definite advantage over propofol with respect to hemodynamic stability during rigid bronchoscopy, while propofol seems more suitable during the recovery period.

Use of fundus autofluorescence images to predict geographic atrophy progression.

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Bearelly, Srilaxmi; Khanifar, Aziz A; Lederer, David E; Lee, Jane J; Ghodasra, Jason H; Stinnett, Sandra S; Cousins, Scott W

2011-01-01

Fundus autofluorescence imaging has been shown to be helpful in predicting progression of geographic atrophy (GA) secondary to age-related macular degeneration. We assess the ability of fundus autofluorescence imaging to predict rate of GA progression using a simple categorical scheme. Subjects with GA secondary to age-related macular degeneration with fundus autofluorescence imaging acquired at least 12 months apart were included. Rim area focal hyperautofluorescence was defined as percentage of the 500-μm-wide margin bordering the GA that contained increased autofluorescence. Rim area focal hyperautofluorescence on baseline fundus autofluorescence images was assessed and categorized depending on the extent of rim area focal hyperautofluorescence (Category 1: ≤33%; Category 2: between 33 and 67%; Category 3: ≥67%). Total GA areas at baseline and follow-up were measured to calculate change in GA progression. Forty-five eyes of 45 subjects were included; average duration of follow-up was 18.5 months. Median growth rates differed among categories of baseline rim area focal hyperautofluorescence (P = 0.01 among Categories 1, 2, and 3; P = 0.008 for Category 1 compared with Category 3, Jonckheere-Terpstra test). A simple categorical scheme that stratifies the amount of increased autofluorescence in the 500-μm margin bordering GA may be used to differentiate faster and slower progressors.

Therapeutic rigid bronchoscopy at a tertiary care center in North India: Initial experience and systematic review of Indian literature

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Karan Madan

2014-01-01

Full Text Available Background and Aim: Rigid bronchoscopy is often an indispensable procedure in the therapeutic management of a wide variety of tracheobronchial disorders. However, it is performed at only a few centers in adult patients in India. Herein, we report our initial 1-year experience with this procedure. Materials and Methods: A prospective observational study on the indications, outcomes, and safety of various rigid bronchoscopy procedures performed between November 2009 and October 2010. Improvement in dyspnea, cough, and the overall quality of life was recorded on a visual analog scale from 0 to 100 mm. A systematic review of PubMed was performed to identify studies reporting the use of rigid bronchoscopy from India. Results: Thirty-eight rigid bronchoscopies (50 procedures were performed in 19 patients during the study period. The commonest indication was benign tracheal stenosis followed by central airway tumor, and the procedures performed were rigid bronchoplasty, tumor debulking, and stent placement. The median procedure duration was 45 (range, 30-65 min. There was significant improvement in quality of life associated with therapeutic rigid bronchoscopy. Minor procedural complications were encountered in 18 bronchoscopies, and there was no procedural mortality. The systematic review identified 15 studies, all on the role of rigid bronchoscopy in foreign body removal. Conclusions: Rigid bronchoscopy is a safe and effective modality for treatment of a variety of tracheobronchial disorders. There is a dire need of rigid bronchoscopy training at teaching hospitals in India.

Indication for fiberoptic bronchoscopy in HIV-infected patients suspected for Pneumocystis carinii pneumonia

DEFF Research Database (Denmark)

Orholm, M; Lundgren, Jens Dilling; Nielsen, T L

1990-01-01

During a six-month period, 40 consecutive fiberoptic bronchoscopic procedures including bronchoalveolar lavage, bronchial brushing and forceps biopsy were performed in local anaesthesia on 34 HIV-infected males presenting symptoms compatible with Pneumocystis carinii pneumonia. In 23 examinations...... did not differ with regard to history, clinical examination, immunology, serology or chest radiograph. We conclude that fiberoptic bronchoscopy should be performed on wide indications in HIV-infected patients with symptoms compatible with P. carinii pneumonia. The procedure is easily performed...

Training on a new, portable, simple simulator transfers to performance of complex bronchoscopy procedures

DEFF Research Database (Denmark)

Loumann Krogh, Charlotte; Konge, Lars; Bjurström, Johanna Margareta

2013-01-01

Virtual-reality (VR) simulation provides a safe and effective learning environment prior to practicing on patients. However, existing bronchoscopy simulators are expensive and not easily portable.......Virtual-reality (VR) simulation provides a safe and effective learning environment prior to practicing on patients. However, existing bronchoscopy simulators are expensive and not easily portable....

Management of airway foreign body using flexible bronchoscopy: Experience with 80 cases during 2011–2013

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Safy Kaddah

2015-01-01

Conclusions: Flexible bronchoscopy is successful in retrieving airway foreign bodies (88.8%. With skilled personnel and perfect equipments, flexible bronchoscopy could be considered as the first choice for the removal of airway foreign body.

PATTERNS OF FUNDUS AUTOFLUORESCENCE DEFECTS IN NEOVASCULAR AGE-RELATED MACULAR DEGENERATION SUBTYPES.

Science.gov (United States)

Ozkok, Ahmet; Sigford, Douglas K; Tezel, Tongalp H

2016-11-01

To test define characteristic fundus autofluorescence patterns of different exudative age-related macular degeneration subtypes. Cross-sectional study. Fifty-two patients with choroidal neovascularization because of three different neovascular age-related macular degeneration subtypes were included in the study. Macular and peripheral fundus autofluorescence patterns of study subjects were compared in a masked fashion. Fundus autofluorescence patterns of all three neovascular age-related macular degeneration subtypes revealed similar patterns. However, peripapillary hypo-autofluorescence was more common among patients with polypoidal choroidal vasculopathy (88.2%) compared with patients with retinal angiomatous proliferation (12.5%) and patients without retinal angiomatous proliferation and polypoidal choroidal vasculopathy (21.1%) (P autofluorescence defects in neovascular age-related macular degeneration maybe suggestive of polypoidal choroidal vasculopathy as a variant of neovascular age-related macular degeneration.

Fundus autofluorescence findings in a mouse model of retinal detachment.

Science.gov (United States)

Secondi, Roberta; Kong, Jian; Blonska, Anna M; Staurenghi, Giovanni; Sparrow, Janet R

2012-08-07

Fundus autofluorescence (fundus AF) changes were monitored in a mouse model of retinal detachment (RD). RD was induced by transscleral injection of hyaluronic acid (Healon) or sterile balanced salt solution (BSS) into the subretinal space of 4-5-day-old albino Abca4 null mutant and Abca4 wild-type mice. Images acquired by confocal scanning laser ophthalmoscopy (Spectralis HRA) were correlated with spectral domain optical coherence tomography (SD-OCT), infrared reflectance (IR), fluorescence spectroscopy, and histologic analysis. Results. In the area of detached retina, multiple hyperreflective spots in IR images corresponded to punctate areas of intense autofluorescence visible in fundus AF mode. The puncta exhibited changes in fluorescence intensity with time. SD-OCT disclosed undulations of the neural retina and hyperreflectivity of the photoreceptor layer that likely corresponded to histologically visible photoreceptor cell rosettes. Fluorescence emission spectra generated using flat-mounted retina, and 488 and 561 nm excitation, were similar to that of RPE lipofuscin. With increased excitation wavelength, the emission maximum shifted towards longer wavelengths, a characteristic typical of fundus autofluorescence. In detached retinas, hyper-autofluorescent spots appeared to originate from photoreceptor outer segments that were arranged within retinal folds and rosettes. Consistent with this interpretation is the finding that the autofluorescence was spectroscopically similar to the bisretinoids that constitute RPE lipofuscin. Under the conditions of a RD, abnormal autofluorescence may arise from excessive production of bisretinoid by impaired photoreceptor cells.

Bronchoscopy as a supplement to computed tomography in patients with haemoptysis may be unnecessary

DEFF Research Database (Denmark)

Nielsen, Klaus; Gottlieb, Magnus; Colella, Sara

2016-01-01

. RESULTS: A total of 326 patients were included in the study (mean age 60.5 [SD 15.3] years, 63.3% male). The most common aetiologies of haemoptysis were cryptogenic (52.5%), pneumonia (16.3%), emphysema (8.0%), bronchiectasis (5.8%) and lung cancer (4.0%). In patients diagnosed with lung cancer......BACKGROUND: Haemoptysis is a common symptom and can be an early sign of lung cancer. Careful investigation of patients with haemoptysis may lead to early diagnosis. The strategy for investigation of these patients, however, is still being debated. OBJECTIVES: We studied whether the combination......, bronchoscopy, CT and the combination of bronchoscopy and CT had a sensitivity of 0.61, 0.92 (pemphysema and bronchiectasis. Bronchoscopy did...

Do technical parameters affect the diagnostic accuracy of virtual bronchoscopy in patients with suspected airways stenosis?

International Nuclear Information System (INIS)

Jones, Catherine M.; Athanasiou, Thanos; Nair, Sujit; Aziz, Omer; Purkayastha, Sanjay; Konstantinos, Vlachos; Paraskeva, Paraskevas; Casula, Roberto; Glenville, Brian; Darzi, Ara

2005-01-01

Purpose: Virtual bronchoscopy has gained popularity over the past decade as an alternative investigation to conventional bronchoscopy in the diagnosis, grading and monitoring of airway disease. The effect of technical parameters on diagnostic outcome from virtual bronchoscopy has not been determined. This meta-analysis aims to estimate accuracy of virtual compared to conventional bronchoscopy in patients with suspected airway stenosis, and evaluate the influence of technical parameters. Materials and methods: A MEDLINE search was used to identify relevant published studies. The primary endpoint was the 'correct diagnosis' of stenotic lesions on virtual compared to conventional bronchoscopy. Secondary endpoints included the effects of the technical parameters (pitch, collimation, reconstruction interval, rendering method, and scanner type), and date of publication on the diagnostic accuracy of virtual bronchoscopy. Results: Thirteen studies containing 454 patients were identified. Meta-analysis showed good overall diagnostic performance with 85% calculated pooled sensitivity (95% CI 77-91%), 87% specificity (95% CI 81-92%) and area under the curve (AUC) of 0.947. Subgroups included collimation of 3 mm or more (AUC 0.948), pitch of 1 (AUC 0.955), surface rendering technique (AUC 0.935), and reconstruction interval of more than 1.25 mm (AUC 0.914). There was no significant difference in accuracy accounting for publication date, scanner type or any of the above variables. Weighted regression analysis confirmed none of these variables could significantly account for study heterogeneity. Conclusion: Virtual bronchoscopy performs well in the investigation of patients with suspected airway stenosis. Overall sensitivity and specificity and diagnostic odds ratio for diagnosis of airway stenosis were high. The effects of pitch, collimation, reconstruction interval, rendering technique, scanner type, and publication date on diagnostic accuracy were not significant

Removal of metallic tracheobronchial stents in lung transplantation with flexible bronchoscopy

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Fruchter Oren

2010-09-01

Full Text Available Abstract Background Airway complications are among the most challenging problems after lung transplantation, and Self-Expandable Metallic Stents (SEMS are used to treat airway complications such as stenosis or malacia at the bronchial anastomosis sites. Several transplantation centers are reluctant to use SEMS since their removal is sometimes needed and usually requires the use of rigid bronchoscopy under general anesthesia. The objective of the current report is to describe our experience in SEMS retrieval by flexible bronchoscopy under conscious sedation. Methods A retrospective review was done of patients requiring tracheobronchial stent placement after lung transplantation in which the SEMS had to be removed. The retrieval procedure was done by flexible bronchoscopy on a day-care ambulatory basis. Results Between January 2004 and January 2010, out of 305 lung transplantation patients, 24 (7.8% underwent SEMS placement. Indications included bronchial stenosis in 20 and bronchomalacia in 4. In six patients (25% the SEMS had to be removed due to excessive granulation tissue formation and stent obstruction. The average time from SEMS placement to retrieval was 30 months (range 16-48 months. The stent was completely removed in five patients and partially removed in one patient; no major complications were encountered, and all patients were discharged within 3 hours of the procedure. In all procedures, new SEMS was successfully re-inserted thereafter. Conclusions The retrieval of SEMS in patients that underwent lung transplantation can be effectively and safely done under conscious sedation using flexible bronchoscopy on a day-care basis, this observation should encourage increasing usage of SEMS in highly selected patients.

FUNDUS AUTOFLUORESCENCE IN RUBELLA RETINOPATHY: Correlation With Photoreceptor Structure and Function.

Science.gov (United States)

Bukowska, Danuta M; Wan, Sue Ling; Chew, Avenell L; Chelva, Enid; Tang, Ivy; Mackey, David A; Chen, Fred K

2017-01-01

To illustrate altered fundus autofluorescence in rubella retinopathy and to investigate their relationships with photoreceptor structure and function using multimodal imaging. The authors report four cases of rubella retinopathy aged 8, 33, 42, and 50 years. All patients had dilated clinical fundus examination; wide-field color photography; blue, green, and near-infrared autofluorescence imaging and spectral domain optical coherence tomography. Two patients also underwent microperimetry and adaptive optics imaging. En face optical coherence tomography, cone mosaic, and microperimetry were coregistered with autofluorescence images. The authors explored the structure-function correlation. All four patients had a "salt-and-pepper" appearance on dilated fundus examination and wide-field color photography. There were variable-sized patches of hypoautofluorescence on both blue and near-infrared excitation in all four patients. Wave-guiding cones were visible and retinal sensitivity was intact over these regions. There was no correlation between hypoautofluorescence and regions of attenuated ellipsoid and interdigitation zones. Hyperautofluorescent lesions were also noted and some of these were pseudo-vitelliform lesions. Patchy hypoautofluorescence on near-infrared excitation can be a feature of rubella retinopathy. This may be due to abnormal melanin production or loss of melanin within retinal pigment epithelium cells harboring persistent rubella virus infection. Preservation of the ellipsoid zone, wave-guiding cones, and retinal sensitivity within hypoautofluorescent lesions suggest that these retinal pigment epithelium changes have only mild impact on photoreceptor cell function.

Classification of clinical autofluorescence spectra of oral leukoplakia using an artificial neural network : a pilot study

NARCIS (Netherlands)

van Staveren, HJ; van Veen, RLP; Speelman, OC; Witjes, MJH; Roodenburg, JLN

The performance of an artificial neural network was evaluated as an alternative classification technique of autofluorescence spectra of oral leukoplakia, which may reflect the grade of tissue dysplasia. Twenty-two visible lesions of 21 patients suffering from oral leukoplakia and six locations on

Autofluorescence guided diagnostic evaluation of suspicious oral mucosal lesions: opportunities, limitations, and pitfalls

Science.gov (United States)

Vigneswaran, Nadarajah

2011-03-01

Wide-filed autofluorescence examination is currently considered as a standard of care for screening and diagnostic evaluation of early neoplastic changes of the skin, cervix, lung, bladder, gastrointestinal tract and oral cavity. Naturally occurring fluorophores within the tissue absorb UV and visible light and can re-emit some of this light at longer wavelengths in the form of fluorescence. This non-invasive tissue autofluorescence imaging is used in optical diagnostics, especially in the early detection of cancer. Usually, malignant transformation is associated with thickening of the epithelium, enhanced cellular density due to increased nuclear cytoplasmic ratio which may attenuate the excitation leading to a decrease in collagen autofluorescence. Hence, dysplastic and cancerous tissues often exhibit decreased blue-green autofluorescence and appear darker compared to uninvolved mucosa. Currently, there are three commercially available devices to examine tissue autofluorescence in the oral cavity. In this study we used the oral cancer screening device IdentafiTM 3000 to examine the tissue reflectance and autofluorescence of PML and confounding lesions of the oral cavity. Wide-field autofluorescence imaging enables rapid inspection of large mucosal surfaces, to aid in recognition of suspicious lesions and may also help in discriminate the PML (class 1) from some of the confounding lesions (class II). However, the presence of inflammation or pigments is also associated with loss of stromal autofluorescence, and may give rise to false-positive results with widefield fluorescence imaging. Clinicians who use these autofluorescence based oral cancer screening devices should be aware about the benign oral mucosal lesions that may give false positivity so that unnecessary patient's anxiety and the need for scalpel biopsy can be eliminated.

High-risk respiratory patients' experiences of bronchoscopy with conscious sedation and analgesia: A qualitative study.

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Saxon, Catherine; Fulbrook, Paul; Fong, Kwun M; Ski, Chantal F

2017-10-20

To understand the experiences of high-risk respiratory patients undergoing bronchoscopy with conscious sedation. Due to possible complications, high-risk respiratory patients are usually given smaller, cautious doses of sedation and analgesia for bronchoscopy. Described as "conscious sedation," this facilitates depression of the patient's consciousness without causing respiratory compromise. Previously, studies have investigated patient experience using quantitative methods. This is the first study that has explored the patient experience during bronchoscopy from a qualitative perspective. Qualitative, phenomenological approach as described by Van Manen. The setting was an endoscopy unit within an Australian tertiary hospital. Unstructured interviews were conducted with 13 patients with chronic obstructive pulmonary disease who underwent day-case bronchoscopy. All participants received conscious sedation. They were interviewed twice, within a week, postprocedure. Interviews were transcribed verbatim and analysed using Van Manen's interpretive approach. Participants had varying experiences. Five themes emerged from the analysis: Frustration and fear; Comfort and safety; Choking and coughing; Being aware; and Consequences. Whilst not all participants experienced procedural awareness or remembered it, for those who did it was a significant event. Overall, experiences were found to be negative; however, participants accepted and tolerated them, perceiving them as necessary to obtain a diagnostic result. The findings demonstrate that often patients are aware during the procedure and their experience may be uncomfortable and distressing. These findings have implications for patient preparation pre- and post-bronchoscopy in terms of what they might expect, and to discuss what has happened after the procedure. Some practices of the bronchoscopy team during the procedure may need modification. For example, in anticipation of the possibility that the patient may be aware

Prevention of increased abnormal fundus autofluorescence with blue light-filtering intraocular lenses.

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Nagai, Hiroyuki; Hirano, Yoshio; Yasukawa, Tsutomu; Morita, Hiroshi; Nozaki, Miho; Wolf-Schnurrbusch, Ute; Wolf, Sebastian; Ogura, Yuichiro

2015-09-01

To observe changes in fundus autofluorescence 2 years after implantation of blue light-filtering (yellow-tinted) and ultraviolet light-filtering (colorless) intraocular lenses (IOLs). Department of Ophthalmology and Visual Science, Nagoya City University Graduate School of Medical Sciences, Nagoya, Japan, and the Department of Ophthalmology, University of Bern, Bern, Switzerland. Prospective comparative observational study. Patients were enrolled who had cataract surgery with implantation of a yellow-tinted or colorless IOL and for whom images were obtained on which the fundus autofluorescence was measurable using the Heidelberg Retina Angiogram 2 postoperatively. The fundus autofluorescence in the images was classified into 8 abnormal patterns based on the classification of the International Fundus Autofluorescence Classification Group, The presence of normal fundus autofluorescence, geographic atrophy, and wet age-related macular degeneration (AMD) also was recorded. The fundus findings at baseline and 2 years postoperatively were compared. Fifty-two eyes with a yellow-tinted IOL and 79 eyes with a colorless IOL were included. Abnormal fundus autofluorescence did not develop or increase in the yellow-tinted IOL group; however, progressive abnormal fundus autofluorescence developed or increased in 12 eyes (15.2%) in the colorless IOL group (P = .0016). New drusen, geographic atrophy, and choroidal neovascularization were observed mainly in the colorless IOL group. The incidence of AMD was statistically significantly higher in the colorless IOL group (P = .042). Two years after cataract surgery, significant differences were seen in the progression of abnormal fundus autofluorescence between the 2 groups. The incidence of AMD was lower in eyes with a yellow-tinted IOL. No author has a financial or proprietary interest in any material or method mentioned. Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.

LED induced autofluorescence (LIAF) imager with eight multi-filters for oral cancer diagnosis

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Huang, Ting-Wei; Cheng, Nai-Lun; Tsai, Ming-Hsui; Chiou, Jin-Chern; Mang, Ou-Yang

2016-03-01

Oral cancer is one of the serious and growing problem in many developing and developed countries. The simple oral visual screening by clinician can reduce 37,000 oral cancer deaths annually worldwide. However, the conventional oral examination with the visual inspection and the palpation of oral lesions is not an objective and reliable approach for oral cancer diagnosis, and it may cause the delayed hospital treatment for the patients of oral cancer or leads to the oral cancer out of control in the late stage. Therefore, a device for oral cancer detection are developed for early diagnosis and treatment. A portable LED Induced autofluorescence (LIAF) imager is developed by our group. It contained the multiple wavelength of LED excitation light and the rotary filter ring of eight channels to capture ex-vivo oral tissue autofluorescence images. The advantages of LIAF imager compared to other devices for oral cancer diagnosis are that LIAF imager has a probe of L shape for fixing the object distance, protecting the effect of ambient light, and observing the blind spot in the deep port between the gumsgingiva and the lining of the mouth. Besides, the multiple excitation of LED light source can induce multiple autofluorescence, and LIAF imager with the rotary filter ring of eight channels can detect the spectral images of multiple narrow bands. The prototype of a portable LIAF imager is applied in the clinical trials for some cases in Taiwan, and the images of the clinical trial with the specific excitation show the significant differences between normal tissue and oral tissue under these cases.

Laser induced autofluorescence for diagnosis of non-melanoma skin cancer

Science.gov (United States)

Drakaki, E.; Makropoulou, M.; Serafetinides, A. A.; Merlemis, N.; Kalatzis, I.; Sianoudis, I. A.; Batsi, O.; Christofidou, E.; Stratigos, A. J.; Katsambas, A. D.; Antoniou, Ch.

2015-01-01

Non melanoma skin cancer is one of the most frequent malignant tumors among humans. A non-invasive technique, with high sensitivity and high specificity, would be the most suitable method for basal cell carcinoma (BCC) or other malignancies diagnostics, instead of the well established biopsy and histopathology examination. In the last decades, a non-invasive, spectroscopic diagnostic method was introduced, the laser induced fluorescence (LIF), which could generate an image contrast between different states of skin tissue. The noninvasiveness consists in that this biophotonic method do not require tissue sample excision, what is necessary in histopathology characterization and biochemical analysis of the skin tissue samples, which is worldwide used as an evaluation gold standard. The object of this study is to establish the possibilities of a relatively portable system for laser induced skin autofluorescence to differentiate malignant from nonmalignant skin lesions. Unstained human skin samples, excised from humans undergoing biopsy examination, were irradiated with a Nd:YAG-3ω laser (λ=355 nm, 6 ns), used as an excitation source for the autofluorescence measurements. A portable fiber-based spectrometer was used to record fluorescence spectra of the sites of interest. The ex vivo results, obtained with this spectroscopic technique, were correlated with the histopathology results. After the analysis of the fluorescence spectra of almost 60 skin tissue areas, we developed an algorithm to distinguish different types of malignant lesions, including inflammatory areas. Optimization of the data analysis and potential use of LIF spectroscopy with 355 nm Nd:YAG laser excitation of tissue autofluorescence for clinical applications are discussed.

Reduced background autofluorescence for cell imaging using nanodiamonds and lanthanide chelates.

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Cordina, Nicole M; Sayyadi, Nima; Parker, Lindsay M; Everest-Dass, Arun; Brown, Louise J; Packer, Nicolle H

2018-03-14

Bio-imaging is a key technique in tracking and monitoring important biological processes and fundamental biomolecular interactions, however the interference of background autofluorescence with targeted fluorophores is problematic for many bio-imaging applications. This study reports on two novel methods for reducing interference with cellular autofluorescence for bio-imaging. The first method uses fluorescent nanodiamonds (FNDs), containing nitrogen vacancy centers. FNDs emit at near-infrared wavelengths typically higher than most cellular autofluorescence; and when appropriately functionalized, can be used for background-free imaging of targeted biomolecules. The second method uses europium-chelating tags with long fluorescence lifetimes. These europium-chelating tags enhance background-free imaging due to the short fluorescent lifetimes of cellular autofluorescence. In this study, we used both methods to target E-selectin, a transmembrane glycoprotein that is activated by inflammation, to demonstrate background-free fluorescent staining in fixed endothelial cells. Our findings indicate that both FND and Europium based staining can improve fluorescent bio-imaging capabilities by reducing competition with cellular autofluorescence. 30 nm nanodiamonds coated with the E-selectin antibody was found to enable the most sensitive detective of E-selectin in inflamed cells, with a 40-fold increase in intensity detected.

Characterization of tissue autofluorescence in Barrett's esophagus by confocal fluorescence microscopy

NARCIS (Netherlands)

Kara, M. A.; DaCosta, R. S.; Streutker, C. J.; Marcon, N. E.; Bergman, J. J. G. H. M.; Wilson, B. C.

2007-01-01

High grade dysplasia and early cancer in Barrett's esophagus can be distinguished in vivo by endoscopic autofluorescence point spectroscopy and imaging from non-dysplastic Barrett's mucosa. We used confocal fluorescence microscopy for ex vivo comparison of autofluorescence in non-dysplastic and

Fiberoptic bronchoscopy in the diagnosis and therapeutic decision for respiratory infections in hematological febrile neutropenic patients

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Luiza Bento

2014-06-01

Full Text Available Background: Febrile neutropenia is a common complication in patients undergoing chemotherapy or hematopoietic Stem Cell Transplantation (HSCT. Flexible fiberoptic bronchoscopy has been used to aid in the diagnosis of pulmonary diseases. However, there is no consensus regarding the benefit of the exam in establishing diagnosis and in changing the treatment of lung disease in this context. Previous retrospective studies, quite heterogeneous and with non-HIV immunocompromised patients, showed that the yield of fiberoptic bronchoscopy in establishing etiology ranges from 13% to 81%, and in changing therapy, from 5% to 51%. Aim: To evaluate the efficiency of Fiberoptic bronchoscopy and the procedure-related risk for neutropenic patients with hematologic malignancy. Methods: This retrospective cross-sectional study analyzed the medical records of patients with hematologic malignancy with febrile neutropenia who had undergone diagnostic fiberoptic bronchoscopy between January 2011 and December 2012 at the Hospital de Clínicas de Porto Alegre. Results: A total of 45 patients were included: 18 (36% tested positive for bronchoalveolar lavage, with change in therapeutic management occurring for 95% of them. The procedure-related risk was 2.2%, with one patient showing desaturation immediately after the procedure. Conclusion:  Despite the limited number of patients, our findings indicate that fiberoptic bronchoscopy in neutropenic patients is safe, and the results are similar to those previously reported.

Immediate and long-term changes of fundus autofluorescence in continuous wave laser lesions of the retina.

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Framme, Carsten; Roider, Johann

2004-01-01

To determine whether fundus autofluorescence imaging is able to show changes in retinal pigment epithelium (RPE) fluorescence after thermal laser photocoagulation. In vivo imaging of fundus autofluorescence was performed with a scanning laser ophthalmoscope. A laser with a wavelength of 488 nm was used for excitation of the tissue and autofluorescence was detected above 500 nm using a barrier filter. One hundred eight eyes of 87 patients who had had previous laser treatment were monitored. The appearance and size of the laser lesions were documented and correlated to the time of treatment. Immediate changes were observed prospectively in 13 eyes; long-term follow-up was studied retrospectively in 95 eyes. In all patients but one, autofluorescence was decreased in the area of laser lesions 1 hour after laser treatment. After 1 month, previously decreased autofluorescence in all lesions changed to significantly increased autofluorescence, which was stable up to 6 months after treatment. Mixed forms were present approximately 6 to 12 months after treatment, showing a central island of increased autofluorescence surrounded by a ring of decreased autofluorescence. After 1 to 2 years, lesions again changed to complete dark spots, enlarging later on. RPE destruction and subsequent proliferation after continuous wave laser photocoagulation can be visualized noninvasively by autofluorescence imaging. Immediate decreased autofluorescence may indicate acute damage of the RPE, subsequent increased autofluorescence seems to indicate proliferative behavior of the RPE, and final dark spots can indicate RPE atrophy secondary to a denaturation of neurosensory retinal tissue. Thus, autofluorescence can be used in the long-term monitoring of RPE changes after laser treatment. The enlargement of the laser atrophy zone demonstrates the potential risk of visual loss after central laser photocoagulation even years after treatment.

Complete subglottic tracheal stenosis managed with rigid bronchoscopy and T-tube placement

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Kuruswamy Thurai Prasad

2016-01-01

Full Text Available Surgery is the preferred treatment modality for benign tracheal stenosis. Interventional bronchoscopy is used as a bridge to surgery or in instances when surgery is not feasible or has failed. Stenosis in the subglottic trachea is particularly a treatment challenge, in view of its proximity to the vocal cords. Herein, we describe a patient with complete tracheal stenosis in the subglottic region, which developed after prolonged intubation and mechanical ventilation. The patient developed recurrent stenosis despite multiple surgical and endoscopic procedures. We were able to manage the patient successfully with rigid bronchoscopy and Montgomery T-tube placement.

Using Performance in Multiple Simulated Scenarios to Assess Bronchoscopy Skills

DEFF Research Database (Denmark)

Konge, Lars; Arendrup, Henrik; Buchwald, Christian von

2011-01-01

using a standardized scoring form. Methods: The test was administered on a virtual reality bronchoscopy simulator to a total of 42 test subjects (14 senior consultants, 14 trainees and 14 medical students). The inter-rater reliability of the test procedure was explored according to examination of test......Background: International guidelines suggest that trainees should perform at least 100 flexible bronchoscopies in a supervised setting, but this number is not evidence based. An objective assessment method could provide educational feedback to trainees and help supervisors decide when basic...... competency is established. No former assessment instrument has been able to distinguish between trainees and experts. Objectives: The aim of this study was to explore the validity and reliability of a new assessment procedure relating to testing operators across multiple tasks with increasing difficulty...

Comparative study between computed tomography and bronchoscopy in the diagnosis of lung cancer

International Nuclear Information System (INIS)

Oliveira, Christopher; Saraiva, Antonio

2010-01-01

Objective: to analyze the role of computed tomography and bronchoscopy in the diagnosis of lung cancer, evaluating the effectiveness of these techniques in the presence of this disease. Parameters such as age, gender, smoking habits, histological types, staging and treatment were also analyzed. Materials and methods: the sample of the present study included 70 patients assisted at the Department of Pneumology of Hospital Distrital da Figueira da Foz, Coimbra, Portugal, who were submitted to both diagnostic methods, namely, computed tomography and bronchoscopy, to confirm the presence or the absence of lung cancer. Results: thirty-seven patients (23 men and 14 women) were diagnosed with lung cancer. Histologically 40.54% were adenocarcinoma, followed by squamous carcinoma (32.43% cases) and small-cell lung cancer (18.92%). Staging showed 6.70% stage IB disease, 23.30% stage IIIA and 36.70% stage IIIB, and 33.30% stage IV. Chemotherapy alone was the first treatment of choice for 75.7% of patients. Bronchoscopy sensitivity was 83.8%, specificity 81.8%, and accuracy 82.8%. Computed tomography sensitivity was 81.1%, specificity 63.6%, and accuracy 72.8%. Conclusion: bronchoscopy results corroborated the relevance of the method in the diagnosis of lung cancer, considering its dependence on the anatomopathological study of tissue or cells obtained through different biopsy techniques. Computed tomography presented good sensitivity (81.1%), however the specificity of only 63.6% is related to the rate of false-positive results (36.4%). (author)

Comparative study between computed tomography and bronchoscopy in the diagnosis of lung cancer

Energy Technology Data Exchange (ETDEWEB)

Oliveira, Christopher; Saraiva, Antonio, E-mail: asaraiva@estescoimbra.p [Escola Superior de Tecnologia da Saude de Coimbra (ESTeSC), Coimbra (Portugal)

2010-07-15

Objective: to analyze the role of computed tomography and bronchoscopy in the diagnosis of lung cancer, evaluating the effectiveness of these techniques in the presence of this disease. Parameters such as age, gender, smoking habits, histological types, staging and treatment were also analyzed. Materials and methods: the sample of the present study included 70 patients assisted at the Department of Pneumology of Hospital Distrital da Figueira da Foz, Coimbra, Portugal, who were submitted to both diagnostic methods, namely, computed tomography and bronchoscopy, to confirm the presence or the absence of lung cancer. Results: thirty-seven patients (23 men and 14 women) were diagnosed with lung cancer. Histologically 40.54% were adenocarcinoma, followed by squamous carcinoma (32.43% cases) and small-cell lung cancer (18.92%). Staging showed 6.70% stage IB disease, 23.30% stage IIIA and 36.70% stage IIIB, and 33.30% stage IV. Chemotherapy alone was the first treatment of choice for 75.7% of patients. Bronchoscopy sensitivity was 83.8%, specificity 81.8%, and accuracy 82.8%. Computed tomography sensitivity was 81.1%, specificity 63.6%, and accuracy 72.8%. Conclusion: bronchoscopy results corroborated the relevance of the method in the diagnosis of lung cancer, considering its dependence on the anatomopathological study of tissue or cells obtained through different biopsy techniques. Computed tomography presented good sensitivity (81.1%), however the specificity of only 63.6% is related to the rate of false-positive results (36.4%). (author)

Bench-top endomicroscope for visualization and imaging of nuclei using ultraviolet autofluorescence

Science.gov (United States)

Lin, Bevin

The long range goal of this research was to develop autofluorescence technology and instrumentation for transition towards an in vivo endomicroscopy imaging system. This approach would provide resolution sufficient to image nuclei for real-time categorization of normal and abnormal tissue implicative of disease progression. Esophageal adenocarcinoma was the chosen model to develop this diagnostic imaging system because the heterogeneous and multifocal nature of this disease makes early diagnosis extremely challenging during the window of time when the prognosis for survival is high. The asymptomatic character of this disease generally presents at a malignant stage when removal of the esophagus has become the standard treatment. The traditional gold standard of histologic diagnosis suffers from a slow turn-around-time from tissue removal to microscopic observation, compounded by error in random biopsy sampling and tissue-processing artifacts, in addition to significant variation in pathologist diagnosis. Optical biopsy has thus been developed to alleviate the problems associated with current standard video endoscopy and histopathology. Following tremendous research in the realm of optical biopsy, some traction has been gained using confocal endomicroscopy. However, current confocal methods require contrast agents and optical sectioning in order to provide images at a cellular level. We have developed a minimally invasive imaging system using autofluorescence that highlights the short photon penetration depth of ultraviolet excitation. This approach provides cellular level resolution with a clinically relevant field of view without requiring contrast agents or optical sectioning. Optical histopathology has been demonstrated using unprocessed ex vivo human gastrointestinal tissues providing diagnostic assessment in real-time, a function imperative for improved patient care and quality of life. This robust bench-top prototype endomicroscopy system is capable of rapid

A comparison of white light laryngostroboscopy versus autofluorescence endoscopy in the evaluation of vocal fold pathology.

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Caffier, Philipp P; Schmidt, Bernd; Gross, Manfred; Karnetzky, Klaus; Nawka, Tadeus; Rotter, Andreas; Seipelt, Matthias; Sedlmaier, Benedikt

2013-07-01

To prove the diagnostic value of autofluorescence endoscopy (AFE) and white light laryngostroboscopy (WLS) versus the gold standard microlaryngoscopy with histopathological examination in differential diagnostics of laryngeal lesions for experienced phoniatricians and laryngologists, using the PENTAX SAFE-3000 system. Exploratory cohort study. High-resolution rigid WLS was executed in 32 consecutive patients with initial manifestation of benign, precancerous, and malignant vocal fold lesions. Fiberoptic blue light AFE (SAFE-3000; λ = 408 nm) was subsequently performed by an experienced endoscopist in a blinded study setting. Findings were rated based on objective WLS and AFE parameters (e.g., phonatory vibration, mucosal wave propagation, and loss of autofluorescence). The clinically assumed WLS and AFE diagnoses were compared with the final histopathology of biopsied material taken during microlaryngoscopy. In reference to histopathological diagnosis, WLS achieved a higher sensitivity (100% vs. 94%), specificity (94% vs. 69%), and accuracy (97% vs. 81%) than AFE diagnostics. The concordance between both endoscopic techniques was 87.5% (28/32 patients); additional AFE benefits were not detectable. Significant loss of autofluorescence was observed in malignant findings clinically clearly diagnosed by WLS, but also in chronic inflammation, severe dysplasia, granulomas, vascular polyps, and glottal papillomatosis. The evaluation of vocal fold pathology by the clinically experienced examiner precisely applying WLS appears to be more reliable than diagnostics of mucosal tissue changes by means of AFE via the SAFE-3000 system as a relatively nonspecific method. Microlaryngoscopy with histopathological examination and phonomicrosurgical excision of pathologic changes remains the gold standard. © 2012 The American Laryngological, Rhinological and Otological Society, Inc.

Autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytoma.

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Guerra, Ricardo Luz Leitão; Marback, Eduardo Ferrari; Silva, Igor Sandes Pessoa da; Maia Junior, Otacílio de Oliveira; Marback, Roberto Lorens

2014-01-01

The authors report fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (OCT) findings of two consecutive patients who presented with optic disk melanocytoma (ODM). A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluorescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal melanocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.

Autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytoma

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Ricardo Luz Leitão Guerra

2014-12-01

Full Text Available The authors report fundus autofluorescence (FAF and spectral-domain optical coherence tomography (OCT findings of two consecutive patients who presented with optic disk melanocytoma (ODM. A retrospective study was performed by reviewing medical records and ophthalmic imaging examinations. Optical coherence tomography findings were sloped and brightly reflective anterior tumor surface, adjacent retinal desorganization and abrupt posterior optical shadowing. Vitreous seeds were found in one patient. Fundus autofluorescence revealed outstanding hypoautofluorescence at the tumor area and isoautofluorescence at the remaining retina. Optical coherence tomography findings of the reported cases are consistent with those reported in the reviewed literature. Fundus autofluorescence has been used in the assessment of choroidal melanocytic tumors, but not yet in melanocytomas. We assume that this is the first report of these findings and believe that when its pattern has become clearly defined, fundus autofluorescence will be a useful tool to avoid misdiagnosis in suspicious cases and for follow-up.

Music does not alter anxiety in patients with suspected lung cancer undergoing bronchoscopy

DEFF Research Database (Denmark)

Jeppesen, Elisabeth; Pedersen, Carsten M; Larsen, Klaus R

2016-01-01

BACKGROUND: The use of music to relieve anxiety has been examined in various studies, but the results are inconclusive. METHODS: From April to October 2015, 160 patients undergoing examination of pulmonary nodules were randomly assigned to MusiCure or no music. MusiCure was administered through e...... earplugs to ensure blinding of the staff and was played from admission to the operating theatre to the end of the bronchoscopy. Spielberger's State-Trait Anxiety Inventory (STAI) was administered on admission, immediately before bronchoscopy, and on discharge. Secondary outcomes were p...

Identification of endogenous fluorophores in the photoreceptors using autofluorescence spectroscopy

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Zhao, Lingling; Qu, Junle; Niu, Hanben

2007-11-01

In this paper, we present our investigation on the identification of endogenous fluorophores in photoreceptors using autofluorescence spectroscopy, which is performed with an inverted laser scanning confocal microscope equipped with an Argon ion laser and a GreNe laser. In our experiments, individual cones and rods are clearly resolved even in freshly prepared retina samples, without slicing or labeling. The experiment results show that autofluorescence spectrum of the photoreceptors has three peaks approximately at 525nm, 585nm and 665nm. Furthermore, the brightest autofluorescence originates from the photoreceptor outer segments. We can, therefore, come to a conclusion that the peaks at 525nm, 585nm are corresponding to FAD and A2-PE, respectively, which are distributed in the photoreceptor outer segments.

Pneumocystis carinii pneumonia in AIDS patients: clinical course in relation to the parasite number found in routine specimens obtained by fiberoptic bronchoscopy

DEFF Research Database (Denmark)

Orholm, M; Nielsen, T L; Holten-Andersen, W

1992-01-01

The aim of this study was to evaluate whether the amount of Pneumocystis carinii organisms found at fiberoptic bronchoscopy (FB) performed on HIV-positive patients correlated to the character of the P. carinii pneumonia (PCP). A consecutive series of 105 patients presented with 131 episodes...... of pulmonary symptoms requiring FB, and in 75 of these episodes a diagnosis of PCP was made. Specimens were stained with Giemsa and methenamine silver nitrate and the number of parasites found was given as: numerous, many, few or none. The following signs and symptoms were registered: cough, dyspnoea, fever......, loss of weight, chest radiograph, haemoglobin, WBC, CD4 cell count, PO2 and HIV p24 antigen. The PCP was characterized by the clinical course: mild, moderate, severe, and by the outcome: pulmonary healthy, pulmonary insufficiency and death. No correlations between the number of P. carinii organisms...

Retinal pigment epithelial changes in chronic Vogt-Koyanagi-Harada disease: fundus autofluorescence and spectral domain optical coherence tomography findings

Science.gov (United States)

Vasconcelos-Santos, Daniel V.; Sohn, Elliott H.; Sadda, Srinivas; Rao, Narsing A.

2009-01-01

Purpose To determine whether fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT) imaging allows better assessment of RPE and outer retina (OR) in subjects with chronic VKH compared to examination and angiography alone. Methods Cross-sectional analysis of a series of seven consecutive patients with chronic VKH undergoing FAF and SD-OCT. Chronic VKH was defined as during >3 months. Color fundus photographs were correlated to FAF and SD-OCT images. The images were later correlated to fluorescein angiography (FA) and indocyanine green angiography (ICG-A). Results All patients had sunset glow fundus, which resulted in no apparent corresponding abnormality on FAF or SD-OCT. Lesions with decreased autofluorescence signal were observed in 11 eyes (85%), being associated with loss of the RPE and involvement of OR on SD-OCT. In 5 eyes (38%) some of these lesions were very subtle on clinical examination but easily detected by FAF. Lesions with increased autofluorescence signal were seen in 8 eyes (61.5%), showing variable involvement of the OR on SD-OCT and corresponding clinically to areas of RPE proliferation and cystoid macular edema. Conclusion Combined use of FAF and SD-OCT imaging allowed noninvasive delineation of RPE/OR changes in patients with chronic VKH, which were consistent with previous histopathological reports. Some of these changes were not apparent on clinical examination. PMID:20010321

Therapeutic bronchoscopy vs. standard of care in acute respiratory failure

DEFF Research Database (Denmark)

Ellekjaer, K L; Meyhoff, T S; Møller, M H

2017-01-01

) according to the Cochrane Handbook and GRADE methodology, including a predefined protocol (PROSPERO no. CRD42016046235). We included randomized clinical trials (RCTs) comparing therapeutic bronchoscopy to standard of care in critically ill patients with ARF. Two reviewers independently assessed trials...... for inclusion, extracted data and assessed risk of bias. Risk ratios (RR) with 95% confidence intervals (CI) were estimated by conventional meta-analysis. The risk of random errors was assessed by TSA. Exclusively patient-important outcomes were evaluated. RESULTS: We included five trials (n = 212); all were....... A shorter duration of mechanical ventilation was suggested by conventional meta-analysis, however TSA highlighted that only 42% of the required information size had been accrued, indicating high risk of random errors. No trials reported data on adverse events, hospital length of stay, quality of life...

Case report: Inhaled foreign body mismanaged as TB, finally removed using a rigid bronchoscopy after 6 years of impaction

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Justin Rubena Lumaya

2016-02-01

Full Text Available Foreign body aspiration is an important cause of mortality in children aged less than three years. Foreign body (FB inhalation can pose diagnostic and therapeutic challenges, especially in longstanding cases and complications such as recurrent pneumonia, lung collapse and lung abscess may develop. We report a case of an 11-year old boy with foreign body impacted in his bronchus for six years, which was mistakenly managed as pulmonary tuberculosis. Radiological evidence confirmed the diagnosis and a rigid bronchoscopy was used to remove the metallic foreign body. The standard of care for the management of a FB in a bronchus is a rigid bronchoscopy; however flexible bronchoscopy can be used, especially in adults. A thorough history with radiological evidence are essential and sometimes, followed by a diagnostic bronchoscopy.

Fundus autofluorescence in retinal artery occlusion: A more precise diagnosis.

Science.gov (United States)

Bacquet, J-L; Sarov-Rivière, M; Denier, C; Querques, G; Riou, B; Bonin, L; Barreau, E; Labetoulle, M; Rousseau, A

2017-10-01

Retinal artery occlusion (RAO) is a medical emergency associated with a high risk of cerebral vascular accident and other cardiovascular events. Among patients with non-arteritic RAO, a retinal embolus is observed in approximately 40% of cases. Fundus examination and retinography are not reliable to predict the nature of the emboli. We report three consecutive cases of central and branch RAO that were investigated with fundus autofluorescence, fluorescein angiography and color retinal photographs. All patients underwent complete neurological and cardiovascular workups, with brain imaging, cardiac Doppler ultrasound, carotid Dopplers and Holter ECG's, to determine the underlying mechanism of retinal embolism. In the three cases, aged 77.7±4 years (2 women and 1 man), fundus autofluorescence demonstrated hyperautofluorescent emboli. In two cases, it allowed visualization of emboli that were not detected with fundus examination or retinography. The cardiovascular work-up demonstrated atheromatous carotid or aortic plaques in all patients. In one case, it permitted the diagnosis of RAO. Two of the three cases were considered to be of atherosclerotic origin and one of undefined origin. Fundus autofluorescence may help to detect and characterize retinal emboli. Since lipofuscin, which is present in large quantity in atherosclerotic plaques, is the main fluorophore detected with fundus autofluorescence, this non-invasive and simple examination may give information about the underlying mechanism of retinal embolism, and thus impact the etiologic assessment of RAO. Additional studies are necessary to confirm this potential role of autofluorescence. Copyright © 2017 Elsevier Masson SAS. All rights reserved.

Autofluorescence Lifetimes in Patients With Choroideremia Identify Photoreceptors in Areas With Retinal Pigment Epithelium Atrophy.

Science.gov (United States)

Dysli, Chantal; Wolf, Sebastian; Tran, Hoai Viet; Zinkernagel, Martin S

2016-12-01

The purpose of this study was to investigate fundus autofluorescence lifetimes in patients with choroideremia and to identify tissue-specific lifetime characteristics and potential prognostic markers. Autofluorescence lifetimes of the retina were measured in two spectral channels (498-560 nm and 560-720 nm) in patients with choroideremia and age-matched healthy controls. Furthermore, autofluorescence intensities and spectral-domain optical coherence tomography (OCT) data were acquired and compared to fundus autofluorescence lifetime data. Sixteen eyes from 8 patients with advanced choroideremia (mean ± SD age, 55 ± 13 years) were included in this study and compared with 10 age-matched healthy participants. Whereas fundus autofluorescence intensity measurement identified areas of remaining retinal pigment epithelium (RPE), autofluorescence lifetime maps identified areas with remaining photoreceptor layers in OCT but RPE atrophy. In these areas, mean (±SEM) lifetimes were 567 ± 59 ps in the short and 603 ± 49 ps in the long spectral channels (+98% and +88% compared to controls). In areas of combined RPE atrophy and loss of photoreceptors, autofluorescence lifetimes were significantly prolonged by 1116 ± 63 ps (+364%) in the short and by 915 ± 52 ps (+270%) in the long spectral channels compared with controls. Because autofluorescence lifetimes identify areas of remaining photoreceptors in the absence of RPE, this imaging modality may be useful to monitor disease progression in the natural course of disease and in context of potential future therapeutic interventions.

Web-based versus traditional lecture: are they equally effective as a flexible bronchoscopy teaching method?

OpenAIRE

Sterse Mata, Caio Augusto [UNIFESP; Ota, Luiz Hirotoshi [UNIFESP; Suzuki, Iunis [UNIFESP; Telles, Adriana [UNIFESP; Miotto, Andre [UNIFESP; Leao, Luiz Eduardo Villaca [UNIFESP

2012-01-01

This study compares the traditional live lecture to a web-based approach in the teaching of bronchoscopy and evaluates the positive and negative aspects of both methods. We developed a web-based bronchoscopy curriculum, which integrates texts, images and animations. It was applied to first-year interns, who were later administered a multiple-choice test. Another group of eight first-year interns received the traditional teaching method and the same test. the two groups were compared using the...

Fundus autofluorescence and optical coherence tomography findings in thiamine responsive megaloblastic anemia.

Science.gov (United States)

Ach, Thomas; Kardorff, Rüdiger; Rohrschneider, Klaus

2015-01-01

To report ophthalmologic fundus autofluorescence and spectral domain optical coherence tomography findings in a patient with thiamine responsive megaloblastic anemia (TRMA). A 13-year-old girl with genetically proven TRMA was ophthalmologically (visual acuity, funduscopy, perimetry, electroretinogram) followed up over >5 years. Fundus imaging also included autofluorescence and spectral domain optical coherence tomography. During a 5-year follow-up, visual acuity and visual field decreased, despite a special TRMA diet. Funduscopy revealed bull's eye appearance, whereas fundus autofluorescence showed central and peripheral hyperfluorescence and perifoveal hypofluorescence. Spectral domain optical coherence tomography revealed affected inner segment ellipsoid band and irregularities in the retinal pigment epithelium and choroidea. Autofluorescence and spectral domain optical coherence tomography findings in a patient with TRMA show retinitis pigmentosa-like retina, retinal pigment epithelium, and choroid alterations. These findings might progress even under special TRMA diet, indispensable to life. Ophthalmologist should consider TRMA in patients with deafness and ophthalmologic disorders.

Avaliação da autofluorescência do fundo de olho nas distrofias de retina com o aparelho Heidelberg Retina Angiograph2 Evaluation of fundus autofluorescence in hereditary retinal diseases using Heidelberg Retina Angiograph2

Directory of Open Access Journals (Sweden)

Monique Côco

2007-10-01

Full Text Available OBJETIVOS: Definir características do exame de autofluorescência, verificando sua utilidade no diagnóstico e acompanhamento de distrofias retinianas. MÉTODOS: Participaram do estudo, 28 pacientes, adultos, divididos igualmente em quatro grupos com diagnósticos de doença de Stargardt, distrofia de Cones, retinose pigmentar e voluntários saudáveis para estabelecimento do padrão de normalidade. Em média foram obtidas nove imagens com o filtro para angiofluoresceinografia para a formação da imagem autofluorescente no Heidelberg Retina Angiograph2. As imagens de cada grupo de pacientes foram analisadas para verificar características comuns. RESULTADOS: As imagens fundoscópicas autofluorescentes dos voluntários do grupo controle mostraram área foveal hipoautofluorescente em relação à retina do pólo posterior. As imagens dos portadores de doença de Stargardt, em geral, apresentaram lesão hipoautofluorescente, correspondendo à área macular. As principais alterações da autofluorescência em pacientes com distrofia de cones foram hipoautofluorescência macular com halo hiperautofluorescente. Nos portadores de retinose pigmentar, foram encontrados pigmentos periféricos causando hipoautofluorescência. Na região macular, hipoautofluorescência ou apenas desorganização do pigmento. CONCLUSÃO: O estudo mostrou a existência de padrões de autofluorescência de fundo nas distrofias de retina que permitem o diagnóstico e melhor interpretação da fisiopatogenia destas doenças.PURPOSE: To define characteristics of the fundus autofluorescence examination, verifying usefulness in the diagnosis and care of hereditary retinal diseases. METHODS: 28 patients, adults, divided equally into four groups with diagnoses of Stargardt macular dystrophy, cone dystrophy, retinitis pigmentosa and healthy volunteers for the establishment of the normality pattern. An average of nine images with the filter for fluorescein angiography was obtained

REPRODUCIBILITY OF MACULAR PIGMENT OPTICAL DENSITY MEASUREMENT BY TWO-WAVELENGTH AUTOFLUORESCENCE IN A CLINICAL SETTING.

Science.gov (United States)

You, Qi Sheng; Bartsch, Dirk-Uwe G; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William R

2016-07-01

Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration, likely because of filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of this study is to determine the reproducibility of MPOD measurement by two-wavelength autofluorescence method using scanning laser ophthalmoscopy. Sixty-eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet age-related macular degeneration, 16 eyes with dry age-related macular degeneration, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia, and 14 eyes with tractional maculopathy, including vitreomacular traction, epiretinal membrane, or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) autofluorescence method with the Spectralis HRA + OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The analysis of variance and Bland-Altman plot were used to assess the reproducibility between the two measurements. The mean MPOD at eccentricities of 1° and 2° was 0.36 ± 0.17 (range: 0.04-0.69) and 0.15 ± 0.08 (range: -0.03 to 0.35) for the first measurement and 0.35 ± 0.17 (range: 0.02-0.68) and 0.15 ± 0.08 (range: -0.01 to 0.33) for the second measurement, respectively. The difference between the 2 measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2°, and 6° radius, and the Bland

Jet Ventilation during Rigid Bronchoscopy in Adults: A Focused Review

Directory of Open Access Journals (Sweden)

Laurie Putz

2016-01-01

Full Text Available The indications for rigid bronchoscopy for interventional pulmonology have increased and include stent placements and transbronchial cryobiopsy procedures. The shared airway between anesthesiologist and pulmonologist and the open airway system, requiring specific ventilation techniques such as jet ventilation, need a good understanding of the procedure to reduce potentially harmful complications. Appropriate adjustment of the ventilator settings including pause pressure and peak inspiratory pressure reduces the risk of barotrauma. High frequency jet ventilation allows adequate oxygenation and carbon dioxide removal even in cases of tracheal stenosis up to frequencies of around 150 min−1; however, in an in vivo animal model, high frequency jet ventilation along with normal frequency jet ventilation (superimposed high frequency jet ventilation has been shown to improve oxygenation by increasing lung volume and carbon dioxide removal by increasing tidal volume across a large spectrum of frequencies without increasing barotrauma. General anesthesia with a continuous, intravenous, short-acting agent is safe and effective during rigid bronchoscopy procedures.

Eosinophil autofluorescence and its use in isolation and analysis of human eosinophils using flow microfluorometry

International Nuclear Information System (INIS)

Weil, G.J.; Chused, T.M.

1981-01-01

Unstained human eosinophils exhibit unusually bright autofluorescence, which allows them to be distinguished from other leukocytes using fluorescence microscopy. Eosinophil fluorescence is associated with the cytoplasmic granules of the cells. Eosinophil granule extracts, containing an as-yet-undefined eosinophil fluorescence factor, exhibited excitation maxima at 370 nm and 450 nm, with maximum emission at 520 nm. Eosinophils adhering to opsonized parasites in vitro deposit fluorescent material onto the parasite surface. Eosinophil fluorescence was of sufficient intensity to allow the preparation of viable, highly enriched (greater than or equal to 98%), eosinophil suspensions from peripheral blood of normal and eosinophilic donors using a fluorescence-activated cell sorter. Quantitative studies of eosinophil autofluorescence were performed using flow microfluorometry. Fluorescence intensity of blood eosinophils from normal volunteers and eosinophilic patients varied inversely with the log of the donor's absolute eosinophil count regardless of clinical diagnosis

Statistical and fractal analysis of autofluorescent myocardium images in posthumous diagnostics of acute coronary insufficiency

Science.gov (United States)

Boichuk, T. M.; Bachinskiy, V. T.; Vanchuliak, O. Ya.; Minzer, O. P.; Garazdiuk, M.; Motrich, A. V.

2014-08-01

This research presents the results of investigation of laser polarization fluorescence of biological layers (histological sections of the myocardium). The polarized structure of autofluorescence imaging layers of biological tissues was detected and investigated. Proposed the model of describing the formation of polarization inhomogeneous of autofluorescence imaging biological optically anisotropic layers. On this basis, analytically and experimentally tested to justify the method of laser polarimetry autofluorescent. Analyzed the effectiveness of this method in the postmortem diagnosis of infarction. The objective criteria (statistical moments) of differentiation of autofluorescent images of histological sections myocardium were defined. The operational characteristics (sensitivity, specificity, accuracy) of these technique were determined.

[The flexible fiberoptic bronchoscopy report: medico-legal issues].

Science.gov (United States)

Trosini-Désert, V; Morin, J-M; Fournier, C; Similowski, T; Vergnon, J-M

2010-09-01

The flexible bronchoscopy report is one of the tools permitting exchange of medical information in respiratory medicine and is an integral part of the medical record. Currently, there is no consensus on its content, and consequently, there are no recommendations. A survey was carried out involving experts from the Groupe d'Endoscopie de Langue Française (GELF--Endoscopy Research Group of the French Language Society of Pneumology) and a lawyer from the legal affairs and patient's rights department of the Paris public hospital system. Thirty-four questions distributed in eight chapters were asked in an eight-part questionnaire covering: 1) general administration, 2) environmental safety, 3) medical and anatomical description of the examination, 4) tolerance/complications of the examination, 5) conclusion, 6) image and video sequence capture, 7) administrative data for archiving, 8) disposable elements used during the examination. The results showed as many areas of convergence as they did divergence, between physicians, and between physicians and lawyer. Collective consideration is required to harmonize the writing of bronchoscopy reports, to provide a tool that is not only consensual and complete, but also valid and sound from the medicolegal viewpoint. Copyright © 2010 SPLF. Published by Elsevier Masson SAS. All rights reserved.

Posterior pharyngeal candidiasis in the absence of clinically overt oral involvement: a cross-sectional study.

Science.gov (United States)

Glavey, Siobhan V; Keane, Niamh; Power, Maria; O'Regan, Anthony W

2013-12-01

Although oropharyngeal candidiasis is associated with inhaled corticosteroid (ICS) usage, there is sparse data on the prevalence of posterior pharyngeal candidiasis in those without any detectable oral candidiasis on clinical examination. We systematically investigated the relationship between oral candidiasis on clinical examination and the presence of posterior pharyngeal candidiasis at bronchoscopy. We conducted a cross-sectional study on a convenience sample of 100 patients undergoing bronchoscopy at our institution. Patients were assessed for symptoms of and risk factors for candida infection and had an examination of their oropharynx for evidence of candidiasis before bronchoscopy. They subsequently had a detailed assessment for posterior candidiasis at bronchoscopy. We performed a posteriori subgroup analysis, which focused solely on those patients on ICS maintenance therapy. Median age was 54.7 (27-84) years, and 55 patients were male; 47 % of patients were on ICS, and 20 % of this cohort received recent oral corticosteroids. Twenty-eight percent of this convenience sample had posterior pharyngeal candidiasis; however, only 10.7 % (3/28) of these patients had clinically detectable oral candidiasis on clinical examination before bronchoscopy. Factors that were independently associated with the presence of pharyngeal candidiasis at bronchoscopy were OR (95 % CI) ICS usage 6.9 (2.5-19.2), particularly fluticasone usage 6.8 (2.62-17.9) and the presence of dysphonia 3.2 (1.3-8.0). In the subgroup analysis of ICS usage, posterior pharyngeal candidiasis was correlated with the presence of dysphonia but was not independently associated with fluticasone or budesonide dosage. This study demonstrates that posterior pharyngeal candidiasis in the absence of clinically overt oral candidiasis is frequent amongst ICS users. A history of ICS use, particularly fluticasone usage, as well as the presence of dysphonia are associated with posterior pharyngeal candidiasis at

Skin autofluorescence as a measure of advanced glycation endproduct deposition : a novel risk marker in chronic kidney disease

NARCIS (Netherlands)

Smit, Andries J.; Gerrits, Esther G.

2010-01-01

Purpose of review Skin autofluorescence (SAF) is a new method to noninvasively assess accumulation of advanced glycation endproducts (AGEs) in a tissue with low turnover. Recent progress in the clinical application of SAF as a risk marker for diabetic nephropathy as well as cardiovascular disease in

Suppression of Red Blood Cell Autofluorescence for Immunocytochemistry on Fixed Embryonic Mouse Tissue.

Science.gov (United States)

Whittington, Niteace C; Wray, Susan

2017-10-23

Autofluorescence is a problem that interferes with immunofluorescent staining and complicates data analysis. Throughout the mouse embryo, red blood cells naturally fluoresce across multiple wavelengths, spanning the emission and excitation spectra of many commonly used fluorescent reporters, including antibodies, dyes, stains, probes, and transgenic proteins, making it difficult to distinguish assay fluorescence from endogenous fluorescence. Several tissue treatment methods have been developed to bypass this issue with varying degrees of success. Sudan Black B dye has been commonly used to quench autofluorescence, but can also introduce background fluorescence. Here we present a protocol for an alternative called TrueBlack Lipofuscin Autofluorescence Quencher. The protocol described in this unit demonstrates how TrueBlack efficiently quenches red blood cell autofluorescence across red and green wavelengths in fixed embryonic tissue without interfering with immunofluorescent signal intensity or introducing background staining. We also identify optimal incubation, concentration, and multiple usage conditions for routine immunofluorescence microscopy. © 2017 by John Wiley & Sons, Inc. Copyright © 2017 John Wiley & Sons, Inc.

Demystifying autofluorescence with excitation scanning hyperspectral imaging

Science.gov (United States)

Deal, Joshua; Harris, Bradley; Martin, Will; Lall, Malvika; Lopez, Carmen; Rider, Paul; Boudreaux, Carole; Rich, Thomas; Leavesley, Silas J.

2018-02-01

Autofluorescence has historically been considered a nuisance in medical imaging. Many endogenous fluorophores, specifically, collagen, elastin, NADH, and FAD, are found throughout the human body. Diagnostically, these signals can be prohibitive since they can outcompete signals introduced for diagnostic purposes. Recent advances in hyperspectral imaging have allowed the acquisition of significantly more data in a shorter time period by scanning the excitation spectra of fluorophores. The reduced acquisition time and increased signal-to-noise ratio allow for separation of significantly more fluorophores than previously possible. Here, we propose to utilize excitation-scanning of autofluorescence to examine tissues and diagnose pathologies. Spectra of autofluorescent molecules were obtained using a custom inverted microscope (TE-2000, Nikon Instruments) with a Xe arc lamp and thin film tunable filter array (VersaChrome, Semrock, Inc.) Scans utilized excitation wavelengths from 360 nm to 550 nm in 5 nm increments. The resultant spectra were used to examine hyperspectral image stacks from various collaborative studies, including an atherosclerotic rat model and a colon cancer study. Hyperspectral images were analyzed with ENVI and custom Matlab scripts including linear spectral unmixing (LSU) and principal component analysis (PCA). Initial results suggest the ability to separate the signals of endogenous fluorophores and measure the relative concentrations of fluorophores among healthy and diseased states of similar tissues. These results suggest pathology-specific changes to endogenous fluorophores can be detected using excitationscanning hyperspectral imaging. Future work will expand the library of pure molecules and will examine more defined disease states.

Skin autofluorescence is associated with the progression of chronic kidney disease: a prospective observational study.

Science.gov (United States)

Tanaka, Kenichi; Nakayama, Masaaki; Kanno, Makoto; Kimura, Hiroshi; Watanabe, Kimio; Tani, Yoshihiro; Kusano, Yuki; Suzuki, Hodaka; Hayashi, Yoshimitsu; Asahi, Koichi; Sato, Keiji; Miyata, Toshio; Watanabe, Tsuyoshi

2013-01-01

Advanced glycation end product (AGE) accumulation is thought to be a measure of cumulative metabolic stress that has been reported to independently predict cardiovascular disease in diabetes and renal failure. The aim of this study was to evaluate the association between AGE accumulation, measured as skin autofluorescence, and the progression of renal disease in pre-dialysis patients with chronic kidney disease (CKD). Skin autofluorescence was measured noninvasively with an autofluorescence reader at baseline in 449 pre-dialysis patients with CKD. The primary end point was defined as a doubling of serum creatinine and/or need for dialysis. Thirty-three patients were lost to follow-up. Forty six patients reached the primary end point during the follow-up period (Median 39 months). Kaplan-Meier analysis showed a significantly higher risk of development of the primary end points in patients with skin autofluorescence levels above the optimal cut-off level of 2.31 arbitrary units, derived by receiver operator curve analysis. Cox regression analysis revealed that skin autofluorescence was an independent predictor of the primary end point, even after adjustment for age, gender, smoking history, diabetes, estimated glomerular filtration rate and proteinuria (adjusted hazard ratio 2.58, P = 0.004). Tissue accumulation of AGEs, measured as skin autofluorescence, is a strong and independent predictor of progression of CKD. Skin autofluorescence may be useful for risk stratification in this group of patients; further studies should clarify whether AGE accumulation could be one of the therapeutic targets to improve the prognosis of CKD.

Retinal pigment epithelial changes in chronic Vogt-Koyanagi-Harada disease: fundus autofluorescence and spectral domain-optical coherence tomography findings.

Science.gov (United States)

Vasconcelos-Santos, Daniel V; Sohn, Elliott H; Sadda, Srinivas; Rao, Narsing A

2010-01-01

The purpose of this study was to determine whether fundus autofluorescence (FAF) and spectral domain-optical coherence tomography (SD-OCT) imaging allow better assessment of retinal pigment epithelium and the outer retina in subjects with chronic Vogt-Koyanagi-Harada disease compared with examination and angiography alone. A cross-sectional analysis of a series of seven consecutive patients with chronic Vogt-Koyanagi-Harada disease undergoing FAF and SD-OCT was conducted. Chronic disease was defined as duration of intraocular inflammation >3 months. Color fundus photographs were correlated to FAF and SD-OCT images. The images were later correlated to fluorescein angiography and indocyanine green angiography. All patients had sunset glow fundus, which resulted in no apparent corresponding abnormality on FAF or SD-OCT. Lesions with decreased autofluorescence signal were observed in 11 eyes (85%), being associated with loss of the retinal pigment epithelium and involvement of the outer retina on SD-OCT. In 5 eyes (38%), some of these lesions were very subtle on clinical examination but easily detected by FAF. Lesions with increased autofluorescence signal were seen in 8 eyes (61.5%), showing variable involvement of the outer retina on SD-OCT and corresponding clinically to areas of retinal pigment epithelium proliferation and cystoid macular edema. Combined use of FAF and SD-OCT imaging allowed noninvasive delineation of retinal pigment epithelium/outer retina changes in patients with chronic Vogt-Koyanagi-Harada disease, which were consistent with previous histopathologic reports. Some of these changes were not apparent on clinical examination.

Interventional bronchoscopy in malignant central airway obstruction by extra-pulmonary malignancy.

Science.gov (United States)

Shin, Beomsu; Chang, Boksoon; Kim, Hojoong; Jeong, Byeong-Ho

2018-03-13

Interventional bronchoscopy is considered an effective treatment option for malignant central airway obstruction (MCAO). However, there are few reports of interventional bronchoscopy in patients with MCAOs due to extra-pulmonary malignancy. Therefore, the objective of this study was to investigate treatment outcomes and prognostic factors for bronchoscopic intervention in patients with MCAO due to extra-pulmonary malignancy. We retrospectively analyzed consecutive 98 patients with MCAO due to extra-pulmonary malignancy who underwent interventional bronchoscopy between 2004 and 2014 at Samsung Medical Center (Seoul, Korea). The most common primary site of malignancy was esophageal cancer (37.9%), followed by thyroid cancer (16.3%) and head & neck cancer (10.2%). Bronchoscopic interventions were usually performed using a combination of mechanical debulking (84.7%), stent insertion (70.4%), and laser cauterization (37.8%). Of 98 patients, 76 (77.6%) patients had MCAO due to progression of malignancy, and 42 (42.9%) patients had exhausted all other anti-cancer treatment at the time of bronchoscopic intervention. Technical success was achieved in 89.9% of patients, and acute complications and procedure-related deaths occurred in 20.4% and 3.1% of patients, respectively. Reduced survival was associated with MCAO due to cancer other than thyroid cancer or lymphoma, mixed lesions, and not receiving adjuvant treatment after bronchoscopic intervention. Bronchoscopic intervention could be a safe and effective procedure for MCAO due to end-stage extra-pulmonary malignancies. In addition, we identified possible prognostic factors for poor survival after intervention, which could guide clinicians select candidates that will benefit from bronchoscopic intervention.

Two-photon excited autofluorescence imaging of human retinal pigment epithelial cells

Science.gov (United States)

Han, Meng; Blindewald-Wittich, Almut; Holz, Frank G.; Giese, Günter; Niemz, Markolf H.; Snyder, Sarah; Sun, Hui; Yu, Jiayi; Agopov, Michael; La Schiazza, Olivier; Bille, Josef F.

2006-01-01

Degeneration of retinal pigment epithelial (RPE) cells severely impairs the visual function of retina photoreceptors. However, little is known about the events that trigger the death of RPE cells at the subcellular level. Two-photon excited autofluorescence (TPEF) imaging of RPE cells proves to be well suited to investigate both the morphological and the spectral characteristics of the human RPE cells. The dominant fluorophores of autofluorescence derive from lipofuscin (LF) granules that accumulate in the cytoplasm of the RPE cells with increasing age. Spectral TPEF imaging reveals the existence of abnormal LF granules with blue shifted autofluorescence in RPE cells of aging patients and brings new insights into the complicated composition of the LF granules. Based on a proposed two-photon laser scanning ophthalmoscope, TPEF imaging of the living retina may be valuable for diagnostic and pathological studies of age related eye diseases.

Multi-site and multi-depth in vivo cancer localization enhancement after auto-fluorescence removal

International Nuclear Information System (INIS)

Montcuquet, A.S.; Herve, L.; Navarro, F.; Dinten, J.M.; Mars, J.I.

2011-01-01

Fluorescence imaging in diffusive media locates tumors tagged by injected fluorescent markers in NIR wavelengths. For deep embedded markers, natural auto-fluorescence of tissues comes to be a limiting factor to tumor detection and accurate FDOT reconstructions. A spectroscopic approach coupled with Non-negative Matrix Factorization source separation method is explored to discriminate fluorescence sources according to their fluorescence spectra and remove unwanted auto-fluorescence. We successfully removed auto-fluorescence from acquisitions on living mice with a single subcutaneous tumor or two capillary tubes inserted at different depths. (authors)

Analysis of visual pigment by fundus autofluorescence.

NARCIS (Netherlands)

Theelen, T.; Berendschot, T.T.; Boon, C.J.F.; Hoyng, C.B.; Klevering, B.J.

2008-01-01

This study investigated changes of short-wavelength fundus autofluorescence (SW-AF) by retinal bleaching effects. All measurements were performed with the Heidelberg Retina Angiograph 2 (HRA 2). Initially, experimental imaging was done on a healthy eye after dark adaptation. Photopigment was

Dermal factors influencing measurement of skin autofluorescence

NARCIS (Netherlands)

Noordzij, Margaretha J.; Lefrandt, Johan; Graaff, Reindert; Smit, Andries J.

Background: Skin autofluorescence (SAF) is a noninvasive marker of accumulation of advanced glycation end products. It predicts cardiovascular complications and mortality in diabetes and renal failure. We assessed the influence of potential common confounders in SAF measurement, by determining the

Web-based versus traditional lecture: are they equally effective as a flexible bronchoscopy teaching method?

Science.gov (United States)

Mata, Caio Augusto Sterse; Ota, Luiz Hirotoshi; Suzuki, Iunis; Telles, Adriana; Miotto, Andre; Leão, Luiz Eduardo Vilaça

2012-01-01

This study compares the traditional live lecture to a web-based approach in the teaching of bronchoscopy and evaluates the positive and negative aspects of both methods. We developed a web-based bronchoscopy curriculum, which integrates texts, images and animations. It was applied to first-year interns, who were later administered a multiple-choice test. Another group of eight first-year interns received the traditional teaching method and the same test. The two groups were compared using the Student's t-test. The mean scores (± SD) of students who used the website were 14.63 ± 1.41 (range 13-17). The test scores of the other group had the same range, with a mean score of 14.75 ± 1. The Student's t-test showed no difference between the test results. The common positive point noted was the presence of multimedia content. The web group cited as positive the ability to review the pages, and the other one the role of the teacher. Web-based bronchoscopy education showed results similar to the traditional live lecture in effectiveness.

Tryptophan autofluorescence imaging of neoplasms of the human colon

Science.gov (United States)

Banerjee, Bhaskar; Renkoski, Timothy; Graves, Logan R.; Rial, Nathaniel S.; Tsikitis, Vassiliki Liana; Nfonsom, Valentine; Pugh, Judith; Tiwari, Piyush; Gavini, Hemanth; Utzinger, Urs

2012-01-01

Detection of flat neoplasia is a major challenge in colorectal cancer screening, as missed lesions can lead to the development of an unexpected `incident' cancer prior to the subsequent endoscopy. The use of a tryptophan-related autofluorescence has been reported to be increased in murine intestinal dysplasia. The emission spectra of cells isolated from human adenocarcinoma and normal mucosa of the colon were studied and showed markedly greater emission intensity from cancerous cells compared to cells obtained from the surrounding normal mucosa. A proto-type multispectral imaging system optimized for ultraviolet macroscopic imaging of tissue was used to obtain autofluorescence images of surgical specimens of colonic neoplasms and normal mucosa after resection. Fluorescence images did not display the expected greater emission from the tumor as compared to the normal mucosa, most probably due to increased optical absorption and scattering in the tumors. Increased fluorescence intensity in neoplasms was observed however, once fluorescence images were corrected using reflectance images. Tryptophan fluorescence alone may be useful in differentiating normal and cancerous cells, while in tissues its autofluorescence image divided by green reflectance may be useful in displaying neoplasms.

Fundus Autofluorescence and Optical Coherence Tomography Findings in Branch Retinal Vein Occlusion

Directory of Open Access Journals (Sweden)

Tetsuju Sekiryu

2012-01-01

Full Text Available Purpose. To describe the findings of fundus autofluorescence (FAF and optical coherence tomography (OCT in patients with branch retinal vein occlusion (BRVO. Methods. In this institutional, retrospective, observational case series, FAF was evaluated in 65 eyes with BRVO in 64 consecutive patients and compared with visual acuity, OCT findings, and other clinical observations. Results. Five types of autofluorescence appeared during the course of BRVO: (1 petaloid-shaped hyperautofluorescence in the area of macular edema and (2 hyperautofluorescence coincident with yellow subretinal deposits. (3 Diffuse hyperautofluorescence appeared within the area of serous retinal detachment (SRD and OCT showed precipitates on the undersurface of the retina in 5/5 of these eyes (100%. (4 The area of vein occlusion showed diffuse hyperautofluorescence after resolution of the retinal bleeding. (5 Hard exudates exhibited hyper- or hypoautofluorescence. OCT indicated that most of the hard exudates with hyperautofluorescence were located on the retinal pigment epithelium. Conclusions. Hyperautofluorescence associated with subretinal fluid or hard exudate appeared in the subretinal space. This type of hyperautofluorescence may be attributed to blood cell or macrophages. FAF and OCT are noninvasive modalities that provide additional information regarding macular edema due to BRVO.

Phasor analysis of multiphoton spectral images distinguishes autofluorescence components of in vivo human skin

NARCIS (Netherlands)

Fereidouni, F.; Bader, A.N.; Colonna, A.; Gerritsen, H.C.

2014-01-01

Skin contains many autofluorescent components that can be studied using spectral imaging. We employed a spectral phasor method to analyse two photon excited auto-fluorescence and second harmonic generation images of in vivo human skin. This method allows segmentation of images based on spectral

Pseudo-outbreak of pseudomonas aeruginosa in HIV-infected patients undergoing fiberoptic bronchoscopy

DEFF Research Database (Denmark)

Kolmos, H J; Lerche, A; Kristoffersen, Kirsten Lydia

1994-01-01

Pseudomonas aeruginosa was isolated from bronchoalveolar lavage fluid from 8 consecutive patients undergoing bronchoscopy at an infectious diseases unit. None of the patients developed signs of respiratory tract infection that could be ascribed to the organism. The source of contamination...

The influence of airway supporting maneuvers on glottis view in pediatric fiberoptic bronchoscopy

Directory of Open Access Journals (Sweden)

Tarik Umutoglu

2015-10-01

Full Text Available ABSTRACTINTRODUCTION:Flexible fiber optic bronchoscopy is a valuable intervention for evaluation and management of respiratory diseases in both infants, pediatric and adult patients. The aim of this study is to investigate the influence of the airway supporting maneuvers on glottis view during pediatric flexible fiberoptic bronchoscopy.MATERIALS AND METHODS:In this randomized, controlled, crossover study; patients aged between 0 and 15 years who underwent flexible fiberoptic bronchoscopy procedure having American Society of Anesthesiologists I---II risk score were included. Patients having risk of difficult intubation, intubated or patients with tracheostomy, and patients with reduced neck mobility or having cautions for neck mobility were excluded from this study. After obtaining best glottic view at the neutral position, patients were positioned jaw trust with open mouth, jaw trust with teeth prottution, head tilt chin lift and triple airway maneuvers and best glottis scores were recorded.RESULTS:Total of 121 pediatric patients, 57 girls and 64 boys, were included in this study. Both jaw trust with open mouth and jaw trust with teeth prottution maneuvers improved the glottis view compared with neutral position (p 0.05. Head tilt chin lift and triple airway maneuvers improved glottis view when compared with both jaw trust with open mouth and jaw trust with teeth prottution maneuvers and neutral position (p 0.05.

Diabetic retinal pigment epitheliopathy: fundus autofluorescence and spectral-domain optical coherence tomography findings.

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Kang, Eui Chun; Seo, Yuri; Byeon, Suk Ho

2016-10-01

To describe the characteristics of an unfamiliar disease entity, diabetic retinal pigment epitheliopathy (DRPE), using fundus autofluorescence (FAF) and spectral-domain optical coherence tomography (SD-OCT). This retrospective study included 17 eyes from 10 proliferative diabetic retinopathy (PDR) patients with granular hypo-autofluorescence and/or variable hyper-autofluorescence on FAF (DRPE group) and 17 eyes from 10 age- and sex-matched PDR patients without abnormal autofluorescence (PDR group). Eyes with diabetic macular edema were excluded. Visual acuity (VA), retinal thickness (RT), and choroidal thickness (CT) were compared between the groups. Eyes in the DRPE group had worse logMAR VA than eyes in the PDR group (0.369 ± 0.266 vs. 0.185 ± 0.119; P = 0.026). The thickness of the retinal pigment epithelium plus the inner segment/outer segment of the photoreceptors was reduced to a greater degree in the DRPE group than the PDR group (P retina showed no differences between the two groups. CT was significantly thicker in the DRPE group than in the PDR group (329.00 ± 33.76 vs. 225.62 ± 37.47 μm; P retina, and thicker choroid in comparison with eyes with PDR. Alterations of autofluorescence on FAF and changes in the outer retinal thickness and CT on SD-OCT can be helpful for differentiating DRPE in patients with PDR.

Maintaining Oxygenation Successfully with High Flow Nasal Cannula during Diagnostic Bronchoscopy on a Postoperative Lung Transplant Patient in the Intensive Care

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Sara Diab

2014-01-01

Full Text Available Bronchoscopy is an important diagnostic and therapeutic intervention for a variety of patients displaying pulmonary pathology. The heterogeneity of the patients undergoing bronchoscopy affords a challenge for providing minimal and safe respiratory support during anesthesia. Currently, options are intubation and general anesthesia versus frequently inadequate sedation or local anaesthesia with low flow oxygen through nasal prongs or mouthpiece. The advent of high flow nasal cannula allows the clinician to have a “middle man” that allows high flow oxygen delivery as well as a degree of respiratory support, which in some cases has been noted to be between 3 and 4 cm of continuous positive airway pressure-like effect. There are minimal data analyzing the use of high flow nasal cannula during anesthesia for bronchoscopy. We present a case report of orthotropic lung transplant recipient undergoing diagnostic bronchoscopy whilst being supported with high flow nasal oxygen in the intensive care unit.

Topical Nasal Anesthesia in Flexible Bronchoscopy--A Cross-Over Comparison between Two Devices.

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Thomas Fuehner

Full Text Available Topical airway anesthesia is known to improve tolerance and patient satisfaction during flexible bronchoscopy (FB. Lidocaine is commonly used, delivered as an atomized spray. The current study assesses safety and patient satisfaction for nasal anesthesia of a new atomization device during outpatient bronchoscopy in lung transplant recipients.Using a prospective, non-blinded, cross-over design, patients enrolled between 01-10-2014 and 24-11-2014 received 2% lidocaine using the standard reusable nasal atomizer (CRNA. Those enrolled between 25-11-2014 and 30-01-2015, received a disposable intranasal mucosal atomization device (DIMAD. After each procedure, the treating physician, their assistant and the patient independently rated side-effects and satisfaction, basing their responses on visual analogue scales (VAS. At their next scheduled bronchoscopy during the study period, patients then received the alternative atomizer. Written consent was obtained prior to the first bronchoscopy, and the study approved by the institutional ethics committee.Of the 252 patients enrolled between 01-10-2014 and 30-01-2015, 80 (32% received both atomizers. Physicians reported better efficacy (p = 0.001 and fewer side effects (p< = 0.001 for DIMAD in patients exposed to both procedures. Among patients with one visit, physicians and their assistants reported improved efficacy (p = 0.018, p = 0.002 and fewer side effects (p< = 0.001, p = 0.029 for the disposable atomizer, whereas patients reported no difference in efficacy or side effects (p = 0.72 and p = 0.20. No severe adverse events were noted. The cost of the reusable device was 4.08€ per procedure, compared to 3.70€ for the disposable device.Topical nasal anesthesia via a disposable intranasal mucosal atomization device (DIMAD offers comparable safety and patient comfort, compared to conventional reusable nasal atomizers (CRNA in lung transplant recipients. Procedural costs were reduced by 0.34€ per

Analysis on Clinical Features of 2168 Patients with Lung Cancer Diagnosed by Bronchoscope

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Yu Zhang

2013-06-01

Full Text Available Objective: To analyze the clinical features of lung cancer diagnosed by bronchoscopy. Methods: The clinical features of 2168 patients with lung cancer diagnosed by bronchoscopy were retrospectively analyzed, including gender, age, pathological type, diseased region, manifestations under bronchoscopy and methods of drawing materials. Results: The ratio of male/female was 4.8:1 and the peak onset age was 60 - 69 years old. The major pathological type was squamous cell carcinoma (44.5%, then adenocarcinoma (25.9% and small cell lung cancer (18.3%. The incidence of squamous cell carcinoma was the highest in males (50.6%, while that of adenocarcinoma in females (56.2%. The positive diagnostic rates of forceps biopsy, brush biopsy, bronchial alveolar lavage and transbronchial needle aspiration were 81.6%, 49.4%, 18.2% and 62.6%, respectively, whereas that of biopsy combined with brush biopsy came up to 89.0%. Conclusion: Bronchoscopy is an important method in diagnosis of lung cancer. Different ages and genders of patients with lung cancer have different onset, and the distribution of pathological types is diverse. Attaching more importance to bronchoscopy and improving biopsy technique can significantly improve the diagnostic rate and provide reliable evidences for clinical treatment.

Portable LED-induced autofluorescence spectroscopy for oral cancer diagnosis

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Yan, Yung-Jhe; Huang, Ting-Wei; Cheng, Nai-Lun; Hsieh, Yao-Fang; Tsai, Ming-Hsui; Chiou, Jin-Chern; Duann, Jeng-Ren; Lin, Yung-Jiun; Yang, Chin-Siang; Ou-Yang, Mang

2017-04-01

Oral cancer is a serious and growing problem in many developing and developed countries. To improve the cancer screening procedure, we developed a portable light-emitting-diode (LED)-induced autofluorescence (LIAF) imager that contains two wavelength LED excitation light sources and multiple filters to capture ex vivo oral tissue autofluorescence images. Compared with conventional means of oral cancer diagnosis, the LIAF imager is a handier, faster, and more highly reliable solution. The compact design with a tiny probe allows clinicians to easily observe autofluorescence images of hidden areas located in concave deep oral cavities. The ex vivo trials conducted in Taiwan present the design and prototype of the portable LIAF imager used for analyzing 31 patients with 221 measurement points. Using the normalized factor of normal tissues under the excitation source with 365 nm of the central wavelength and without the bandpass filter, the results revealed that the sensitivity was larger than 84%, the specificity was not smaller than over 76%, the accuracy was about 80%, and the area under curve of the receiver operating characteristic (ROC) was achieved at about 87%, respectively. The fact shows the LIAF spectroscopy has the possibilities of ex vivo diagnosis and noninvasive examinations for oral cancer.

Progression of Stargardt Disease as Determined by Fundus Autofluorescence in the Retrospective Progression of Stargardt Disease Study (ProgStar Report No. 9).

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Strauss, Rupert W; Muñoz, Beatriz; Ho, Alexander; Jha, Anamika; Michaelides, Michel; Cideciyan, Artur V; Audo, Isabelle; Birch, David G; Hariri, Amir H; Nittala, Muneeswar G; Sadda, SriniVas; West, Sheila; Scholl, Hendrik P N

2017-11-01

progression depended on the initial size of the lesion. In Stargardt disease with DDAF lesions, fundus autofluorescence may serve as a monitoring tool for interventional clinical trials that aim to slow disease progression. Rates of progression depended mainly on initial lesion size.

Fospropofol Disodium for Sedation in Elderly Patients Undergoing Flexible Bronchoscopy.

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Silvestri, Gerard A; Vincent, Brad D; Wahidi, Momen M

2011-01-01

BACKGROUND: Fospropofol disodium is a water-soluble prodrug of propofol. A subset analysis was undertaken of elderly patients (≥65 y) undergoing flexible bronchoscopy, who were part of a larger multicenter, randomized, double-blind study. METHODS: Patients received fentanyl citrate (50 mcg) followed by fospropofol at initial (4.88mg/kg) and supplemental (1.63mg/kg) doses. The primary end point was sedation success (3 consecutive Modified Observer's Assessment of Alertness/Sedation scores of ≤4 and procedure completion without alternative sedative or assisted ventilation). Treatment success, time to fully alert, patient and physician satisfaction, and safety/tolerability were also evaluated. RESULTS: In the elderly patients subset (n=61), sedation success was 92%, the mean time to fully alert was 8.0±10.9 min, and memory retention was 72% during recovery, and these were comparable with the younger patients subgroup (age, Sedation-related adverse events occurred in 23% of the elderly and 18% of the younger patients (age, sedation, rapid time to fully alert, and high satisfaction in this elderly subset undergoing flexible bronchoscopy, which was comparable with outcomes in younger patients.

Patient-specific bronchoscopy visualization through BRDF estimation and disocclusion correction.

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Chung, Adrian J; Deligianni, Fani; Shah, Pallav; Wells, Athol; Yang, Guang-Zhong

2006-04-01

This paper presents an image-based method for virtual bronchoscope with photo-realistic rendering. The technique is based on recovering bidirectional reflectance distribution function (BRDF) parameters in an environment where the choice of viewing positions, directions, and illumination conditions are restricted. Video images of bronchoscopy examinations are combined with patient-specific three-dimensional (3-D) computed tomography data through two-dimensional (2-D)/3-D registration and shading model parameters are then recovered by exploiting the restricted lighting configurations imposed by the bronchoscope. With the proposed technique, the recovered BRDF is used to predict the expected shading intensity, allowing a texture map independent of lighting conditions to be extracted from each video frame. To correct for disocclusion artefacts, statistical texture synthesis was used to recreate the missing areas. New views not present in the original bronchoscopy video are rendered by evaluating the BRDF with different viewing and illumination parameters. This allows free navigation of the acquired 3-D model with enhanced photo-realism. To assess the practical value of the proposed technique, a detailed visual scoring that involves both real and rendered bronchoscope images is conducted.

Autofluorescence from the outer retina and subretinal space: hypothesis and review.

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Spaide, Richard

2008-01-01

To review the pathophysiologic principles underlying increased autofluorescence from the outer retina and subretinal space using selected diseases as examples. The ocular imaging information and histopathologic features, when known, were integrated for diseases causing increased autofluorescence from the outer retina and subretinal space. Inferences were taken from this information and used to create a classification scheme. These diseases are principally those that cause separation of the outer retina from the retinal pigment epithelium, thereby preventing proper phagocytosis of photoreceptor outer segments. The separation can arise from increased exudation into the subretinal space or inadequate removal of fluid from the subretinal space. Lack of normal outer segment processing initially leads to increased accumulation of outer segments on the outer retina and subretinal space. Over time, this material is visible as an increasingly thick coating on the outer retina, is yellow, and is autofluorescent. Over time, atrophy develops with thinning of the deposited material and decreasing autofluorescence. The accumulated material is ultimately capable of inducing damage to the retinal pigment epithelium. Diseases causing accumulation of the material include central serous chorioretinopathy, vitelliform macular dystrophy, acute exudative polymorphous vitelliform maculopathy, choroidal tumors, and vitreomacular traction syndrome. The physical separation of the retinal outer segments from the retinal pigment epithelium hinders proper phagocytosis of the outer segments. Accumulation of the shed but not phagocytized outer segments plays a role in disease manifestations for a number of macular diseases.

Fundus Autofluorescence in Multiple Evanescent White Dot Syndrome

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Fernando Marcondes Penha

2011-01-01

Full Text Available A patient complained of photopsia and vision loss in the left eye for two days, with visual acuity of 20/32. Right eye was normal. Funduscopy revealed foveal granularity and gray-white lesions in the posterior pole, mainly temporal to the fovea. The lesions (dots and spots, along with a few other areas surrounding them, showed hyperautofluorescence on autofluorescence imaging. Fluorescein angiogram (FA depicted some early hyperfluorescent dots with late staining. Indocyanine green angiogram (ICGA showed hypofluorescent lesions in a greater number compared with funduscopy, autofluorescence, and FA. Thirty days later, BCVA was 20/20 in both eyes and the complimentary exams were almost normal, despite an ICGA that showed few small hypofluorescent lesions. This case supports the hypothesis that the choroidal involvement occurs primarily in MEWDS, with secondary involvement of the RPE and the neurosensory retina.

Routine examination for tuberculosis is still indicated during bronchoscopy for pulmonary infiltrates

DEFF Research Database (Denmark)

Laub, Rasmus Rude; Sivapalan, Pradeesh; Wilcke, Torgny

2015-01-01

INTRODUCTION: Tuberculosis (TB) can present in numerous ways and can be radiological indistinguishable from cancer. In several guidelines for bronchoscopy (FOB) in low-incidence areas, a Mycobacterium tuberculosis test is only recommended when TB is clinically suspected. Due to the expenses...... associated with M. tuberculosis cultures, we did an analysis of tests obtained by FOB and other invasive procedures (endoscopic ultrasound (EUS)-guided needle biopsy via the oesophagus or trachea and percutaneous needle lung biopsy (PNLB)). METHODS: All patients tested positive for M. tuberculosis by culture...... and with samples obtained by FOB, EUS or PNLB in the 2008-2012 period were identified retrospectively in two centres in a low-incidence area (Copenhagen, Denmark). Patient records and radiological reports were reviewed. RESULTS: A total of 57 (1.2%) patients out of the 4,680 tested were M. tuberculosis culture...

Association between fundus autofluorescence and visual outcome in surgically closed macular holes.

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Lee, Young Seob; Yu, Seung-Young; Cho, Nam Suk; Kim, Moo Sang; Kim, Young Gyun; Kim, Eung Suk; Kwak, Hyung Woo

2013-06-01

To investigate the association between fundus autofluorescence (FAF) and visual acuity, recovery of foveal microstructure, and FAF in surgically closed macular holes. Twenty-six eyes with surgically closed macular hole were classified into two groups based on foveal FAF: normal autofluorescence (NAF) or increased autofluorescence (IAF). The association between foveal FAF and visual acuity was analyzed. In addition, we examined the relationship between recovery of the foveal microstructure assessed by spectral domain optical coherence tomography and FAF after macular hole surgery. At 1 month and 6 months after surgery, there were 9 NAF eyes and 17 IAF eyes. There were no differences between NAF and IAF eyes at 1 month and 6 months after surgery. Preoperative best-corrected visual acuity (logarithm of the minimum angle of resolution) did not differ between groups. Best-corrected visual acuity was significantly higher in the NAF group than in the IAF group at 1 month postoperatively (0.59 ± 0.34 vs. 0.91 ± 0.36, P = 0.044) and tended to be higher at 6 months (0.37 ± 0.38 vs. 0.69 ± 0.53, P = 0.126). Restoration of photoreceptor external limiting membrane differed significantly in 8 NAF eyes (89%) and 4 IAF eyes (24%) at postoperation 1 month (P = 0.001). After 6 months, external limiting membrane was restored in all 9 NAF eyes (100%) and in only 11 IAF eyes (65%) (P = 0.042). Fundus autofluorescence findings observed in surgically closed macular holes correlated with visual improvement and photoreceptor status. Eyes with visual improvement had restoration of normal foveal autofluorescence and retinal microstructure, whereas eyes with persistent foveal hyperautofluorescence did not achieve complete restoration of the retinal microstructure, and visual improvement was not as significant.

Scanning laser ophthalmoscope measurement of local fundus reflectance and autofluorescence changes arising from rhodopsin bleaching and regeneration.

Science.gov (United States)

Morgan, Jessica I W; Pugh, Edward N

2013-03-01

We measured the bleaching and regeneration kinetics of rhodopsin in the living human eye with two-wavelength, wide-field scanning laser ophthalmoscopy (SLO), and investigated the effect of rhodopsin bleaching on autofluorescence intensity. The retina was imaged with an Optos P200C SLO by its reflectance of 532 and 633 nm light, and its autofluorescence excited by 532 nm light, before and after exposure to lights calibrated to bleach rhodopsin substantially. Bleaching was confined to circular retinal regions of 4.8° visual angle located approximately 16° superotemporal and superonasal to fixation. Images were captured as 12-bit tiff files and postprocessed to extract changes in reflectance and autofluorescence. At the locus of bleaching transient increases in reflectance of the 532 nm, but not the 633 nm beam were observed readily and quantified. A transient increase in autofluorescence also occurred. The action spectrum, absolute sensitivity, and recovery of the 532 nm reflectance increase were consistent with previous measurements of human rhodopsin's spectral sensitivity, photosensitivity, and regeneration kinetics. The autofluorescence changes closely tracked the changes in rhodopsin density. The bleaching and regeneration kinetics of rhodopsin can be measured locally in the human retina with a widely available SLO. The increased autofluorescence excited by 532 nm light upon bleaching appears primarily due to transient elimination of rhodopsin's screening of autofluorescent fluorochromes in the RPE. The spatially localized measurement with a widely available SLO of rhodopsin, the most abundant protein in the retina, could be a valuable adjunct to retinal health assessment.

Early simultaneous fundus autofluorescence and optical coherence tomography features after pars plana vitrectomy for primary rhegmatogenous retinal detachment.

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Dell'Omo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y; Bijl, Heico; Tan, H Stevie

2012-04-01

To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the involvement of the macula were prospectively investigated with simultaneous fundus autofluorescence and OCT imaging using the Spectralis HRA+OCT (Heidelberg Engineering, Heidelberg, Germany) within a few weeks after the operation. Fundus autofluorescence imaging of the macula showed lines of increased and decreased autofluorescence in 19 cases (57.6%). On OCT, these lines corresponded to the following abnormalities: outer retinal folds, inner retinal folds, and skip reflectivity abnormalities of the photoreceptor inner segment/outer segment band. Other OCT findings, not related to abnormal lines on fundus autofluorescence, consisted of disruption of photoreceptor inner segment/outer segment band and collection of intraretinal or subretinal fluid. The presence of outer retinal folds significantly related to metamorphopsia but did not relate to poor postoperative visual acuity. Partial-thickness retinal folds occur commonly after vitrectomy for rhegmatogenous retinal detachment repair and may represent an important anatomical substrate for postoperative metamorphopsia. Fundus autofluorescence and OCT are both sensitive techniques for the detection of these abnormalities.

Correlation between Spectral Optical Coherence Tomography and Fundus Autofluorescence at the margins of Geographic Atrophy

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Brar, Manpreet; Kozak, Igor; Cheng, Lingyun; Bartsch, Dirk-Uwe G.; Yuson, Ritchie; Nigam, Nitin; Oster, Stephen F.; Mojana, Francesca; Freeman, William R.

2009-01-01

Purpose We studied the appearance of margins of Geographic atrophy in high- resolution optical coherence tomography (OCT) images and correlate those changes with fundus autofluorescence imaging. Design Retrospective observational case study. Methods Patients with geographic atrophy secondary to dry age related macular degeneration (ARMD) were assessed by means of Spectral Domain OCT (Spectralis HRA/OCT; Heidelberg Engineering, Heidelberg, Germany or OTI, Inc, Toronto, Canada) as well as Autofluoresence Imaging (HRA or Spectralis Heidelberg Engineering, Heidelberg, Germany): The outer retinal layer alterations were analyzed in the junctional zone between normal retina and atrophic retina, and correlated with corresponding fundus autofluorescence. Results 23 eyes of 16 patients aged between 62 years to 96 years were examined. There was a significant association between OCT findings and the fundus autofluorescence findings(r=0.67, pautofluorescence; Smooth margins on OCT correspond significantly to normal fundus autofluorescence. (Kappa-0.7348, pautofluorescence; secondary to increased lipofuscin may together serve as determinants of progression of geographic atrophy. PMID:19541290

Infrared autofluorescence, short-wave autofluorescence and spectral-domain optical coherence tomography of optic disk melanocytomas

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Peng Zhang

2016-05-01

Full Text Available AIM: To investigate the findings of infrared fundus autofluorescence (IR-AF and spectral-domain optical coherence tomography (SD-OCT in eyes with optic disc melanocytoma (ODM. METHODS: IR-AF findings and those of other ophthalmologic imaging examinations, including short-wave autofluorescence (SW-AF, fluorescein angiography (FA, fundus color photography, and SD-OCT of 8 eyes of 8 consecutive cases with ODM were assessed. RESULTS: The ODMs in all cases (100% presented similar IR-AF, SW-AF, and FA findings. On IR-AF images, ODMs showed outstanding hyper-AF with well-defined outline. On SW-AF images, the area of ODMs presented as hypo-AF. FA images revealed the leaking retinal telangiectasia on the surface of the ODMs. On SD-OCT images in 8 cases (100%, the ODMs were sloped with highly reflective surface, which were disorganized retina and optic nerve layers. In 7 cases (87.5%, peripapillary choroids were involved. The melanocytomas of 8 cases (100% presented as optically empty spaces. Vitreous seeds were found in one case (12.5%. CONCLUSION: IR-AF imaging may provide a new modality to evaluate the pathologic features of ODMs, and together with SW-AF imaging, offers a new tool to study biological characteristics associated with ODMs. SD-OCT is a valuable tool in delimitating the tumor extension and providing morphological information about the adjacent retinal tissue.

Fundus autofluorescence and optical coherence tomographic findings in acute zonal occult outer retinopathy.

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Fujiwara, Takamitsu; Imamura, Yutaka; Giovinazzo, Vincent J; Spaide, Richard F

2010-09-01

The purpose of this study was to investigate the fundus autofluorescence and optical coherence tomography findings in eyes with acute zonal occult outer retinopathy (AZOOR). A retrospective observational case series of the fundus autofluorescence and spectral domain optical coherence tomography in a series of patients with AZOOR. There were 19 eyes of 11 patients (10 women), who had a mean age of 49.1 +/- 13.9 years. Fundus autofluorescence abnormalities were seen in 17 of the 19 eyes, were more common in the peripapillary area, and were smaller in extent than the optical coherence tomography abnormalities. Nine eyes showed progression of hypoautofluorescence area during the mean follow-up of 69.7 months. The mean thickness of the photoreceptor layer at fovea was 177 microm in eyes with AZOOR, which was significantly thinner than controls (193 microm, P = 0.049). Abnormal retinal laminations were found in 12 eyes and were located over areas of loss of the photoreceptors. The subfoveal choroidal thickness was 243 microm, which is normal. Fundus autofluorescence abnormalities in AZOOR showed distinct patterns of retinal pigment epithelial involvement, which may be progressive. Thinning of photoreceptor cell layer with loss of the outer segments and abnormal inner retinal lamination in the context of a normal choroid are commonly found in AZOOR.

Autofluorescence in samples obtained from chronic biofilm infections – “all that glitters is not gold”

DEFF Research Database (Denmark)

Eickhardt-Dalbøge, Steffen Robert; Kragh, Kasper N.; Schrøder, Stine

2015-01-01

When looking at tissue sections of ex vivo samples, autofluorescence can be a major cause of artifacts and misinterpretations. We here reiterate evidence that autofluorescing granules, often hemosiderin but also ceroid or mucinogen granules, are severe obstacles when imaging and diagnosing biofil...

UTILIZATION OF FUNDUS AUTOFLUORESCENCE, SPECTRAL DOMAIN OPTICAL COHERENCE TOMOGRAPHY, AND ENHANCED DEPTH IMAGING IN THE CHARACTERIZATION OF BIETTI CRYSTALLINE DYSTROPHY IN DIFFERENT STAGES.

Science.gov (United States)

Li, Qian; Li, Yang; Zhang, Xiaohui; Xu, Zhangxing; Zhu, Xiaoqing; Ma, Kai; She, Haicheng; Peng, Xiaoyan

2015-10-01

To characterize Bietti crystalline dystrophy (BCD) in different stages using multiple imaging modalities. Sixteen participants clinically diagnosed as BCD were included in the retrospective study and were categorized into 3 stages according to fundus photography. Eleven patients were genetically confirmed. Fundus autofluorescence, spectral domain optical coherence tomography, and enhanced depth imaging features of BCD were analyzed. On fundus autofluorescence, the abnormal autofluorescence was shown to enlarge in area and decrease in intensity with stages. Using spectral domain optical coherence tomography, the abnormalities in Stage 1 were observed to localize in outer retinal layers, whereas in Stage 2 and Stage 3, more extensive retinal atrophy was seen. In enhanced depth imaging, the subfoveal choroidal layers were delineated clearly in Stage 1; in Stage 2, destructions were primarily found in the choriocapillaris with associated alterations in the outer vessels; Stage 3 BCD displayed severe choroidal thinning. Choroidal neovascularization and macular edema were exhibited with high incidence. IVS6-8del17bp/inGC of the CYP4V2 gene was the most common mutant allele. Noninvasive fundus autofluorescence, spectral domain optical coherence tomography, and enhanced depth imaging may help to characterize the chorioretinal pathology of BCD at different degrees, and therefore, we propose staging of BCD depending on those methods. Physicians should be cautious of the vision-threatening complications of the disease.

[Hybrid 3-D rendering of the thorax and surface-based virtual bronchoscopy in surgical and interventional therapy control].

Science.gov (United States)

Seemann, M D; Gebicke, K; Luboldt, W; Albes, J M; Vollmar, J; Schäfer, J F; Beinert, T; Englmeier, K H; Bitzer, M; Claussen, C D

2001-07-01

The aim of this study was to demonstrate the possibilities of a hybrid rendering method, the combination of a color-coded surface and volume rendering method, with the feasibility of performing surface-based virtual endoscopy with different representation models in the operative and interventional therapy control of the chest. In 6 consecutive patients with partial lung resection (n = 2) and lung transplantation (n = 4) a thin-section spiral computed tomography of the chest was performed. The tracheobronchial system and the introduced metallic stents were visualized using a color-coded surface rendering method. The remaining thoracic structures were visualized using a volume rendering method. For virtual bronchoscopy, the tracheobronchial system was visualized using a triangle surface model, a shaded-surface model and a transparent shaded-surface model. The hybrid 3D visualization uses the advantages of both the color-coded surface and volume rendering methods and facilitates a clear representation of the tracheobronchial system and the complex topographical relationship of morphological and pathological changes without loss of diagnostic information. Performing virtual bronchoscopy with the transparent shaded-surface model facilitates a reasonable to optimal, simultaneous visualization and assessment of the surface structure of the tracheobronchial system and the surrounding mediastinal structures and lesions. Hybrid rendering relieve the morphological assessment of anatomical and pathological changes without the need for time-consuming detailed analysis and presentation of source images. Performing virtual bronchoscopy with a transparent shaded-surface model offers a promising alternative to flexible fiberoptic bronchoscopy.

Autofluorescence of the fungus Morchella conica var. rigida

Czech Academy of Sciences Publication Activity Database

Žižka, Zdeněk; Gabriel, Jiří

2011-01-01

Roč. 56, č. 2 (2011), s. 166-169 ISSN 0015-5632 R&D Projects: GA ČR GA526/07/0620 Institutional research plan: CEZ:AV0Z50200510 Keywords : Autofluorescence * fungi * Morchella conica Subject RIV: EE - Microbiology, Virology Impact factor: 0.677, year: 2011

Probing Endogenous Collagen by Laser Induced Autofluorescence in Burn Wound Biopsies- A Pilot Study.

Science.gov (United States)

Prabhu, Vijendra; Acharya, Anusha; Rao, Bola Sadashiva Satish; Rathnakar, Bharath; Kumar, Pramod; Guddattu, Vasudeva; Mahato, Krishna Kishore

2018-04-19

The focus of the current study was to interrogate the predictive potential of laser-induced autofluorescence (LIAF) by objectively assessing collagen synthesis in burn wound granulation tissues ex vivo. Prior grafting, granulation tissues (20 samples) following burn injury were collected from 17 subjects of age range 18- 60 years with patient/donor consent and the corresponding autofluorescence spectra were recorded at 325 nm He-Cd laser (≈ 2 mW) excitations. The resulting endogenous collagen intensity from the above tissue samples was computed by normalizing the NADH levels. In addition, the hydroxyproline content was also estimated biochemically from the same granulation tissues. A comparative assessment of both LIAF and biochemical estimations for endogenous collagen by hydroxyproline resulted in strong positive correlation among them. The above relevant observations suggest that LIAF is equally informative as that of biochemical estimations, in evaluating endogenous collagen content in wound granulation tissues. Thus, it can be concluded that LIAF has the predictive potential, as a non-invasive objective tool to measure the endogenous collagen levels in wound biopsy tissues and provide complementary data conducive for making clinical decisions. This article is protected by copyright. All rights reserved.

Fundus autofluorescence and optical coherence tomography in the management of progressive outer retinal necrosis

Science.gov (United States)

Yeh, Steven; Wong, Wai T.; Weichel, Eric D.; Lew, Julie C.; Chew, Emily Y.; Nussenblatt, Robert B.

2011-01-01

A 41 year-old female patient with acquired immune deficiency syndrome (AIDS) presented with progressive nasal visual field loss in her right eye. Ophthalmic exam revealed widespread areas of retinal opacification with hemorrhage consistent with progressive outer retinal necrosis (PORN), which was confirmed by polymerase chain reaction (PCR) for varicella zoster virus (VZV) DNA. The patient was treated with intravenous and intravitreal foscarnet and ganciclovir with a resultant improvement clinically. Optical coherence tomography (OCT) and fundus autofluorescence (FAF) imaging revealed progressive changes indicative of widespread retinal pigment epithelial (RPE) and outer retinal dysfunction. OCT was useful in documenting progressive changes in macular architecture during therapy including neurosensory elevation, cystoid macular edema, and severe outer retinal necrosis, at initial exam, 1 week, and 1 month follow-up. Fundus autofluorescence revealed areas of stippled, hyperfluorescence within extensive zones of hypofluorescence, which progressed during the follow-up period. These areas appeared to represent lipofuscin or its photoreactive components within larger regions of RPE loss. The combination of OCT and FAF was useful in the characterization of the RPE and retinal anatomy in this patient with PORN. PMID:20337261

Scanning Laser Ophthalmoscope Measurement of Local Fundus Reflectance and Autofluorescence Changes Arising from Rhodopsin Bleaching and Regeneration

OpenAIRE

Morgan, Jessica I. W.; Pugh, Edward N.

2013-01-01

Rhodopsin was measured locally in the retina with a widely available, dual wavelength scanning laser ophthalmoscope that does not require pupil dilation. Increased autofluorescence attendant bleaching arises largely from transient removal of rhodopsin's screening of autofluorescent fluorochromes.

Sub-cellular trafficking of phytochemicals explored using auto-fluorescent compounds in maize cells

Directory of Open Access Journals (Sweden)

Grotewold Erich

2003-12-01

Full Text Available Abstract Background Little is known regarding the trafficking mechanisms of small molecules within plant cells. It remains to be established whether phytochemicals are transported by pathways similar to those used by proteins, or whether the expansion of metabolic pathways in plants was associated with the evolution of novel trafficking pathways. In this paper, we exploited the induction of green and yellow auto-fluorescent compounds in maize cultured cells by the P1 transcription factor to investigate their targeting to the cell wall and vacuole, respectively. Results We investigated the accumulation and sub-cellular localization of the green and yellow auto-fluorescent compounds in maize BMS cells expressing the P1 transcription factor from an estradiol inducible promoter. We established that the yellow fluorescent compounds accumulate inside the vacuole in YFBs that resemble AVIs. The green fluorescent compounds accumulate initially in the cytoplasm in large spherical GFBs. Cells accumulating GFBs also contain electron-dense structures that accumulate initially in the ER and which later appear to fuse with the plasma membrane. Structures resembling the GFBs were also observed in the periplasmic space of plasmolized cells. Ultimately, the green fluorescence accumulates in the cell wall, in a process that is insensitive to the Golgi-disturbing agents BFA and monensin. Conclusions Our results suggest the presence of at least two distinct trafficking pathways, one to the cell wall and the other to the vacuole, for different auto-fluorescent compounds induced by the same transcription factor in maize BMS cells. These compartments represent two of the major sites of accumulation of phenolic compounds characteristic of maize cells. The secretion of the green auto-fluorescent compounds occurs by a pathway that does not involve the TGN, suggesting that it is different from the secretion of most proteins, polysaccharides or epicuticular waxes. The

Reproducibility of Macular Pigment Optical Density Measurement by Two-wave Length Auto-fluorescence in a Clinical Setting

Science.gov (United States)

You, Qi-Sheng; Bartsch, Dirk-Uwe G.; Espina, Mark; Alam, Mostafa; Camacho, Natalia; Mendoza, Nadia; Freeman, William

2015-01-01

Purpose Macular pigment, composed of lutein, zeaxanthin, and meso-zeaxanthin, is postulated to protect against age-related macular degeneration (AMD), likely due to filtering blue light and its antioxidant properties. Macular pigment optical density (MPOD) is reported to be associated with macular function evaluated by visual acuity and multifocal electroretinogram. Given the importance of macular pigment, reliable and accurate measurement methods are important. The main purpose of current study is to determine the reproducibility of MPOD measurement by two-wave length auto-fluorescence method using scanning laser ophthalmoscopy. Methods Sixty eight eyes of 39 persons were enrolled in the study, including 11 normal eyes, 16 eyes with wet AMD, 16 eyes with dry AMD, 11 eyes with macular edema due to diabetic mellitus, branch retinal vein occlusion or macular telangiectasia and 14 eyes with tractional maculopathy including vitreomacular traction, epiretinal membrane or macular hole. MPOD was measured with a two-wavelength (488 and 514 nm) auto-fluorescence method with the Spectralis HRA+OCT after pupil dilation. The measurement was repeated for each eye 10 minutes later. The Analysis of variance (ANOVA) and Bland-Altman plot were used to assess the reproducibility between the two measurements. Results The mean MPOD at eccentricities of 1° and 2° was 0.36±0.17 (range: 0.04–0.69) and 0.15±0.08(range: −0.03, 0.35) for the first measurement and 0.35±0.17 (range: 0.02, 0.68) and 0.15±0.08 (range: −0.01, 0.33) for the second measurement respectively. The difference between the two measurements was not statistically significant, and the Bland-Altman plot showed 7.4% and 5.9% points outside the 95% limits of agreement, indicating an overall excellent reproducibility. Similarly, there is no significant difference between the first and second measurements of MPOD volume within eccentricities of 1°, 2° and 6° radius, and the Bland-Altman plot showed 8.8%, 2.9% and

Distributed practice. The more the merrier? A randomised bronchoscopy simulation study

OpenAIRE

Bjerrum, Anne Sofie; Eika, Berit; Charles, Peder; Hilberg, Ole

2016-01-01

Introduction: The distribution of practice affects the acquisition of skills. Distributed practice has shown to be more effective for skills acquisition than massed training. However, it remains unknown as to which is the most effective distributed practice schedule for learning bronchoscopy skills through simulation training. This study compares two distributed practice schedules: One-day distributed practice and weekly distributed practice.Method: Twenty physicians in training were randomly...

Effectiveness of bronchoscopy in the diagnosis of bronchial-type mycobacterium avium-intracellulare complex pulmonary disease

International Nuclear Information System (INIS)

Sato, Kazuhiro; Kourakata, Hiroyo

2004-01-01

Mycobacterium avium-intracellulare complex (MAC) pulmonary disease with associated nodules and bronchiectasis is an increasingly prevalent condition. This condition is often difficult to diagnose in the early stages of the disease, because of the limited effectiveness of sputum culture cytology. The effectiveness of bronchoscopy in the isolation and diagnosis of MAC in respiratory secretions is still unclear. Over a three-year period, we examined the effectiveness of bronchoscopy in 45 non-HIV-infected patients who had clusters of small peripheral lung nodules. These nodules were associated with changes of the draining bronchi detected by high-resolution CT (HRCT). A total of 22 of 45 patients (48.9%) had cultures positive for MAC. In the MAC-positive group, 10 patients tested positive for disease in sputum and 22 tested positive for disease in bronchial washings. A total of 13 of 45 patients (28.9%) fulfilled the American Thoracic Society criteria for pulmonary MAC disease, and 9 (20.0%) others with cultures positive for MAC did not fulfill the criteria. Radiographic measures and sputum cultures of 13 of 16 patients (81.3%) with negative cultures revealed no further disease progression. We found that HRCT was a useful technique in the diagnosis of MAC-pulmonary disease. We also found that bronchoscopy was a more sensitive diagnostic technique than sputum culture, analysis in the differential diagnosis of MAC pulmonary diseases. (author)

Evaluation of a flexible bronchoscope prototype designed for bronchoscopy during mechanical ventilation: a proof-of-concept study.

Science.gov (United States)

Nay, M-A; Auvet, A; Mankikian, J; Herve, V; Dequin, P-F; Guillon, A

2017-06-01

Bronchoscopy during mechanical ventilation of patients' lungs significantly affects ventilation because of partial obstruction of the tracheal tube, and may thus be omitted in the most severely ill patients. It has not previously been possible to reduce the external diameter of the bronchoscope without reducing the diameter of the suction channel, thus reducing the suctioning capacity of the device. We believed that a better-designed bronchoscope could improve the safety of bronchoscopy in patients whose lungs were ventilated. We designed a flexible bronchoscope prototype with a drumstick-shaped head consisting of a long, thin proximal portion; a short and large distal portion for camera docking; and a large suction channel throughout the length of the device. The aims of our study were to test the impact of our prototype on mechanical ventilation when inserted into the tracheal tube, and to assess suctioning capacity. We first tested the efficiency of the suction channel, and demonstrated that the suction flow of the prototype was similar to that of conventional adult bronchoscopes. We next evaluated the consequences of bronchoscopy when using the prototype on minute ventilation and intrathoracic pressures during mechanical ventilation: firstly, in vitro using a breathing simulator; and secondly, in vivo using a porcine model of pulmonary ventilation. The insertion of adult bronchoscopes into the tracheal tube immediately impaired the protective ventilation strategy employed, whereas the prototype preserved it. For the first time, we have developed an innovative flexible bronchoscope designed for bronchoscopy during invasive mechanical ventilation, that both preserved the protective ventilation strategy, and enabled efficient suction flow. © 2017 The Association of Anaesthetists of Great Britain and Ireland.

Peroperative optical autofluorescence biopsy-verification of its diagnostic potential

Czech Academy of Sciences Publication Activity Database

Ducháč, V.; Zavadil, Jiří; Vránová, J.; Jirásek, T.; Štukavec, J.; Horák, L.

2011-01-01

Roč. 26, č. 3 (2011), s. 325-333 ISSN 0268-8921 Institutional research plan: CEZ:AV0Z20670512 Keywords : Autofluorescence spectroscopy * Colorectal cancer * Optical fibres Subject RIV: BM - Solid Matter Physics ; Magnetism Impact factor: 2.004, year: 2011

Feasibility for detection of autofluorescent signatures in rat organs using a novel excitation-scanning hyperspectral imaging system

Science.gov (United States)

Favreau, Peter F.; Deal, Joshua A.; Weber, David S.; Rich, Thomas C.; Leavesley, Silas J.

2016-04-01

The natural fluorescence (autofluorescence) of tissues has been noted as a biomarker for cancer for several decades. Autofluorescence contrast between tumors and healthy tissues has been of significant interest in endoscopy, leading to development of autofluorescence endoscopes capable of visualizing 2-3 fluorescence emission wavelengths to achieve maximal contrast. However, tumor detection with autofluorescence endoscopes is hindered by low fluorescence signal and limited quantitative information, resulting in prolonged endoscopic procedures, prohibitive acquisition times, and reduced specificity of detection. Our lab has designed a novel excitation-scanning hyperspectral imaging system with high fluorescence signal detection, low acquisition time, and enhanced spectral discrimination. In this study, we surveyed a comprehensive set of excised tissues to assess the feasibility of detecting tissue-specific pathologies using excitation-scanning. Fresh, untreated tissue specimens were imaged from 360 to 550 nm on an inverted fluorescence microscope equipped with a set of thin-film tunable filters (Semrock, A Unit of IDEX). Images were subdivided into training and test sets. Automated endmember extraction (ENVI 5.1, Exelis) with PCA identified endmembers within training images of autofluorescence. A spectral library was created from 9 endmembers. The library was used for identification of endmembers in test images. Our results suggest (1) spectral differentiation of multiple tissue types is possible using excitation scanning; (2) shared spectra between tissue types; and (3) the ability to identify unique morphological features in disparate tissues from shared autofluorescent components. Future work will focus on isolating specific molecular signatures present in tissue spectra, and elucidating the contribution of these signatures in pathologies.

Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

Energy Technology Data Exchange (ETDEWEB)

Ferretti, G.R.; Kocier, M.; Calaque, O.; Coulomb, M. [Service Central de Radiologie et Imagerie Medicale, INSERM EMI 9924, CHU, BP 217, 38043, Grenoble Cedex 9 (France); Arbib, F.; Pison, C. [Departement de Medecine Aigue Specialisee (DMAS), CHU Grenoble, CHU, BP 217, 38043, Grenoble Cedex 9 (France); Righini, C. [Service d' Oto Rhino Laryngologie, CHU Grenoble, BP 217, 38043, Grenoble Cedex 9 (France)

2003-05-01

The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting. (orig.)

Follow-up after stent insertion in the tracheobronchial tree: role of helical computed tomography in comparison with fiberoptic bronchoscopy

International Nuclear Information System (INIS)

Ferretti, G.R.; Kocier, M.; Calaque, O.; Coulomb, M.; Arbib, F.; Pison, C.; Righini, C.

2003-01-01

The aim of this study was to compare helical CT with fiberoptic bronchoscopy findings to appraise the medium-term results of proximal-airways stenting. Twenty-five patients with 28 endobronchial metallic stents inserted for local advanced malignancy (n=13) or benign diseases (n=12) underwent follow-up CT from 3 days to 50 months (mean 8 months). All studies were obtained using helical CT with subsequent multiplanar reformation and three-dimensional reconstruction including virtual bronchoscopy. The location, shape, and patency of stents and adjacent airway were assessed. The results of CT were compared with the results of fiberoptic bronchoscopy obtained with a mean delay of 2.5 days (SD 9 days) after CT scan. Twelve stents (43%) remained in their original position, patent and without deformity. Sixteen stents were associated with local complications: migration (n=6); external compression with persistent stenosis (n=4); local recurrence of malignancy (n=4); fracture (n=1); and non-congruence between the airway and the stent (n=1). The CT demonstrated all the significant abnormalities demonstrated at fiberoptic bronchoscopy except two moderate stenoses (20%) related to granulomata at the origin of the stent. Ten of 14 stents inserted for benign conditions were without complications as compared with 2 of 14 in malignant conditions (p=0.008). Computed tomography is an accurate noninvasive method for evaluating endobronchial stents. The CT is a useful technique for follow-up of patients who have undergone endobronchial stenting. (orig.)

Effect of metalloporphyrins on red autofluorescence from oral bacteria

NARCIS (Netherlands)

Volgenant, C.M.C.; van der Veen, M.H.; de Soet, J.J.; ten Cate, J.M.

2013-01-01

The aim of this study was to assess the red autofluorescence from bacterial species related to dental caries and periodontitis in the presence of different nutrients in the growth medium. Bacteria were grown anaerobically on tryptic soy agar (TSA) supplemented with nutrients, including

Role of flexible bronchoscopy and bronchoalveolar lavage in the diagnosis of pediatric acquired immunodeficiency syndrome-related pulmonary disease.

Science.gov (United States)

Birriel, J A; Adams, J A; Saldana, M A; Mavunda, K; Goldfinger, S; Vernon, D; Holzman, B; McKey, R M

1991-06-01

Flexible fiberoptic bronchoscopy with bronchoalveolar lavage was performed in 16 pediatric patients with the acquired immunodeficiency syndrome (AIDS) and deterioration in pulmonary function suggestive of opportunistic infection. In 62% of the patients Pneumocystis carinii was identified. Culture results showed a pure growth of Pseudomonas aeruginosa for one patient in addition to the Pneumocystis carinii. Bronchoscopy with lavage was well tolerated, with few complications even among patients with significant tachypnea and hypoxia. Because of its relative safety and effectiveness, this procedure should be considered the first invasive measurement used for evaluation of parenchymal lung disease in this population of patients.

Post-bronchoscopy fatal endobronchial hemorrhage in a woman with bronchopulmonary mucormycosis: a case report

Directory of Open Access Journals (Sweden)

La Licata Francesco

2010-12-01

Full Text Available Abstract Introduction During infection, Mucorales fungi invade major blood vessels, leading to extensive necrosis, and in cases of extensive pulmonary disease, bleeding into the lungs may occur. Case presentation We report an unexpected event of post-bronchoscopy fatal endobronchial hemorrhage in a 62-year-old HIV-negative Italian woman with well controlled diabetes mellitus who presented with diffuse cavitated pulmonary lesions. Fiberoptic bronchoscopy revealed bilateral obstruction of the segmental bronchi. Fatal massive bleeding occurred after standard biopsy procedures. Histologic examination showed that the hyphae were more deeply colored by hematoxylin-eosin (H&E than by other stains for fungi. Culture and autopsy confirmed bronchopulmonary mucormycosis. Conclusion Infection by Mucorales fungi should be considered in the diabetes population regardless of the degree of metabolic control. In these patients, particular caution should be taken during bronchoscopic procedures because of the greater friability of the fungal lesions.

Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

Energy Technology Data Exchange (ETDEWEB)

Erol, Muhammet Kazim; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet, E-mail: muhammetkazimerol@gmail.com [Kazim Erol. Antalya Training and Research Hospital, Ophthalmology Department, Antalya (Turkey)

2013-11-01

The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma. (author)

Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

International Nuclear Information System (INIS)

Erol, Muhammet Kazim; Coban, Deniz Turgut; Ceran, Basak Bostanci; Bulut, Mehmet

2013-01-01

The authors present enhanced depth imaging optical coherence tomography (EDI OCT) and fundus autofluorescence (FAF) characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma. (author)

Enhanced depth imaging optical coherence tomography and fundus autofluorescence findings in bilateral choroidal osteoma: a case report

Directory of Open Access Journals (Sweden)

Muhammet Kazim Erol

2013-06-01

Full Text Available The authors present enhanced depth imaging optical coherence tomography (EDI OCT and fundus autofluorescence (FAF characteristics of a patient with bilateral choroidal osteoma and try to make a correlation between two imaging techniques. Two eyes of a patient with choroidal osteoma underwent complete ophthalmic examination. Enhanced depth imaging optical coherence tomography revealed a cage-like pattern, which corresponded to the calcified region of the tumor. Fundus autofluorescence imaging of the same area showed slight hyperautofluorescence. Three different reflectivity patterns in the decalcified area were defined. In the areas of subretinal fluid, outer segment elongations similar to central serous chorioretinopathy were observed. Hyperautofluorescent spots were evident in fundus autofluorescence in the same area. Calcified and decalcified portions of choroidal osteoma as well as the atrophy of choriocapillaris demonstrated different patterns with enhanced depth imaging and fundus autofluorescence imaging. Both techniques were found to be beneficial in the diagnosis and follow-up of choroidal osteoma.

Application of Autofluorescence for Analysis of Medicinal Plants

Directory of Open Access Journals (Sweden)

Victoria V. Roshchina

2017-01-01

Full Text Available Autofluorescence of secondary compounds contained in plant secretory cells may be applied to the analysis of medicinal plants for pharmacy. Emission and prevailing fluorescent pharmaceuticals have been estimated in several models of species such as Salvia officinalis, Berberis vulgaris, Humulus lupulus, and Matricaria chamomilla, by luminescence microscopy, microspectrofluorimetry, and confocal microscopy.

Skin color independent assessment of aging using skin autofluorescence

NARCIS (Netherlands)

Koetsier, M.; Nur, Erfan; Chunmao, Han; Lutgers, Helen L.; Links, Thera P.; Smit, Andries J.; Rakhorst, Gerhard; Graaff, Reindert

2010-01-01

Skin autofluorescence (AF) for the non-invasive assessment of the amount of accumulated tissue Advanced Glycation Endproducts (AGEs) increases with aging. In subjects with darker skin colors, measurements typically result in lower AF values than in subjects with fair skin colors, e.g. due to

Skin color independent assessment of aging using skin autofluorescence

NARCIS (Netherlands)

Koetsier, M.; Nur, E.; Chunmao, H.; Lutgers, H.L.; Links, T.P.; Smit, A.J.; Rakhorst, G.; de Graaff, R.

2010-01-01

Skin autofluorescence (AF) for the non-invasive assessment of the amount of accumulated tissue Advanced Glycation Endproducts (AGEs) increases with aging. In subjects with darker skin colors, measurements typically result in lower AF values than in subjects with fair skin colors, e. g. due to

Quantitative Autofluorescence Intensities in Acute Zonal Occult Outer Retinopathy vs Healthy Eyes

Science.gov (United States)

Boudreault, Katherine; Schuerch, Kaspar; Zhao, Jin; Lee, Winston; Cabral, Thiago; Yannuzzi, Lawrence A.; Tsang, Stephen H.; Sparrow, Janet R.

2018-01-01

IMPORTANCE Acute zonal occult outer retinopathy (AZOOR) remains a challenging diagnosis. Early recognition of the disease depends on advances in imaging modalities that can improve phenotyping and contribute to the understanding of the underlying pathogenesis. OBJECTIVES To expand the range of approaches available to assist in the identification of AZOOR by multimodal imaging and to analyze the fundus lesions by quantifying short-wavelength fundus autofluorescence (quantitative fundus autofluorescence [qAF]) and spectral-domain optical coherence tomography. DESIGN, SETTING, AND PARTICIPANTS In this observational study, patients underwent imaging at Columbia University Medical Center between November 2010 and March 2016 and were analyzed between September 2015 and August 2016. Six patients diagnosed as having AZOOR were studied by qAF and spectral-domain optical coherence tomography and were compared with 30 age and race/ethnicity–matched controls from a database of 277 healthy control eyes. MAIN OUTCOMES AND MEASURES In unaffected regions of the macula, qAF was calculated within predetermined circularly arranged segments (qAF8). In addition, qAF was measured within specified regions of interest positioned at the autofluorescent lesion border (AZOOR line). Electroretinograms and electro-oculograms were recorded in 5 of 6 patients. RESULTS Among 6 patients (age range, 26–61 years; 4 female; 4 of white race/ethnicity, 1 Asian, and 1 Hispanic), 5 exhibited an autofluorescent AZOOR line in short-wavelength fundus autofluorescence images, delineating the peripapillary lesion. The mean (SD) region-of-interest qAF measured on the AZOOR line was 60 (26) times higher than in healthy control eyes (P = .03) at equivalent fundus locations. The qAF8 within nondiseased macular regions were within the normal range. At the lesion border, spectral-domain optical coherence tomography revealed a loss of outer retinal integrity in all patients. Single-flash cone b-wave latency and

The Spectrum of Fundus Autofluorescence Findings in Birdshot Chorioretinopathy

Directory of Open Access Journals (Sweden)

GianPaolo Giuliari

2009-01-01

Full Text Available Objective. To describe the diverse patterns observed with the use of autofluorescence fundus photography (FAF in patients with Birdshot chorioretinopathy (BSCR. Methods. A chart review of patients with BSCR seen at the Massachusetts Eye Research and Surgery Institution, who had autofluorescence fundus photography. The data obtained included age, gender, presence of the HLA-A29 haplotype, and current treatment. Results. Eighteen eyes with HLA-A29 associated BSCR were included. Four eyes presented with active inflammation. Correspondence of the lesions noted in the colour fundus photograph was observed in 3 eyes which were more easily identified with the FAF. Fifteen eyes had fundus lesions more numerous and evident in the FAF than in the colour fundus photograph. Conclusion. Because FAF testing provides valuable insight into the metabolic state of the PR/RPE-complex, it may serve as a useful noninvasive assessment tool in patients with posterior uveitis in which the outer retina-RPE-choriocapillaries-complex is involved.

[Fundus Autofluorescence Imaging].

Science.gov (United States)

Schmitz-Valckenberg, S

2015-09-01

Fundus autofluorescence (FAF) imaging allows for non-invasive mapping of changes at the level of the retinal pigment epithelium/photoreceptor complex and of alterations of macular pigment distribution. This imaging method is based on the visualisation of intrinsic fluorophores and may be easily and rapidly used in routine patient care. Main applications include degenerative disorders of the outer retina such as age-related macular degeneration, hereditary and acquired retinal diseases. FAF imaging is particularly helpful for differential diagnosis, detection and extent of involved retinal areas, structural-functional correlations and monitoring of changes over time. Recent developments include - in addition to the original application of short wavelength light for excitation ("blue" FAF imaging) - the use of other wavelength ranges ("green" or "near-infrared" FAF imaging), widefield imaging for visualisation of peripheral retinal areas and quantitative FAF imaging. Georg Thieme Verlag KG Stuttgart · New York.

COMPARISON OF MANUAL AND SEMIAUTOMATED FUNDUS AUTOFLUORESCENCE ANALYSIS OF MACULAR ATROPHY IN STARGARDT DISEASE PHENOTYPE.

Science.gov (United States)

Kuehlewein, Laura; Hariri, Amir H; Ho, Alexander; Dustin, Laurie; Wolfson, Yulia; Strauss, Rupert W; Scholl, Hendrik P N; Sadda, SriniVas R

2016-06-01

To evaluate manual and semiautomated grading techniques for assessing decreased fundus autofluorescence (DAF) in patients with Stargardt disease phenotype. Certified reading center graders performed manual and semiautomated (region finder-based) grading of confocal scanning laser ophthalmoscopy (cSLO) fundus autofluorescence (FAF) images for 41 eyes of 22 patients. Lesion types were defined based on the black level and sharpness of the border: definite decreased autofluorescence (DDAF), well, and poorly demarcated questionably decreased autofluorescence (WDQDAF, PDQDAF). Agreement in grading between the two methods and inter- and intra-grader agreement was assessed by kappa coefficients (κ) and intraclass correlation coefficients (ICC). The mean ± standard deviation (SD) area was 3.07 ± 3.02 mm for DDAF (n = 31), 1.53 ± 1.52 mm for WDQDAF (n = 9), and 6.94 ± 10.06 mm for PDQDAF (n = 17). The mean ± SD absolute difference in area between manual and semiautomated grading was 0.26 ± 0.28 mm for DDAF, 0.20 ± 0.26 mm for WDQDAF, and 4.05 ± 8.32 mm for PDQDAF. The ICC (95% confidence interval) for method comparison was 0.992 (0.984-0.996) for DDAF, 0.976 (0.922-0.993) for WDQDAF, and 0.648 (0.306-0.842) for PDQDAF. Inter- and intra-grader agreement in manual and semiautomated quantitative grading was better for DDAF (0.981-0.996) and WDQDAF (0.995-0.999) than for PDQDAF (0.715-0.993). Manual and semiautomated grading methods showed similar levels of reproducibility for assessing areas of decreased autofluorescence in patients with Stargardt disease phenotype. Excellent agreement and reproducibility were observed for well demarcated lesions.

Green autofluorescence, a double edged monitoring tool for bacterial growth and activity in micro-plates

Science.gov (United States)

Mihalcescu, Irina; Van-Melle Gateau, Mathilde; Chelli, Bernard; Pinel, Corinne; Ravanat, Jean-Luc

2015-12-01

The intrinsic green autofluorescence of an Escherichia coli culture has long been overlooked and empirically corrected in green fluorescent protein (GFP) reporter experiments. We show here, by using complementary methods of fluorescence analysis and HPLC, that this autofluorescence, principally arise from the secreted flavins in the external media. The cells secrete roughly 10 times more than what they keep inside. We show next that the secreted flavin fluorescence can be used as a complementary method in measuring the cell concentration particularly when the classical method, based on optical density measure, starts to fail. We also demonstrate that the same external flavins limit the dynamical range of GFP quantification and can lead to a false interpretation of lower global dynamic range of expression than what really happens. In the end we evaluate different autofluorescence correction methods to extract the real GFP signal.

The P2Y12 Receptor Antagonist Ticagrelor Reduces Lysosomal pH and Autofluorescence in Retinal Pigmented Epithelial Cells From the ABCA4-/- Mouse Model of Retinal Degeneration

Directory of Open Access Journals (Sweden)

Wennan Lu

2018-04-01

Full Text Available The accumulation of partially degraded lipid waste in lysosomal-related organelles may contribute to pathology in many aging diseases. The presence of these lipofuscin granules is particularly evident in the autofluorescent lysosome-associated organelles of the retinal pigmented epithelial (RPE cells, and may be related to early stages of age-related macular degeneration. While lysosomal enzymes degrade material optimally at acidic pH levels, lysosomal pH is elevated in RPE cells from the ABCA4-/- mouse model of Stargardt’s disease, an early onset retinal degeneration. Lowering lysosomal pH through cAMP-dependent pathways decreases accumulation of autofluorescent material in RPE cells in vitro, but identification of an appropriate receptor is crucial for manipulating this pathway in vivo. As the P2Y12 receptor for ADP is coupled to the inhibitory Gi protein, we asked whether blocking the P2Y12 receptor with ticagrelor could restore lysosomal acidity and reduce autofluorescence in compromised RPE cells from ABCA4-/- mice. Oral delivery of ticagrelor giving rise to clinically relevant exposure lowered lysosomal pH in these RPE cells. Ticagrelor also partially reduced autofluorescence in the RPE cells of ABCA4-/- mice. In vitro studies in ARPE-19 cells using more specific antagonists AR-C69931 and AR-C66096 confirmed the importance of the P2Y12 receptor for lowering lysosomal pH and reducing autofluorescence. These observations identify P2Y12 receptor blockade as a potential target to lower lysosomal pH and clear lysosomal waste in RPE cells.

Comparing Patient Satisfaction and Intubating Conditions Using Succinylcholine or Low-Dose Rocuronium for Rigid Bronchoscopy: A Randomized Study.

Science.gov (United States)

Ghezel-Ahmadi, Verena; Ghezel-Ahmadi, David; Mangen, Jacques; Bolukbas, Servet; Welker, Andreas; Kuerschner, Veit Christian; Fischer, Andreas; Schirren, Joachim; Beck, Grietje

2015-09-01

Despite its serious side effects, succinylcholine is commonly used for neuromuscular relaxation in short procedures, such as rigid bronchoscopy and tracheobronchial interventions. The application of low-dose rocuronium reversed by low-dose sugammadex might be a modern alternative. The aim of this study was to compare patient satisfaction, incidence of postoperative myalgia (POM) as well as intubating conditions of these two muscle relaxants for rigid bronchoscopy. A single-center, prospective-randomized, blinded study of 95 patients, scheduled for rigid bronchoscopy and tracheobronchial intervention was conducted. The patients were anesthetized with propofol, remifentanil and either low-dose succinylcholine (S) (0.5 mg/kg) or low-dose rocuronium (0.25 mg/kg) with sugammadex (RS) (0.5 mg/kg). All patients were evaluated on the first and second postinterventional day for their satisfaction with the treatment (rigid bronchoscopy) using a Numeric Analog Rating Scale (NAS 0-10) and the presence and severity of POM (NAS 1-4). Intubating conditions were assessed as excellent, good, or poor on the basis of position of vocal cords and reaction to insertion of the rigid bronchoscope. Patients in the S group were less satisfied with the treatment than patients in RS group (72.7 vs. 93.7%, p = 0.007). The incidence of POM on the first day after intervention was significantly higher in the S group then in the RS group (56.9% vs. 4.3%, p rocuronium in 75% of patients. The anesthetic drug costs were significantly higher in the RS group then in the S group (p rocuronium provided better patient satisfaction and less POM. But with the use of low-dose succinylcholine, the intubating conditions are more comfortable, and it is less expensive than rocuronium/sugammadex. Georg Thieme Verlag KG Stuttgart · New York.

Autofluorescence imaging can identify preinvasive or clinically occult lesions in fallopian tube epithelium: a promising step towards screening and early detection.

Science.gov (United States)

McAlpine, J N; El Hallani, S; Lam, S F; Kalloger, S E; Luk, M; Huntsman, D G; MacAulay, C; Gilks, C B; Miller, D M; Lane, P M

2011-03-01

Optical imaging systems are robust, portable, relatively inexpensive, and have proven utility in detecting precancerous lesions in the lung, esophagus, colon, oral cavity and cervix. We describe the use of light-induced endogenous fluorescence (autofluorescence) in identifying preinvasive and occult carcinomas in ex vivo samples of human fallopian tube (FT) epithelium. Women undergoing surgery for an i) ovarian mass, ii) a history suggestive of hereditary breast-ovarian cancer, or iii) known serous ovarian cancer following neoadjuvant chemotherapy (NAC) were approached for informed consent. Immediately following surgery, FT's were photographed in reflectance and fluorescence at high resolution. Images included: (1) white-light reflectance of luminal/epithelial surface; (2) narrow-band green reflectance (570 nm) (3) green autofluorescence (405/436 nm excitation); and (4) blue autofluorescence (405 nm excitation). Areas revealing a loss of natural tissue fluorescence or marked increase in tissue microvasculature were recorded and compared to final histopathologic diagnosis (SEE-FIM protocol). Fifty-six cases involving one or both fallopian tubes underwent reflectance and fluorescence visualization. Nine cases were excluded, either secondary to non-ovarian primary pathology (7) or excessive trauma (2) rendering tissue interpretation impossible. Of the 47 cases remaining, there were 11 high grade serous (HGS) and 9 non-serous ovarian carcinomas undergoing primary debulking surgery, 5 serous carcinomas having received NAC, 8 benign ovarian tumors, and 14 women undergoing risk-reducing bilateral salpingo-oophorectomy (RRBSO). Methodology was feasible, efficient, and reproducible. TIC or carcinoma was identified in 7/11 HGS, 3/5 NAC, and 1/14 RRBSO. Optical images were reviewed to determine test positive or negative based on standardized criteria. Sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) were calculated for the entire

Geographic atrophy segmentation in infrared and autofluorescent retina images using supervised learning.

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Devisetti, K; Karnowski, T P; Giancardo, L; Li, Y; Chaum, E

2011-01-01

Geographic Atrophy (GA) of the retinal pigment epithelium (RPE) is an advanced form of atrophic age-related macular degeneration (AMD) and is responsible for about 20% of AMD-related legal blindness in the United States. Two different imaging modalities for retinas, infrared imaging and autofluorescence imaging, serve as interesting complimentary technologies for highlighting GA. In this work we explore the use of neural network classifiers in performing segmentation of GA in registered infrared (IR) and autofluorescence (AF) images. Our segmentation achieved a performance level of 82.5% sensitivity and 92.9% specificity on a per-pixel basis using hold-one-out validation testing. The algorithm, feature extraction, data set and experimental results are discussed and shown.

Methylene Blue-Aided In Vivo Staining of Central Airways during Flexible Bronchoscopy

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Sabine Zirlik

2012-01-01

Full Text Available Background. The early diagnosis of malignant and premalignant changes of the bronchial mucosa remains a major challenge during bronchoscopy. Intravital staining techniques are not new. Previous small case series suggested that analysis of the bronchial mucosal surface using chromoendoscopy allows a prediction between neoplastic and nonneoplastic lesions. Objectives. The aim of the present study was to evaluate chromobronchoscopy as a method to identify malignant and premalignant lesions in the central airways in a prospective manner. Methods. In 26 patients we performed chromoendoscopy with 0.1% methylene blue during ongoing flexible white light bronchoscopy. Circumscribed lesions in central airways were further analyzed by biopsies and histopathologic examination. Results. In the majority of cases neither flat nor polypoid lesions in the central airways were stained by methylene blue. In particular, exophytic growth of lung cancer did not show any specific pattern in chromobronchoscopy. However, a specific dye staining was detected in one case where exophytic growth of metastatic colorectal cancer was present in the right upper lobe. In two other cases, a circumscribed staining was noted in unsuspicious mucosa. But histology revealed inflammation only. Conclusions. In contrast to previous studies, the present findings clearly indicate that chromobronchoscopy is not useful for early detection of malignant or premalignant lesions of the central airways.

Tissue Discrimination by Uncorrected Autofluorescence Spectra: A Proof-of-Principle Study for Tissue-Specific Laser Surgery

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Katja Tangermann-Gerk

2013-10-01

Full Text Available Laser surgery provides a number of advantages over conventional surgery. However, it implies large risks for sensitive tissue structures due to its characteristic non-tissue-specific ablation. The present study investigates the discrimination of nine different ex vivo tissue types by using uncorrected (raw autofluorescence spectra for the development of a remote feedback control system for tissue-selective laser surgery. Autofluorescence spectra (excitation wavelength 377 ± 50 nm were measured from nine different ex vivo tissue types, obtained from 15 domestic pig cadavers. For data analysis, a wavelength range between 450 nm and 650 nm was investigated. Principal Component Analysis (PCA and Quadratic Discriminant Analysis (QDA were used to discriminate the tissue types. ROC analysis showed that PCA, followed by QDA, could differentiate all investigated tissue types with AUC results between 1.00 and 0.97. Sensitivity reached values between 93% and 100% and specificity values between 94% and 100%. This ex vivo study shows a high differentiation potential for physiological tissue types when performing autofluorescence spectroscopy followed by PCA and QDA. The uncorrected autofluorescence spectra are suitable for reliable tissue discrimination and have a high potential to meet the challenges necessary for an optical feedback system for tissue-specific laser surgery.

The segmentation of zones with increased autofluorescence in the junctional zone of parapapillary atrophy

International Nuclear Information System (INIS)

Kolář, R; Jan, J; Laemmer, R; Mardin, Ch Y

2009-01-01

The autofluorescence (AF) derived from the retinal pigment epithelium has the potential to be used as a feature for early glaucoma diagnosis. The aim of this paper is to design and evaluate the method used for semi-automatic segmentation of the zones with increased autofluorescence. A randomized sample of 20 patients (age: 56 ± 10 years) with open angle glaucoma was used. A new method for semi-automatic detection and segmentation of the zones with a higher level of autofluorescence in the junctional zone of parapapillary atrophy has been evaluated. Good agreement has been observed between manually and semi-automatically segmented zones for most of the images, but higher differences may occur for larger hyperfluorescent regions. The data were evaluated using the limits of agreement, with a 2σ border. The described method allows fast and objective evaluation of AF images, preventing undesirable inter-expert variance. A large proportion of AF images could be evaluated successfully by the developed procedure, and the obtained results are comparable to the manual procedure in most cases

Ultrathin bronchoscopy for solitary pulmonary lesions in a region endemic for tuberculosis: a randomised pilot trial.

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Franzen, Daniel; Diacon, Andreas H; Freitag, Lutz; Schubert, Pawel T; Wright, Colleen A; Schuurmans, Macé M

2016-04-27

The evaluation of solitary pulmonary lesions (SPL) requires a balance between procedure-related morbidity and diagnostic yield, particularly in areas where tuberculosis (TB) is endemic. Data on ultrathin bronchoscopy (UB) for this purpose is limited. To evaluate feasibility and safety of UB compared to SB for diagnosis of SPL in a TB endemic region. In this prospective randomised trial we compared diagnostic yield and adverse events of UB with standard-size bronchoscopy (SB), both combined with fluoroscopy, in a cohort of patients with SPL located beyond the visible range of SB. We included 40 patients (mean age 55.2 years, 45 % male) with malignant SPL (n = 16; 40 %), tuberculous SPL (n = 11; 27.5 %) and other benign SPL (n = 13; 32.5 %). Mean procedure time in UB and SB was 30.6 and 26.0 min, respectively (p = 0.15). By trend, adverse events were recorded more often with UB than with SB (30.0 vs. 5.0 %, p = 0.091), including extensive coughing (n = 2), blocked working channel (n = 2), and arterial hypertension requiring therapeutic intervention (n = 1), all with UB. The overall diagnostic yield of UB compared to SB was 55.0 % vs. 80.0 %, respectively (p = 0.18). Sensitivity for the diagnosis of malignancy of UB and SB was 50.0 % and 62.5 %, respectively (p = 0.95). UB is not superior to SB for the evaluation of SPL in a region endemic with tuberculosis, when combined with fluoroscopic guidance only. ClinicalTrials.gov (Identifier: NCT02490059 ).

The diagnostic value of multi-slice spiral CT virtual bronchoscopy in tracheal and bronchial disease

International Nuclear Information System (INIS)

Han Ying; Ma Daqing

2006-01-01

Objective: To assess the diagnostic value of multi-slice spiral CT virtual bronchoscopy (CTVB) in tracheal and bronchial disease. Methods: Forty-two patients including central lung cancer (n=35), endobronchial tuberculosis (n=3), intrabronchial benign tumor (n=3), and intrabronchial foreign body (n=1) were examined by using multi-slice spiral CT examinations. All the final diagnosis were proved by pathology except 1 patient with endoluminal foreign body was proved by clinic. All patients were scanned on GE Lightspeed 99 scanner, using 10 mm collimation, pitch of 1.35, and reconstructed at 1 mm intervals and 1.25 mm thickness. The chest images of transverse CT and virtual bronchoscopy were viewed by two separate radiologists who were familiar with the tracheal and bronchial anatomy. Results: Among the 42 patients, the tumor of trachea and bronchial lumen appeared as masses in 22 of 35 patients with central lung cancer and bronchial stenosis was found in 13 of 35 patients with central lung cancer, and bronchial wall thickening was revealed on transverse CT in all 35 cases. 3 patients of endobronchial tuberculosis showed bronchial lumen narrowing on CTVB, the bronchial wall thickening was revealed on transverse CT, and the length of the wall thickening was long. 3 patients with intrabronchial benign tumor showed nodules in trachea and bronchial lumen on CTVB, and without wall thickening on transverse CT. CTVB could detect the occlusion of bronchial lumen in 1 patient with intrabronchial foreign body and CTVB was able to visualize the areas beyond stenosis, and the bronchial wall was without thickening on transverse CT. Conclusion: Multi- slice spiral CTVB could reflect the morphology of tracheal and bronchial disease. Combined with transverse CT, it could provide diagnostic reference value for bronchial disease. (authors)

Lung abscess following bronchoscopy due to multidrug-resistant Capnocytophaga sputigena adjacent to lung cancer with high PD-L1 expression.

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Migiyama, Yohei; Anai, Moriyasu; Kashiwabara, Kosuke; Tomita, Yusuke; Saeki, Sho; Nakamura, Kazuyoshi; Okamoto, Shinichiro; Ichiyasu, Hidenori; Fujii, Kazuhiko; Kohrogi, Hirotsugu

2018-04-24

Lung abscess following flexible bronchoscopy is a rare and sometimes fatal iatrogenic complication. Here, we report the first case of a lung abscess caused by multidrug-resistant Capnocytophaga sputigena following bronchoscopy. A 67-year-old man underwent bronchoscopy to evaluate a lung mass. Seven days after transbronchial lung biopsy, he presented with an abscess formation in a lung mass. Empirical antibiotic therapy, including with garenoxacin, ampicillin/sulbactam, clindamycin and cefepime, was ineffective. Percutaneous needle aspiration of lung abscess yielded C. sputigena resistant to multiple antibiotics but remained susceptible to carbapenem. He was successfully treated by the combination therapy with surgery and with approximately 6 weeks of intravenous carbapenem. Finally he was diagnosed with a lung abscess with adenocarcinoma expressing high levels of programmed cell death ligand 1. The emergence of multidrug-resistant Capnocytophaga species is a serious concern for effective antimicrobial therapy. Clinicians should consider multidrug-resistant C. sputigena as a causative pathogen of lung abscess when it is refractory to antimicrobial treatment. Copyright © 2018 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

The Effect of Dextromethorphan Premedication on Cough and Patient Tolerance During Flexible Bronchoscopy: A Randomized, Double-blind, Placebo-controlled Trial.

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Amini, Shahideh; Peiman, Soheil; Khatuni, Mahdi; Ghalamkari, Marziyeh; Rahimi, Besharat

2017-10-01

Patients undergoing bronchoscopy can experience problems such as anxiety and cough, requiring various doses of sedatives and analgesics. The purposes of this study were to investigate the effect of premedication with dextromethorphan on patients' cough and anxiety, and the use of analgesics/sedatives during flexible bronchoscopy (FB). A randomized, double-blind, placebo-controlled, prospective study was performed to assess the effect of dextromethorphan premedication on patients who underwent diagnostic bronchoscopy. Seventy patients included in this study were randomly allocated into 2 groups: group A consisted of 35 patients who received dextromethorphan before FB; and group B consisted of 35 patients who received a placebo. A questionnaire was given to the patients and bronchoscopist about perception of cough, anxiety, and discomfort. The amount of sedative medication and lidocaine use during the procedure and the procedure time were recorded. The group that was premedicated with dextromethorphan had lower complaint scores, significantly less coughing, significantly less stress assessed by the patient and the physician evaluation, shorter total procedure time, and fewer midazolam requirements during FB (P-value dextromethorphan premedication is an effective approach to facilitate the performance of FB for the physician, and could improve patient comfort.

Sedation during bronchoscopy: data from a nationwide sedation and monitoring survey.

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Gaisl, Thomas; Bratton, Daniel J; Heuss, Ludwig T; Kohler, Malcolm; Schlatzer, Christian; Zalunardo, Marco P; Frey, Martin; Franzen, Daniel

2016-08-05

There is limited knowledge on practice patterns in procedural sedation and analgesia (PSA), the use of propofol, and monitoring during flexible bronchoscopy (FB). The purpose of this study was to assess the current practice patterns of FBs and to focus on the use of propofol, the education of the proceduralist, and the involvement of anaesthesiologists during FB. An anonymous questionnaire was sent to 299 pulmonologists. Only respondents who were active physicians in adult respiratory medicine performing FB were subsequently analysed. The response rate was 78 % and 27,149 FB in the previous 12 months were analysed. The overall sedation-related morbidity rate was 0.02 % and mortality was 7/100'000 FB. Sedation was used in 95 % of bronchoscopies. The main drugs used for PSA were propofol (77 %) and midazolam (46 %). In 84 % of PSAs propofol was used without the attendance of an anaesthesiologist. The use of propofol was associated with high volume bronchoscopists (p vital parameters has become standard practice, pulmonologists reported a very low rate of systematic basic education and training in the field of PSA (50 %). In Switzerland, PSA during FB is mostly performed with propofol without the attendance of an anaesthesiologist and the use of this drug is expected to increase in the future. While monitoring standards are very high there is need for policies to improve education, systematic training, and support for pulmonologists for PSA during FB.

Fundus autofluorescence imaging of the white dot syndromes.

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Yeh, Steven; Forooghian, Farzin; Wong, Wai T; Faia, Lisa J; Cukras, Catherine; Lew, Julie C; Wroblewski, Keith; Weichel, Eric D; Meyerle, Catherine B; Sen, Hatice Nida; Chew, Emily Y; Nussenblatt, Robert B

2010-01-01

To characterize the fundus autofluorescence (FAF) findings in patients with white dot syndromes (WDSs). Patients with WDSs underwent ophthalmic examination, fundus photography, fluorescein angiography, and FAF imaging. Patients were categorized as having no, minimal, or predominant foveal hypoautofluorescence. The severity of visual impairment was then correlated with the degree of foveal hypoautofluorescence. Fifty-five eyes of 28 patients with WDSs were evaluated. Visual acuities ranged from 20/12.5 to hand motions. Diagnoses included serpiginous choroidopathy (5 patients), birdshot retinochoroidopathy (10), multifocal choroiditis (8), relentless placoid chorioretinitis (1), presumed tuberculosis-associated serpiginouslike choroidopathy (1), acute posterior multifocal placoid pigment epitheliopathy (1), and acute zonal occult outer retinopathy (2). In active serpiginous choroidopathy, notable hyperautofluorescence in active disease distinguished it from the variegated FAF features of tuberculosis-associated serpiginouslike choroidopathy. The percentage of patients with visual acuity impairment of less than 20/40 differed among eyes with no, minimal, and predominant foveal hypoautofluorescence (P < .001). Patients with predominant foveal hypoautofluorescence demonstrated worse visual acuity than those with minimal or no foveal hypoautofluorescence (both P < .001). Fundus autofluorescence imaging is useful in the evaluation of the WDS. Visual acuity impairment is correlated with foveal hypoautofluorescence. Further studies are needed to evaluate the precise role of FAF imaging in the WDSs.

Skin autofluorescence and risk of micro- and macrovascular complications in patients with Type 2 diabetes mellitus-a multi-centre study

NARCIS (Netherlands)

Noordzij, M J; Mulder, D.J.; Oomen, P H N; Brouwer, T; Jager, J; Castro Cabezas, M; Lefrandt, J D; Smit, Andries

2012-01-01

AIMS: Skin autofluorescence is a non-invasive marker of advanced glycation end product accumulation. In a previous study, skin autofluorescence correlated with and predicted micro- and macrovascular complications in Type 2 diabetes in a primary care setting. The present cross-sectional study aims to

Use of fluorescence spectroscopy to measure molecular autofluorescence in diabetic subjects

International Nuclear Information System (INIS)

Gomes, Cinthia Zanini

2011-01-01

Diabetes Mellitus (DM) comprises a complex metabolic syndrome, caused by reduced or absent secretion of insulin by pancreatic beta cells, leading to hyperglycemia. Hyperglycemia promotes glycation of proteins and, consequently, the appearance of advanced glycation end products (AGEs). Currently, diabetic patients are monitored by determining levels of glucose and glycated hemoglobin (HbA1c). The complications caused by hyperglycemia may be divided into micro and macrovascular complications, represented by retinopathy, nephropathy, neuropathy and cardiovascular disease. Albumin (HSA) is the most abundant serum protein in the human body and is subject to glycation. The Protoporphyrin IX (PpIX) is the precursor molecule of heme synthesis, structural component of hemoglobin. The in vitro and animals studies have indicated that hyperglycemia promotes a decrease in its concentration in erythrocytes. The fluorescence spectroscopy is a technique widely used in biomedical field. The autofluorescence corresponds to the intrinsic fluorescence present in some molecules, this being associated with the same structure. The aim of this study was to use fluorescence spectroscopy to measure levels of erythrocyte PpIX autofluorescence and AGE-HSA in diabetic and healthy subjects and compare them with levels of blood glucose and HbA1c. This study was conducted with 151 subjects (58 controls and 93 diabetics). Epidemiological data of patients and controls were obtained from medical records. For control subjects, blood glucose levels were obtained from medical records and levels of Hb1Ac obtained by using commercial kits. The determination of the PpIX autofluorescence was performed with excitation at 405 nm and emission at 632 nm. Determination of AGE-HSA was performed with excitation at 370 nm and emission at 455 nm. Approximately 50% of diabetic had micro and macrovascular lesions resulting from hyperglycemia. There were no significant differences in the PpIX emission intensity values

Drusen regression is associated with local changes in fundus autofluorescence in intermediate age-related macular degeneration.

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Toy, Brian C; Krishnadev, Nupura; Indaram, Maanasa; Cunningham, Denise; Cukras, Catherine A; Chew, Emily Y; Wong, Wai T

2013-09-01

To investigate the association of spontaneous drusen regression in intermediate age-related macular degeneration (AMD) with changes on fundus photography and fundus autofluorescence (FAF) imaging. Prospective observational case series. Fundus images from 58 eyes (in 58 patients) with intermediate AMD and large drusen were assessed over 2 years for areas of drusen regression that exceeded the area of circle C1 (diameter 125 μm; Age-Related Eye Disease Study grading protocol). Manual segmentation and computer-based image analysis were used to detect and delineate areas of drusen regression. Delineated regions were graded as to their appearance on fundus photographs and FAF images, and changes in FAF signal were graded manually and quantitated using automated image analysis. Drusen regression was detected in approximately half of study eyes using manual (48%) and computer-assisted (50%) techniques. At year-2, the clinical appearance of areas of drusen regression on fundus photography was mostly unremarkable, with a majority of eyes (71%) demonstrating no detectable clinical abnormalities, and the remainder (29%) showing minor pigmentary changes. However, drusen regression areas were associated with local changes in FAF that were significantly more prominent than changes on fundus photography. A majority of eyes (64%-66%) demonstrated a predominant decrease in overall FAF signal, while 14%-21% of eyes demonstrated a predominant increase in overall FAF signal. FAF imaging demonstrated that drusen regression in intermediate AMD was often accompanied by changes in local autofluorescence signal. Drusen regression may be associated with concurrent structural and physiologic changes in the outer retina. Published by Elsevier Inc.

Interpretations of Fundus Autofluorescence from Studies of the Bisretinoids of the Retina

OpenAIRE

Sparrow, Janet R.; Yoon, Kee Dong; Wu, Yalin; Yamamoto, Kazunori

2010-01-01

Elevated fundus autofluorescence signals can reflect enhanced lipofuscin in RPE cells, augmented fluorescence due to photooxidation, and/or excess bisretinoid fluorophores in photoreceptor cells due to mishandling of vitamin A aldehyde by dysfunctional cells.

Autofluorescence spectroscopy and imaging: a tool for biomedical research and diagnosis

Directory of Open Access Journals (Sweden)

A.C. Croce

2014-10-01

Full Text Available Native fluorescence, or autofluorescence (AF, consists in the emission of light in the UV-visible, near-IR spectral range when biological substrates are excited with light at suitable wavelength. This is a well-known phenomenon, and the strict relationship of many endogenous fluorophores with morphofunctional properties of the living systems, influencing their AF emission features, offers an extremely powerful resource for directly monitoring the biological substrate condition. Starting from the last century, the technological progresses in microscopy and spectrofluorometry were convoying attention of the scientific community to this phenomenon. In the future, the interest in the autofluorescence will certainly continue. Current instrumentation and analytical procedures will likely be overcome by the unceasing progress in new devices for AF detection and data interpretation, while a progress is expected in the search and characterization of endogenous fluorophores and their roles as intrinsic biomarkers.

No need for labels: the autofluorescence of Leishmania tarentolae mitochondria and the necessity of negative controls.

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Elisabeth Eckers

Full Text Available BACKGROUND: Fluorescence microscopy is a powerful tool to study the morphology and function of subcellular compartments or to determine the localization of proteins. The method is also regularly used for the analysis of parasitic protists including kinetoplastida. RESULTS: Here, we report a significant autofluorescence of Leishmania tarentolae mitochondria. The autofluorescence, presumably caused by flavoproteins, was detectable using a variety of cell fixation protocols and had a maximum emission at approximately 538 nm. Stable signals were obtained with xenon lamps as a light source and filter sets that are commonly used for the detection of green fluorescent protein. CONCLUSIONS: On the one hand, we present a methodological approach to examine mitochondrial morphology or to study the colocalization of mitochondrial proteins without additional staining or labeling procedures. On the other hand, under certain experimental conditions, mitochondrial autofluorescence can result in false positive signals, demonstrating the necessity to analyze unlabeled cells as negative controls.

Fundus Autofluorescence Captured With a Nonmydriatic Retinal Camera in Vegetarians Versus Nonvegetarians.

Science.gov (United States)

Kommana, Sumana S; Padgaonkar, Pooja; Mendez, Nicole; Wu, Lesley; Szirth, Bernard; Khouri, Albert S

2015-09-09

A baseline level of lipofuscin in the retinal pigment epithelium (RPE) is inevitable with age, but increased levels due to increased oxidative stress can result in deleterious vision loss at older ages. As earlier detection of differences in levels can lead to superior preventative management, we studied the relationship between lipofuscin accumulation and dietary lifestyle (vegetarian vs. nonvegetarian) in the younger, healthy South Asian population using retinal fundus autofluorescence (FAF) imaging. In this pilot study, we examined 37 healthy subjects (average age 23 years ± 1) all undergoing similar stress levels as medical students at Rutgers New Jersey Medical School. Levels of lipofuscin concentrations were imaged using a FAF retinal camera (Canon CX-1). Two images (color and FAF) were captured of the left eye and included in the analysis. FAF quantitative scoring was measured in 2 regions of the captured image, the papillo-macular region (P) and the macula (M), by determining the grayscale score of a 35.5 mm(2) rectangle in the respective regions. Standardized scores (corrected to remove baseline fluorescence) were then obtained. Means, standard deviations, and t tests were performed for comparisons. Fundus autofluorescence scores of regions P and M were significantly different (P vegetarians had statistically significant lower levels of autofluorescence. These findings can have potential implications regarding long-term retinal health and risk for developing certain diseases over decades in subjects at risk for vision-threatening diseases. © 2015 Diabetes Technology Society.

Microperimetry and fundus autofluorescence in diabetic macular edema: subthreshold micropulse diode laser versus modified early treatment diabetic retinopathy study laser photocoagulation.

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Vujosevic, Stela; Bottega, Elisa; Casciano, Margherita; Pilotto, Elisabetta; Convento, Enrica; Midena, Edoardo

2010-06-01

The purpose of this study was to evaluate and compare microperimetry and fundus autofluorescence (FAF) after subthreshold micropulse diode laser versus modified Early Treatment Diabetic Retinopathy Study photocoagulation for clinically significant diabetic macular edema. A prospective randomized clinical trial including 62 eyes (50 patients) with untreated, center-involving, clinically significant diabetic macular edema was performed. All patients underwent best-corrected visual acuity determination (logarithm of the minimum angle of resolution), slit-lamp biomicroscopy, FAF, optical coherence tomography, microperimetry (macular sensitivity), and fluorescein angiography before and after treatment. Best-corrected visual acuity, optical coherence tomography, microperimetry, and FAF were repeated at 1-, 3-, 6-, 9-, and 12-month follow-up examinations. Fluorescein angiography was performed at baseline and at 6 and 12 months. Before treatment, demographic and macular parameters were not different between the two treatment groups. At 12 months, best-corrected visual acuity remained stable in both groups (P = 0.41 and P = 0.82), mean central retinal thickness decreased in both groups (P = 0.0002 and P autofluorescence never changed in the micropulse diode laser group even after retreatment. In the Early Treatment Diabetic Retinopathy Study group, FAF increased up to 9 months and decreased in 6 eyes (20%) at 12 months. Micropulse diode laser seems to be as effective as modified Early Treatment Diabetic Retinopathy Study laser photocoagulation in the treatment of clinically significant diabetic macular edema. Micropulse diode laser treatment does not determine any change on FAF showing (at least) nonclinically visible damage of the retinal pigment epithelium. Microperimetry data encourage the use of a new, less aggressive laser therapeutic approach in the treatment of clinically significant diabetic macular edema.

Mueller-matrix of laser-induced autofluorescence of polycrystalline films of dried peritoneal fluid in diagnostics of endometriosis

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Ushenko, Yuriy A.; Koval, Galina D.; Ushenko, Alexander G.; Dubolazov, Olexander V.; Ushenko, Vladimir A.; Novakovskaia, Olga Yu.

2016-07-01

This research presents investigation results of the diagnostic efficiency of an azimuthally stable Mueller-matrix method of analysis of laser autofluorescence of polycrystalline films of dried uterine cavity peritoneal fluid. A model of the generalized optical anisotropy of films of dried peritoneal fluid is proposed in order to define the processes of laser autofluorescence. The influence of complex mechanisms of both phase (linear and circular birefringence) and amplitude (linear and circular dichroism) anisotropies is taken into consideration. The interconnections between the azimuthally stable Mueller-matrix elements characterizing laser autofluorescence and different mechanisms of optical anisotropy are determined. The statistical analysis of coordinate distributions of such Mueller-matrix rotation invariants is proposed. Thereupon the quantitative criteria (statistic moments of the first to the fourth order) of differentiation of polycrystalline films of dried peritoneal fluid, group 1 (healthy donors) and group 2 (uterus endometriosis patients), are determined.

Unusual optical coherence tomography and fundus autofluorescence findings of eclipse retinopathy

Directory of Open Access Journals (Sweden)

Kun-Hsien Li

2012-01-01

Full Text Available A 63-year-old female patient complained of dimness in the central field of vision in the left eye after viewing an annular partial eclipse without adequate eye protection on 22 July 2009. Fundoscopy showed a wrinkled macular surface. Fundus autofluorescence study revealed well-demarcated hyperautofluorescence at the fovea. Optical coherence tomography demonstrated tiny intraretinal cysts. Fluorescein angiography and indocyanine green angiography were unremarkable. Epimacular membrane developed in the following month with deteriorated vision. Vitrectomy, epiretinal membrane and internal limiting membrane peeling were performed. Vision was restored to 20/20 after the operation. Direct sun-gazing may damage the retinal structures resulting in macular inflammation and increased focal metabolism, which explains the hyperautofluorescence. It may also induce epimacular membrane. Fundus autofluorescence might represent a useful technique to detect subtle solar-induced injuries of the retina. The visual prognosis is favorable but prevention remains the mainstay of treatment. Public health education is mandatory in reducing visual morbidity.

A simple protocol for attenuating the auto-fluorescence of cyanobacteria for optimized fluorescence in situ hybridization (FISH) imaging.

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Zeller, Perrine; Ploux, Olivier; Méjean, Annick

2016-03-01

Cyanobacteria contain pigments, which generate auto-fluorescence that interferes with fluorescence in situ hybridization (FISH) imaging of cyanobacteria. We describe simple chemical treatments using CuSO4 or H2O2 that significantly reduce the auto-fluorescence of Microcystis strains. These protocols were successfully applied in FISH experiments using 16S rRNA specific probes and filamentous cyanobacteria. Copyright © 2016 Elsevier B.V. All rights reserved.

NEAR-INFRARED AUTOFLUORESCENCE IN BILATERAL DIFFUSE UVEAL MELANOCYTIC PROLIFERATION ASSOCIATED WITH ESOPHAGEAL CARCINOMA AND CHOROIDAL METASTASIS.

Science.gov (United States)

Golshahi, Azadeh; Bornfeld, Norbert; Weinitz, Silke; Kellner, Ulrich

2016-01-01

To investigate the advantage of near-infrared autofluorescence (787 nm) for the detection of melanocytic lesions in a patient with bilateral diffuse uveal melanocytic proliferation in association with esophageal carcinoma complicated by most likely unilateral choroidal metastasis. In this retrospective case report, a 55-year-old woman referred for the evaluation of sudden visual loss underwent normal ophthalmological evaluation and, in addition, was examined with near-infrared reflectance, near-infrared autofluorescence, fundus autofluorescence (Heidelberg Retina Angiograph II [HRA2; Heidelberg Engineering]), spectral domain optical coherence tomography (Spectralis OCT; Heidelberg Engineering), and multifocal electroretinography (RetiScan; Roland Consult). The patient had been diagnosed with esophageal carcinoma 3 months before the onset of visual symptoms. The visual acuity was 20/40 in the right eye and 20/20 in the left eye. Bilateral patchy melanocytic proliferation was detected on ophthalmoscopy. The extent of lesions was best detected with near-infrared reflectance and near-infrared autofluorescence, whereas fundus autofluorescence and spectral domain optical coherence tomography did not reveal alterations of the outer retina or retinal pigment epithelium in this early stage of bilateral diffuse uveal melanocytic proliferation. The right eye showed in addition to the findings on the left eye choroidal folds in the fovea and an elevated lesion inferotemporal of the fovea suspicious of a choroidal metastasis. In the B-scan ultrasonography, a homogenous lesion was seen. Spectral domain optical coherence tomography demonstrated a mild accumulation of subretinal fluid adjacent to and over the choroidal metastasis. Transretinal biopsy of this elevated lesion revealed a low differentiated carcinoma of squamous epithelium, compatible with choroidal metastasis of the esophageal carcinoma. The choroidal metastasis increased within 3 months after the first visit. The

Macular autofluorescence in eyes with cystoid macula edema, detected with 488 nm-excitation but not with 580 nm-excitation.

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Bessho, Kenichiro; Gomi, Fumi; Harino, Seiyo; Sawa, Miki; Sayanagi, Kaori; Tsujikawa, Motokazu; Tano, Yasuo

2009-06-01

Fundus autofluorescence (AF) derives from lipofuscin in the retinal pigment epithelium (RPE). Because lipofuscin is a by-product of phagocytosis of photoreceptors by RPE, AF imaging is expected to describe some functional aspect of the retina. In this study we report distribution of AF in patients showing macular edema. Three eyes with diabetic macular edema (DME) and 11 with retinal vein occlusion (RVO), associated with macular edema (ME) were examined. ME was determined by standard fundus examination, fluorescein angiography (FA) and optical coherence tomography (OCT). AF was recorded using a Heidelberg confocal scanning laser ophthalmoscope (cSLO) with 488 nm laser exciter (488 nm-AF), and a conventional Topcon fundus camera with halogen lamp exciter and 580 nm band-pass filter (580 nm-AF). Color fundus picture, FA image and these two AF images were analyzed by superimposing all images. All subjects presented cystoid macular edema (CME) with petaloid pattern hyperfluorescence in FA. In 488 nm-AF, all eyes (100%) showed macular autofluorescence of a similar shape to that of the CME in FA. In contrast, in 580 nm-AF only one eye (7%) presented this corresponding petaloid-shaped autofluorescence. In all cases, peripheral retinal edemas did not show autofluorescence corresponding to the leakage in FA. In eyes with CME, analogous hyperautofluorescence to the CME was always observed in 488 nm-AF, while it was rarely observed in 580 nm-AF. Moreover, this CME hyperautofluorescence was only seen in the macular area. We hypothesize that autofluorescence from CME may be considered as a "pseudo" or "relative" autofluorescence, due to macular stretching following CME that may result in lateral displacement of macular pigments (MPs) and subsequent reduction of MPs density, as MPs block 488 nm-AF more intensely than 580 nm-AF. Although this phenomenon may not directly indicate change of RPE function, it may be used as a method to assess or track CME non-invasively.

Hybrid rendering of the chest and virtual bronchoscopy [corrected].

Science.gov (United States)

Seemann, M D; Seemann, O; Luboldt, W; Gebicke, K; Prime, G; Claussen, C D

2000-10-30

Thin-section spiral computed tomography was used to acquire the volume data sets of the thorax. The tracheobronchial system and pathological changes of the chest were visualized using a color-coded surface rendering method. The structures of interest were then superimposed on a volume rendering of the other thoracic structures, thus producing a hybrid rendering. The hybrid rendering technique exploit the advantages of both rendering methods and enable virtual bronchoscopic examinations using different representation models. Virtual bronchoscopic examinations with a transparent color-coded shaded-surface model enables the simultaneous visualization of both the airways and the adjacent structures behind of the tracheobronchial wall and therefore, offers a practical alternative to fiberoptic bronchoscopy. Hybrid rendering and virtual endoscopy obviate the need for time consuming detailed analysis and presentation of axial source images.

COMPARISON STUDY OF COUGH SUPPRESSION DURING FLEXIBLE BRONCHOSCOPY USING LOCAL ANAESTHESIA IN DIFFERENT TECHNIQUES- (10% LIGNOCAINE SPRAY + 2% LIGNOCAINE AS YOU GO VERSUS (4% LIGNOCAINE NEBULISATION + 2% LIGNOCAINE AS YOU GO

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Koushik Muthu Raja Mathivanan

2017-08-01

Full Text Available BACKGROUND Anaesthesia for bronchoscopy poses unique challenges for the pulmonologist. By definition, bronchoscopy is an endoscopic technique to visualise the inside of the airways, it is a pivotal diagnostic and therapeutic tool in Pulmonary Medicine. Rigid bronchoscopy is usually done for diagnosis and treatment of intra and/or extra luminal obstruction in the airway for adults and children. With the development of fibreoptic and advanced electronic technology, the flexible bronchoscope has replaced the rigid bronchoscope for most diagnostic and some therapeutic indications. Rigid bronchoscopy requires general anaesthesia, however, flexible bronchoscopy can be performed with conscious sedation supplemented with local anaesthesia. The aim of the study is to- 1. Assess the effect of local anaesthesia on cough suppression during flexible bronchoscopy, when given by two different methods. 2. Compare the degree of cough and patient comfort while using “10% lignocaine spray + 2% lignocaine as you go technique, versus 4% lignocaine nebulisation + 2% lignocaine as you go technique.” MATERIALS AND METHODS It is a prospective study done on 50 consecutive patients undergoing diagnostic flexible bronchoscopy from December 2016 to February 2017. The study groups were assembled by block randomisation technique to receive lignocaine (local anaesthesia as either “as you go” and “spray” or “as you go” and “nebulisation”. Institutional Ethics Committee clearance was obtained prior to commencement of the study. RESULTS The study involving 50 patients and statistical analysis illustrated that in 2% lignocaine as you go + 10% lignocaine spray “no cough” and “mild cough” is 18 out of sample 25, which is 72%. Hence, “10% lignocaine spray + 2% lignocaine as you go” is better than “4% lignocaine nebulisation + 2% lignocaine as you go” technique. There was no significant arrhythmias in any of the patients. The dose of lidocaine is

Imaging of Neuronal Activity in Awake Mice by Measurements of Flavoprotein Autofluorescence Corrected for Cerebral Blood Flow.

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Takahashi, Manami; Urushihata, Takuya; Takuwa, Hiroyuki; Sakata, Kazumi; Takado, Yuhei; Shimizu, Eiji; Suhara, Tetsuya; Higuchi, Makoto; Ito, Hiroshi

2017-01-01

Green fluorescence imaging (e.g., flavoprotein autofluorescence imaging, FAI) can be used to measure neuronal activity and oxygen metabolism in living brains without expressing fluorescence proteins. It is useful for understanding the mechanism of various brain functions and their abnormalities in age-related brain diseases. However, hemoglobin in cerebral blood vessels absorbs green fluorescence, hampering accurate assessments of brain function in animal models with cerebral blood vessel dysfunctions and subsequent cerebral blood flow (CBF) alterations. In the present study, we developed a new method to correct FAI signals for hemoglobin-dependent green fluorescence reductions by simultaneous measurements of green fluorescence and intrinsic optical signals. Intrinsic optical imaging enabled evaluations of light absorption and scatters by hemoglobin, which could then be applied to corrections of green fluorescence intensities. Using this method, enhanced flavoprotein autofluorescence by sensory stimuli was successfully detected in the brains of awake mice, despite increases of CBF, and hemoglobin interference. Moreover, flavoprotein autofluorescence could be properly quantified in a resting state and during sensory stimulation by a CO 2 inhalation challenge, which modified vascular responses without overtly affecting neuronal activities. The flavoprotein autofluorescence signal data obtained here were in good agreement with the previous findings from a condition with drug-induced blockade of cerebral vasodilation, justifying the current assaying methodology. Application of this technology to studies on animal models of brain diseases with possible changes of CBF, including age-related neurological disorders, would provide better understanding of the mechanisms of neurovascular coupling in pathological circumstances.

Repeated Bronchoscopy - Treatment of Severe Respiratory Failure in a Fire Victim

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Petris Ovidiu Rusalim

2017-10-01

Full Text Available A case of respiratory failure in a domestic fire victim presenting with 1-3-degree skin burns on 10% of the total body surface, is reported. Forty-eight hours after admission to hospital, the patient developed severe respiratory failure that did not respond to mechanical ventilation. Severe obstruction of the airway had resulted from secretions and deposits of soot forming bronchial casts. The patient required repeated bronchoscopies to separate and remove the bronchial secretions and soot deposits. An emergency bronchial endoscopic exam was crucial in the patient’s survival and management. The patient was discharged from the hospital after twenty-four days.

Fibreoptic bronchoscopy without sedation: Is transcricoid injection better than the "spray as you go" technique?

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Alka Chandra

2011-01-01

Full Text Available Aim: The aim of the study was to compare transcricoid injection with "spray as you go" technique for diagnostic fibreoptic bronchoscopy, to perform the procedure without sedation and to record any complication or side effects. Methods: Sixty patients belonging to the age group 20-70 years, undergoing diagnostic bronchoscopy over a period of 6 months, were randomly selected and divided into two groups alternatively to receive 3 ml of 4% lignocaine by a single transcricoid puncture (group I or 2 ml of 4% lignocaine instilled through the bronchoscope on to the vocal cords and further 1 ml of 2% lignocaine into each main bronchus (group II. Additional dose of lignocaine as required was given in both the groups. All patients were given intramuscular atropine 0.6 mg, 20 min before the procedure. Nebulisation with 3 ml of 4% lignocaine was given to all patients. The time from nasal insertion of the bronchoscope to reach the carina was recorded, and the total dose of lignocaine required in both the groups was calculated and compared. The cough episodes during the procedure, systolic blood pressure, and pulse rate were compared before the procedure and 5 min after the procedure in both the groups. A 0-10 visual analogue scale (VAS was used to assess discomfort 30 min after the procedure. Results: The time to reach carina was more in group II (P<0.02, and cough episodes were also more in group II (P<0.05 than in group I. The vitals before the procedure were comparable in both the groups, but 5 min after the procedure the vitals were more stable in group I than in group II, and the total dose of lignocaine required in group II was more than in group I (P<0.001. However, the VAS score was comparable in both the groups. Conclusion: Transcricoid puncture for diagnostic bronchoscopies without sedation was associated with no complication and discomfort and required lesser dose of local anaesthetic with more stable vitals and good conditions for bronchoscopists.

In vivo optical imaging of amblyopia: Digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography.

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Guo, Lei; Tao, Jun; Xia, Fan; Yang, Zhi; Ma, Xiaoli; Hua, Rui

2016-09-01

Amblyopia is a visual impairment that is attributed to either abnormal binocular interactions or visual deprivation. The retina and choroids have been shown to be involved in the development of amblyopia. The purpose of this study was to investigate the retinal and choroidal microstructural abnormalities of amblyopia using digital subtraction autofluorescence and split-spectrum amplitude-decorrelation angiography (SSADA) approaches. This prospective study included 44 eyes of 22 patients with unilateral amblyopia. All patients who received indirect ophthalmoscopy, combined depth imaging spectral domain optical coherence tomography (OCT), SSADA-OCT, and macular blue light (BL-) and near-infrared (NIR-) autofluorescences underwent pupil dilation. The subfoveal choroidal thickness (SFCT) was measured. BL- and NIR-autofluorescences were determined for all patients and used to generate subtraction images with ImageJ software. The superficial, deep layers of the retina, and inner choroid layer were required for SSADA-OCT. For the normal eyes, a regularly increasing signal was observed in the central macula based on the subtraction images. In contrast, a decreased signal for the central patch or a reduced peak was detected in 16 of 22 amblyopic eyes (72.7%). The mean SFCT of the amblyopic eyes was greater than that of the fellow normal eyes (399.25 ± 4.944 µm vs. 280.58 ± 6.491 µm, respectively, P autofluorescence. The mechanistic relationship of a thicker choroid and choroidal capillary atrophy with amblyopia remains to be described. The digital subtraction image confirmed the changes in the microstructure of the amblyopic retina as a supplementary approach to detect the progression of amblyopia. Lasers Surg. Med. 48:660-667, 2016. © 2016 Wiley Periodicals, Inc. © 2016 Wiley Periodicals, Inc.

Efficient simulation of autofluorescence effects in microscopic lenses

DEFF Research Database (Denmark)

Gross, Herbert; Rodenko, Olga; Esslinger, Moritz

2015-01-01

The use of fluorescence in microscopy is a well known technology today. Due to the autofluorescence of the materials of the optical system components, the contrast of the images is degraded. The calculation of autofluorescense usually is performed by brute force methods as volume scattering...... of the domains are determined by simple tracing of the limiting rays of the light cone of the source as well as the pixel area under consideration. The small overlap of both domains can be estimated by geometrical considerations. The correct photometric scaling and the discretization of the volumes must...

Skin Autofluorescence Based Decision Tree in Detection of Impaired Glucose Tolerance and Diabetes

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Smit, Andries J.; Smit, Jitske M.; Botterblom, Gijs J.; Mulder, Douwe

2013-01-01

Aim: Diabetes (DM) and impaired glucose tolerance (IGT) detection are conventionally based on glycemic criteria. Skin autofluorescence (SAF) is a noninvasive proxy of tissue accumulation of advanced glycation endproducts (AGE) which are considered to be a carrier of glycometabolic memory. We

Selection/extraction of spectral regions for autofluorescence spectra measured in the oral cavity

NARCIS (Netherlands)

Skurichina, M; Paclik, P; Duin, RPW; de Veld, D; Sterenborg, HJCM; Witjes, MJH; Roodenburg, JLN; Fred, A; Caelli, T; Duin, RPW; Campilho, A; DeRidder, D

2004-01-01

Recently a number of successful algorithms to select/extract discriminative spectral regions was introduced. These methods may be more beneficial than the standard feature selection/extraction methods for spectral classification. In this paper, on the example of autofluorescence spectra measured in

Spectral autofluorescence imaging of the retina for drusen detection

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Foubister, James J.; Gorman, Alistair; Harvey, Andy; Hemert, Jano van

2018-02-01

The presence and characteristics of drusen in retinal images, namely their size, location, and distribution, can be used to aid in the diagnosis and monitoring of Age Related Macular Degeneration (AMD); one of the leading causes for blindness in the elderly population. Current imaging techniques are effective at determining the presence and number of drusen, but fail when it comes to classifying their size and form. These distinctions are important for correctly characterising the disease, especially in the early stages where the development of just one larger drusen can indicate progression. Another challenge for automated detection is in distinguishing them from other retinal features, such as cotton wool spots. We describe the development of a multi-spectral scanning-laser ophthalmoscope that records images of retinal autofluorescence (AF) in four spectral bands. This will offer the potential to detect drusen with improved contrast based on spectral discrimination for automated classification. The resulting improved specificity and sensitivity for their detection offers more reliable characterisation of AMD. We present proof of principle images prior to further system optimisation and clinical trials for assessment of enhanced detection of drusen.

Multi-color autofluorescence and scattering spectroscopy provides rapid assessment of kidney function following ischemic injury

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Raman, Rajesh N.; Pivetti, Chris D.; Ramsamooj, Rajendra; Troppmann, Christoph; Demos, Stavros G.

2018-02-01

A major source of kidneys for transplant comes from deceased donors whose tissues have suffered an unknown amount of warm ischemia prior to retrieval, with no quantitative means to assess function before transplant. Toward addressing this need, non-contact monitoring of optical signatures in rat kidneys was performed in vivo during ischemia and reperfusion. Kidney autofluorescence images were captured under ultraviolet illumination (355 nm, 325 nm, and 266 nm) in order to provide information on related metabolic and non-metabolic response. In addition, light scattering images under 355 nm, 325 nm, and 266 nm, 500 nm illumination were monitored to report on changes in kidney optical properties giving rise to the observed autofluorescence signals during these processes. During reperfusion, various signal ratios were generated from the recorded signals and then parametrized. Time-dependent parameters derived from the ratio of autofluorescence under 355 nm excitation to that under 266 nm excitation, as well as from 500 nm scattered signal, were found capable of discriminating dysfunctional kidneys from those that were functional (p Kidney dysfunction was confirmed by subsequent survival study and histology following autopsy up to a week later. Physiologic changes potentially giving rise to the observed signals, including those in cellular metabolism, vascular response, tissue microstructure, and microenvironment chemistry, are discussed.

Wide-field spectral imaging of human ovary autofluorescence and oncologic diagnosis via previously collected probe data

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Renkoski, Timothy E.; Hatch, Kenneth D.; Utzinger, Urs

2012-03-01

With no sufficient screening test for ovarian cancer, a method to evaluate the ovarian disease state quickly and nondestructively is needed. The authors have applied a wide-field spectral imager to freshly resected ovaries of 30 human patients in a study believed to be the first of its magnitude. Endogenous fluorescence was excited with 365-nm light and imaged in eight emission bands collectively covering the 400- to 640-nm range. Linear discriminant analysis was used to classify all image pixels and generate diagnostic maps of the ovaries. Training the classifier with previously collected single-point autofluorescence measurements of a spectroscopic probe enabled this novel classification. The process by which probe-collected spectra were transformed for comparison with imager spectra is described. Sensitivity of 100% and specificity of 51% were obtained in classifying normal and cancerous ovaries using autofluorescence data alone. Specificity increased to 69% when autofluorescence data were divided by green reflectance data to correct for spatial variation in tissue absorption properties. Benign neoplasm ovaries were also found to classify as nonmalignant using the same algorithm. Although applied ex vivo, the method described here appears useful for quick assessment of cancer presence in the human ovary.

Intraretinal Correlates of Reticular Pseudodrusen Revealed by Autofluorescence and En Face OCT.

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Paavo, Maarjaliis; Lee, Winston; Merriam, John; Bearelly, Srilaxmi; Tsang, Stephen; Chang, Stanley; Sparrow, Janet R

2017-09-01

We sought to determine whether information revealed from the reflectance, autofluorescence, and absorption properties of RPE cells situated posterior to reticular pseudodrusen (RPD) could provide insight into the origins and structure of RPD. RPD were studied qualitatively by near-infrared fundus autofluorescence (NIR-AF), short-wavelength fundus autofluorescence (SW-AF), and infrared reflectance (IR-R) images, and the presentation was compared to horizontal and en face spectral domain optical coherence tomographic (SD-OCT) images. Images were acquired from 23 patients (39 eyes) diagnosed with RPD (mean age 80.7 ± 7.1 [SD]; 16 female; 4 Hispanics, 19 non-Hispanic whites). In SW-AF, NIR-AF, and IR-R images, fundus RPD were recognized as interlacing networks of small scale variations in IR-R and fluorescence (SW-AF, NIR-AF) intensities. Darkened foci of RPD colocalized in SW-AF and NIR-AF images, and in SD-OCT images corresponded to disturbances of the interdigitation (IZ) and ellipsoid (EZ) zones and to more pronounced hyperreflective lesions traversing photoreceptor-attributable bands in SD-OCT images. Qualitative assessment of the outer nuclear layer (ONL) revealed thinning as RPD extended radially from the outer to inner retina. In en face OCT, hyperreflective areas in the EZ band correlated topographically with hyporeflective foci at the level of the RPE. The hyperreflective lesions corresponding to RPD in SD-OCT scans are likely indicative of degenerating photoreceptor cells. The darkened foci at positions of RPD in NIR-AF and en face OCT images indicate changes in the RPE monolayer with the reduced NIR-AF and en face OCT signal suggesting a reduction in melanin that could be accounted for by RPE thinning.

Characterization of porcine eyes based on autofluorescence lifetime imaging

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Batista, Ana; Breunig, Hans Georg; Uchugonova, Aisada; Morgado, António Miguel; König, Karsten

2015-03-01

Multiphoton microscopy is a non-invasive imaging technique with ideal characteristics for biological applications. In this study, we propose to characterize three major structures of the porcine eye, the cornea, crystalline lens, and retina using two-photon excitation fluorescence lifetime imaging microscopy (2PE-FLIM). Samples were imaged using a laser-scanning microscope, consisting of a broadband sub-15 femtosecond (fs) near-infrared laser. Signal detection was performed using a 16-channel photomultiplier tube (PMT) detector (PML-16PMT). Therefore, spectral analysis of the fluorescence lifetime data was possible. To ensure a correct spectral analysis of the autofluorescence lifetime data, the spectra of the individual endogenous fluorophores were acquired with the 16-channel PMT and with a spectrometer. All experiments were performed within 12h of the porcine eye enucleation. We were able to image the cornea, crystalline lens, and retina at multiple depths. Discrimination of each structure based on their autofluorescence intensity and lifetimes was possible. Furthermore, discrimination between different layers of the same structure was also possible. To the best of our knowledge, this was the first time that 2PE-FLIM was used for porcine lens imaging and layer discrimination. With this study we further demonstrated the feasibility of 2PE-FLIM to image and differentiate three of the main components of the eye and its potential as an ophthalmologic technique.

Possible role for fundus autofluorescence as a predictive factor for visual acuity recovery after epiretinal membrane surgery.

Science.gov (United States)

Brito, Pedro N; Gomes, Nuno L; Vieira, Marco P; Faria, Pedro A; Fernandes, Augusto V; Rocha-Sousa, Amândio; Falcão-Reis, Fernando

2014-02-01

To study the potential association between fundus autofluorescence, spectral-domain optical coherence tomography, and visual acuity in patients undergoing surgery because of epiretinal membranes. Prospective, interventional case series including 26 patients submitted to vitrectomy because of symptomatic epiretinal membranes. Preoperative evaluation consisted of a complete ophthalmologic examination, autofluorescence, and spectral-domain optical coherence tomography. Studied variables included foveal autofluorescence (fov.AF), photoreceptor inner segment/outer segment (IS/OS) junction line integrity, external limiting membrane integrity, central foveal thickness, and foveal morphology. All examinations were repeated at the first, third, and sixth postoperative months. The main outcome measures were logarithm of minimal angle resolution visual acuity, fov.AF integrity, and IS/OS integrity. All cases showing a continuous IS/OS line had an intact fov.AF, whereas patients with IS/OS disruption could have either an increased area of foveal hypoautofluorescence or an intact fov.AF, with the latter being associated with IS/OS integrity recovery in follow-up spectral-domain optical coherence tomography imaging. The only preoperative variables presenting a significant correlation with final visual acuity were baseline visual acuity (P = 0.047) and fov.AF grade (P = 0.023). Recovery of IS/OS line integrity after surgery, in patients with preoperative IS/OS disruption and normal fov.AF, can be explained by the presence of a functional retinal pigment epithelium-photoreceptor complex, supporting normal photoreceptor activity. Autofluorescence imaging provides a functional component to the study of epiretinal membranes, complementing the structural information obtained with optical coherence tomography.

Imaging of Neuronal Activity in Awake Mice by Measurements of Flavoprotein Autofluorescence Corrected for Cerebral Blood Flow

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Manami Takahashi

2018-01-01

Full Text Available Green fluorescence imaging (e.g., flavoprotein autofluorescence imaging, FAI can be used to measure neuronal activity and oxygen metabolism in living brains without expressing fluorescence proteins. It is useful for understanding the mechanism of various brain functions and their abnormalities in age-related brain diseases. However, hemoglobin in cerebral blood vessels absorbs green fluorescence, hampering accurate assessments of brain function in animal models with cerebral blood vessel dysfunctions and subsequent cerebral blood flow (CBF alterations. In the present study, we developed a new method to correct FAI signals for hemoglobin-dependent green fluorescence reductions by simultaneous measurements of green fluorescence and intrinsic optical signals. Intrinsic optical imaging enabled evaluations of light absorption and scatters by hemoglobin, which could then be applied to corrections of green fluorescence intensities. Using this method, enhanced flavoprotein autofluorescence by sensory stimuli was successfully detected in the brains of awake mice, despite increases of CBF, and hemoglobin interference. Moreover, flavoprotein autofluorescence could be properly quantified in a resting state and during sensory stimulation by a CO2 inhalation challenge, which modified vascular responses without overtly affecting neuronal activities. The flavoprotein autofluorescence signal data obtained here were in good agreement with the previous findings from a condition with drug-induced blockade of cerebral vasodilation, justifying the current assaying methodology. Application of this technology to studies on animal models of brain diseases with possible changes of CBF, including age-related neurological disorders, would provide better understanding of the mechanisms of neurovascular coupling in pathological circumstances.

Utility of multidetector row computed tomography and virtual bronchoscopy in evaluation of hemoptysis due to lung cancer

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Sherif A.A. Mohamed

2016-01-01

Conclusion: MDCT angiography is a useful and non invasive method that allows a rapid and detailed identification of abnormal vasculature responsible for hemoptysis in patients with lung cancer. MDCT-generated virtual bronchoscopy is an accurate, and non invasive method for evaluating obstructions, endoluminal masses, and external compressions in patients with hemoptysis due to lung cancer.

Evaluation of the contribution of the renal capsule and cortex to kidney autofluorescence intensity under ultraviolet excitation

Energy Technology Data Exchange (ETDEWEB)

Raman, R N; Pivetti, C D; Rubenchik, A M; Matthews, D L; Troppmann, C; Demos, S G

2008-12-12

The use of reduced nicotinamide adenine dinucleotide (NADH) fluorescence to gain metabolic information on kidneys in response to an alteration in oxygen availability has previously been experimentally demonstrated, but signal quantification has not to date been addressed. In this work the relative contribution to rat kidney autofluorescence of the capsule vs. cortex under ultraviolet excitation is determined from experimental results obtained using autofluorescence microscopy and a suitable mathematical model. The results allow for a quantitative assessment of the relative contribution of the signal originating in the metabolically active cortex as a function of capsule thickness for different wavelengths.

Optimized endoscopic autofluorescence spectroscopy for the identification of premalignant lesions in Barrett's oesophagus.

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Holz, Jasmin A; Boerwinkel, David F; Meijer, Sybren L; Visser, Mike; van Leeuwen, Ton G; Aalders, Maurice C G; Bergman, Jacques J G H M

2013-12-01

Fluorescence spectroscopy has the potential to detect early cellular changes in Barrett's oesophagus before these become visible. As the technique is based on varying concentrations of intrinsic fluorophores, each with its own optimal excitation wavelength, it is important to assess the optimal excitation wavelength(s) for identification of premalignant lesions in patients with Barrett's oesophagus. The endoscopic spectroscopy system used contained five (ultra)violet light sources (λexc=369-416 nm) to generate autofluorescence during routine endoscopic surveillance. Autofluorescence spectroscopy was followed by a biopsy for histological assessment and spectra correlation. Three intensity ratios (r1, r2, r3) were calculated by dividing the area, A, under the spectral curve of selected emission wavelength ranges for each spectrum generated by each excitation wavelength λexc as follows (Equation is included in full-text article.). Double intensity ratios were calculated using two excitation wavelengths. Fifty-eight tissue areas from 22 patients were used for autofluorescence spectra analysis. Excitation with 395, 405 or 410 nm showed a significant (P≤0.0006) differentiation between intestinal metaplasia and grouped high-grade dysplasia/early carcinoma for intensity ratios r2 and r3. A sensitivity of 80.0% and specificity of 89.5% with an area under the ROC curve of 0.85 was achieved using 395 nm excitation and intensity ratio r3. Double excitation showed no additional value over single excitation. The combination of 395 nm excitation and intensity ratio r3 showed optimal conditions to discriminate nondysplastic from early neoplasia in Barrett's oesophagus.

Hyperspectral laser-induced autofluorescence imaging of dental caries

Science.gov (United States)

Bürmen, Miran; Fidler, Aleš; Pernuš, Franjo; Likar, Boštjan

2012-01-01

Dental caries is a disease characterized by demineralization of enamel crystals leading to the penetration of bacteria into the dentine and pulp. Early detection of enamel demineralization resulting in increased enamel porosity, commonly known as white spots, is a difficult diagnostic task. Laser induced autofluorescence was shown to be a useful method for early detection of demineralization. The existing studies involved either a single point spectroscopic measurements or imaging at a single spectral band. In the case of spectroscopic measurements, very little or no spatial information is acquired and the measured autofluorescence signal strongly depends on the position and orientation of the probe. On the other hand, single-band spectral imaging can be substantially affected by local spectral artefacts. Such effects can significantly interfere with automated methods for detection of early caries lesions. In contrast, hyperspectral imaging effectively combines the spatial information of imaging methods with the spectral information of spectroscopic methods providing excellent basis for development of robust and reliable algorithms for automated classification and analysis of hard dental tissues. In this paper, we employ 405 nm laser excitation of natural caries lesions. The fluorescence signal is acquired by a state-of-the-art hyperspectral imaging system consisting of a high-resolution acousto-optic tunable filter (AOTF) and a highly sensitive Scientific CMOS camera in the spectral range from 550 nm to 800 nm. The results are compared to the contrast obtained by near-infrared hyperspectral imaging technique employed in the existing studies on early detection of dental caries.

Fundus Autofluorescence and Spectral Domain OCT in Central Serous Chorioretinopathy

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Luiz Roisman

2011-01-01

Full Text Available Background. To describe the standard autofluorescence (FAF, the near infrared autofluorescence (NIA and optical coherence tomography (OCT patterns in central serous chorioretinopathy, correlating them with fluorescein angiography. Methods. Cross-sectional observational study, in which patients with at least seven months of CSC underwent ophthalmologic examination, fundus photography, FAF, NIA, fluorescein angiography (FA, and spectral-domain OCT. Results. Seventeen eyes of thirteen patients were included. The presentation features were a mottled hyperFAF in the detached area and areas with pigment mottling. NIA images showed areas of hyperNIA similar to FAF and localized areas of hypoNIA, which correlated with the points of leakage in the FA. OCT showed pigment epithelium detachment at the location of these hypoNIA spots. Discussion. FAF showed increased presence of fluorophores in the area of retinal detachment, which is believed to appear secondary to lipofuscin accumulation in the RPE or the presence of debris in the subretinal fluid. NIA has been related to the choroidal melanin content and there were areas of both increased and decreased NIA, which could be explained by damage ahead the retina, basically RPE and choroid. These findings, along with the PEDs found in the areas of hypoNIA, support the notion of a primary choroidal disease in CSC.

Skin Autofluorescence and Complications of Diabetes : Does Ethnic Background or Skin Color Matter?

NARCIS (Netherlands)

Ahdi, Mohamed; Gerdes, Victor E. A.; Graaff, Reindert; Kuipers, Saskia; Smit, Andries J.; Meesters, Eelco W.

2015-01-01

Aims: Skin autofluorescence (AF) has been associated with complications of diabetes. We evaluated the influence of skin color and ethnicity on the association between skin AF and the presence of diabetes-related complications. Materials and Methods: In a multiethnic type 2 diabetes cohort we

Subretinal drusenoid deposits with increased autofluorescence in eyes with reticular pseudodrusen.

Science.gov (United States)

Lee, Mee Yon; Ham, Don-Il

2014-01-01

To characterize a variant type of drusenoid deposit with different imaging features in comparison to reticular pseudodrusen. Retrospective observational consecutive case series. Eyes showing atypical drusenoid lesions were sorted out from 257 eyes of 133 patients previously diagnosed as reticular pseudodrusen. Eyes were evaluated using color fundus photography, confocal scanning laser ophthalmoscopy, and spectral domain optical coherence tomography. A variant type of drusenoid deposits showing different imaging features from reticular pseudodrusen was found in 17 eyes of 12 patients (6.6%). The mean age of patients was 62.7 ± 11.6 years, and all patients were women. These deposits were observed as yellowish white, round to oval lesions on color photographs, located under the sensory retina and above the retinal pigment epithelium on spectral domain optical coherence tomography similar to reticular pseudodrusen. However, they were present in a smaller number as discrete lesions and showed increased autofluorescence. None of them were accompanied by late age-related macular degeneration. Subretinal drusenoid deposits are not homogeneous and can be classified into two types according to the fundus autofluorescence. Multimodal imaging tests are needed for the differential diagnosis of subretinal drusenoid deposits.

Autofluorescence lifetime metrology for label-free detection of cartilage matrix degradation

Science.gov (United States)

Nickdel, Mohammad B.; Lagarto, João. L.; Kelly, Douglas J.; Manning, Hugh B.; Yamamoto, Kazuhiro; Talbot, Clifford B.; Dunsby, Christopher; French, Paul; Itoh, Yoshifumi

2014-03-01

Degradation of articular cartilage extracellular matrix (ECM) by proteolytic enzyme is the hallmark of arthritis that leads to joint destruction. Detection of early biochemical changes in cartilage before irreversible structural damages become apparent is highly desirable. Here we report that the autofluorescence decay profile of cartilage is significantly affected by proteolytic degradation of cartilage ECM and can be characterised by measurements of the autofluorescence lifetime (AFL). A multidimensional fluorometer utilizing ultraviolet excitation at 355 nm or 375 nm coupled to a fibreoptic probe was developed for single point time-resolved AFL measurements of porcine articular cartilage explants treated with different proteinases. Degradation of cartilage matrix components by treating with bacterial collagenase, matrix metalloproteinase 1, or trypsin resulted in significant reduction of AFL of the cartilage in both a dose and time dependent manner. Differences in cartilage AFL were also confirmed by fluorescence lifetime imaging microscopy (FLIM). Our data suggest that AFL of cartilage tissue is a potential non-invasive readout to monitor cartilage matrix integrity that may be utilized for diagnosis of arthritis as well as monitoring the efficacy of anti-arthritic therapeutic agents.

EVALUATION OF PATCHY ATROPHY SECONDARY TO HIGH MYOPIA BY SEMIAUTOMATED SOFTWARE FOR FUNDUS AUTOFLUORESCENCE ANALYSIS.

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Miere, Alexandra; Capuano, Vittorio; Serra, Rita; Jung, Camille; Souied, Eric; Querques, Giuseppe

2017-05-31

To evaluate the progression of patchy atrophy in high myopia using semiautomated software for fundus autofluorescence (FAF) analysis. The medical records and multimodal imaging of 21 consecutive highly myopic patients with macular chorioretinal patchy atrophy (PA) were retrospectively analyzed. All patients underwent repeated fundus autofluorescence and spectral domain optical coherence tomography over at least 12 months. Color fundus photography was also performed in a subset of patients. Total atrophy area was measured on FAF images using Region Finder semiautomated software embedded in Spectralis (Heidelberg Engineering, Heidelberg, Germany) at baseline and during follow-up visits. Region Finder was compared with manually measured PA on FAF images. Twenty-two eyes of 21 patients (14 women, 7 men; mean age 62.8 + 13.0 years, range 32-84 years) were included. Mean PA area using Region Finder was 2.77 ± 2.91 SD mm at baseline, 3.12 ± 2.68 mm at Month 6, 3.43 ± 2.68 mm at Month 12, and 3.73 ± 2.74 mm at Month 18 (overall P autofluorescence analysis by Region Finder semiautomated software provides accurate measurements of lesion area and allows us to quantify the progression of PA in high myopia. In our series, PA enlarged significantly over at least 12 months, and its progression seemed to be related to the lesion size at baseline.

A simple viability analysis for unicellular cyanobacteria using a new autofluorescence assay, automated microscopy, and ImageJ

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Schulze Katja

2011-11-01

Full Text Available Abstract Background Currently established methods to identify viable and non-viable cells of cyanobacteria are either time-consuming (eg. plating or preparation-intensive (eg. fluorescent staining. In this paper we present a new and fast viability assay for unicellular cyanobacteria, which uses red chlorophyll fluorescence and an unspecific green autofluorescence for the differentiation of viable and non-viable cells without the need of sample preparation. Results The viability assay for unicellular cyanobacteria using red and green autofluorescence was established and validated for the model organism Synechocystis sp. PCC 6803. Both autofluorescence signals could be observed simultaneously allowing a direct classification of viable and non-viable cells. The results were confirmed by plating/colony count, absorption spectra and chlorophyll measurements. The use of an automated fluorescence microscope and a novel ImageJ based image analysis plugin allow a semi-automated analysis. Conclusions The new method simplifies the process of viability analysis and allows a quick and accurate analysis. Furthermore results indicate that a combination of the new assay with absorption spectra or chlorophyll concentration measurements allows the estimation of the vitality of cells.

Autofluorescence and high-definition optical coherence tomography of retinal artery occlusions

OpenAIRE

Mathew, Raeba; Papavasileiou, Evangelia; Sivaprasad, Sobha

2010-01-01

Raeba Mathew, Evangelia Papavasileiou, Sobha SivaprasadLaser and Retinal Research Unit, Department of Ophthalmology, King’s College Hospital, Denmark Hill, London, UKBackground: The purpose of this study is to illustrate the fundus autofluorescence and high-definition optical coherence tomography (HD-OCT) features of acute and long-standing retinal artery occlusions.Design: Retrospective case series.Participants: Patients with acute and chronic retinal and cilioretinal artery occlus...

Imaging autofluorescence temporal signatures of the human ocular fundus in vivo

Science.gov (United States)

Papour, Asael; Taylor, Zachary; Stafsudd, Oscar; Tsui, Irena; Grundfest, Warren

2015-11-01

We demonstrate real-time in vivo fundus imaging capabilities of our fluorescence lifetime imaging technology for the first time. This implementation of lifetime imaging uses light emitting diodes to capture full-field images capable of showing direct tissue contrast without executing curve fitting or lifetime calculations. Preliminary results of fundus images are presented, investigating autofluorescence imaging potential of various retina biomarkers for early detection of macular diseases.

Autofluorescence imaging system to discriminate and quantify the distribution of benthic cyanobacteria and diatoms

DEFF Research Database (Denmark)

Carreira, Cátia; Staal, Marc Jaap; Middelboe, Mathias

2015-01-01

successfully to (mixed) laboratory cultures as well as natural photosynthetic microbial mats. Cultures of the diatom Nitzschia capitellata and the cyanobacterium Geitlerinema sp. showed close correlation between autofluorescence and cell abundance. This simple and cheap imaging system allows fast observations...

Skin autofluorescence is increased in patients with carotid artery stenosis and peripheral artery disease

NARCIS (Netherlands)

Noordzij, Marjon J.; Lefrandt, Joop D.; Loeffen, Erik A. H.; Saleem, Ben R.; Meerwaldt, Robbert; Lutgers, Helen L.; Smit, Andries J.; Zeebregts, Clark J.

Advanced glycation end products (AGEs) have a pivotal role in atherosclerosis. We evaluated skin autofluorescence (SAF), a non-invasive measurement of tissue AGE accumulation, in patients with carotid artery stenosis with and without coexisting peripheral artery occlusive disease (PAOD). SAF was

Quantitative analysis of myocardial tissue with digital autofluorescence microscopy

Directory of Open Access Journals (Sweden)

Thomas Jensen

2016-01-01

Full Text Available Background: The opportunity offered by whole slide scanners of automated histological analysis implies an ever increasing importance of digital pathology. To go beyond the importance of conventional pathology, however, digital pathology may need a basic histological starting point similar to that of hematoxylin and eosin staining in conventional pathology. This study presents an automated fluorescence-based microscopy approach providing highly detailed morphological data from unstained microsections. This data may provide a basic histological starting point from which further digital analysis including staining may benefit. Methods: This study explores the inherent tissue fluorescence, also known as autofluorescence, as a mean to quantitate cardiac tissue components in histological microsections. Data acquisition using a commercially available whole slide scanner and an image-based quantitation algorithm are presented. Results: It is shown that the autofluorescence intensity of unstained microsections at two different wavelengths is a suitable starting point for automated digital analysis of myocytes, fibrous tissue, lipofuscin, and the extracellular compartment. The output of the method is absolute quantitation along with accurate outlines of above-mentioned components. The digital quantitations are verified by comparison to point grid quantitations performed on the microsections after Van Gieson staining. Conclusion: The presented method is amply described as a prestain multicomponent quantitation and outlining tool for histological sections of cardiac tissue. The main perspective is the opportunity for combination with digital analysis of stained microsections, for which the method may provide an accurate digital framework.

Development of a miniature autofluorescence device for the early diagnosis of squamous cell carcinoma

Science.gov (United States)

Patil, Ajeetkumar; Rao K., Swati; V. K., Unnikrishnan; Pai, Keerthilatha M.; Kartha, V. B.; Chidangil, Santhosh

2017-07-01

Autofluorescence spectroscopy offer noninvasive and promising tools for the detection of alternations biochemical compositions of tissues and cells, in presence of disease. They have the added advantage of being highly objective due to the fact that diagnostic evaluation is by statistical methods, eliminating errors from lack of experience, fatigue factor, and subjectivity of visual perceptions. The present research work involves in designing and assembling of a low cost, miniature oral cancer screening device with for routine clinical applications. A miniature system was designed and assembled with much smaller and cost-effective components like compact light source and miniature spectrometer, in a hand-held unit configuration. The performance of the system was evaluated using animal -mouse- SCC model. The current system can be used in handheld operation, which makes it very useful for many applications like, screening of squamous cell carcinoma susceptible population.

Multidetector CT evaluation of central airways stenoses: Comparison of virtual bronchoscopy, minimal-intensity projection, and multiplanar reformatted images

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Dinesh K Sundarakumar

2011-01-01

Full Text Available Aims: To evaluate the diagnostic utility of virtual bronchoscopy, multiplanar reformatted images, and minimal-intensity projection in assessing airway stenoses. Settings and Design: It was a prospective study involving 150 patients with symptoms of major airway disease. Materials and Methods: Fifty-six patients were selected for analysis based on the detection of major airway lesions on fiber-optic bronchoscopy (FB or routine axial images. Comparisons were made between axial images, virtual bronchoscopy (VB, minimal-intensity projection (minIP, and multiplanar reformatted (MPR images using FB as the gold standard. Lesions were evaluated in terms of degree of airway narrowing, distance from carina, length of the narrowed segment and visualization of airway distal to the lesion. Results: MPR images had the highest degree of agreement with FB (Κ = 0.76 in the depiction of degree of narrowing. minIP had the least degree of agreement with FB (Κ = 0.51 in this regard. The distal visualization was best on MPR images (84.2%, followed by axial images (80.7%, whereas FB could visualize the lesions only in 45.4% of the cases. VB had the best agreement with FB in assessing the segment length (Κ = 0.62. Overall there were no statistically significant differences in the measurement of the distance from the carina in the axial, minIP, and MPR images. MPR images had the highest overall degree of confidence, namely, 70.17% (n = 40. Conclusion: Three-dimensional reconstruction techniques were found to improve lesion evaluation compared with axial images alone. The technique of MPR images was the most useful for lesion evaluation and provided additional information useful for surgical and airway interventions in tracheobronchial stenosis. minIP was useful in the overall depiction of airway anatomy.

Quantitative Fluorescence Sensing Through Highly Autofluorescent, Scattering, and Absorbing Media Using Mobile Microscopy

KAUST Repository

Gö rö cs, Zoltá n; Rivenson, Yair; Ceylan Koydemir, Hatice; Tseng, Derek; Troy, Tamara L.; Demas, Vasiliki; Ozcan, Aydogan

2016-01-01

Compact and cost-effective systems for in vivo fluorescence and near-infrared imaging in combination with activatable reporters embedded inside the skin to sample interstitial fluid or blood can enable a variety of biomedical applications. However, the strong autofluorescence of human skin creates an obstacle for fluorescence-based sensing. Here we introduce a method for quantitative fluorescence sensing through highly autofluorescent, scattering, and absorbing media. For this, we created a compact and cost-effective fluorescence microscope weighing <40 g and used it to measure various concentrations of a fluorescent dye embedded inside a tissue phantom, which was designed to mimic the optical characteristics of human skin. We used an elliptical Gaussian beam excitation to digitally separate tissue autofluorescence from target fluorescence, although they severely overlap in both space and optical spectrum. Using ∼10-fold less excitation intensity than the safety limit for skin radiation exposure, we successfully quantified the density of the embedded fluorophores by imaging the skin phantom surface and achieved a detection limit of ∼5 × 105 and ∼2.5 × 107 fluorophores within ∼0.01 μL sample volume that is positioned 0.5 and 2 mm below the phantom surface, corresponding to a concentration of 105.9 pg/mL and 5.3 ng/mL, respectively. We also confirmed that this approach can track the spatial misalignments of the mobile microscope with respect to the embedded target fluorescent volume. This wearable microscopy platform might be useful for designing implantable biochemical sensors with the capability of spatial multiplexing to continuously monitor a panel of biomarkers and chronic conditions even at patients’ home.

Quantitative Fluorescence Sensing Through Highly Autofluorescent, Scattering, and Absorbing Media Using Mobile Microscopy

KAUST Repository

Göröcs, Zoltán

2016-09-13

Compact and cost-effective systems for in vivo fluorescence and near-infrared imaging in combination with activatable reporters embedded inside the skin to sample interstitial fluid or blood can enable a variety of biomedical applications. However, the strong autofluorescence of human skin creates an obstacle for fluorescence-based sensing. Here we introduce a method for quantitative fluorescence sensing through highly autofluorescent, scattering, and absorbing media. For this, we created a compact and cost-effective fluorescence microscope weighing <40 g and used it to measure various concentrations of a fluorescent dye embedded inside a tissue phantom, which was designed to mimic the optical characteristics of human skin. We used an elliptical Gaussian beam excitation to digitally separate tissue autofluorescence from target fluorescence, although they severely overlap in both space and optical spectrum. Using ∼10-fold less excitation intensity than the safety limit for skin radiation exposure, we successfully quantified the density of the embedded fluorophores by imaging the skin phantom surface and achieved a detection limit of ∼5 × 105 and ∼2.5 × 107 fluorophores within ∼0.01 μL sample volume that is positioned 0.5 and 2 mm below the phantom surface, corresponding to a concentration of 105.9 pg/mL and 5.3 ng/mL, respectively. We also confirmed that this approach can track the spatial misalignments of the mobile microscope with respect to the embedded target fluorescent volume. This wearable microscopy platform might be useful for designing implantable biochemical sensors with the capability of spatial multiplexing to continuously monitor a panel of biomarkers and chronic conditions even at patients’ home.

An evaluation of fundus photography and fundus autofluorescence in the diagnosis of cuticular drusen

DEFF Research Database (Denmark)

Høeg, Tracy B; Moldow, Birgitte; Klein, Ronald

2016-01-01

PURPOSE: To examine non-mydriatic fundus photography (FP) and fundus autofluorescence (FAF) as alternative non-invasive imaging modalities to fluorescein angiography (FA) in the detection of cuticular drusen (CD). METHODS: Among 2953 adults from the Danish Rural Eye Study (DRES) with gradable FP...

Reduced-illuminance autofluorescence imaging in ABCA4-associated retinal degenerations

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Cideciyan, Artur V.; Swider, Malgorzata; Aleman, Tomas S.; Roman, Marisa I.; Sumaroka, Alexander; Schwartz, Sharon B.; Stone, Edwin M.; Jacobson, Samuel G.

2007-05-01

The health of the retinal pigment epithelium (RPE) can be estimated with autofluorescence (AF) imaging of lipofuscin, which accumulates as a byproduct of retinal exposure to light. Lipofuscin may be toxic to the RPE, and its toxicity may be enhanced by short-wavelength (SW) illumination. The high-intensity and SW excitation light used in conventional AF imaging could, at least in principle, increase the rate of lipofuscin accumulation and/or increase its toxicity. We considered two reduced-illuminance AF imaging (RAFI) methods as alternatives to conventional AF imaging. RAFI methods use either near-infrared (NIR) light or reduced-radiance SW illumination for excitation of fluorophores. We quantified the distribution of RAFI signals in relation to retinal structure and function in patients with the prototypical lipofuscin accumulation disease caused by mutations in ABCA4. There was evidence for two subclinical stages of macular ABCA4 disease involving hyperautofluorescence of both SW- and NIR-RAFI with and without associated loss of visual function. Use of RAFI methods and microperimetry in future clinical trials involving lipofuscinopathies should allow quantification of subclinical disease expression and progression without subjecting the diseased retina/RPE to undue light exposure.

Reliability of a two-wavelength autofluorescence technique by Heidelberg Spectralis to measure macular pigment optical density in Asian subjects.

Science.gov (United States)

Obana, Akira; Gellermann, Werner; Gohto, Yuko; Seto, Takahiko; Sasano, Hiroyuki; Tanito, Masaki; Okazaki, Shigetoshi

2018-03-01

This study evaluates the accuracy of an objective two-wavelength fundus autofluorescence technique for the purpose of measuring the macular pigment optical density (MPOD) in Asian pigmented eyes. Potential differences between MPOD values obtained via autofluorescence technique and subjective heterochromatic photometry (HFP) were examined. Inter-examiner reproducibility between three examiners and test-retest reliability over five time points were also explored. Subjects were 27 healthy Japanese volunteers aged 24 to 58 (mean ± standard deviation, 40.2 ± 9.0) years. An MPOD module of the Spectralis MultiColor instrument configuration (Spectralis-MP) was used for the autofluorescence technique, and a Macular Metrics Densitometer (MM) was used for HFP. The mean MPOD values at 0.25° and 0.5° eccentricities using the Spectralis-MP were 0.51 ± 0.12 and 0.48 ± 0.13, respectively. In comparison, the MM based values were 0.72 ± 0.23 and 0.61 ± 0.25, respectively. High correlations between the Spectralis-MP and MM instrument were found (Pearson's correlation coefficients of 0.73 and 0.87 at 0.25° and 0.5° eccentricities, respectively), but there was a systematic bias: the MPOD values by MM method were significantly higher than those by Spectralis-MP at 0.25° eccentricity. High inter-examiner reproducibility and test-retest reliability were found for MM measurements at 0.5° eccentricity, but not at 0.25°. The Spectralis-MP showed less inter-examiner and test-retest variability than the MM instrument at 0.25° and 0.5° eccentricities. We conclude that the Spectralis-MP, given its high agreement with the HFP method and due to its higher reproducibility and reliability, is well suited for clinical measurements of MPOD levels in Asian pigmented eyes. Copyright © 2018. Published by Elsevier Ltd.

Bimodal spectroscopy in elastic scattering and spatially resolved auto-fluorescence: instrumentation, light-tissues interaction modeling and application to ex vivo and in vivo biological tissues characterization for cancers detection

International Nuclear Information System (INIS)

Pery, Emilie

2007-01-01

This research activity aims at developing and validating a multimodal spectroscopy method in elastic scattering and auto-fluorescence to characterize biological tissues in vitro and in vivo. It is articulated in four axes. At first, instrumentation is considered with the development, the engineering and the experimental characterization of a fibers bimodal, multi-points spectrometry system allowing the acquisition of spectra in vivo (variable distances, fast acquisition). Secondly, the optical properties of tissues are modelled with the development and the experimental validation on phantoms of a photons propagation simulation algorithm in turbid media and multi-fluorescent. Thirdly, an experimental study has been conducted ex vivo on fresh and cryo-preserved arterial rings. It confirms the complementarity of spectroscopic measurements in elastic scattering and auto-fluorescence, and validates the method of multi-modality spectroscopy and the simulation of photons propagation algorithm. Results have well proved a correlation between rheological and optical properties. Finally, one second experimental study in vivo related to a pre-clinical tumoral model of bladder has been carried out. It highlights a significant difference in diffuse reflectance and/or auto-fluorescence and/or intrinsic fluorescence between healthy, inflammatory and tumoral tissues, on the basis of specific wavelength. The results of not supervised classification show that the combination of various spectroscopic approaches increases the reliability of the diagnosis. (author) [fr

Two-Photon Autofluorescence Imaging Reveals Cellular Structures Throughout the Retina of the Living Primate Eye.

Science.gov (United States)

Sharma, Robin; Williams, David R; Palczewska, Grazyna; Palczewski, Krzysztof; Hunter, Jennifer J

2016-02-01

Although extrinsic fluorophores can be introduced to label specific cell types in the retina, endogenous fluorophores, such as NAD(P)H, FAD, collagen, and others, are present in all retinal layers. These molecules are a potential source of optical contrast and can enable noninvasive visualization of all cellular layers. We used a two-photon fluorescence adaptive optics scanning light ophthalmoscope (TPF-AOSLO) to explore the native autofluorescence of various cell classes spanning several layers in the unlabeled retina of a living primate eye. Three macaques were imaged on separate occasions using a custom TPF-AOSLO. Two-photon fluorescence was evoked by pulsed light at 730 and 920 nm excitation wavelengths, while fluorescence emission was collected in the visible range from several retinal layers and different locations. Backscattered light was recorded simultaneously in confocal modality and images were postprocessed to remove eye motion. All retinal layers yielded two-photon signals and the heterogeneous distribution of fluorophores provided optical contrast. Several structural features were observed, such as autofluorescence from vessel walls, Müller cell processes in the nerve fibers, mosaics of cells in the ganglion cell and other nuclear layers of the inner retina, as well as photoreceptor and RPE layers in the outer retina. This in vivo survey of two-photon autofluorescence throughout the primate retina demonstrates a wider variety of structural detail in the living eye than is available through conventional imaging methods, and broadens the use of two-photon imaging of normal and diseased eyes.

Enhancing analysis of cells and proteins by fluorescence imaging on silk-based biomaterials: modulating the autofluorescence of silk.

Science.gov (United States)

Neo, Puay Yong; Tan, Daryl Jian-An; Shi, Pujiang; Toh, Siew Lok; Goh, James Cho-Hong

2015-02-01

Silk is a versatile and established biomaterial for various tissue engineering purposes. However, it also exhibits strong autofluorescence signals-thereby hindering fluorescence imaging analysis of cells and proteins on silk-derived biomaterials. Sudan Black B (SB) is a lysochrome dye commonly used to stain lipids in histology. It has also been reported to be able to quench autofluorescence of tissues in histology and has been tested on artificial biomedical polymers in recent years. It was hypothesized that SB would exert similar quenching effects on silk, modulating the autofluorescence signals, and thereby enabling improved imaging analysis of cells and molecules of interests. The quenching effect of SB on the intrinsic fluorescence properties of silk and on commercial fluorescent dyes were first investigated in this study. SB was then incorporated into typical fluorescence-based staining protocols to study its effectiveness in improving fluorescence-based imaging of the cells and proteins residing with the silk-based biomaterials. Silk processed into various forms of biomaterials (e.g., films, sponges, fibers, and electrospun mats) was seeded with cells and cultured in vitro. At sacrificial time points, specimens were harvested, fixed, and prepared for fluorescence staining. SB, available commercially as a powder, was dissolved in 70% ethanol (0.3% [w/v]) to form staining solutions. SB treatment was introduced at the last step of typical immunofluorescence staining protocols for 15-120 min. For actin staining protocols by phalloidin toxin, SB staining solutions were added before and after permeabilization with Triton-X for 15-30 min. Results showed that ideal SB treatment duration is about 15 min. Apart from being able to suppress the autofluorescence of silk, this treatment duration was also not too long to adversely affect the fluorescent labeling probes used. The relative improvement brought about by SB treatment was most evident in the blue and green

Unusual Fundus Autofluorescence Appearance in a Patient with Hydroxychloroquine Retinal Toxicity

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Sleiman Abou-Ltaif

2015-06-01

Full Text Available Purpose: To report an unusual fundus autofluorescence aspect in a patient with suspected hydroxychloroquine retinal toxicity. Method: Case report of an unusual presentation of a patient treated for 9 consecutive years with a therapeutically recommended dose of hydroxychloroquine. Result: We report the case of a 53-year-old Caucasian female treated with 400 mg hydroxychloroquine for rheumatoid arthritis over 9 years, currently on methotrexate and folinic acid, who stopped treatment 3 years ago. The cumulative dose is estimated at 1.314 kg. She recently noticed a reduction of vision in both eyes to 0.34 logMAR, with colour vision problems and major distortion in central vision. Fundus autofluorescence revealed minimal foveal pigmentary changes and more pronounced changes in the retina elsewhere. Foveal changes were confirmed by optical coherence tomography in both eyes. The patient did not report any colour perception difficulties or night vision problems and has no family history of any eye condition. Her visual field tested by an optician was full, with some central changes. Conclusion: Retinal toxicity from hydroxychloroquine can present in a different aspect than the commonly known retinal toxicity, and it happens even after years of cessation of the drug. The role of cumulative dose in toxicity is supported in this paper.

Wide-field fundus autofluorescence corresponds to visual fields in chorioretinitis patients

Directory of Open Access Journals (Sweden)

Seidensticker F

2011-11-01

Full Text Available Florian Seidensticker1, Aljoscha S Neubauer1, Tamer Wasfy1,2, Carmen Stumpf1, Stephan R Thurau1,*, Anselm Kampik1, Marcus Kernt1,*1Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany; 2Department of Ophthalmology, Tanta University, Tanta, Egypt *Both authors contributed equally to this workBackground and objectives: Detection of peripheral fundus autofluorescence (FAF using conventional scanning laser ophthalmoscopes (SLOs is difficult and requires pupil dilation. Here we evaluated the diagnostic properties of wide-field FAF detected by a two-laser wavelength wide-field SLO in uveitis patients.Study design/materials and methods: Observational case series of four patients suffering from different types of posterior uveitis/chorioretinitis. Wide-field FAF images were compared to visual fields. Panretinal FAF was detected by a newly developed SLO, which allows FAF imaging of up to 200° of the retina in one scan without the need for pupil dilation. Visual fields were obtained by Goldmann manual perimetry.Results: Findings from wide-field FAF imaging showed correspondence to visual field defects in all cases.Conclusion: Wide-field FAF allowed the detection of visual field defect-related alterations of the retinal pigment epithelium in all four uveitis cases.Keywords: fundus autofluorescence (FAF, Optomap, wide-field scanning laser ophthalmoscopy, imaging, uveitis, visual field

High-resolution optical coherence tomography, autofluorescence, and infrared reflectance imaging in Sjögren reticular dystrophy.

Science.gov (United States)

Schauwvlieghe, Pieter-Paul; Torre, Kara Della; Coppieters, Frauke; Van Hoey, Anneleen; De Baere, Elfride; De Zaeytijd, Julie; Leroy, Bart P; Brodie, Scott E

2013-01-01

To describe the phenotype of three cases of Sjögren reticular dystrophy in detail, including high-resolution optical coherence tomography, autofluorescence imaging, and near-infrared reflectance imaging. Two unrelated teenagers were independently referred for ophthalmologic evaluation. Both underwent a full ophthalmologic workup, including electrophysiologic and extensive imaging with spectral-domain optical coherence tomography, autofluorescence imaging, and near-infrared reflectance imaging. In addition, mutation screening of ABCA4, PRPH2, and the mitochondrial tRNA gene was performed in Patient 1. Subsequently, the teenage sister of Patient 2 was examined. Strikingly similar phenotypes were present in these three patients. Fundoscopy showed bilateral foveal pigment alterations, and a lobular network of deep retinal, pigmented deposits throughout the posterior pole, tapering toward the midperiphery, with relative sparing of the immediate perifoveal macula and peripapillary area. This network is mildly to moderately hyperautofluorescent on autofluorescence and bright on near-infrared reflectance imaging. Optical coherence tomography showed abnormalities of the retinal pigment epithelium-Bruch membrane complex, photoreceptor outer segments, and photoreceptor inner/outer segment interface. The results of retinal function test were entirely normal. No molecular cause was detected in Patient 1. Imaging suggested that the lobular network of deep retinal deposits in Sjögren reticular dystrophy is the result of accumulation of both pigment and lipofuscin between photoreceptors and retinal pigment epithelium, as well as within the retinal pigment epithelium.

HYPERSPECTRAL AUTOFLUORESCENCE IMAGING OF DRUSEN AND RETINAL PIGMENT EPITHELIUM IN DONOR EYES WITH AGE-RELATED MACULAR DEGENERATION.

Science.gov (United States)

Tong, Yuehong; Ben Ami, Tal; Hong, Sungmin; Heintzmann, Rainer; Gerig, Guido; Ablonczy, Zsolt; Curcio, Christine A; Ach, Thomas; Smith, R Theodore

2016-12-01

To elucidate the molecular pathogenesis of age-related macular degeneration (AMD) and interpretation of fundus autofluorescence imaging, the authors identified spectral autofluorescence characteristics of drusen and retinal pigment epithelium (RPE) in donor eyes with AMD. Macular RPE/Bruch membrane flat mounts were prepared from 5 donor eyes with AMD. In 12 locations (1-3 per eye), hyperspectral autofluorescence images in 10-nm-wavelength steps were acquired at 2 excitation wavelengths (λex 436, 480 nm). A nonnegative tensor factorization algorithm was used to recover 5 abundant emission spectra and their corresponding spatial localizations. At λex 436 nm, the authors consistently localized a novel spectrum (SDr) with a peak emission near 510 nm in drusen and sub-RPE deposits. Abundant emission spectra seen previously (S0 in Bruch membrane and S1, S2, and S3 in RPE lipofuscin/melanolipofuscin, respectively) also appeared in AMD eyes, with the same shapes and peak wavelengths as in normal tissue. Lipofuscin/melanolipofuscin spectra localizations in AMD eyes varied widely in their overlap with drusen, ranging from none to complete. An emission spectrum peaking at ∼510 nm (λex 436 nm) appears to be sensitive and specific for drusen and sub-RPE deposits. One or more abundant spectra from RPE organelles exhibit characteristic relationships with drusen.

Two-photon autofluorescence/FLIM/SHG endoscopy to study the oral cavity and wound healing in humans (Conference Presentation)

Science.gov (United States)

König, Karsten

2016-03-01

Monitoring the oral cavity noninvasively with superior 3D resolution is realized by clinical multiphoton tomography and high NA two-photon endoscopy without the need of additional contrast agents. The technology behind this investigation is based on nonlinear optical contrast of the multiphoton tomograph MPTflex®. Furthermore, the miniaturized GRIN endoscope was used to realize more accessibility for more demanding wound conditions in skin. The MPTflex® distinguishes autofluorescence (AF) signals from second harmonic generation (SHG) signals simultaneously. Fluorescence lifetime imaging (FLIM) based on time correlated single photon counting (TCSPC) technology offers additional information on the functional level of the intratissue fluorophores, their binding status, and the contribution of SHG signals in chronic wounds.

Therapeutic bronchoscopy in a child with sand aspiration and respiratory failure from near drowning--case report and literature review.

Science.gov (United States)

Kapur, N; Slater, A; McEniery, J; Greer, M L; Masters, I B; Chang, A B

2009-10-01

Foreign matter aspiration occurs relatively commonly in drowning and near-drowning events. In most cases, stomach contents are aspirated. Sand aspiration rarely occurs and there are no reported cases in children with near drowning. Limited data are available on clinical presentation and management of sand aspiration with accidental burial. We report a 3-year-old boy who nearly drowned while swimming in brackish waters and was found face down in sand. Sand aspiration was suspected when the child continued to have persistent wheezing and high ventilatory requirement despite intensive bronchodilator and corticosteroids therapy with an inability to wean after 4 days post-near-drowning event. Radiology was non-specific in the absence of sand bronchogram. Presence of sand in the airways was confirmed when a bronchoscopy was undertaken and sand seen in the bronchoalveolar lavage fluid. Sequential lung washing followed by exogenous surfactant administration (3 ml/kg) was undertaken and lead to significant improvement such that within 12 hr post-therapeutic lavage, his ventilatory requirements reduced substantially. The child was extubated 4 days post-lavage and on review 2 months post-event, was clinically well with airway resistance within normal predicted values measured on forced oscillatory spirometry (IOS).

Utilization of low-dose multidetector CT and virtual bronchoscopy in children with suspected foreign body aspiration

International Nuclear Information System (INIS)

Adaletli, Ibrahim; Kurugoglu, Sebuh; Ulus, Sila; Ozer, Harun; Kantarci, Fatih; Mihmanli, Ismail; Akman, Canan; Elicevik, Mehmet

2007-01-01

Foreign body aspiration is common in children, especially those under 3 years of age. Chest radiography and CT are the main imaging modalities for the evaluation of these children. Management of children with suspected foreign body aspiration (SFBA) mainly depends on radiological findings. To investigate the potential use of low-dose multidetector CT (MDCT) and virtual bronchoscopy (VB) in the evaluation and management of SFBA in children. Included in the study were 37 children (17 girls, 20 boys; age 4 months to 10 years, mean 32 months) with SFBA. Chest radiographs were obtained prior to MDCT in all patients. MDCT was performed using a low-dose technique. VB images were obtained in the same session. Conventional bronchoscopy (CB) was performed within 24 h on patients in whom an obstructive abnormality had been found by MDCT and VB. Obstructive pathology was found in 16 (43.25%) of the 37 patients using MDCT and VB. In 13 of these patients, foreign bodies were detected and removed via CB. The foreign bodies were located in the right main bronchus (n = 5), in the bronchus intermedius (n = 6), in the medial segment of the middle lobe bronchus (n = 1), and in the left main bronchus (n = 1). In the remaining three patients, the diagnosis was false-positive for an obstructive pathology by MDCT and VB; the final diagnoses were secretions (n = 2) and schwannoma (n = 1), as demonstrated by CB. In 21 patients in whom no obstructive pathology was detected by MDCT and VB, CB was not performed. These patients were followed for 5-20 months without any recurrent obstructive symptomatology. Low-dose MDCT and VB are non-invasive radiological modalities that can be used easily in the investigation of SFBA in children. MDCT and VB provide the exact location of the obstructive pathology prior to CB. If obstructive pathology is depicted with MDCT and VB, CB should be performed either for confirmation of the diagnosis or for the diagnosis of an alternative cause for the obstruction

Effect of pharmacologically induced retinal degeneration on retinal autofluorescence lifetimes in mice.

Science.gov (United States)

Dysli, Chantal; Dysli, Muriel; Zinkernagel, Martin S; Enzmann, Volker

2016-12-01

Fluorescence lifetime imaging ophthalmoscopy (FLIO) was used to investigate retinal autofluorescence lifetimes in mouse models of pharmacologically induced retinal degeneration over time. Sodium iodate (NaIO 3 , 35 mg/kg intravenously) was used to induce retinal pigment epithelium (RPE) degeneration with subsequent loss of photoreceptors (PR) whereas N-methyl-N-nitrosourea (MNU, 45 mg/kg intraperitoneally) was employed for degeneration of the photoreceptor cell layer alone. All mice were measured at day 3, 7, 14, and 28 after the respective injection of NaIO 3 , MNU or NaCl (control). Fluorescence lifetime imaging was performed using a fluorescence lifetime imaging ophthalmoscope (Heidelberg Engineering, Heidelberg, Germany). Fluorescence was excited at 473 nm and fluorescence lifetimes were measured in a short and a long spectral channel (498-560 nm and 560-720 nm). Corresponding optical coherence tomography (OCT) images were consecutively acquired and histology was performed at the end of the experiments. Segmentation of OCT images and histology verified the cell type-specific degeneration process over time. Retinal autofluorescence lifetimes increased from day 3 to day 28 in mice after NaIO 3 treatment. Finally, at day 28, fluorescence lifetimes were prolonged by 8% in the short and 61% in the long spectral channel compared to control animals (p = 0.21 and p = 0.004, respectively). In mice after MNU treatment, the mean retinal autofluorescence lifetimes were already decreased at day 3 and retinal lifetimes were finally shortened by 27% in the short and 51% in the long spectral channel at day 28 (p = 0.0028). In conclusion, degeneration of the RPE with subsequent photoreceptor degeneration by NaIO 3 lead to longer mean fluorescence lifetimes of the retina compared to control mice, whereas during specific degeneration of the photoreceptor layer induced by MNU shorter lifetimes were measured. Therefore, short retinal fluorescence lifetimes may originate

Complementary angiographic and autofluorescence findings in pseudoxanthoma elasticum.

Science.gov (United States)

Lee, Thomas K M; Forooghian, Farzin; Cukras, Catherine; Wong, Wai T; Chew, Emily Y; Meyerle, Catherine B

2010-02-01

Pseudoxanthoma elasticum (PXE) is a systemic disease with characteristic findings on fundus examination. The fundus findings may be difficult to detect with ophthalmoscopy. A case report is described as follows. A PXE patient had subtle retinal findings on fundoscopy that were more prominently seen using a combination of both fundus autofluorescence (FAF) imaging and indocyanine green (ICG) angiography. The fundus features visualized using each of these two modalities appeared different from each other. FAF imaging and ICG angiography may be able to more prominently detect pathology at the level of the retinal pigment epithelium and Bruch's membrane, respectively. The use of these imaging modalities together may be complementary and useful in the evaluation of patients with PXE.

[Fundus autofluorescence in patients with inherited retinal diseases : Patterns of fluorescence at two different wavelengths.

NARCIS (Netherlands)

Theelen, T.; Boon, C.J.F.; Klevering, B.J.; Hoyng, C.B.

2008-01-01

BACKGROUND: Fundus autofluorescence (FAF) may be excited and measured at different wavelengths. In the present study we compared short wavelength and near-infrared FAF patterns of retinal dystrophies. METHODS: We analysed both eyes of 108 patients with diverse retinal dystrophies. Besides colour

Skin autofluorescence as a noninvasive marker of vascular damage in patients with type 2 diabetes

NARCIS (Netherlands)

Lutgers, Helen L.; Graaff, Reindert; Links, Thera P.; Ubink-Veltmaat, Lielith J.; Bilo, Henk J.; Gans, Rijk O.; Smit, Andries J.

2006-01-01

OBJECTIVE - Advanced glycation end products (AGES) are thought to have a role in the pathogenesis of diabetes complications. We recently reported the association between skin autofluorescence, as a measure of tissue AGE accumulation, and diabetic neuropathy in a selected diabetic population. In this

Physical limits to autofluorescence signals in vivo recordings in the rat olfactory bulb: a Monte Carlo study

Science.gov (United States)

L'Heureux, B.; Gurden, H.; Pinot, L.; Mastrippolito, R.; Lefebvre, F.; Lanièce, P.; Pain, F.

2007-07-01

Understanding the cellular mechanisms of energy supply to neurons following physiological activation is still challenging and has strong implications to the interpretation of clinical functional images based on metabolic signals such as Blood Oxygen Level Dependent Magnetic Resonance Imaging or 18F-Fluorodexoy-Glucose Positron Emission Tomography. Intrinsic Optical Signal Imaging provides with high spatio temporal resolution in vivo imaging in the anaesthetized rat. In that context, intrinsic signals are mainly related to changes in the optical absorption of haemoglobin depending on its oxygenation state. This technique has been validated for imaging of the rat olfactory bulb, providing with maps of the actived olfactory glomeruli, the functional modules involved in the first step of olfactory coding. A complementary approach would be autofluorescence imaging relying on the fluorescence properties of endogenous Flavin Adenine Dinucleotide (FAD) or Nicotinamide Adenine Dinucleotide (NADH) both involved in intracellular metabolic pathways. The purpose of the present study was to investigate the feasibility of in vivo autofluorescence imaging in the rat olfactory bulb. We performed standard Monte Carlo simulations of photons scattering and absorption at the excitation and emission wavelengths of FAD and NADH fluorescence. Characterization of the fluorescence distribution in the glomerulus, effect of hemoglobin absorption at the excitation and absorption wavelengths as well as the effect of the blurring due to photon scattering and the depth of focus of the optical apparatus have been studied. Finally, optimal experimental parameters are proposed to achieve in vivo validation of the technique in the rat olfactory bulb.

Anatomy and bronchoscopy of the porcine lung. A model for translational respiratory medicine.

LENUS (Irish Health Repository)

Judge, Eoin P

2014-09-01

The porcine model has contributed significantly to biomedical research over many decades. The similar size and anatomy of pig and human organs make this model particularly beneficial for translational research in areas such as medical device development, therapeutics and xenotransplantation. In recent years, a major limitation with the porcine model was overcome with the successful generation of gene-targeted pigs and the publication of the pig genome. As a result, the role of this model is likely to become even more important. For the respiratory medicine field, the similarities between pig and human lungs give the porcine model particular potential for advancing translational medicine. An increasing number of lung conditions are being studied and modeled in the pig. Genetically modified porcine models of cystic fibrosis have been generated that, unlike mouse models, develop lung disease similar to human cystic fibrosis. However, the scientific literature relating specifically to porcine lung anatomy and airway histology is limited and is largely restricted to veterinary literature and textbooks. Furthermore, methods for in vivo lung procedures in the pig are rarely described. The aims of this review are to collate the disparate literature on porcine lung anatomy, histology, and microbiology; to provide a comparison with the human lung; and to describe appropriate bronchoscopy procedures for the pig lungs to aid clinical researchers working in the area of translational respiratory medicine using the porcine model.

Time-resolved autofluorescence imaging of human donor retina tissue from donors with significant extramacular drusen.

Science.gov (United States)

Schweitzer, Dietrich; Gaillard, Elizabeth R; Dillon, James; Mullins, Robert F; Russell, Stephen; Hoffmann, Birgit; Peters, Sven; Hammer, Martin; Biskup, Christoph

2012-06-08

Time and spectrally resolved measurements of autofluorescence have the potential to monitor metabolism at the cellular level. Fluorophores that emit with the same fluorescence intensity can be discriminated from each other by decay time of fluorescence intensity after pulsed excitation. We performed time-resolved autofluorescence measurements on fundus samples from a donor with significant extramacular drusen. Tissue sections from two human donors were prepared and imaged with a laser scanning microscope. The sample was excited with a titanium-sapphire laser, which was tuned to 860 nm, and frequency doubled by a BBO crystal to 430 nm. The repetition rate was 76 MHz and the pulse width was 170 femtoseconds (fs). The time-resolved autofluorescence was recorded simultaneously in 16 spectral channels (445-605 nm) and bi-exponentially fitted. RPE can be discriminated clearly from Bruch's membrane, drusen, and choroidal connective tissue by fluorescence lifetime. In RPE, bright fluorescence of lipofuscin could be detected with a maximum at 510 nm and extending beyond 600 nm. The lifetime was 385 ps. Different types of drusen were found. Most of them did not contain lipofuscin and exhibited a weak fluorescence, with a maximum at 470 nm. The lifetime was 1785 picoseconds (ps). Also, brightly emitting lesions, presumably representing basal laminar deposits, with fluorescence lifetimes longer than those recorded in RPE could be detected. The demonstrated differentiation of fluorescent structures by their fluorescence decay time is important for interpretation of in vivo measurements by the new fluorescence lifetime imaging (FLIM) ophthalmoscopy on healthy subjects as well as on patients.

Usefulness of computed tomography virtual bronchoscopy in the evaluation of bronchi divisions

International Nuclear Information System (INIS)

Adamczyk, Michał; Tomaszewski, Grzegorz; Naumczyk, Patrycja; Kluczewska, Ewa; Walecki, Jerzy

2013-01-01

Since introduction of multislice CT scanners into clinical practice, virtual brochoscopy has gained a lot of quality and diagnostic potential. Nevertheless it does not have established place in diagnostics of tracheal and bronchi disorders and its potential has not been examined enough. Nowadays a majority of bronchial tree variants and lesions are revealed by bronchofiberoscopy, which is an objective and a relatively safe method, but has side effects, especially in higher-risk subjects. Therefore noninvasive techniques enabling evaluation of airways should be consistently developed and updated. Material consisted of 100 adults (45 female, 55 male) aged between 18 and 65 years (mean 40 years, median 40.5 years, SD 14.02), who underwent chest CT examination by means of a 16-slice scanner. Every patient had normal appearance of chest organs, with the exception of minor abnormalities that did not alter airways route. Divisions of bronchial tree to segmental level were evaluated and assigned to particular types by means of virtual bronchoscopy projection. In case of difficulties MPR or MinIP projection was used. The frequency of lobar bronchi divisions other than the typical ones was in: right upper lobar bronchi 45%, left 55%; middle lobar bronchi 21%, lingula 26%; right lower lobar bronchi 28%, left 29%. Subsuperior bronchus or bronchi were found on the right side in 44% and on the left side in 37%. No dependency between types of bronchial divisions on different levels was found

[Electrocautery and bronchoscopy as a first step for the management of central airway obstruction and associated hemoptysis].

Science.gov (United States)

Jalilie, Alfredo; Carvajal, Juan Carlos; Aparicio, Rodrigo; Meneses, Manuel

2016-11-01

Central airway obstruction caused by malignant or benign lesions, associated in some cases with hemoptysis, is a condition with high morbidity and mortality. The use of electrocautery by flexible bronchoscopy is an initial treatment option with immediate improvement of obstruction symptoms. It is as effective as Nd: YAG laser. To describe the usefulness of electrocautery in the management of central obstruction of the airway and hemoptysis. A retrospective, descriptive study of patients referred for management of central airway obstruction or associated hemoptysis. Diagnoses, symptoms (dyspnea, cough, and hemoptysis) and radiology before and after the procedures were analyzed. Eighteen patients aged 59 ± 12 years (66% males) were evaluated, registering 25 endoscopic procedures. Three conditions were found: partial or complete airway obstruction, hemoptysis and post lung transplant bronchial stenosis. Seventy two percent presented with dyspnea, 61% with cough and 33% with hemoptysis. Sixty six percent of patients had airway obstruction caused by malignant metastatic lesions. After electrocautery, 17 patients (94.4%) improved their symptoms and achieved complete airway clearing. Three patients had significant bronchial stenosis after lung transplant achieving subsequent clearing after electrocautery. Electrocautery during flexible bronchoscopy is an effective and safe procedure for the management of central airway obstruction and associated hemoptysis.

Diagnostic capabilities of the virtual bronchoscopy at advanced neoplastic process of esophagus with formation of tracheobronchial fistula: Description of a case

Directory of Open Access Journals (Sweden)

M. A. Mitev

2017-09-01

Full Text Available The relevance of the problem is related to the continued increase in the neoplastic processes, and at the same time also to the development and improvement of the endoscopic and CT equipment, and thus expanding the diagnostic capabilities. Purpose: The presented research examines the results of the study of a rare case of ruptured trachea as a result of cancer of the esophagus. Methods: Fiberoptic esophagoscopy (FOE and CT of the chest followed by virtual bronchoscopy on a patient with a ruptured trachea, a 63 year-old man, were performed. Result: Performing MDCT with virtual bronchoscopy, according to this study, is crucial as the sole and complex methodology for the described case in connection with the finding of the trachea-oesophageal fistula and evaluation of the mediastinum and the pulmonary parenchyma. Conclusion: The VB is a successful method equally effective compared to the FB, to diagnose of advanced neoplastic processes.

In-vivo autofluorescence diagnosis of the cancer of oral cavity

International Nuclear Information System (INIS)

Majumder, S.K.; Ghosh, N.; Mohanty, S.K.; Gupta, P.K.

2000-01-01

The results of an in-vivo study carried out on 25 patients with histologically confirmed squamous cell carcinoma (SCC) of the oral cavity are reported. Spectra from different sites of the oral cavity were recorded using a N 2 laser based portable fluorimeter developed in-house. The spectral data acquisition was computer controlled. On an average, 5 spectra from the SCC tissue sites and 4 spectra from the visually normal tissue sites were recorded.The autofluorescence spectra was recorded from different cancerous and normal sites of the oral cavity of a patient

Skin autofluorescence is increased in young people with type 1 diabetes exposed to secondhand smoking

NARCIS (Netherlands)

Vollenbrock, Charlotte E; van Waateringe, Robert P.; Veeze, Henk J; Aanstoot, Henk Jan; Wolffenbuttel, Bruce H. R.

Highlights • Skin autofluorescence is increased in diabetes, rises with age, and predicts diabetes-related complications. • Exposure to secondhand smoke, because one or more family members are smokers, further increases skin auto- fluorescence in children and young adults with type 1 diabetes. •

Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment

International Nuclear Information System (INIS)

Fraga, Andrea de Melo Alexandre; Reis, Marcelo Conrado dos; Zambon, Mariana Porto; Toro, Ivan Contrera; Ribeiro, Jose Dirceu; Baracat, Emilio Carlos Elias

2008-01-01

Objective: To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings. Methods: A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. Results: The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most commonly pneumonia), which were found to be associated with longer aspiration time (p = 0.03). Mechanical ventilation was required in 7 children (10.1%), and multiple bronchoscopies were performed in 5 (7.2%). Conclusions: A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. Longer aspiration time translates to a higher risk of complications. The high prevalence of foreign bodies of vegetal origin underscores the relevance of prevention at children younger than three years of age. (author)

Foreign body aspiration in children: clinical aspects, radiological aspects and bronchoscopic treatment

Energy Technology Data Exchange (ETDEWEB)

Fraga, Andrea de Melo Alexandre; Reis, Marcelo Conrado dos; Zambon, Mariana Porto [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Pediatric Emergency Room]. E-mail: andreafrag@gmail.com; Toro, Ivan Contrera [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Dept. of Thoracic Surgery; Ribeiro, Jose Dirceu; Baracat, Emilio Carlos Elias [Universidade Estadual de Campinas (UNICAMP), Campinas, SP (Brazil). Dept. of Pediatric Pulmonology

2008-02-15

Objective: To describe the clinical manifestations and bronchoscopic treatment of foreign body aspiration in children under 14 years of age, correlating the clinical aspects with the bronchoscopic findings. Methods: A retrospective, descriptive study analyzing data related to children under 14 years of age undergoing bronchoscopy due to clinical suspicion of foreign body aspiration at the State University at Campinas Hospital das Clinicas from January of 2000 to December of 2005. Results: The sample consisted of 69 patients, ranging in age from 8 months to 12 years/7 months (75.4% under 3 years of age), 62.3% of whom were male. The principal complaint was sudden-onset cough (75.4%), auscultation was abnormal in 74%, and dyspnea was observed in 29%. Radiological abnormalities were seen in 88% of the cases. Aspirations were primarily into the right lung (54.8%), and 30.7% of the foreign bodies were of vegetal origin (principally beans and peanuts). In the follow-up period, 29% presented complications (most commonly pneumonia), which were found to be associated with longer aspiration time (p = 0.03). Mechanical ventilation was required in 7 children (10.1%), and multiple bronchoscopies were performed in 5 (7.2%). Conclusions: A history of sudden-onset choking and cough, plus abnormal auscultation and radiological findings, characterizes the profile of foreign body aspiration. In such cases, bronchoscopy is indicated. Longer aspiration time translates to a higher risk of complications. The high prevalence of foreign bodies of vegetal origin underscores the relevance of prevention at children younger than three years of age. (author)

Quantitative Fundus Autofluorescence in Best Vitelliform Macular Dystrophy: RPE Lipofuscin is not Increased in Non-Lesion Areas of Retina.

Science.gov (United States)

Sparrow, Janet R; Duncker, Tobias; Woods, Russell; Delori, François C

2016-01-01

Since the lipofuscin of retinal pigment epithelial (RPE) cells has been implicated in the pathogenesis of Best vitelliform macular dystrophy, we quantified fundus autofluorescence (quantitative fundus autofluorescence, qAF) as an indirect measure of RPE lipofuscin levels. Mean non-lesion qAF was found to be within normal limits for age. By spectral domain optical coherence tomography (SD-OCT) vitelliform lesions presented as fluid-filled subretinal detachments containing reflective material. We discuss photoreceptor outer segment debris as the source of the intense fluorescence of these lesions and loss of anion channel functioning as an explanation for the bullous photoreceptor-RPE detachment. Unexplained is the propensity of the disease for central retina.

Optical coherence tomography in conjunction with bronchoscopy

International Nuclear Information System (INIS)

Rodrigues, Ascedio Jose; Takimura, Celso Kiyochi; Lemos Neto, Pedro Alves; Figueiredo, Viviane Rossi

2012-01-01

To evaluate the feasibility of and the potential for using optical coherence tomography in conjunction with conventional bronchoscopy in the evaluation of the airways. Methods: This was a pilot study based on an ex vivo experimental model involving three animals: one adult New Zealand rabbit and two Landrace pigs. An optical coherence tomography imaging catheter was inserted through the working channel of a flexible bronchoscope in order to reach the distal trachea of the animals. Images of the walls of the trachea were systematically taken along its entire length, from the distal to the proximal portion. Results: The imaging catheter was easily adapted to the working channel of the bronchoscope. High-resolution images of cross sections of the trachea were taken in real time, precisely delineating microstructures, such as the epithelium, submucosa, and cartilage, as well as the adventitia of the anterior and lateral tracheal walls. The corresponding layers of the epithelium, mucosa, and cartilage were clearly differentiated. The mucosa, submucosa, and trachealis muscle were clearly identified in the posterior wall. Conclusions: It is feasible to use an optical coherence tomography imaging catheter in combination with a flexible bronchoscope. Optical coherence tomography produces high resolution images that reveal the microanatomy of the trachea, including structures that are typically seen only on images produced by conventional histology. (author)

Optical coherence tomography in conjunction with bronchoscopy

Energy Technology Data Exchange (ETDEWEB)

Rodrigues, Ascedio Jose; Takimura, Celso Kiyochi; Lemos Neto, Pedro Alves; Figueiredo, Viviane Rossi, E-mail: ascedio@gmail.com [Servico de Endoscopia Respiratoria, Hospital das Clinicas, Universidade de Sao Paulo (FM/USP), SP (Brazil)

2012-07-01

To evaluate the feasibility of and the potential for using optical coherence tomography in conjunction with conventional bronchoscopy in the evaluation of the airways. Methods: This was a pilot study based on an ex vivo experimental model involving three animals: one adult New Zealand rabbit and two Landrace pigs. An optical coherence tomography imaging catheter was inserted through the working channel of a flexible bronchoscope in order to reach the distal trachea of the animals. Images of the walls of the trachea were systematically taken along its entire length, from the distal to the proximal portion. Results: The imaging catheter was easily adapted to the working channel of the bronchoscope. High-resolution images of cross sections of the trachea were taken in real time, precisely delineating microstructures, such as the epithelium, submucosa, and cartilage, as well as the adventitia of the anterior and lateral tracheal walls. The corresponding layers of the epithelium, mucosa, and cartilage were clearly differentiated. The mucosa, submucosa, and trachealis muscle were clearly identified in the posterior wall. Conclusions: It is feasible to use an optical coherence tomography imaging catheter in combination with a flexible bronchoscope. Optical coherence tomography produces high resolution images that reveal the microanatomy of the trachea, including structures that are typically seen only on images produced by conventional histology. (author)

Investigation of in-vivo skin autofluorescence lifetimes under long-term cw optical excitation

International Nuclear Information System (INIS)

Lihachev, A; Ferulova, I; Vasiljeva, K; Spigulis, J

2014-01-01

The main results obtained during the last five years in the field of laser-excited in-vivo human skin photobleaching effects are presented. The main achievements and results obtained, as well as methods and experimental devices are briefly described. In addition, the impact of long-term 405-nm cw low-power laser excitation on the skin autofluorescence lifetime is experimentally investigated. (laser biophotonics)

Fundus Autofluorescence and Photoreceptor Cell Rosettes in Mouse Models

Science.gov (United States)

Flynn, Erin; Ueda, Keiko; Auran, Emily; Sullivan, Jack M.; Sparrow, Janet R.

2014-01-01

Purpose. This study was conducted to study correlations among fundus autofluorescence (AF), RPE lipofuscin accumulation, and photoreceptor cell degeneration and to investigate the structural basis of fundus AF spots. Methods. Fundus AF images (55° lens; 488-nm excitation) and spectral-domain optical coherence tomography (SD-OCT) scans were acquired in pigmented Rdh8−/−/Abca4−/− mice (ages 1–9 months) with a confocal scanning laser ophthalmoscope (cSLO). For quantitative fundus AF (qAF), gray levels (GLs) were calibrated to an internal fluorescence reference. Retinal bisretinoids were measured by quantitative HPLC. Histometric analysis of outer nuclear layer (ONL) thicknesses was performed, and cryostat sections of retina were examined by fluorescence microscopy. Results. Quantified A2E and qAF intensities increased until age 4 months in the Rdh8−/−/Abca4−/− mice. The A2E levels declined after 4 months of age, but qAF intensity values continued to rise. The decline in A2E levels in the Rdh8−/−/Abca4−/− mice paralleled reduced photoreceptor cell viability as reflected in ONL thinning. Hyperautofluorescent puncta in fundus AF images corresponded to photoreceptor cell rosettes in SD-OCT images and histological sections stained with hematoxylin and eosin. The inner segment/outer segment–containing core of the rosette emitted an autofluorescence detected by fluorescence microscopy. Conclusions. When neural retina is disordered, AF from photoreceptor cells can contribute to noninvasive fundus AF images. Hyperautofluorescent puncta in fundus AF images are attributable, in at least some cases, to photoreceptor cell rosettes. PMID:25015357

Skin autofluorescence : A tool to identify type 2 diabetic patients at risk for developing microvascular complications

NARCIS (Netherlands)

Gerrits, E.sther G.; Lutgers, Helen L.; Kleefstra, Nanne; Graaff, R.; Groenier, Klaas H.; Smit, Andries J.; Gans, Reinold; Bilo, Henk J.

OBJECTIVE - Skin auto fluorescence is a noninvasive measure of the level of tissue accumulation of advanced glycation end products, representing cumulative glycemic and oxidative stress. Recent studies have already shown a relationship between skin autofluorescence and diabetes complications, as

Fundus autofluorescence imaging in dry AMD: 2014 Jules Gonin lecture of the Retina Research Foundation.

Science.gov (United States)

Holz, Frank G; Steinberg, Julia S; Göbel, Arno; Fleckenstein, Monika; Schmitz-Valckenberg, Steffen

2015-01-01

Fundus autofluorescence (FAF) imaging allows for topographic mapping of intrisnic fluorophores in the retinal pigment epithelial cell monolayer, as well as mapping of other fluorophores that may occur with disease in the outer retina and the sub-neurosensory space. FAF imaging provides information not obtainable with other imaging modalities. Near-infrared fundus autofluorescence images can also be obtained in vivo, and may be largely melanin-derived. FAF imaging has been shown to be useful in a wide spectrum of macular and retinal diseases. The scope of applications now includes identification of diseased RPE in macular/retinal diseases, elucidating pathophysiological mechanisms, identification of early disease stages, refined phenotyping, identification of prognostic markers for disease progression, monitoring disease progression in the context of both natural history and interventional therapeutic studies, and objective assessment of luteal pigment distribution and density as well as RPE melanin distribution. Here, we review the use of FAF imaging in various phenotypic manifestations of dry AMD.

Tracheal rupture caused by blunt chest trauma: radiological and clinical features

Energy Technology Data Exchange (ETDEWEB)

Kunisch-Hoppe, M.; Rauber, K.; Rau, W.S. [Dept. of Diagnostic Radiology, Justus Liebig Univ., Giessen (Germany); Hoppe, M. [Dept. of Diagnostic Radiology, University Hospital, Philipps University, Marburg (Germany); Popella, C. [Dept. of ENT, Justus Liebig University, Giessen (Germany)

2000-03-01

The aim of this study was to assess radiomorphologic and clinical features of tracheal rupture due to blunt chest trauma. From 1992 until 1998 the radiomorphologic and clinical key findings of all consecutive tracheal ruptures were retrospectively analyzed. The study included ten patients (7 men and 3 women; mean age 35 years); all had pneumothoraces which were persistent despite suction drainage. Seven patients developed a pneumomediastinum as well as a subcutaneous emphysema on conventional chest X-rays. In five patients, one major hint leading to the diagnosis was a cervical emphysema, discovered on the lateral cervical spine view. Contrast-media-enhanced thoracic CT was obtained in all ten cases and showed additional injuries (atelectasis n = 5; lung contusion n = 4; lung laceration n = 2; hematothorax n = 2 and hematomediastinum n = 4). The definite diagnosis of tracheal rupture was made by bronchoscopy, which was obtained in all patients. Tracheal rupture due to blunt chest trauma occurs rarely. Key findings were all provided by conventional chest X-ray. Tracheal rupture is suspected in front of a pneumothorax, a pneumomediastinum, or a subcutaneous emphysema on lateral cervical spine and chest films. Routine thoracic CT could also demonstrate these findings but could not confirm the definite diagnosis of an tracheal rupture except in one case; in the other 9 cases this was done by bronchoscopy. Thus, bronchoscopy should be mandatory in all suspicious cases of tracheal rupture and remains the gold standard. (orig.)

Tracheal rupture caused by blunt chest trauma: radiological and clinical features

International Nuclear Information System (INIS)

Kunisch-Hoppe, M.; Rauber, K.; Rau, W.S.; Hoppe, M.; Popella, C.

2000-01-01

The aim of this study was to assess radiomorphologic and clinical features of tracheal rupture due to blunt chest trauma. From 1992 until 1998 the radiomorphologic and clinical key findings of all consecutive tracheal ruptures were retrospectively analyzed. The study included ten patients (7 men and 3 women; mean age 35 years); all had pneumothoraces which were persistent despite suction drainage. Seven patients developed a pneumomediastinum as well as a subcutaneous emphysema on conventional chest X-rays. In five patients, one major hint leading to the diagnosis was a cervical emphysema, discovered on the lateral cervical spine view. Contrast-media-enhanced thoracic CT was obtained in all ten cases and showed additional injuries (atelectasis n = 5; lung contusion n = 4; lung laceration n = 2; hematothorax n = 2 and hematomediastinum n = 4). The definite diagnosis of tracheal rupture was made by bronchoscopy, which was obtained in all patients. Tracheal rupture due to blunt chest trauma occurs rarely. Key findings were all provided by conventional chest X-ray. Tracheal rupture is suspected in front of a pneumothorax, a pneumomediastinum, or a subcutaneous emphysema on lateral cervical spine and chest films. Routine thoracic CT could also demonstrate these findings but could not confirm the definite diagnosis of an tracheal rupture except in one case; in the other 9 cases this was done by bronchoscopy. Thus, bronchoscopy should be mandatory in all suspicious cases of tracheal rupture and remains the gold standard. (orig.)

Acute Retinal Pigment Epitheliitis: Spectral Domain Optical Coherence Tomography, Fluorescein Angiography, and Autofluorescence Findings

Directory of Open Access Journals (Sweden)

Tuğba Aydoğan

2015-01-01

Full Text Available A 17-year-old presented with central and paracentral scotomas in his right eye for one week. There was no remarkable medical or ocular history. Blood analyses were within normal range. At presentation both eyes’ best-corrected visual acuities were 20/20. Slit-lamp examination result was normal. Fundus examination revealed yellow-white hypopigmented areas in the macula. Fluorescein angiography (FA showed hypofluorescence surrounded by ring of hyperfluorescence. Fundus autofluorescence (FAF was slightly increased. Spectral domain optical coherence tomography (SD-OCT showed disruption of IS/OS junction with expansion of abnormal hyperreflectivity from retinal pigment epithelium to the outer nuclear layer (ONL. One month later fundus examination showed disappearance of the lesions. FA revealed transmission hyperfluorescence. FAF showed increased autofluorescence and pigment clumping. Hyperreflective band in SD-OCT disappeared. Loss of photoreceptor segment layers was observed in some of the macular lesions. The diagnosis of acute retinal pigment epitheliitis can be challenging after disappearance of fundus findings. FA, FAF, and SD-OCT are important tests for diagnosis after resolution of the disease.

Role of Autofluorescence in Inflammatory/Infective Diseases of the Retina and Choroid

OpenAIRE

Samy, Ahmed; Lightman, Sue; Ismetova, Filis; Talat, Lazha; Tomkins-Netzer, Oren

2014-01-01

Fundus autofluorescence (FAF) has recently emerged as a novel noninvasive imaging technique that uses the fluorescent properties of innate fluorophores accumulated in the retinal pigment epithelium (RPE) to assess the health and viability of the RPE/photoreceptor complex. Recent case reports suggest FAF as a promising tool for monitoring eyes with posterior uveitis helping to predict final visual outcome. In this paper we review the published literature on FAF in these disorders, specifically...

Electromagnetic Navigational Bronchoscopy versus CT-guided Percutaneous Sampling of Peripheral Indeterminate Pulmonary Nodules: A Cohort Study.

Science.gov (United States)

Bhatt, Kavita M; Tandon, Yasmeen K; Graham, Ruffin; Lau, Charles T; Lempel, Jason K; Azok, Joseph T; Mazzone, Peter J; Schneider, Erika; Obuchowski, Nancy A; Bolen, Michael A

2018-03-01

Purpose To compare the diagnostic yield and complication rates of electromagnetic navigational bronchoscopic (ENB)-guided and computed tomography (CT)-guided percutaneous tissue sampling of lung nodules. Materials and Methods Retrospectively identified were 149 patients sampled percutaneously with CT guidance and 146 patients who underwent ENB with transbronchial biopsy of a lung lesion between 2013 and 2015. Clinical data, incidence of complications, and nodule pathologic analyses were assessed through electronic medical record review. Lung nodule characteristics were reviewed through direct image analysis. Molecular marker studies and pathologic analyses from surgical excision were reviewed when available. Multiple-variable logistic regression models were built to compare the diagnostic yield and complication rates for each method and for different patient and disease characteristics. Results CT-guided sampling was more likely to be diagnostic than ENB-guided biopsy (86.0% [129 of 150] vs 66.0% [99 of 150], respectively), and this difference remained significant even after adjustments were made for patient and nodule characteristics (P guided sampling (P guided sampling, 88.9% [32 of 36]; CT-guided sampling, 82.0% [41 of 50]). The two groups had similar rates of major complications (symptomatic hemorrhage, P > .999; pneumothorax requiring chest tube and/or admission, P = .417). Conclusion CT-guided transthoracic biopsy provided higher diagnostic yield in the assessment of peripheral pulmonary nodules than navigational bronchoscopy with a similar rate of clinically relevant complications. © RSNA, 2017 Online supplemental material is available for this article.

[Joint application of 7 interventional pulmonology methods in early diagnosis of lung cancer].

Science.gov (United States)

Jin, Fa-Guang; Li, Wang-Ping; Mu, De-Guang; Chu, Dong-Ling; Fu, En-Qing; Xie, Yong-Hong; Lu, Jing-Li; Sun, Ya-Ni

2009-06-23

To evaluate the combination of 7 interventional pulmonology methods in early diagnosis of lung cancer. A total of 467 patients with thoracic and pulmonary lesions (include hilum pulmonis lymphadenectasis, mediastinal lymphadenectasis, pulmonary scobination, lump, lamellar infiltration, small amount of pleural fluid and pleural scobination) had negative results via exfoliative cytology, bacteriology and routine bronchoscopy. All these patients had ultrathin bronchoscopy with biopsy and brushing. For those 155 cases whose foci were located at porta pulmonis, inner zone or median zone, the authors applied ultrathin bronchoscopy with biopsy and brushing guided by X-ray. For those 95 cases whose foci were located at median zone or outer zone and unconnected with chest wall, per cutem lung puncture needle aspiration was employed under the guidance of X-ray. For those 102 cases whose foci were tightly connected with pleural membrane, per cutem lung puncture biopsy was employed under the guidance of type-B ultrasonic. For those 59 cases with suspected central airway foci, auto-fluorescence bronchoscopic biopsy and brushing were employed. For those 67 cases with hilum pulmonis or mediastinal lymphadenectasis, endobronchial ultrasonic transbronchial needle aspiration (EBUS-TBNA) was employed. For those 23 cases with small amount of pleural fluid or pleural scobination, electronic thoracoscopic biopsy and brushing were employed. It was found that 118 cases were diagnosed by ultrathin bronchoscopic biopsy and brushing with a positive rate of 25.3% (118/467), 105 cases by ultrathin bronchoscopy with biopsy and brushing guided by X-ray with a positive rate of 67.7% (105/155), 63 cases by per cutem lung puncture needle aspiration under the guidance of X-ray with a positive rate of 66.3% (63/95), 69 cases by per cutem lung puncture biopsy under the guidance of type-B ultrasound with a positive rate of 67.6% (69/102), 18 cases by auto-fluorescence bronchoscopic biopsy and brushing

Inhibition or Stimulation of Autophagy Affects Early Formation of Lipofuscin-Like Autofluorescence in the Retinal Pigment Epithelium Cell

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Lei Lei

2017-03-01

Full Text Available The accumulation of lipofuscin in the retinal pigment epithelium (RPE is dependent on the effectiveness of photoreceptor outer segment material degradation. This study explored the role of autophagy in the fate of RPE lipofuscin degradation. After seven days of feeding with either native or modified rod outer segments, ARPE-19 cells were treated with enhancers or inhibitors of autophagy and the autofluorescence was detected by fluorescence-activated cell sorting. Supplementation with different types of rod outer segments increased lipofuscin-like autofluorescence (LLAF after the inhibition of autophagy, while the induction of autophagy (e.g., application of rapamycin decreased LLAF. The effects of autophagy induction were further confirmed by Western blotting, which showed the conversion of LC3-I to LC3-II, and by immunofluorescence microscopy, which detected the lysosomal activity of the autophagy inducers. We also monitored LLAF after the application of several autophagy inhibitors by RNA-interference and confocal microscopy. The results showed that, in general, the inhibition of the autophagy-related proteins resulted in an increase in LLAF when cells were fed with rod outer segments, which further confirms the effect of autophagy in the fate of RPE lipofuscin degradation. These results emphasize the complex role of autophagy in modulating RPE autofluorescence and confirm the possibility of the pharmacological clearance of RPE lipofuscin by small molecules.

Characteristics of Fundus Autofluorescence in Active Polypoidal Choroidal Vasculopathy

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Zafer Öztaş

2016-08-01

Full Text Available Objectives: To define characteristic fundus autofluorescence (FAF findings in eyes with active polypoidal choroidal vasculopathy (PCV. Materials and Methods: Thirty-five eyes of 29 patients with active PCV who were diagnosed at Ege University Faculty of Medicine, Department of Ophthalmology, Retina Division between January 2012 and November 2014 were included in the study. All the patients underwent a complete ophthalmological examination including fundus photography, spectral-domain optical coherence tomography, fluorescein angiography, FAF photography, and indocyanine green angiography (ICGA. ICGA was used to diagnose active PCV and identify lesion components. FAF findings were described at the retinal site of the corresponding lesions identified and diagnosed using ICGA. Results: The mean age of the 29 study patients (15 men, 14 women was 64.6±7.5 years (range, 54-82 years. ICGA revealed active PCV in 35 eyes, consisting of polypoid lesions in 11 eyes (31.4%, branching vascular networks (BVN in 10 eyes (28.6%, and a combination of polypoid lesions and BVNs in 14 eyes (40%. On FAF images, 4 different patterns were detected at the corresponding retinal sites of 25 polypoid lesions detected by ICGA: confluent hypoautofluorescence with a hyperautofluorescent ring in 18 eyes (72%, hyperautofluorescence with hypoautofluorescent ring in 2 eyes (8%, confluent hypoautofluorescence in 1 eye (4%, and granular hypoautofluorescence in 1 eye (4%. The remaining 3 eyes (12% demonstrated blocked hypoautofluorescence because of the excessive hemorrhaging in the macula. The FAF images showed the granular hypoautofluorescent FAF pattern in all 24 BVNs (100% consistent with the location of the lesions on ICGA. Conclusion: The typical PCV lesions, polypoid lesions and BVNs had characteristic autofluorescent findings on FAF imaging. Non-invasive, quick, and repeatable FAF imaging can be considered a reliable and helpful diagnostic technique for the diagnosis of

Multiphoton autofluorescence lifetime imaging of induced pluripotent stem cells

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Uchugonova, Aisada

2017-06-01

The multiphoton fluorescence lifetime imaging tomograph MPTflex with its flexible 360-deg scan head, articulated arm, and tunable femtosecond laser source was employed to study induced pluripotent stem cell (iPS) cultures. Autofluorescence (AF) lifetime imaging was performed with 250-ps temporal resolution and submicron spatial resolution using time-correlated single-photon counting. The two-photon excited AF was based on the metabolic coenzymes NAD(P)H and flavin adenine dinucleotide/flavoproteins. iPS cells generated from mouse embryonic fibroblasts (MEFs) and cocultured with growth-arrested MEFs as feeder cells have been studied. Significant differences on AF lifetime signatures were identified between iPS and feeder cells as well as between their differentiating counterparts.

Topical timolol with and without benzalkonium chloride: epithelial permeability and autofluorescence of the cornea in glaucoma.

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de Jong, C; Stolwijk, T; Kuppens, E; de Keizer, R; van Best, J

1994-04-01

Epithelial permeability and autofluorescence of the cornea were determined by fluorophotometry in 21 patients with open-angle glaucoma or ocular hypertension using timolol medication with the preservative benzalkonium chloride (BAC) and 2 weeks after changing to timolol medication without BAC. The investigation was performed to determine whether removal of BAC would reduce toxic effects on the cornea and complaints of sensations of burning or dry eye. Corneal epithelial permeability decreased significantly after changing medication (mean decrease per patient 27%, P = 0.025). Corneal autofluorescence increased significantly after changing medication suggesting an alteration in corneal metabolism (mean increase per patient 6%, P = 0.003). Timolol without BAC was found to be as effective as timolol with BAC in reducing intraocular pressure (P = 0.4). Removal of BAC from timolol resulted in an improvement of corneal epithelial barrier function and in a reduction of complaints. The improvement was found to be proportional to the duration of the preceding BAC-containing therapy.

ULTRA-WIDE-FIELD FUNDUS AUTOFLUORESCENCE FINDINGS IN PATIENTS WITH ACUTE ZONAL OCCULT OUTER RETINOPATHY.

Science.gov (United States)

Shifera, Amde Selassie; Pennesi, Mark E; Yang, Paul; Lin, Phoebe

2017-06-01

To determine whether ultra-wide-field fundus autofluorescence (UWFFAF) findings in acute zonal occult outer retinopathy correlated well with perimetry, optical coherence tomography, and electroretinography findings. Retrospective observational study on 16 eyes of 10 subjects with AZOOR seen at a single referral center from October 2012 to March 2015 who had UWFFAF performed. Chi-square analysis was performed to compare categorical variables, and Mann-Whitney U test used for comparisons of nonparametric continuous variables. All eyes examined within 3 months of symptom onset (five of the five eyes) had diffusely hyperautofluorescent areas on UWFFAF. The remaining eyes contained hypoautofluorescent lesions with hyperautofluorescent borders. In 11/16 (68.8%) eyes, UWFFAF showed the full extent of lesions that would not have been possible with standard fundus autofluorescence centered on the fovea. There were 3 patterns of spread: centrifugal spread (7/16, 43.8%), centripetal spread (5/16, 31.3%), and centrifugal + centripetal spread (4/16, 25.0%). The UWFFAF lesions corresponded well with perimetric, optical coherence tomography, and electroretinography abnormalities. The UWFFAF along with optical coherence tomography can be useful in the evaluation and monitoring of acute zonal occult outer retinopathy patients.

Broncoscopia no diagnóstico de tuberculose pulmonar em pacientes com baciloscopia de escarro negativa Bronchoscopy for the diagnosis of pulmonary tuberculosis in patients with negative sputum smear microscopy results

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Márcia Jacomelli

2012-04-01

Full Text Available OBJETIVO: Avaliar a acurácia diagnóstica da broncoscopia em pacientes com suspeita clínica ou radiológica de tuberculose, com baciloscopia negativa ou incapazes de produzir escarro. MÉTODOS: Estudo transversal prospectivo de 286 pacientes com suspeita clínica/radiológica de tuberculose pulmonar e submetidos à broncoscopia - LBA e biópsia transbrônquica (BTB. As amostras de LBA foram testadas por pesquisas diretas e culturas de BAAR e de fungos, e as de BTB por exame histopatológico. RESULTADOS: Dos 286 pacientes estudados, a broncoscopia contribuiu para o diagnóstico em 225 (79%: tuberculose pulmonar em 127 (44%; inflamações crônicas inespecíficas em 51 (18%; pneumocistose, infecções fúngicas ou nocardiose em 20 (7%; bronquiolite obliterante com pneumonia em organização, alveolites ou pneumoconioses em 14 (5%; neoplasias pulmonares ou metastáticas em 7 (2%; e micobacterioses não tuberculosas em 6 (2%. Para o diagnóstico de tuberculose, o LBA mostrou sensibilidade e especificidade de 60% e 100% respectivamente, havendo um aumento importante da sensibilidade quando associado à biópsia (84% e à baciloscopia após a broncoscopia (94%. Complicações controláveis decorrentes do procedimento ocorreram em 5,6% dos casos. CONCLUSÕES: A broncoscopia representa um método diagnóstico confiável para pacientes com tuberculose pulmonar, apresentando baixos índices de complicações. A associação de biópsia transbrônquica ao lavado broncoalveolar elevou a sensibilidade diagnóstica do método e permitiu o diagnóstico diferencial com outras doenças.OBJECTIVE: To evaluate the diagnostic accuracy of bronchoscopy in patients with clinical or radiological suspicion of tuberculosis who were unable to produce sputum or with negative sputum smear microscopy results. METHODS: A prospective cross-sectional study involving 286 patients under clinical or radiological suspicion of having pulmonary tuberculosis and submitted to

[How practical guidelines can be applied in poor countries? Example of the introduction of a bronchoscopy unit in Cambodia].

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Couraud, S; Chan, S; Avrillon, V; Horn, K; Try, S; Gérinière, L; Perrot, É; Guichon, C; Souquet, P-J; Ny, C

2013-10-01

According to UN, Cambodia is one of the poorest countries in the World. Respiratory diseases are current public health priorities. In this context, a new bronchoscopy unit (BSU) was created in the respiratory medicine department of Preah Kossamak hospital (PKH) thanks to a tight cooperation between a French and a Cambodian team. Aim of this study was to describe conditions of introduction of this equipment. Two guidelines for practice are available. They are respectively edited by the French and British societies of pulmonology. These guidelines were reviewed and compared to the conditions in which BS was introduced in PKH. Each item from guidelines was combined to a categorical value: "applied", "adapted" or "not applied". In 2009, 54 bronchoscopies were performed in PKH, mainly for suspicion of infectious or tumour disease. In total, 52% and 46% of the French and British guideline items respectively were followed in this Cambodian unit. Patient safety items are those highly followed. By contrast "staff safety" items were those weakly applied. Implementation of EBS in developing countries seems feasible in good conditions of quality and safety for patients. However, some recommendations cannot be applied due to local conditions. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

Association of age and macular pigment optical density using dual-wavelength autofluorescence imaging

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Lima VC

2013-04-01

Full Text Available Verônica Castro Lima,1,2 Richard B Rosen,1,3 Tiago Santos Prata,2 Syril Dorairaj,4 Leigh Spielberg,1 Mauricio Maia,2 Juliana M Sallum21Retina Service, Department of Ophthalmology, The New York Eye and Ear Infirmary, New York, NY, 2Department of Ophthalmology, Federal University of São Paulo, São Paulo, Brazil; 3New York Medical College, New York, NY, 4Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USABackground: Several lines of evidence suggest that macular pigment may play a protective role against age-related macular degeneration, but the influence of age on macular pigment density levels remains unclear. This study was designed to investigate the relationship between age and the normal distribution of macular pigment optical density (MPOD values surrounding the fovea.Methods: Consecutive healthy subjects with no evidence of ocular disease were enrolled in this study. After inclusion, MPOD values were measured at specific eccentricities (0.5, 1, and 2 degrees from the foveal center using a dual-wavelength autofluorescence method employing a modified confocal scanning laser ophthalmoscope. Whenever both eyes were eligible, one was randomly selected for analysis. The correlation between age and MPOD values was investigated using regression analysis.Results: Thirty subjects (30 eyes were included (mean age 48.6 ± 16.4 [range 23–77] years. Significant differences were found between MPOD values measured at 0.5, 1, and 2 degrees from the center of the fovea (0.49 ± 0.12 density units, 0.37 ± 0.11 density units, and 0.13 ± 0.05 density units, respectively, P < 0.05. Significant correlations between age and MPOD values at 0.5 and 1 degree were found (P ≤ 0.02. Values measured at 2 degrees did not correlate significantly with age (P = 0.06.Conclusion: In healthy subjects, MPOD values were highest near the foveal center. These values appeared to increase during adulthood (peak at 45–50 years, followed by a gradual reduction

Quantitative analysis of myocardial tissue with digital autofluorescence microscopy

DEFF Research Database (Denmark)

Jensen, Thomas; Holten-Rossing, Henrik; Svendsen, Ida M H

2016-01-01

to that of hematoxylin and eosin staining in conventional pathology. This study presents an automated fluorescence-based microscopy approach providing highly detailed morphological data from unstained microsections. This data may provide a basic histological starting point from which further digital analysis including...... staining may benefit. METHODS: This study explores the inherent tissue fluorescence, also known as autofluorescence, as a mean to quantitate cardiac tissue components in histological microsections. Data acquisition using a commercially available whole slide scanner and an image-based quantitation algorithm......BACKGROUND: The opportunity offered by whole slide scanners of automated histological analysis implies an ever increasing importance of digital pathology. To go beyond the importance of conventional pathology, however, digital pathology may need a basic histological starting point similar...

EARLY SIMULTANEOUS FUNDUS AUTOFLUORESCENCE AND OPTICAL COHERENCE TOMOGRAPHY FEATURES AFTER PARS PLANA VITRECTOMY FOR PRIMARY RHEGMATOGENOUS RETINAL DETACHMENT

NARCIS (Netherlands)

Dellʼomo, Roberto; Mura, Marco; Lesnik Oberstein, Sarit Y.; Bijl, Heico; Tan, H. Stevie

2012-01-01

Purpose: To describe fundus autofluorescence and optical coherence tomography (OCT) features of the macula after pars plana vitrectomy for rhegmatogenous retinal detachment. Methods: Thirty-three eyes of 33 consecutive patients with repaired rhegmatogenous retinal detachment with or without the

High resolution CT for localization of early hilar lung carcinoma

International Nuclear Information System (INIS)

Minami, Yuko; Ishikawa, Shigemi; Saida, Yukihisa; Kajitani, Motomasa; Yamamoto, Tatsuo; Sato, Yukio; Onizuka, Masataka; Sakakibara, Yuzuru; Noguchi, Masayuki

2002-01-01

The purpose of this study was to analyse the usefulness of high resolution CT (HRCT) for the diagnosis and localization of roentgenographically occult lung cancer. HRCT was performed prospectively on chest X-ray negative patients with bloody sputum or suspicious or positive cells on sputum cytology between 1998 and 2000. After the HRCT scan, white light bronchoscopy and autofluorescence bronchoscopy were performed. HRCT depicted 19 hilar bronchial lesions in 13 cases out of 19 patients, of which 9 lesions were confirmed by white light broncoscope. Of 8 hilar squamous cell carcinomas diagnosed in this study, 7 lesions (87.5%) were depicted by HRCT. One CT-negative case (12.5%) was an in situ carcinoma in left B 1+2 . Four out of 20 lesions which showed bronchoscopic abnormality, could not be depicted by HRCT. HRCT could prospectively detect 80% of the bronchoscopic abnormalities and 87.5% of the hilar squamous cell carcinomas of the tracheobronchial lesions of the lung. Therefore, HRCT can be an effective supplemental means for screening for hilar squamous cell carcinoma. (author)

Role of autofluorescence in inflammatory/infective diseases of the retina and choroid.

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Samy, Ahmed; Lightman, Sue; Ismetova, Filis; Talat, Lazha; Tomkins-Netzer, Oren

2014-01-01

Fundus autofluorescence (FAF) has recently emerged as a novel noninvasive imaging technique that uses the fluorescent properties of innate fluorophores accumulated in the retinal pigment epithelium (RPE) to assess the health and viability of the RPE/photoreceptor complex. Recent case reports suggest FAF as a promising tool for monitoring eyes with posterior uveitis helping to predict final visual outcome. In this paper we review the published literature on FAF in these disorders, specifically patterns in infectious and noninfectious uveitis, and illustrate some of these with short case histories.

Role of Autofluorescence in Inflammatory/Infective Diseases of the Retina and Choroid

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Ahmed Samy

2014-01-01

Full Text Available Fundus autofluorescence (FAF has recently emerged as a novel noninvasive imaging technique that uses the fluorescent properties of innate fluorophores accumulated in the retinal pigment epithelium (RPE to assess the health and viability of the RPE/photoreceptor complex. Recent case reports suggest FAF as a promising tool for monitoring eyes with posterior uveitis helping to predict final visual outcome. In this paper we review the published literature on FAF in these disorders, specifically patterns in infectious and noninfectious uveitis, and illustrate some of these with short case histories.

Surface Modification of Photoresist SU-8 for Low Autofluorescence and Bioanalytical Applications

DEFF Research Database (Denmark)

Cao, Cuong; Birtwell, Sam W.; Høgberg, Jonas

2011-01-01

This paper reports a surface modification of epoxy-based negative photoresist SU-8 for reducing its autofluorescence while enhancing its biofunctionality. By covalently depositing a thin layer of 20 nm Au nanoparticles (AuNPs) onto the SU-8 surface, we found that the AuNPs-coated SU-8 surface...... is much less fluorescent than the untreated SU-8. Moreover, DNA probes can easily be immobilized on the Au surface and are thermally stable over a wide range of temperature. These improvements will benefit bioanalytical applications such as DNA hybridization and solid-phase PCR (SP-PCR)....

Skin autofluorescence is a predictor of cardiovascular disease in chronic kidney disease patients.

Science.gov (United States)

Furuya, Fumihiko; Shimura, Hiroki; Takahashi, Kazuya; Akiyama, Daiichiro; Motosugi, Ai; Ikegishi, Yukinobu; Haraguchi, Kazutaka; Kobayashi, Tetsuro

2015-02-01

Accelerated formation and tissue accumulation of advanced glycation end products (AGEs), reflecting cumulative glycemic and oxidative stress, occurs in age-related and chronic diseases like diabetes mellitus (DM) and renal failure, and contributes to vascular damage. Skin autofluorescence (AFR), a noninvasive measurement method, reflects tissue accumulation of AGEs. AFR has been reported to be an independent predictor of mortality in Caucasian hemodialysis patients. We assessed the relationship between levels of AFR and the prevalence of cardiovascular disease (CVD), and clarified the prognostic usefulness of skin AFR levels in Asian (non-Caucasian) hemodialysis (HD) patients. AFR was measured with an autofluorescence reader in 64 HD patients. Overall and cardiovascular mortality was monitored prospectively during the 3-year follow-up. During follow-up, CVD events occurred in 21 patients. The deaths of 10 HD patients were associated with CVD. Multivariate logistic regression analyses showed that initial AFR was an independent risk factor for de novo CVD in HD patients with or without diabetes. When patients were classified on the basis of AFR tertiles, Cochran-Armitage analysis demonstrated that the highest tertile of AFR level showed an increased odds ratio for the prevalence of CVD. These findings suggest that AFR levels can be used to detect the prevalence of CVD in HD patients with or without diabetes. © 2014 The Authors. Therapeutic Apheresis and Dialysis © 2014 International Society for Apheresis.

Comparative study between fundus autofluorescence and red reflectance imaging of choroidal nevi using ultra-wide-field scanning laser ophthalmoscopy.

Science.gov (United States)

Zapata, Miguel Angel; Leila, Mahmoud; Teixidor, Teresa; Garcia-Arumi, Jose

2015-06-01

To explore the utility of fundus autofluorescence (FAF) and red reflectance (RR) imaging using ultra-wide-field scanning laser ophthalmoscope in choroidal nevi. Retrospective observational case study reviewing clinical data, color, FAF, and RR images of patients with choroidal nevi and comparing the findings. The ultra-wide-field scanning laser ophthalmoscope uses green laser 532 nm and red laser 633 nm that enabled FAF and RR imaging, respectively in separate channels. Superimposition of both images yielded a composite color image. The study included 46 eyes of 45 patients. Nevi were unilateral in 44 patients (98%). Forty-one nevi (89.1%) were located temporally between the macula and the equator. All nevi (100%) were deeply pigmented. The most frequent surface changes were lipofuscin pigments, zones of retinal pigment epithelium atrophy, and retinal pigment epithelium pigment clumps in 31 (67.3%), 18 (39.1%), and 8 eyes (17.3%), respectively. Color photographs were superior to FAF in detecting nevus boundaries and surface changes. Red reflectance correlated strongly with color images, although the nevus boundaries and surface changes were better delineated in RR mode. Red reflectance was superior to FAF in delineating the boundaries and surface changes of the nevus; clear visibility (3+) for RR versus no or poor visibility (0/1+) for FAF. Nevertheless, the areas of retinal pigment epithelium atrophy were better delineated in FAF mode; clear visibility (3+) for FAF versus poor visibility (1+) for FAF. Red reflectance imaging is more sensitive than conventional photography for follow-up of choroidal nevi. Fundus autofluorescence should be considered only as a complementary tool to RR imaging.

Noninvasive near infrared autofluorescence imaging of retinal pigment epithelial cells in the human retina using adaptive optics.

Science.gov (United States)

Liu, Tao; Jung, HaeWon; Liu, Jianfei; Droettboom, Michael; Tam, Johnny

2017-10-01

The retinal pigment epithelial (RPE) cells contain intrinsic fluorophores that can be visualized using infrared autofluorescence (IRAF). Although IRAF is routinely utilized in the clinic for visualizing retinal health and disease, currently, it is not possible to discern cellular details using IRAF due to limits in resolution. We demonstrate that the combination of adaptive optics (AO) with IRAF (AO-IRAF) enables higher-resolution imaging of the IRAF signal, revealing the RPE mosaic in the living human eye. Quantitative analysis of visualized RPE cells in 10 healthy subjects across various eccentricities demonstrates the possibility for in vivo density measurements of RPE cells, which range from 6505 to 5388 cells/mm 2 for the areas measured (peaking at the fovea). We also identified cone photoreceptors in relation to underlying RPE cells, and found that RPE cells support on average up to 18.74 cone photoreceptors in the fovea down to an average of 1.03 cone photoreceptors per RPE cell at an eccentricity of 6 mm. Clinical application of AO-IRAF to a patient with retinitis pigmentosa illustrates the potential for AO-IRAF imaging to become a valuable complementary approach to the current landscape of high resolution imaging modalities.

Quantitative method to assess caries via fluorescence imaging from the perspective of autofluorescence spectral analysis

Science.gov (United States)

Chen, Q. G.; Zhu, H. H.; Xu, Y.; Lin, B.; Chen, H.

2015-08-01

A quantitative method to discriminate caries lesions for a fluorescence imaging system is proposed in this paper. The autofluorescence spectral investigation of 39 teeth samples classified by the International Caries Detection and Assessment System levels was performed at 405 nm excitation. The major differences in the different caries lesions focused on the relative spectral intensity range of 565-750 nm. The spectral parameter, defined as the ratio of wavebands at 565-750 nm to the whole spectral range, was calculated. The image component ratio R/(G + B) of color components was statistically computed by considering the spectral parameters (e.g. autofluorescence, optical filter, and spectral sensitivity) in our fluorescence color imaging system. Results showed that the spectral parameter and image component ratio presented a linear relation. Therefore, the image component ratio was graded as 1.62 to quantitatively classify sound, early decay, established decay, and severe decay tissues, respectively. Finally, the fluorescence images of caries were experimentally obtained, and the corresponding image component ratio distribution was compared with the classification result. A method to determine the numerical grades of caries using a fluorescence imaging system was proposed. This method can be applied to similar imaging systems.

MACULAR ATROPHY FINDINGS BY OPTICAL COHERENCE TOMOGRAPHY ANGIOGRAPHY COMPARED WITH FUNDUS AUTOFLUORESCENCE IN TREATED EXUDATIVE AGE-RELATED MACULAR DEGENERATION.

Science.gov (United States)

Takasago, Yukari; Shiragami, Chieko; Kobayashi, Mamoru; Osaka, Rie; Ono, Aoi; Yamashita, Ayana; Tsujikawa, Akitaka; Hirooka, Kazuyuki

2017-11-28

To compare the areas of choriocapillaris (CC) nonperfusion and macular atrophy (MA) in treated exudative age-related macular degeneration. This was a prospective, observational, cross-sectional study. Forty-four eyes exhibiting MA (42 patients with age-related macular degeneration), with a dry macula, underwent fundus autofluorescence and optical coherence tomography angiography. The area of MA detected by fundus autofluorescence and CC nonperfusion detected by optical coherence tomography angiography was measured using image analysis software. The rates of concordance between the MA and CC nonperfusion areas were calculated. We qualitatively and quantitatively compared the areas of MA and CC nonperfusion in age-related macular degeneration eyes. The mean areas of MA and CC nonperfusion were 5.95 ± 4.50 mm and 10.66 ± 7.05 mm, respectively (paired t-test, P autofluorescence matching optical coherence tomography angiography showed that the CC nonperfusion area was almost included in the MA area. The mean concordance rate for the MA area inside the CC nonperfusion area was 87.7 ± 13.9%. The MA and CC nonperfusion areas markedly overlapped. The area of CC nonperfusion correlated with the MA area. Choroidal ischemia might be involved in the pathogenesis of MA in treated age-related macular degeneration.This is an open access article distributed under the Creative Commons Attribution License 4.0 (CCBY), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

The association between various smoking behaviors, cotinine biomarkers and skin autofluorescence, a marker for advanced glycation end product accumulation

NARCIS (Netherlands)

van Waateringe, Robert P.; Mook-Kanamori, Marjonneke J.; Slagter, Sandra N.; van der Klauw, Melanie M.; van Vliet-Ostaptchouk, Jana V.; Graaff, Reindert; Lutgers, Helen L.; Suhre, Karsten; Selim, Mohammed M. El-Din; Mook-Kanamori, Dennis O.; Wolffenbuttel, Bruce H. R.

2017-01-01

BACKGROUND: Skin autofluorescence, a biomarker for advanced glycation end products (AGEs) accumulation, has been shown to predict diabetes-related cardiovascular complications and is associated with several environmental and lifestyle factors. In the present study, we examined the association

A hybrid segmentation approach for geographic atrophy in fundus auto-fluorescence images for diagnosis of age-related macular degeneration.

Science.gov (United States)

Lee, Noah; Laine, Andrew F; Smith, R Theodore

2007-01-01

Fundus auto-fluorescence (FAF) images with hypo-fluorescence indicate geographic atrophy (GA) of the retinal pigment epithelium (RPE) in age-related macular degeneration (AMD). Manual quantification of GA is time consuming and prone to inter- and intra-observer variability. Automatic quantification is important for determining disease progression and facilitating clinical diagnosis of AMD. In this paper we describe a hybrid segmentation method for GA quantification by identifying hypo-fluorescent GA regions from other interfering retinal vessel structures. First, we employ background illumination correction exploiting a non-linear adaptive smoothing operator. Then, we use the level set framework to perform segmentation of hypo-fluorescent areas. Finally, we present an energy function combining morphological scale-space analysis with a geometric model-based approach to perform segmentation refinement of false positive hypo- fluorescent areas due to interfering retinal structures. The clinically apparent areas of hypo-fluorescence were drawn by an expert grader and compared on a pixel by pixel basis to our segmentation results. The mean sensitivity and specificity of the ROC analysis were 0.89 and 0.98%.

Feasibility of bispectral index-guided propofol infusion for flexible bronchoscopy sedation: a randomized controlled trial.

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Yu-Lun Lo

Full Text Available There are safety issues associated with propofol use for flexible bronchoscopy (FB. The bispectral index (BIS correlates well with the level of consciousness. The aim of this study was to show that BIS-guided propofol infusion is safe and may provide better sedation, benefiting the patients and bronchoscopists.After administering alfentanil bolus, 500 patients were randomized to either propofol infusion titrated to a BIS level of 65-75 (study group or incremental midazolam bolus based on clinical judgment to achieve moderate sedation. The primary endpoint was safety, while the secondary endpoints were recovery time, patient tolerance, and cooperation.The proportion of patients with hypoxemia or hypotensive events were not different in the 2 groups (study vs. control groups: 39.9% vs. 35.7%, p = 0.340; 7.4% vs. 4.4%, p = 0.159, respectively. The mean lowest blood pressure was lower in the study group. Logistic regression revealed male gender, higher American Society of Anesthesiologists physical status, and electrocautery were associated with hypoxemia, whereas lower propofol dose for induction was associated with hypotension in the study group. The study group had better global tolerance (p<0.001, less procedural interference by movement or cough (13.6% vs. 36.1%, p<0.001; 30.0% vs. 44.2%, p = 0.001, respectively, and shorter time to orientation and ambulation (11.7±10.2 min vs. 29.7±26.8 min, p<0.001; 30.0±18.2 min vs. 55.7±40.6 min, p<0.001, respectively compared to the control group.BIS-guided propofol infusion combined with alfentanil for FB sedation provides excellent patient tolerance, with fast recovery and less procedure interference.ClinicalTrials. gov NCT00789815.

Evaluation of fundus autofluorescence in hereditary retinal diseases using Heidelberg Retina Angiograph2

OpenAIRE

Côco, Monique [UNIFESP; Baba, Natalia Tamie [UNIFESP; Sallum, Juliana Maria Ferraz [UNIFESP

2007-01-01

OBJETIVOS: Definir características do exame de autofluorescência, verificando sua utilidade no diagnóstico e acompanhamento de distrofias retinianas. MÉTODOS: Participaram do estudo, 28 pacientes, adultos, divididos igualmente em quatro grupos com diagnósticos de doença de Stargardt, distrofia de Cones, retinose pigmentar e voluntários saudáveis para estabelecimento do padrão de normalidade. Em média foram obtidas nove imagens com o filtro para angiofluoresceinografia para a formação da image...

Skin autofluorescence reflects individual seasonal UV exposure, skin photodamage and skin cancer development in organ transplant recipients.

Science.gov (United States)

Togsverd-Bo, Katrine; Philipsen, Peter Alshede; Hædersdal, Merete; Wulf, Hans Christian Olsen

2018-01-01

Ultraviolet radiation (UVR)-induced skin cancers varies among organ transplant recipients (OTRs). To improve individual risk assessment of skin cancer, objectively quantified skin photodamage is needed. We measured personal UVR-exposure dose in OTRs and assessed the relation between individual UVR exposure, skin cancer and objectively measured photodamage in terms of skin autofluorescence, pigmentation, and black light-evaluated solar lentigines. Danish OTRs with (n=15) and without a history of skin cancer (n=15) kept sun diaries from May to September and wore personal dosimeters recording time-stamped UVR doses in standard erythema doses (SED). Photodamage was quantified as skin autofluorescence with excitation at 370nm (F370) and 430nm (F430), skin pigmentation (pigment protection factor, PPF), and black light-evaluated solar lentigines. OTRs with skin cancer received a higher UVR dose than OTRs without skin cancer (median 116 SED vs. 67 SED, p=0.07) and UVR exposure doses were correlated with increased PPF (p=0.052) and F370 on the shoulder (F370 shoulder ) (p=0.04). We found that skin cancer was associated with F370 shoulder (OR 10.53, CI 3.3-31,938; p=0.018) and time since transplantation (OR 1.34, CI 0.95-1.91, p=0.097). A cut-off at 7.2 arbitrary units, 89% of OTRs with skin cancer had F370 shoulder values above 7.2 arbitrary units and F370 shoulder was additionally related to patient age (p=0.09) and black light-evaluated solar lentigines (p=0.04). F370 autofluorescence indicates objectively measured photodamage and may be used for individual risk assessment of skin cancer development in OTRs. Copyright © 2017. Published by Elsevier B.V.

Vital Autofluorescence: Application to the Study of Plant Living Cells

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Victoria V. Roshchina

2012-01-01

approach to study the autofluorescence of plant living cells—from cell diagnostics up to modelling the cell-cell contacts and cell interactions with fluorescent biologically active substances. It bases on the direct observations of secretions released from allelopathic and medicinal species and the cell-donor interactions with cell-acceptors as biosensors (unicellular plant generative and vegetative microspores. Special attention was paid to the interactions with pigmented and fluorescing components of the secretions released by the cells-donors from plant species. Colored components of secretions are considered as histochemical dyes for the analysis of cellular mechanisms at the cell-cell contacts and modelling of cell-cell interactions. The fluorescence of plant biosensors was also recommended for the testing of natural plant excretions as medical drugs.

Quantitative Characteristics of Spectral-Domain Optical Coherence Tomography in Corresponding Areas of Increased Autofluorescence at the Margin of Geographic Atrophy in Patients With Age-Related Macular Degeneration.

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Hariri, Amir H; Nittala, Muneeswar G; Sadda, SriniVas R

2016-06-01

To evaluate the spectral-domain optical coherence tomography (SD-OCT) characteristics of the junctional zone corresponding to areas of increased autofluorescence (IAF) at the margin of geographic atrophy (GA) in patients with age-related macular degeneration (AMD). SD-OCT and fundus autofluorescence (FAF) images from untreated eyes with GA available from archived studies at Doheny Image Reading Center were evaluated. Areas of definite decreased autofluorescence (DDAF) corresponding to GA, and areas of IAF at the margins of the GA were manually segmented. Eyes with evidence of IAF were selected. Following manual registration of FAF and OCT data, areas of IAF and normal fluorescence were correlated with OCT features at these locations. Thirty eyes were included. The mean retinal pigment epithelium (RPE) thickness in areas of IAF was 40.6 µm ± 7.69 µm, compared to 28.8 µm ± 7.09 µm in normal adjacent areas (P Retina. 2016;47:523-527.]. Copyright 2016, SLACK Incorporated.

Relation between food and drinking habits, and skin autofluorescence and intima media thickness in subjects at high cardiovascular risk

NARCIS (Netherlands)

Jochemsen, B. M.; Van Doormaal, J. J.; Mulder, G.; Volmer, M.; Graaff, R.; Smit, A. J.; Mulder, Douwe J.

2009-01-01

We investigated the relations between food and drinking habits, and estimated exogenous advanced glycation end products (AGE) intake, skin autofluorescence (AF) as a marker of AGE accumulation, and intima media thickness (IMT). IMT of the carotid artery and skin AF were measured in 147 elderly

Quantitative method to assess caries via fluorescence imaging from the perspective of autofluorescence spectral analysis

International Nuclear Information System (INIS)

Chen, Q G; Xu, Y; Zhu, H H; Chen, H; Lin, B

2015-01-01

A quantitative method to discriminate caries lesions for a fluorescence imaging system is proposed in this paper. The autofluorescence spectral investigation of 39 teeth samples classified by the International Caries Detection and Assessment System levels was performed at 405 nm excitation. The major differences in the different caries lesions focused on the relative spectral intensity range of 565–750 nm. The spectral parameter, defined as the ratio of wavebands at 565–750 nm to the whole spectral range, was calculated. The image component ratio R/(G + B) of color components was statistically computed by considering the spectral parameters (e.g. autofluorescence, optical filter, and spectral sensitivity) in our fluorescence color imaging system. Results showed that the spectral parameter and image component ratio presented a linear relation. Therefore, the image component ratio was graded as <0.66, 0.66–1.06, 1.06–1.62, and >1.62 to quantitatively classify sound, early decay, established decay, and severe decay tissues, respectively. Finally, the fluorescence images of caries were experimentally obtained, and the corresponding image component ratio distribution was compared with the classification result. A method to determine the numerical grades of caries using a fluorescence imaging system was proposed. This method can be applied to similar imaging systems. (paper)

Skin autofluorescence is associated with arterial stiffness and insulin level in endurance runners and healthy controls

DEFF Research Database (Denmark)

Couppé, Christian; Dall, Christian Have; Svensson, Rene Brüggebusch

2017-01-01

distance, and 12 young untrained (YU) (24±3years) were recruited. Endothelial function (reactive hyperemia index, RHI) and arterial stiffness (augmentation index, AI@75 and AI) were measured by an operator-independent PAT 2000. SAF was non-invasively determined using an autofluorescence spectrometer....... RESULTS: For AI@75 there was an effect of age (p... correction (both r2=0.19, pfuture be a helpful tool...

Assessing the utility of autofluorescence-based pulmonary optical endomicroscopy to predict the malignant potential of solitary pulmonary nodules in humans

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Seth, Sohan; Akram, Ahsan R.; McCool, Paul; Westerfeld, Jody; Wilson, David; McLaughlin, Stephen; Dhaliwal, Kevin; Williams, Christopher K. I.

2016-08-01

Solitary pulmonary nodules are common, often incidental findings on chest CT scans. The investigation of pulmonary nodules is time-consuming and often leads to protracted follow-up with ongoing radiological surveillance, however, clinical calculators that assess the risk of the nodule being malignant exist to help in the stratification of patients. Furthermore recent advances in interventional pulmonology include the ability to both navigate to nodules and also to perform autofluorescence endomicroscopy. In this study we assessed the efficacy of incorporating additional information from label-free fibre-based optical endomicrosopy of the nodule on assessing risk of malignancy. Using image analysis and machine learning approaches, we find that this information does not yield any gain in predictive performance in a cohort of patients. Further advances with pulmonary endomicroscopy will require the addition of molecular tracers to improve information from this procedure.

Pleural Dye Marking Using Radial Endobronchial Ultrasound and Virtual Bronchoscopy before Sublobar Pulmonary Resection for Small Peripheral Nodules.

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Lachkar, Samy; Baste, Jean-Marc; Thiberville, Luc; Peillon, Christophe; Rinieri, Philippe; Piton, Nicolas; Guisier, Florian; Salaun, Mathieu

2018-01-01

Minimally invasive surgery of pulmonary nodules allows suboptimal palpation of the lung compared to open thoracotomy. The objective of this study was to assess endoscopic pleural dye marking using radial endobronchial ultrasound (r-EBUS) and virtual bronchoscopy to localize small peripheral lung nodules immediately before minimally invasive resection. The endoscopic procedure was performed without fluoroscopy, under general anesthesia in the operating room immediately before minimally invasive surgery. Then, 1 mL of methylene blue (0.5%) was instilled into the guide sheath, wedged in the subpleural space. Wedge resection or segmentectomy were guided by visualization of the dye on the pleural surface. Contribution of dye marking to the surgical procedure was rated by the surgeon. Twenty-five nodules, including 6 ground glass opacities, were resected in 22 patients by video-assisted thoracoscopic wedge resection (n = 11) or robotic-assisted thoracoscopic surgery (10 segmentectomies and 1 wedge resection). The median greatest diameter of nodules was 8 mm. No conversion to open thoracotomy was needed. The endoscopic procedure added an average 10 min to surgical resection. The dye was visible on the pleural surface in 24 cases. Histological diagnosis and free margin resection were obtained in all cases. Median skin-to-skin operating time was 90 min for robotic segmentectomy and 40 min for video-assisted wedge resection. The same operative precision was considered impossible by the surgeon without dye marking in 21 cases. Dye marking using r-EBUS and virtual bronchoscopy can be easily and safely performed to localize small pulmonary nodules immediately before minimally invasive resection. © 2018 S. Karger AG, Basel.

The clinical features of foreign body aspiration into the lower airway in geriatric patients

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Lin LJ

2014-09-01

Full Text Available Lianjun Lin,1 Liping Lv,2,* Yuchuan Wang,1 Xiankui Zha,2 Fei Tang,2 Xinmin Liu1,* 1Geriatric Department, Peking University First Hospital, Beijing, People’s Republic of China; 2Pulmonary Intervention Department, Anhui Chest Hospital, Hefei, People’s Republic of China *These authors contributed equally to this work Purpose: To analyze the clinical features of foreign-body aspiration into the lower airway in geriatric patients. Patients and methods: The clinical data of 17 geriatric patients with foreign-body aspiration were retrospectively analyzed and compared with 26 nongeriatric adult patients. The data were collected from Peking University First Hospital and Anhui Chest Hospital between January 2000 and June 2014.Results: (1 In the geriatric group, the most common symptoms were cough and sputum (15 cases, 88%, dyspnea (six cases, 35%, and hemoptysis (four cases, 24%. Five patients (29% in the geriatric group could supply the history of aspiration on their first visit to doctor, a smaller percentage than in the nongeriatric group (13 cases, 50%. Only three cases in the geriatric group were diagnosed definitely without delay. Another 14 cases were misdiagnosed as pneumonia or lung cancer, and the time of delayed diagnosis ranged from 1 month to 3 years. Complications due to delay in diagnosis included obstructive pneumonitis, atelectasis, lung abscess, and pleural effusion. (2 Chest computed tomography demonstrated the foreign body in three cases (21% in the geriatric group, which was lower than the positive proportion of detection in the nongeriatric group (nine cases, 35%. The most common type of foreign body in the geriatric group was food, such as bone fragments (seven cases, 41% and plants (seven cases, 41%, and the foreign body was most often lodged in the right bronchus tree (eleven cases, 65%, especially the right lower bronchus (seven cases, 41%. Flexible bronchoscopy removed the foreign body successfully in all patients

Defining a Ventilation Strategy for Flexible Bronchoscopy on Mechanically Ventilated Patients in the Medical Intensive Care Unit.

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Greenstein, Yonatan Y; Shakespeare, Eric; Doelken, Peter; Mayo, Paul H

2017-07-01

Flexible bronchoscopy (FB) in intubated patients on mechanical ventilation increases airway resistance. During FB, two ventilatory strategies are possible: maintaining tidal volume (VT) while maintaining baseline CO2 or allowing reduction of VT. The former strategy carries risk of hyperinflation due to expiratory flow limitation with FB. The aim of the authors was too study end expiratory lung volume (EELV) during FB of intubated subjects while limiting VT. We studied 16 subjects who were intubated on mechanical ventilation and required FB. Changes in EELV were measured by respiratory inductance plethysmography. Ventilator mechanics, EELV, and arterial blood gases, were measured. FB insertions decreased EELV in 64% of cases (-325±371 mL) and increased it in 32% of cases (65±59 mL). Suctioning decreased EELV in 76% of cases (-120±104 mL) and increased it in 16% of cases (29±33 mL). Respiratory mechanics were unchanged. Pre-FB and post-FB, PaO2 decreased by 61±96 mm Hg and PaCO2 increased by 15±7 mm Hg. There was no clinically significant increase in EELV in any subject during FB. Decreases in EELV coincided with FB-suctioning maneuvers. Peak pressure limiting ventilation protected the subject against hyperinflation with a consequent, well-tolerated reduction in VT, and hypercapnea. Suctioning should be limited, especially in patients vulnerable to derecruitment effect.

Reference values for the Chinese population of skin autofluorescence as a marker of advanced glycation end products accumulated in tissue

NARCIS (Netherlands)

Yue, X.; Hu, H.; Koetsier, M.; Graaff, R.; Han, C.

Aim Advanced glycation end products play an important role in the pathophysiology of several chronic and age-related diseases, especially diabetes mellitus. Skin autofluorescence is a non-invasive method for assessing levels of tissue advanced glycation end products. This study aims to establish the

Optical coherence tomography and fundus autofluorescence findings in presumed congenital simple retinal pigment epithelium hamartoma

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Baskaran, Prabu

2017-10-01

Full Text Available Aim: Presumed congenital simple retinal pigment epithelium hamartoma is a rare benign lesion of the macula that mimics congenital hypertrophy of the retinal pigment epithelium (RPE and combined hamartoma of the retina and the RPE; newer imaging modalities can help in diagnosis. We report three patients with presumed congenital simple RPE hamartoma, and describe the enhanced-depth imaging optical coherence tomography (EDI-OCT and fundus autofluorescence (FAF findings. Methods: Two patients were asymptomatic; one had an intraocular foreign body in addition to the hamartoma. All had a similar jet black, elevated lesion in the macula, sparing the fovea. EDI-OCT showed a characteristic hyperreflective layer with complete optical shadowing of the deeper layers; FAF showed pronounced hypoautofluorescence of the lesion. Conclusion: Multimodal imaging with FAF and EDI-OCT can help to differentiate simple RPE hamartoma from similar RPE lesions, and may serve as a useful adjunct to clinical diagnosis of this rare tumor. We present the second largest series of presumed congenital simple RPE hamartoma, and – to the best of our knowledge – the first report of FAF findings of this tumor.

Virtual bronchoscopy-guided transbronchial biopsy for aiding the diagnosis of peripheral lung cancer

Energy Technology Data Exchange (ETDEWEB)

Iwano, Shingo, E-mail: iwano45@med.nagoya-u.ac.jp [Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550, Aichi (Japan); Imaizumi, Kazuyoshi [Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550 (Japan); Okada, Tohru [Research Center for Charged Particle Therapy, National Institute of Radiological Science, 4-9-1 Anagawa, Inage-ku, Chiba 2638555 (Japan); Hasegawa, Yoshinori [Department of Respiratory Medicine, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550 (Japan); Naganawa, Shinji [Department of Radiology, Nagoya University Graduate School of Medicine, 65 Tsurumai-cho, Shouwa-ku, Nagoya 4668550, Aichi (Japan)

2011-07-15

Objective: The aim of this study was to evaluate the clinical value of virtual bronchoscopy (VB) in aiding diagnosis of peripheral lung cancer by transbronchial biopsy (TBB). In addition, we sought to systematically analyze the factors that affect the diagnostic sensitivity of VB-guided TBB for the evaluation of peripheral lung cancers. Materials and methods: A hundred and twenty-two peripheral lung cancers from 122 patients (82 men and 40 women, 38-84 years; median 68.5 years) who were performed VB-guided TBB were evaluated retrospectively. VB was reconstructed from 1- or 0.5-mm slice thickness images of multi-detector CT (MDCT). Experienced pulmonologists inserted the conventional and ultrathin bronchoscopes into the target bronchus under direct vision following the VB image. Results: A definitive diagnosis was established by VB-guided TBB in 96 lesions (79%). The diagnostic sensitivity of small pulmonary lesions {<=}30 mm in maximal diameter (71%) was significantly lower than that of lesions >30 mm (91%, p = 0.008). For small pulmonary lesions {<=}30 mm (n = 76), internal opacity of the lesion was the independent predictor of diagnostic sensitivity by VB-guided TBB, and the non-solid type lung cancers were significantly lower than the solid type and part-solid type lung cancers for diagnostic sensitivity (odds ratio = 0.161; 95% confidence interval = 0.033-0.780; p = 0.023). Conclusion: Use of an ultrathin bronchoscope and simulation with VB reconstructed by high quality MDCT images is thought to improve pathological diagnosis of peripheral lung cancers, especially for solid and partly solid types. For small pulmonary lesions {<=}30 mm, the lesion internal opacity is a significant factor for predicting the diagnostic sensitivity, and the sensitivity was low for small non-solid type of lung cancers.

Increase in Skin Autofluorescence and Release of Heart-Type Fatty Acid Binding Protein in Plasma Predicts Mortality of Hemodialysis Patients

NARCIS (Netherlands)

Arsov, Stefan; Trajceska, Lada; van Oeveren, Wim; Smit, Andries J.; Dzekova, Pavlina; Stegmayr, Bernd; Sikole, Aleksandar; Rakhorst, Gerhard; Graaff, Reindert

Advanced glycation end-products (AGEs) are uremic toxins that accumulate progressively in hemodialysis (HD) patients. The aim of this study was to assess the 1-year increase in skin autofluorescence (DAF), a measure of AGEs accumulation and plasma markers, as predictors of mortality in HD patients.

Discomfort during bronchoscopy performed after endobronchial intubation with fentanyl and midazolam: a prospective study.

Science.gov (United States)

Minami, Daisuke; Takigawa, Nagio; Kano, Hirohisa; Ninomiya, Takashi; Kubo, Toshio; Ichihara, Eiki; Ohashi, Kadoaki; Sato, Akiko; Hotta, Katsuyuki; Tabata, Masahiro; Tanimoto, Mitsune; Kiura, Katsuyuki

2017-05-01

Although endobronchial intubation during a bronchoscopic examination is useful for invasive procedures, it is not routine practice in Japan. The present study evaluated discomfort due to endobronchial intubation using fentanyl and midazolam sedation during bronchoscopy. Thirty-nine patients were enrolled prospectively from November 2014 to September 2015 at Okayama University Hospital. Fentanyl (20 µg) was administered to the patients just before endobronchial intubation, and fentanyl (10 µg) and midazolam (1 mg) were added as needed during the procedure. A questionnaire survey was administered 2 h after the examination. In the questionnaire, patient satisfaction was scored using a visual analog scale as follows: excellent (1 point), good (2 points), normal (3 points), uncomfortable (4 points) and very uncomfortable (5 points). An additional question ('Do you remember the bronchoscopic examination?') was also asked. Predefined parameters (blood pressure, heart rate, oxygen saturation and complications) were recorded. The enrolled patients included 22 males and 17 females; their median age was 70 (range: 28-88) years. The patients received a mean dose of 47.9 µg of fentanyl (range: 30-90 µg) and 2.79 mg of midazolam (range: 1-7 mg). In total, 28 patients (71.7%) agreed to undergo a second bronchoscopic examination; the mean levels of discomfort and for the re-examination were 2.07 points each. About 41% of the patients remembered the bronchoscopic examination. No severe complications were reported. Endobronchial intubation using fentanyl and midazolam sedation during an invasive bronchoscopic procedure might be recommended. UMIN000015578 in the UMIN Clinical Trials Registry. © The Author 2017. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Interventional bronchoscopy for treatment of tracheal obstruction secondary to benign or malignant thyroid disease.

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Noppen, Marc; Poppe, Kris; D'Haese, Jan; Meysman, Marc; Velkeniers, Brigitte; Vincken, Walter

2004-02-01

Surgery is the treatment of choice for symptomatic tracheal obstruction due to benign or malignant thyroid disease. In case of inoperability, or when surgery is refused, few therapeutic alternatives are available. Interventional bronchoscopic procedures have only been reported anecdotally. The objective of this study is to evaluate the results of interventional bronchoscopic procedures in the treatment of severe tracheal obstruction due to thyroid disease. Retrospective cohort analysis. University hospital, tertiary referral center. Thirty consecutive patients referred for bronchoscopic treatment of benign (n = 17) or malignant (n = 13) thyroid-related upper airway obstruction due to tracheomalacia, extrinsic compression, and/or tracheal ingrowth. Indications for bronchoscopic treatment were medical or surgical inoperability, prevention or treatment of tracheomalacia, and refusal of surgery. There were no procedure-related complications. Rigid bronchoscopy with dilatation, stenting and/or Nd-YAG laser treatment, and clinical follow-up. Subjective improvement, pulmonary function tests, early and late complications, and survival. In the benign group, immediate (100% relief of dyspnea) and long-term (88% relief of dyspnea) results were excellent after airway stenting (21 stents used in 17 patients). There was one unrelated death 1 week after stenting in a 98-year-old patient. There were 6% and 30% short-term and long-term complications, respectively, that could be managed endoscopically. In the malignant group, Nd-YAG laser treatment (n = 3) and stenting (n = 13) yielded immediate and long-term success in 92% of patients. There were 15% short-term and 8% long-term complications. Median survival time was 540 days. Interventional bronchoscopic procedures including Nd-YAG laser treatment and stenting are valuable alternatives to surgery in inoperable thyroid-induced tracheal obstruction, or when surgery is refused.

Clinical potential for imaging in patients with asthma and other lung disorders.

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DeBoer, Emily M; Spielberg, David R; Brody, Alan S

2017-01-01

The ability of lung imaging to phenotype patients, determine prognosis, and predict response to treatment is expanding in clinical and translational research. The purpose of this perspective is to describe current imaging modalities that might be useful clinical tools in patients with asthma and other lung disorders and to explore some of the new developments in imaging modalities of the lung. These imaging modalities include chest radiography, computed tomography, lung magnetic resonance imaging, electrical impedance tomography, bronchoscopy, and others. Copyright © 2016 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

Autofluorescence imaging of macular pigment: influence and correction of ocular media opacities

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Sharifzadeh, Mohsen; Obana, Akira; Gohto, Yuko; Seto, Takahiko; Gellermann, Werner

2014-09-01

The healthy adult human retina contains in its macular region a high concentration of blue-light absorbing carotenoid compounds, known as macular pigment (MP). Consisting of the carotenoids lutein, zeaxanthin, and meso-zeaxanthin, the MP is thought to shield the vulnerable tissue layers in the retina from light-induced damage through its function as an optical attenuator and to protect the tissue cells within its immediate vicinity through its function as a potent antioxidant. Autofluorescence imaging (AFI) is emerging as a viable optical method for MP screening of large subject populations, for tracking of MP changes over time, and for monitoring MP uptake in response to dietary supplementation. To investigate the influence of ocular media opacities on AFI-based MP measurements, in particular, the influence of lens cataracts, we conducted a clinical trial with a large subject population (93 subjects) measured before and after cataract surgery. General AFI image contrast, retinal blood vessel contrast, and presurgery lens opacity scores [Lens Opacities Classification System III (LOCS III)] were investigated as potential predictors for image degradation. These clinical results show that lens cataracts can severely degrade the achievable pixel contrasts in the AFI images, which results in nominal MP optical density levels that are artifactually reduced. While LOCS III scores and blood vessel contrast are found to be only a weak predictor for this effect, a strong correlation exists between the reduction factor and the image contrast, which can be quantified via pixel intensity histogram parameters. Choosing the base width of the histogram, the presence or absence of ocular media opacities can be determined and, if needed, the nominal MP levels can be corrected with factors depending on the strength of the opacity.

Secondary Metabolite Localization by Autofluorescence in Living Plant Cells

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Pascale Talamond

2015-03-01

Full Text Available Autofluorescent molecules are abundant in plant cells and spectral images offer means for analyzing their spectra, yielding information on their accumulation and function. Based on their fluorescence characteristics, an imaging approach using multiphoton microscopy was designed to assess localization of the endogenous fluorophores in living plant cells. This method, which requires no previous treatment, provides an effective experimental tool for discriminating between multiple naturally-occurring fluorophores in living-tissues. Combined with advanced Linear Unmixing, the spectral analysis extends the possibilities and enables the simultaneous detection of fluorescent molecules reliably separating overlapping emission spectra. However, as with any technology, the possibility for artifactual results does exist. This methodological article presents an overview of the applications of tissular and intra-cellular localization of these intrinsic fluorophores in leaves and fruits (here for coffee and vanilla. This method will provide new opportunities for studying cellular environments and the behavior of endogenous fluorophores in the intracellular environment.

Papel da fibrobroncoscopia no diagnóstico de pacientes com suspeita de tuberculose pulmonar Role of the fiberoptic bronchoscopy in the diagnosis of patients with suspected pulmonary

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Anna Luiza Summers Caymmi

2004-02-01

que representam diagnósticos diferenciais.BACKGROUND: Pulmonary tuberculosis is an infectious disease of high prevalence and incidence. The use of sputum bacilloscopy is a sure and speedy way of reaching a diagnosis. However as 30% to 50% of the bearers of pulmonary tuberculosis have a negative sputum smear or have no sputum the fiber bronchoscopy acquires a special importance. OBJECTIVES: To evaluate the sensitivity of the specimens collected by means of the fiber bronchoscopy (brochoalveolar lavage and transbronchial biopsy for the diagnosis of patients suspected of having pulmonary tuberculosis, without confirmation by sputum bacilloscopy. METHOD: By review of the ledgers of fiber bronchoscopies carried out from March 1997 to March 2001, we identified and included in the study patients over 18 years of age and referred with suspicion of tuberculosis and at least three negative sputum smears. Data regarding age, gender, changes detected at thorax imaging and endoscopy were collected. RESULTS: Fifty-two patients with ages ranging from 19 to 77 years (median of 39, were included, 58% were of the male gender and 37% were patients from the Official Health System. Prevailing finding at chest X-ray was the alveolar infiltrate (80%. In 35 patients tuberculosis was the final diagnosis (one with associated neoplasia; in 28 patients (80% diagnosis was achieved by bronchoscopy. Other diagnoses disclosed by bronchoscopy were neoplasias, histoplasmosis chronic eosinophil alvelolitis, pneumonia by Pneumocystis carinii and pulmonary fibrosis. CONCLUSION: results of this study point to the use of fiber bronchoscopy in patients suspect of tuberculosis, not diagnosed thorough sputum bacilloscopy, not only for pulmonary tuberculosis but also of those that represent differential diagnoses.

Skin autofluorescence as proxy of tissue AGE accumulation is dissociated from SCORE cardiovascular risk score, and remains so after 3 years

NARCIS (Netherlands)

Tiessen, Ans H.; Jager, Willemein; ter Bogt, Nancy C. W.; Beltman, Frank W.; van der Meer, Klaas; Broer, Jan; Smit, Andries J.

Background: Skin autofluorescence (SAF), as a proxy of AGE accumulation, is predictive of cardiovascular (CVD) complications in i.a. type 2 diabetes mellitus and renal failure, independently of most conventional CVD risk factors. The present exploratory substudy of the Groningen Overweight and

Broncoscopia flexível como primeira opção para a remoção de corpo estranho das vias aéreas em adultos Flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults

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Ascedio José Rodrigues

2012-06-01

Full Text Available OBJETIVO: Determinar a taxa de sucesso da broncoscopia flexível como primeira opção na remoção de corpos estranhos das vias aéreas em adultos. MÉTODOS: Estudo retrospectivo de todos os pacientes adultos (acima de 18 anos com aspiração de corpo estranho submetidos a broncoscopia no Hospital das Clínicas, Faculdade de Medicina da Universidade de São Paulo, em São Paulo (SP. RESULTADOS: A amostra foi constituída por 40 pacientes adultos, com média de idade de 52 anos (variação: 18-88 anos. A mediana do tempo de permanência do corpo estranho na via aérea foi de 15 dias (variação: 12 h a 10 anos. Todos os pacientes foram submetidos primeiramente a broncoscopia flexível diagnóstica. A retirada do corpo estranho por meio de broncoscopia flexível foi bem-sucedida em 33 dos pacientes (82,5%. Em 1 paciente, um objeto metálico alojado na árvore brônquica distal requereu o uso de fluoroscopia. Seis pacientes (15% foram submetidos a broncoscopia rígida devido a dispneia induzida por corpo estranho traqueal, em 2, e porque o corpo estranho era muito grande para as pinças flexíveis, em 4. A broncoscopia falhou em apenas 1 paciente, que portanto necessitou de broncotomia. CONCLUSÕES: Embora a broncoscopia rígida seja considerada o padrão ouro na remoção de corpos estranhos na via aérea, nossa experiência mostrou que a broncoscopia flexível pode ser utilizada segura e eficientemente no diagnóstico e tratamento de pacientes adultos estáveis.OBJECTIVE: To determine the success rate of flexible bronchoscopy as the first-choice method of removing foreign bodies from the airways of adults. METHODS: This was a retrospective study of all adult patients (over 18 years of age with foreign body aspiration submitted to bronchoscopy between January of 2009 and January of 2011 at the University of São Paulo School of Medicine Hospital das Clínicas, located in São Paulo, Brazil. RESULTS: The study sample comprised 40 adult patients

Skin autofluorescence as a marker of cardiovascular risk in children with chronic kidney disease.

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Makulska, Irena; Szczepańska, Maria; Drożdż, Dorota; Polak-Jonkisz, Dorota; Zwolińska, Danuta

2013-01-01

We examined skin autofluorescence (sAF) in chronic kidney disease children (CKD) in relation to renal function and dialysis modality. Twenty children on hemodialysis (HD), 20 on peritoneal dialysis (PD), 36 treated conservatively, and 26 healthy subjects were enrolled into the study. In all children sAF, pulse-wave velocity indexed to height (PWV/ht), left ventricular mass index (LVMI), blood pressure (BP), serum lipid profile, phosphate (P), calcium (Ca), and homocysteine were measured. sAF was significantly elevated in CKD groups vs. controls and was significantly associated with PWV/ht, LVMI, BP, P, Ca × P product and homocysteine. sAF in HD and PD groups was positively correlated with dialysis vintage, and in the predialysis group negatively correlated with glomerular filtration rate (eGFR). Multiple regression analysis showed significant association of sAF with LVMI and P in the CKD patient group, and with dialysis treatment duration and BP in dialyzed children. In CKD children, tissue accumulation of advanced glycation end-products (AGEs) was observed. This was aggravated as eGFR declined and was related to early cardiovascular changes and some biochemical cardiovascular disease (CVD) risk markers. sAF as a non-invasive method may be a useful tool for identification of a clinical risk factors of cardiovascular disease in CKD children.

Use of narrow-band imaging bronchoscopy in detection of lung cancer.

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Zaric, Bojan; Perin, Branislav

2010-05-01

Narrow-band imaging (NBI) is a new endoscopic technique designed for detection of pathologically altered submucosal and mucosal microvascular patterns. The combination of magnification videobronchoscopy and NBI showed great potential in the detection of precancerous and cancerous lesions of the bronchial mucosa. The preliminary studies confirmed supremacy of NBI over white-light videobronchoscopy in the detection of premalignant and malignant lesions. Pathological patterns of capillaries in bronchial mucosa are known as Shibuya's descriptors (dotted, tortuous and abrupt-ending blood vessels). Where respiratory endoscopy is concerned, the NBI is still a 'technology in search of proper indication'. More randomized trials are necessary to confirm the place of NBI in the diagnostic algorithm, and more trials are needed to evaluate the relation of NBI to autofluorescence videobronchoscopy and to white-light magnification videobronchoscopy. Considering the fact that NBI examination of the tracheo-bronchial tree is easy, reproducible and clear to interpret, it is certain that NBI videobronchoscopy will play a significant role in the future of lung cancer detection and staging.

A two-channel detection method for autofluorescence correction and efficient on-bead screening of one-bead one-compound combinatorial libraries using the COPAS fluorescence activated bead sorting system

International Nuclear Information System (INIS)

Hintersteiner, Martin; Auer, Manfred

2013-01-01

One-bead one-compound combinatorial library beads exhibit varying levels of autofluorescence after solid phase combinatorial synthesis. Very often this causes significant problems for automated on-bead screening using TentaGel beads and fluorescently labeled target proteins. Herein, we present a method to overcome this limitation when fluorescence activated bead sorting is used as the screening method. We have equipped the COPAS bead sorting instrument with a high-speed profiling unit and developed a spectral autofluorescence correction method. The correction method is based on a simple algebraic operation using the fluorescence data from two detection channels and is applied on-the-fly in order to reliably identify hit beads by COPAS bead sorting. Our method provides a practical tool for the fast and efficient isolation of hit beads from one-bead one-compound library screens using either fluorescently labeled target proteins or biotinylated target proteins. This method makes hit bead identification easier and more reliable. It reduces false positives and eliminates the need for time-consuming pre-sorting of library beads in order to remove autofluorescent beads. (technical note)

The utility of the fiberoptic bronchoscopy in the esophageal cancer

International Nuclear Information System (INIS)

Reyes O, Leonardo; Garcia-Herreros, Plutarco; Rivas P, Pilar; Posso, Hector; Sandoval Rafael L

1998-01-01

The paper establishes the utility of the fiber- optic bronchoscopy (FOB) studies performed in patients with esophageal cancer (EC) and confirm the possibility of tracheo-bronchial compromise. We carry out a descriptive study in 226 patients with esophageal cancer during 1991 to 1996 in the Instituto Nacional de Cancerologia of Colombia (INC). We excluded the patients with previous treatments: radiotherapy or surgery, and others primary cancers with metastases on the esophagus. We analyzed gastric, intestinal and general symptoms, smoking habits, primary cancer location, histological types, radiologic findings, fob findings, micro and macroscopes, and results of the samples: transbronchial, endobronchial biopsies, bronchi alveolar lavage and brush. We included 158 patients, 110 male and 48 female, with age between 32 and 83 years, symptoms duration average of 5,2 months. The most significant were cough, dysphonia and sputum. The location of EC was statistics significance only in the upper third escamocelular type. The significant radiological findings were: parenchymal nodules and interstitial infiltrates, the significant fob findings were: fistula endobronchial infiltration endobronchial mass and vocal cords palsy. The zones with more compromise were trachea, principal bronchi and vocal cords. Only 17 patients were positives in the samples; comparing the histopathologic findings (biopsies) as the gold standard with fob findings the sensitivity was 100%, specificity 35%, positive predictive value 15.6% and negative predictive value 100%

Autofluorescence dynamics during reperfusion following long-term renal ischemia in a rat model

Energy Technology Data Exchange (ETDEWEB)

Raman, R N; Pivetti, C D; Matthews, D L; Troppmann, C; Demos, S G

2008-02-08

Optical properties of near-surface kidney tissue were monitored in order to assess response during reperfusion to long (20 minutes) versus prolonged (150 minutes) ischemia in an in vivo rat model. Specifically, autofluorescence images of the exposed surfaces of both the normal and the ischemic kidneys were acquired during both injury and reperfusion alternately under 355 nm and 266 nm excitations. The temporal profile of the emission of the injured kidney during the reperfusion phase under 355 nm excitation was normalized to that under 266 nm as a means to account for changes in tissue optical properties independent of ischemia as well as changes in the illumination/collection geometrical parameters in future clinical implementation of this technique using a hand-held probe. The scattered excitation light signal was also evaluated as a reference signal and found to be inadequate. Characteristic time constants were extracted using fit to a relaxation model and found to have larger mean values following 150 minutes of injury. The mean values were then compared with the outcome of a chronic survival study where the control kidney had been removed. Rat kidneys exhibiting longer time constants were much more likely to fail. This may lead to a method to assess kidney viability and predict its ability to recover in the initial period following transplantation or resuscitation.

Qualitative and quantitative characteristics of near-infrared autofluorescence in diabetic macular edema.

Science.gov (United States)

Yoshitake, Shin; Murakami, Tomoaki; Horii, Takahiro; Uji, Akihito; Ogino, Ken; Unoki, Noriyuki; Nishijima, Kazuaki; Yoshimura, Nagahisa

2014-05-01

To study the characteristics of near-infrared autofluorescence (NIR-AF) imaging and its association with spectral-domain optical coherence tomography (SD-OCT) findings and logarithm of the minimal angle of resolution (logMAR) visual acuity (VA) in diabetic macular edema (DME). Retrospective, observational, cross-sectional study. One hundred twenty-one consecutive eyes of 87 patients with center-involved DME for whom NIR-AF and SD-OCT images of sufficient quality were obtained. The NIR-AF images were acquired using Heidelberg Retina Angiograph 2 (Heidelberg Engineering, Heidelberg, Germany), and sectional retinal images were obtained using Spectralis OCT (Heidelberg Engineering). The presence of a mosaic pattern and cystoid signs were determined qualitatively. We quantified the average fluorescence intensity in the central 1-mm subfield. The characteristics of the NIR-AF images were compared with the OCT findings and logMAR VA. Qualitative and quantitative characteristics of the NIR-AF images and their association with SD-OCT findings and logMAR VA. Fifty-seven eyes with a mosaic pattern in the NIR-AF macular images had worse logMAR VA (0.355±0.239 vs. 0.212±0.235; P = 0.001), a thicker central subfield (CSF) (530±143 μm vs. 438±105 μm; P qualitative and quantitative NIR-AF characteristics in the macula indicated the clinical relevance and suggested the pathogenesis in DME. Copyright © 2014 American Academy of Ophthalmology. Published by Elsevier Inc. All rights reserved.

Quantitative fundus autofluorescence in healthy eyes.

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Greenberg, Jonathan P; Duncker, Tobias; Woods, Russell L; Smith, R Theodore; Sparrow, Janet R; Delori, François C

2013-08-21

Fundus autofluorescence was quantified (qAF) in subjects with healthy retinae using a standardized approach. The objective was to establish normative data and identify factors that influence the accumulation of RPE lipofuscin and/or modulate the observed AF signal in fundus images. AF images were acquired from 277 healthy subjects (age range: 5-60 years) by employing a Spectralis confocal scanning laser ophthalmoscope (cSLO; 488-nm excitation; 30°) equipped with an internal fluorescent reference. For each image, mean gray level was calculated as the average of eight preset regions, and was calibrated to the reference, zero-laser light, magnification, and optical media density from normative data on lens transmission spectra. Relationships between qAF and age, sex, race/ethnicity, eye color, refraction/axial length, and smoking status were evaluated as was measurement repeatability and the qAF spatial distribution. qAF levels exhibited a significant increase with age. qAF increased with increasing eccentricity up to 10° to 15° from the fovea and was highest superotemporally. qAF values were significantly greater in females, and, compared with Hispanics, qAF was significantly higher in whites and lower in blacks and Asians. No associations with axial length and smoking were observed. For two operators, between-session repeatability was ± 9% and ± 12%. Agreement between the operators was ± 13%. Normative qAF data are a reference tool essential to the interpretation of qAF measurements in ocular disease.

Portable LED-induced autofluorescence imager with a probe of L shape for oral cancer diagnosis

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Huang, Ting-Wei; Lee, Yu-Cheng; Cheng, Nai-Lun; Yan, Yung-Jhe; Chiang, Hou-Chi; Chiou, Jin-Chern; Mang, Ou-Yang

2015-08-01

The difference of spectral distribution between lesions of epithelial cells and normal cells after excited fluorescence is one of methods for the cancer diagnosis. In our previous work, we developed a portable LED Induced autofluorescence (LIAF) imager contained the multiple wavelength of LED excitation light and multiple filters to capture ex-vivo oral tissue autofluorescence images. Our portable system for detection of oral cancer has a probe in front of the lens for fixing the object distance. The shape of the probe is cone, and it is not convenient for doctor to capture the oral image under an appropriate view angle in front of the probe. Therefore, a probe of L shape containing a mirror is proposed for doctors to capture the images with the right angles, and the subjects do not need to open their mouse constrainedly. Besides, a glass plate is placed in probe to prevent the liquid entering in the body, but the light reflected from the glass plate directly causes the light spots inside the images. We set the glass plate in front of LED to avoiding the light spots. When the distance between the glasses plate and the LED model plane is less than the critical value, then we can prevent the light spots caused from the glasses plate. The experiments show that the image captured with the new probe that the glasses plate placed in the back-end of the probe has no light spots inside the image.

Serial imaging and structure-function correlates of high-density rings of fundus autofluorescence in retinitis pigmentosa.

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Robson, Anthony G; Tufail, Adnan; Fitzke, Fred; Bird, Alan C; Moore, Anthony T; Holder, Graham E; Webster, Andrew R

2011-09-01

To document the evolution and functional and structural significance of parafoveal rings of high-density fundus autofluorescence (AF) in patients with retinitis pigmentosa and preserved visual acuity. Fifty-two patients with nonsyndromic retinitis pigmentosa or Usher syndrome, who had a parafoveal ring of high-density AF and a visual acuity of 20/30 or better, were ascertained. All had international standard full-field electroretinography and pattern electroretinography. Autofluorescence imaging was repeated in 30 patients after periods of up to 9.3 years. Of the 52 patients, 35 underwent optical coherence tomography. Progressive constriction of the ring was detected in 17 patients. Ring radius reduced by up to 40% at a mean rate of between 0.8% and 15.8% per year. In 1 patient, a small ring was replaced by irregular AF; visual acuity deteriorated over the same period. There was a high correspondence between the lateral extent of the preserved optical coherence tomography inner segment/outer segment band and the diameter of the ring along the same optical coherence tomographic scan plane (slope, 0.9; r = 0.97; P retina and preserved photopic function. Serial fundus AF may provide prognostic indicators for preservation of central acuity and potentially assist in the identification and evaluation of patients suitable for treatment aimed at preservation of remaining function.

Optical coherence tomography and autofluorescence findings in chronic phototoxic maculopathy secondary to snow-reflected solar radiation

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Dhananjay Shukla

2015-01-01

Full Text Available A professional mountain trekker presented with gradual, moderate visual decline in one eye. The subnormal vision could not be explained by the examination of anterior and posterior segment of either eye, which was unremarkable. Optical coherence tomography and autofluorescence imaging revealed subtle defects in the outer retina, which correlated with the extent of visual disturbance. A novel presentation of retinal phototoxicity due to indirect solar radiation reflected from snow in inadequately protected eyes of a chronically exposed subject is reported.

A New System for Measuring Auto-Fluorescence Changes in Neovascular-AMD after Intravitreal Injection of Bavecizumab

OpenAIRE

Mohammad Norouzifard; Ali Soleymani; Jamshid Shanbehzadeh

2011-01-01

Age-Related Macular Degeneration (AMD) is the second disease diabetes which causes blindness in aged people. The only remedy for AMD is intravenous injection of bavecizumab. To prove the efficiency of remedy, the degenerated cells in Macula should be measured. In this article, a modern system is introduced to measure Auto-Fluorescence in Macula part of retina in order to obtain number of degenerated cells. The system consists of three main parts: Pre-processing stage is omission of margins an...

Optical coherence tomography and autofluorescence findings in chronic phototoxic maculopathy secondary to snow-reflected solar radiation.

Science.gov (United States)

Shukla, Dhananjay

2015-05-01

A professional mountain trekker presented with gradual, moderate visual decline in one eye. The subnormal vision could not be explained by the examination of anterior and posterior segment of either eye, which was unremarkable. Optical coherence tomography and autofluorescence imaging revealed subtle defects in the outer retina, which correlated with the extent of visual disturbance. A novel presentation of retinal phototoxicity due to indirect solar radiation reflected from snow in inadequately protected eyes of a chronically exposed subject is reported.

Clinical value of different detection methods in blunt ocular trauma

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Yang Li

2018-02-01

Full Text Available Blunt ocular can cause persistent change of eye structure and function, the method of detection which is closely related to eye injury including B-can ultrasonography, UBM, OCT, FFA, scanning laser polarimetry, fundus autofluorescence, each examination with particular emphasis. This paper aims to review the advantages and disadvantages of different inspection methods in order to provide reference for clinical diagnosis and treatment of blunt ocular trauma.

Clinical and radiological features of bronchiolitis obliterans in children

International Nuclear Information System (INIS)

Peng Yun; Sun Guoqiang; Zeng Jinjin; Ma Daqing

2006-01-01

Objective: To study the value of chest radiograph and thin-section computed tomography (CT) in diagnosis bronchiolitis obliterans in children, and to determine clinical view of obliterative bronchiolitis in children. Methods: We identified 12 infants, 10 boys, and 2 girls (age range, 5 month to 11 years) with clinical confirmation of bronchiolitis obliterans. Three cases were after Steven-Johnson syndrome, 8 were post-infection (2 adenovirus, 2 measles and 1 Pseudomonas aeruginosa infection, 3 cases were unknown etiology infection); The symptoms lasted for at least 6 weeks. One case had lung ventilation nuclear scan. We evaluated individual bronchoscopy, pulmonary function test, chest radiograph and thin- section CT features and their characteristic appearance. Results: All cases had typical clinical characteristics and pulmonary function testing results that were consistent with nonreversible small airways obstruction. One case had lung ventilation nuclear scan illustrated absent and reduced ventilation of the right lower lobe. Nine cases who underwent bronchoscopy were chronic endobronchial inflammation. Three children had transbronchial biopsy and 1 patient who underwent open pulmonary biopsies were uncertain of histological diagnosis. Chest radiography showed hyperinflation in 8 cases; peribronchial thickening in 6 cases; consolidation/atelectasia in 6 cases; unilateral hyperlucency of a small/normal-sized lung in 4 cases. Thin-section CT/HRCT features included: mosaic perfusion pattern, decreased lung attenuation in 11 cases, pulmonary vascular attenuation in 10 cases; bronchial dilatation in 7 cases; bronchial wall thickening in 9 cases; unilateral hyperlucency of a small/normal-sized lung in 5 cases; consolidation in 6 cases; nodular in 3 cases; mucoid impaction in 5 cases. Conclusions: In our study, correct diagnoses of bronchiolitis obliterans in children were made more special with thin-section CT than with chest radiographs. The diagnosis of BO in

Central serous chorioretinopathy fundus autofluorescence comparison with two different confocal scanning laser ophthalmoscopes.

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Nam, Ki Tae; Yun, Cheol Min; Kim, Jee Taek; Yang, Kyung-Sook; Kim, Hyun Joo; Kim, Seong-Woo; Oh, Jaeryung; Huh, Kuhl

2015-12-01

To compare the lesion characteristics of two different types of confocal scanning laser ophthalmoscopy (cSLO) autofluorescence (AF) images in central serous chorioretinopathy (CSC). The study included 63 eyes of 61 patients; 63 pairs of fundus autofluorescence (FAF) images were compared before CSC resolution in 63 eyes, FAF images of 31 eyes were also compared after CSC resolution. The lesion characteristics (brightness and composite pattern) were compared between Heidelberg Retina Angiograph 2 (HRA2; Heidelberg Engineering, Germany) and Optomap Tx (Optomap; Optos, Scotland) FAF images. The lesion composite pattern was categorized as diffuse or granular. Diffuse AF was defined as homogenously increased or decreased AF, and granular AF was defined as dot-like, coarse changes in AF. The mean disease duration and subretinal fluid (SRF) height in the spectral domain optical coherence tomography were compared according to the FAF image characteristics. Lesion brightness before CSC resolution was hypo-AF in 48 eyes (76.2 %), hyper-AF in three (4.8 %), and mixed-AF in 12 (19.0 %) in HRA2 FAF images. In comparison, nine (14.3 %) images were hypo-AF, 44 (69.8 %) were hyper-AF, and 10 (15.9 %) were mixed-AF in Optomap FAF images (P < 0.0001). There was no significant difference in lesion composite pattern between the two FAF image wavelengths. Patients with lesions that were hyper-AF in Optomap FAF and hypo-AF in HRA2 FAF had a shorter disease duration and greater SRF height (1 month, 281 um) than those who were hyper-AF in both Optomap and HRA2 images (26 months, 153 um; P = 0.004, 0.001). The two types of FAF images of CSC showed different lesion brightness before and after CSC resolution but demonstrated similar lesion composite patterns.

Investigation of dental caries using laser and light-induced autofluorescence methods

International Nuclear Information System (INIS)

Borisova, E.; Avramov, L.; Uzunov, T.

2006-01-01

The aim of this study was to investigate the intrinsic fluorescence in human teeth in vitro and its correspondence to the stages of the carious lesions using different excitation sources. Fluorescence spectra of teeth illuminated with light with wavelengths of 337, 440 and 488 nm were recorded. The spectra were obtained from the healthy, pre-carious and carious stages of the teeth investigated. Fluorosa dentis and odontolithiasis lesions were also studied to determine the effect of other pathologies on the teeth fluorescence spectra. We observed a significant decrease of the autofluorescence signal intensity related to the carious stage. The carious samples also revealed characteristic emission with fluorescence bands in the red spectral region which relative peak intensity increases depending on the stage. Healthy hard dental tissue exhibited no emission bands in the long-wave region. (authors)

E-Liquid Autofluorescence can be used as a Marker of Vaping Deposition and Third-Hand Vape Exposure

OpenAIRE

Davis, Eric S.; Sassano, M. Flori; Goodell, Henry; Tarran, Robert

2017-01-01

In the past 5 years, e-cigarette use has been increasing rapidly, particularly in youth and young adults. Due to the novelty of e-cigarettes (e-cigs) and e-cigarette liquids (e-liquids), research on their chemo-physical properties is still in its infancy. Here, we describe a previously unknown and potentially useful property of e-liquids, namely their autofluorescence. We performed an emission scan at 9 excitation wavelengths common to fluorescent microscopy and found (i) that autofluorescenc...

Correlation of Optical Coherence Tomography and Autofluorescence in the Outer Retina and Choroid of Patients With Choroideremia.

Science.gov (United States)

Xue, Kanmin; Oldani, Marta; Jolly, Jasleen K; Edwards, Thomas L; Groppe, Markus; Downes, Susan M; MacLaren, Robert E

2016-07-01

To evaluate the relationships between RPE, photoreceptor, and choroidal degeneration in choroideremia. Enhanced-depth imaging optical coherence tomography (EDI-OCT), scanning laser ophthalmoscopy (SLO), and autofluorescence (AF) were performed on 39 patients (78 eyes) with choroideremia. The edges of surviving outer retina on OCT and residual AF were aligned. The distribution of outer retinal tubulations was mapped over a range of ages (16-71 years), and comparison made between pre- and postsubretinal gene therapy. Subfoveal choroidal thickness (SFCT) was compared between 23 choroideremia patients (42 eyes) and 20 age- and refraction-matched male controls (40 eyes). The edges of RPE AF aligned with a reduction in outer nuclear layer thickness (Spearman's rho = 0.9992). Correlation was also found between the quality of AF and integrity of ellipsoid zone within islands of surviving retina. Tubulations existed in 71 of 78 (91%) eyes with choroideremia and remained stable following gene therapy. Subfoveal choroidal thickness was reduced at baseline in choroideremia (179.7 ± 17.2 μm) compared with controls (302.0 ± 4.8 μm; P retina and hence being potentially light responsive (ClinicalTrials.gov, NCT01461213).

Potential applications of near infrared auto-fluorescence spectral polarized imaging for assessment of food quality

Science.gov (United States)

Zhou, Kenneth J.; Chen, Jun

2016-03-01

The current growing of food industry for low production costs and high efficiency needs for maintenance of high-quality standards and assurance of food safety while avoiding liability issues. Quality and safety of food depend on physical (texture, color, tenderness etc.), chemical (fat content, moisture, protein content, pH, etc.), and biological (total bacterial count etc.) features. There is a need for a rapid (less than a few minutes) and accurate detection system in order to optimize quality and assure safety of food. However, the fluorescence ranges for known fluorophores are limited to ultraviolet emission bands, which are not in the tissue near infrared (NIR) "optical window". Biological tissues excited by far-red or NIR light would exhibit strong emission in spectral range of 650-1,100 nm although no characteristic peaks show the emission from which known fluorophores. The characteristics of the auto-fluorescence emission of different types of tissues were found to be different between different tissue components such as fat, high quality muscle food. In this paper, NIR auto-fluorescence emission from different types of muscle food and fat was measured. The differences of fluorescence intensities of the different types of muscle food and fat emissions were observed. These can be explained by the change of the microscopic structure of physical, chemical, and biological features in meat. The difference of emission intensities of fat and lean meat tissues was applied to monitor food quality and safety using spectral polarized imaging, which can be detect deep depth fat under the muscle food up to several centimeter.

Analysing the Progression Rates of Macular Lesions with Autofluorescence Imaging Modes in Dry Age-Related Macular Degeneration

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Kenan Olcay

2015-12-01

Full Text Available Objectives: In this study we aimed to compare the sensitivity of blue-light fundus autofluorescence (FAF and near-infrared autofluorescence (NI-AF imaging for determining the progression rates of macular lesions in dry age-related macular degeneration (AMD. Materials and Methods: The study was designed retrospectively and included patients diagnosed with intermediate and advanced stage dry AMD. Best corrected visual acuities and FAF and NI-AF images were recorded in 46 eyes of 33 patients. Lesion borders were drawn manually on the images using Heidelberg Eye Explorer software and lesion areas were calculated by using Microsoft Excel software. BCVA and lesion areas were compared with each other. Results: Patients’ mean follow-up time was 30.98±13.30 months. The lesion area progression rates were 0.85±0.93 mm2/y in FAF and 0.93±1.01 mm2/y in NI-AF, showing statistically significant correlation with each other (r=0.883; p<0.01. Both imaging methods are moderately correlated with visual acuity impairment (r=0.362; p<0.05 and r=0.311; p<0.05, respectively. In addition, larger lesions showed higher progression rates than smaller ones in both imaging methods. Conclusion: NI-AF imaging is as important and effective as FAF imaging for follow-up of dry AMD patients.

A prospective study to evaluate the utility of bronchoalveolar lavage by fiberoptic bronchoscopy in sputum smear negative patients with high suspicion of pulmonary tuberculosis

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Ritesh Kamal

2012-01-01

Full Text Available Aim: To evaluate the utility of bronchoalveolar lavage (BAL by flexible fiberoptic bronchoscopy (FOB in sputum smear negative patients with clinical and radiological characteristics of pulmonary tuberculosis (PTB. Materials and Methods: This prospective study was carried out in 30 sputum smear negative patients of age group 20 to 70 years, who were highly suspicious for PTB by clinical and radiographic criteria. All patients were subjected to sputum culture, BAL stains and cultures, and cytopathology. Patients with moderate to massive pleural effusion, obvious accessible lymph node, history of antitubercular therapy (ATT, and contraindication to FOB were excluded. Results: Sputum culture for acid fast bacilli (AFB was positive in four (12% patients, BAL fluid was positive for Ziehl-Neelsen (ZN stain in nine (27% patients, including four sputum culture patients, while BAL culture for AFB on Lowenstein-Jensen (LJ medium was positive in 18 (60%, including 9 BAL fluid ZN stain positive patients. Six (20% patients had growth on pyogenic culture, while two (7% patients had malignant cell on cytological examination of BAL fluid. Remaining four (13% patients were empirically started on ATT. They had complete response to ATT at 2 months and were retrospectively diagnosed with pulmonary tuberculosis (PTB. All the bacteriologically confirmed PTB patients were given ATT for 6 months and all patients had complete response. Conclusion: We concluded that FOB guided BAL is extremely useful for establishing diagnosis of PTB or other pulmonary diseases in sputum smear negative patients, who have high suspicion for PTB by clinical and radiographic criteria.

Use of fluorescence spectroscopy to measure molecular autofluorescence in diabetic subjects; Utilizacao da espectroscopia de fluorescencia para mensuramento de moleculas autofluorescentes em individuos diabeticos

Energy Technology Data Exchange (ETDEWEB)

Gomes, Cinthia Zanini

2011-07-01

Diabetes Mellitus (DM) comprises a complex metabolic syndrome, caused by reduced or absent secretion of insulin by pancreatic beta cells, leading to hyperglycemia. Hyperglycemia promotes glycation of proteins and, consequently, the appearance of advanced glycation end products (AGEs). Currently, diabetic patients are monitored by determining levels of glucose and glycated hemoglobin (HbA1c). The complications caused by hyperglycemia may be divided into micro and macrovascular complications, represented by retinopathy, nephropathy, neuropathy and cardiovascular disease. Albumin (HSA) is the most abundant serum protein in the human body and is subject to glycation. The Protoporphyrin IX (PpIX) is the precursor molecule of heme synthesis, structural component of hemoglobin. The in vitro and animals studies have indicated that hyperglycemia promotes a decrease in its concentration in erythrocytes. The fluorescence spectroscopy is a technique widely used in biomedical field. The autofluorescence corresponds to the intrinsic fluorescence present in some molecules, this being associated with the same structure. The aim of this study was to use fluorescence spectroscopy to measure levels of erythrocyte PpIX autofluorescence and AGE-HSA in diabetic and healthy subjects and compare them with levels of blood glucose and HbA1c. This study was conducted with 151 subjects (58 controls and 93 diabetics). Epidemiological data of patients and controls were obtained from medical records. For control subjects, blood glucose levels were obtained from medical records and levels of Hb1Ac obtained by using commercial kits. The determination of the PpIX autofluorescence was performed with excitation at 405 nm and emission at 632 nm. Determination of AGE-HSA was performed with excitation at 370 nm and emission at 455 nm. Approximately 50% of diabetic had micro and macrovascular lesions resulting from hyperglycemia. There were no significant differences in the PpIX emission intensity values

Fundus Autofluorescence Imaging in an Ocular Screening Program

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A. M. Kolomeyer

2012-01-01

Full Text Available Purpose. To describe integration of fundus autofluorescence (FAF imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA, intraocular pressure (IOP, and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18% individuals with diabetic retinopathy or macular edema (n=4, focal RPE defects (n=2, age-related macular degeneration (n=1, central serous retinopathy (n=1, and ocular trauma (n=1. Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.

Fundus autofluorescence imaging in an ocular screening program.

Science.gov (United States)

Kolomeyer, A M; Nayak, N V; Szirth, B C; Khouri, A S

2012-01-01

Purpose. To describe integration of fundus autofluorescence (FAF) imaging into an ocular screening program. Methods. Fifty consecutive screening participants were included in this prospective pilot imaging study. Color and FAF (530/640 nm exciter/barrier filters) images were obtained with a 15.1MP Canon nonmydriatic hybrid camera. A clinician evaluated the images on site to determine need for referral. Visual acuity (VA), intraocular pressure (IOP), and ocular pathology detected by color fundus and FAF imaging modalities were recorded. Results. Mean ± SD age was 47.4 ± 17.3 years. Fifty-two percent were female and 58% African American. Twenty-seven percent had a comprehensive ocular examination within the past year. Mean VA was 20/39 in the right eye and 20/40 in the left eye. Mean IOP was 15 mmHg bilaterally. Positive color and/or FAF findings were identified in nine (18%) individuals with diabetic retinopathy or macular edema (n = 4), focal RPE defects (n = 2), age-related macular degeneration (n = 1), central serous retinopathy (n = 1), and ocular trauma (n = 1). Conclusions. FAF was successfully integrated in our ocular screening program and aided in the identification of ocular pathology. Larger studies examining the utility of this technology in screening programs may be warranted.

Skin Autofluorescence Examination as a Diagnostic Tool for Mild Cognitive Impairment in Healthy People.

Science.gov (United States)

Igase, Michiya; Ohara, Maya; Igase, Keiji; Kato, Takeaki; Okada, Yoko; Ochi, Masayuki; Tabara, Yasuharu; Kohara, Katsuhiko; Ohyagi, Yasumasa

2017-01-01

Accumulation of advanced glycation endproducts (AGEs) is thought to be involved in the pathogenesis of dementia, especially Alzheimer's disease. Tissue AGE accumulation can be estimated using the relative simple noninvasive measurement of skin autofluorescence (SAF), a method based on the fluorescent properties of some AGEs. However, possible involvement of tissue AGE accumulation in mild cognitive impairment (MCI) has not been fully investigated. We investigated whether tissue AGE accumulation estimated by SAF is associated with mild cognitive impairment. We analyzed 226 community-dwelling subjects. In addition to several atherosclerosis-related clinical parameters, MCI screening test, assessment of brain atrophy, and SAF were performed on people aged > 40 years. MCI was assessed using the Japanese version of the MCI screening method. Atrophy of the brain was assessed by examining the temporal horn area (THA) by brain MRI. SAF was significantly higher in participants with MCI than in those with normal cognitive function (2.56±0.55 versus 2.10±0.41; p  2.27 was significantly related to the presence of MCI (odds, 6.402; 95% CI, 1.590-25.773, p = 0.009). We found an association between SAF and MCI, which was independent of brain atrophy, in healthy subjects.

A novel needle-type sampling device for flexible ultrathin bronchoscopy

International Nuclear Information System (INIS)

Suda, Yuji; Hayashi, Katsutoshi; Shindoh, Yuriko; Iijima, Hideya; Tanaka, Akiko

2008-01-01

Diagnosis of suspected cancer in the periphery of the lung is difficult. A flexible ultrathin bronchoscope has been developed for the diagnosis of peripherally located pulmonary lesions that cannot be reached with the sampling devices for standard flexible bronchoscopes. The diagnostic yield with forceps and a brush for ultrathin bronchoscopes, however, is not adequate, especially when a lesion is not exposed to the bronchial lumen. We have thus developed a novel needle-type sampling device and tested its yield in transbronchial cytology. The device consists of an elongated dental H-file (0.4 mm in diameter and 110 cm in length), a housing sheath (1.0 mm in outer diameter), and a novel handle, which enables rapid out-and-in motion of the needle. Ten consecutive patients with a peripheral pulmonary lesion who had an indication for diagnostic procedure with a flexible ultrathin bronchoscope were enrolled. The optimal bronchial route to the lesion was analyzed with virtual bronchoscopy in a data set obtained with high-resolution computed tomography, and a novel bronchial route labeling system (prior-ridge-based relative orientation nomenclature) was employed to guide insertion of the bronchoscope. Sampling with the novel needle was performed prior to use of the forceps and brush under conventional fluoroscopy. In all the cases, sampling with the needle was successful and the amount of the specimen was sufficient for cytology. Our novel sampling system with flexible ultrathin bronchoscopes may contribute to accurate and minimally invasive diagnosis of peripheral pulmonary lesions. (author)

Characteristic appearances of fundus autofluorescence in treatment-naive and active polypoidal choroidal vasculopathy: a retrospective study of 170 patients.

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Zhao, Xinyu; Xia, Song; Chen, Youxin

2018-06-01

To investigate the characteristic appearances of fundus autofluorescence (FAF) in patients with treatment-naive and active polypoidal choroidal vasculopathy (PCV). Cases with the diagnosis of treatment-naive and active PCV from November 2012 to May 2017 at Peking Union Medical College Hospital were retrospectively reviewed. All patients underwent comprehensive ophthalmologic examination. Autofluorescence (AF) findings were described at the retinal sites of the corresponding lesions identified and diagnosed using indocyanine green angiography and spectral-domain optical coherence tomography. One hundred seventy patients with 192 affected eyes were included. The logMAR BCVA of the patients were 0.53 ± 0.28. The six AF patterns of 243 polypoidal lesions were confluent hypo-AF with hyper-AF ring (49.8%), confluent hypo-AF (22.6%), hyper-AF with hypo-AF ring (3.7%), granular hypo-AF (7.0%), blocked hypo-AF due to hemorrhage (8.6%), and polyps without apparent AF changes (8.2%). For 146 branching vascular networks (BVNs), 97.3% were granular hypo-AF, and others were blocked hypo-AF due to hemorrhage. In eyes with treatment-naive and active PCV, the polypoidal lesions and BVNs induce characteristic FAF changes. FAF images provide reliable adjunct reference for the diagnosis of PCV.

Skin autofluorescence is associated with arterial stiffness and insulin level in endurance runners and healthy controls - Effects of aging and endurance exercise.

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Couppé, Christian; Dall, Christian Have; Svensson, Rene Brüggebusch; Olsen, Rasmus Huan; Karlsen, Anders; Praet, Stephan; Prescott, Eva; Magnusson, S Peter

2017-05-01

Life-long regular endurance exercise yields positive effects on cardiovascular and metabolic function, disease and mortality rate. Glycation may be a major mechanism behind age-related diseases. However, it remains unknown if skin autofluorescence (SAF), which reflects glycation, is related to arterial and metabolic function in life-long endurance runners and sedentary controls. Healthy elderly men: 15 life-long endurance runners (OT) (64±4years) and 12 old untrained (OU) (66±4years), and healthy young men; ten young athletes (YT) (26±4years) matched to OT for running distance, and 12 young untrained (YU) (24±3years) were recruited. Endothelial function (reactive hyperemia index, RHI) and arterial stiffness (augmentation index, AI@75 and AI) were measured by an operator-independent PAT 2000. SAF was non-invasively determined using an autofluorescence spectrometer. For AI@75 there was an effect of age (page correction (both r 2 =0.19, paging and pathology). Surprisingly, endurance running only had modest effects on cardiovascular function compared to lean healthy controls. Copyright © 2017 Elsevier Inc. All rights reserved.

Long-term reduction in infrared autofluorescence caused by infrared light below the maximum permissible exposure.

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Masella, Benjamin D; Williams, David R; Fischer, William S; Rossi, Ethan A; Hunter, Jennifer J

2014-05-20

Many retinal imaging instruments use infrared wavelengths to reduce the risk of light damage. However, we have discovered that exposure to infrared illumination causes a long-lasting reduction in infrared autofluorescence (IRAF). We have characterized the dependence of this effect on radiant exposure and investigated its origin. A scanning laser ophthalmoscope was used to obtain IRAF images from two macaques before and after exposure to 790-nm light (15-450 J/cm(2)). Exposures were performed with either raster-scanning or uniform illumination. Infrared autofluorescence images also were obtained in two humans exposed to 790-nm light in a separate study. Humans were assessed with direct ophthalmoscopy, Goldmann visual fields, multifocal ERG, and photopic microperimetry to determine whether these measures revealed any effects in the exposed locations. A significant decrease in IRAF after exposure to infrared light was seen in both monkeys and humans. In monkeys, the magnitude of this reduction increased with retinal radiant exposure. Partial recovery was seen at 1 month, with full recovery within 21 months. Consistent with a photochemical origin, IRAF decreases caused by either raster-scanning or uniform illumination were not significantly different. We were unable to detect any effect of the light exposure with any measure other than IRAF imaging. We cannot exclude the possibility that changes could be detected with more sensitive tests or longer follow-up. This long-lasting effect of infrared illumination in both humans and monkeys occurs at exposure levels four to five times below current safety limits. The photochemical basis for this phenomenon remains unknown. Copyright 2014 The Association for Research in Vision and Ophthalmology, Inc.

Skin Autofluorescence Relates to Soluble Receptor for Advanced Glycation End-Products and Albuminuria in Diabetes Mellitus

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J. Škrha

2013-01-01

Full Text Available The aim of this study was to compare skin autofluorescence caused by advanced glycation end-products (AGEs with biochemical markers of endothelial dysfunction and soluble receptor for AGEs (sRAGE in patients with diabetes. Skin autofluorescence (AF assessed by AGE-Reader was evaluated with sRAGE and other biochemical parameters in 88 patients with diabetes (47 Type 1/T1DM/ and 41 Type 2/T2DM/ and 20 controls. Skin AF was significantly higher in T1DM and T2DM in comparison to controls (2.39 ± 0.54, 2.63 ± 0.73 versus 1.96 ± 0.33 AU; P<0.0001. Positive correlation of AF with sRAGE was detected in T1DM and T2DM (r=0.37, P<0.02 and r=0.60, P<0.0001, but not in controls. Significantly higher AF values were found in patients with positive albuminuria as compared to those with normal albuminuria. Similarly, higher AF was detected in patients with endothelial dysfunction expressed by vWF, ICAM-1, and VCAM-1. Multiple regression analysis revealed independent association of skin AF with age, sRAGE, and albumin-creatinine ratio in patients with diabetes (R2=0.38. Our study confirms that AF is elevated in patients with diabetes, especially with positive albuminuria and endothelial dysfunction. The strong and independent relationship between AF and sRAGE supports the idea that AF may reflect AGEs/RAGE interactions. The exact mechanism remains to be established.

Virtual bronchoscopy, importance of the method, application and prospects for tumors of the trachea and bronchi

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M. A. Mitev

2017-09-01

Full Text Available Virtual bronchoscopy (VB is 3-dimensional computer-generated technology, creating endobronchial images from spiral CT data. The study aims to present summarized results from researches of different foreign authors about the advantages of VB, the possibilities for its application and the effectiveness of its use in routine practice in the diagnosis of tumors of the trachea and bronchi. The three-dimensional model of the tracheobronchial tree allows assessment of the airways from inside. The majority of the examined studies relate to the diagnosis of new formations of the respiratory tract, preparation for surgery, assessment of the results of surgery, etc. VB is a noninvasive method allowing to examine the smallest bronchi. Relatively few studies in Bulgaria as well as the ensured during recent years new modern equipment for VB and MDCT, provide great opportunities for making VB examinations to study the effectiveness and its wide application in daily X-ray practice.

Comparison of indocyanine green fluorescence and parathyroid autofluorescence imaging in the identification of parathyroid glands during thyroidectomy.

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Kahramangil, Bora; Berber, Eren

2017-12-01

Indocyanine green fluorescence (ICGF) and parathyroid autofluorescence (AF) are two new techniques that aid in the identification of parathyroid glands (PG) intraoperatively during thyroidectomy. There is no study comparing the efficacy of these techniques. This was an IRB-approved clinical study comparing the utility of ICGF and AF for identification of PGs during thyroidectomy. Data were collected prospectively. Both techniques were compared to naked eye (NE) for PG detection. Standard statistical methods were used for data analysis. Twenty-two patients in each group underwent a total of 39 total thyroidectomies and 5 thyroid lobectomies. AF and ICGF had similar detection rates for PGs [98% (61 of 62) and 95% (60 of 63) of PGs, respectively; P=0.31]. The location of PGs was suggested before detection with NE more frequently by AF than ICGF [52% (32 of 62) vs. 6% (4 of 63) of PGs; P0.99]. To the best of our knowledge, this is the first comparative study between parathyroid AF and ICGF in detection of PGs during thyroidectomy. Our data suggest both techniques have similarly high detection rates and that the main difference lies in the timing of detection. AF more frequently detects PGs before recognition with NE compared to ICGF.

FY 1995 basic research to develop instruments for diagnosis of atherosclerosis on the basis of autofluorescence analysis of blood and vascular walls; 1995 nendo ketsueki oyobi kekkanheki no jiko keiko bunseki ni yoru domyaku koka shindan kiki kaiahtsu no tame no kisoteki kenkyu

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NONE

1997-03-01

To obtain the basic data to develop instruments for diagnosis of atherosclerosis and to elucidate the mechanisms of atherogenesis by focusing on the autofluorescence of blood and vascular walls of atherosclerotic animal models and human patients. We have performed experiments to examine the relationships between autofluorescence of blood and vascular walls of guinea pig atherosclerotic model and human patients and obtained the following results. 1. The autofluorescence from human atherosclerotic aorta included the components with longer wave length than normal aorta, suggesting that diagnosis of atherosclerotic aortic walls will be possible using spectroscopic analysis through glass fiber catheter into vascular system. Further studies should be needed to the quantitative diagnosis. 2. The autofluorescence from blood plasma of human atherosclerotic patients has showed that the peak wave length was shorter than that of normal plasma. This phenomenon was mainly caused by the oxidization of plasma, especially lipoproteins, LDL and HDL. 3. Atherosclerotic model of the guinea pigs was quite similar to human atherosclerosis at the points of cholesterol levels and localization of lipid deposit to arterial walls, and showed to be useful for the studies of atherosclerosis. (NEDO)

A longitudinal study of Stargardt disease: quantitative assessment of fundus autofluorescence, progression, and genotype correlations.

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Fujinami, Kaoru; Lois, Noemi; Mukherjee, Rajarshi; McBain, Vikki A; Tsunoda, Kazushige; Tsubota, Kazuo; Stone, Edwin M; Fitzke, Fred W; Bunce, Catey; Moore, Anthony T; Webster, Andrew R; Michaelides, Michel

2013-12-17

We characterized subtypes of fundus autofluorescence (AF) and the progression of retinal atrophy, and correlated these findings with genotype in Stargardt disease. Full clinical examination and AF imaging was undertaken in 68 patients with Stargardt disease. The baseline data were compared to those at follow-up. Patients were classified into three AF subtypes: type 1 had a localized low signal at the fovea surrounded by a homogeneous background, type 2 had a localized low signal at the macula surrounded by a heterogeneous background with numerous foci of abnormal signal, and type 3 had multiple low signal areas at the posterior pole with a heterogeneous background. At baseline, there were 19 patients with type 1, 41 with type 2, and 8 with type 3 disease. The areas of reduced AF signal were measured and rate of atrophy enlargement (RAE) was calculated as the difference of the atrophy size over time (mm²) divided by the follow-up interval (years). Molecular screening of ABCA4 was undertaken. The mean follow-up interval was 9.1 years. A total of 42% cases with type 1 disease progressed to type 2, and 12% with type 2 progressed to type 3. The RAE (mm²/y) based upon baseline AF subtypes was significantly different; 0.06 in type 1, 0.67 in type 2, and 4.37 in type 3. ABCA4 variants were identified in 57 patients. There was a significant association between AF subtype and genotype. The AF pattern at baseline influences the enlargement of atrophy over time and has genetic correlates. These data are likely to assist in the provision of counseling on prognosis in Stargardt disease and be valuable for future clinical trials.

Simultaneous optical coherence tomography and lipofuscin autofluorescence imaging of the retina with a single broadband light source at 480nm

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Jiang, Minshan; Liu, Tan; Liu, Xiaojing; Jiao, Shuliang

2014-01-01

We accomplished spectral domain optical coherence tomography and auto-fluorescence microscopy for imaging the retina with a single broadband light source centered at 480 nm. This technique is able to provide simultaneous structural imaging and lipofuscin molecular contrast of the retina. Since the two imaging modalities are provided by the same group of photons, their images are intrinsically registered. To test the capabilities of the technique we periodically imaged the retinas of the same ...

Lung cancer screening beyond low-dose computed tomography: the role of novel biomarkers.

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Hasan, Naveed; Kumar, Rohit; Kavuru, Mani S

2014-10-01

Lung cancer is the most common and lethal malignancy in the world. The landmark National lung screening trial (NLST) showed a 20% relative reduction in mortality in high-risk individuals with screening low-dose computed tomography. However, the poor specificity and low prevalence of lung cancer in the NLST provide major limitations to its widespread use. Furthermore, a lung nodule on CT scan requires a nuanced and individualized approach towards management. In this regard, advances in high through-put technology (molecular diagnostics, multi-gene chips, proteomics, and bronchoscopic techniques) have led to discovery of lung cancer biomarkers that have shown potential to complement the current screening standards. Early detection of lung cancer can be achieved by analysis of biomarkers from tissue samples within the respiratory tract such as sputum, saliva, nasal/bronchial airway epithelial cells and exhaled breath condensate or through peripheral biofluids such as blood, serum and urine. Autofluorescence bronchoscopy has been employed in research setting to identify pre-invasive lesions not identified on CT scan. Although these modalities are not yet commercially available in clinic setting, they will be available in the near future and clinicians who care for patients with lung cancer should be aware. In this review, we present up-to-date state of biomarker development, discuss their clinical relevance and predict their future role in lung cancer management.

Simultaneous in vivo imaging of melanin and lipofuscin in the retina with photoacoustic ophthalmoscopy and autofluorescence imaging

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Zhang, Xiangyang; Zhang, Hao F.; Puliafito, Carmen A.; Jiao, Shuliang

2011-08-01

We combined photoacoustic ophthalmoscopy (PAOM) with autofluorescence imaging for simultaneous in vivo imaging of dual molecular contrasts in the retina using a single light source. The dual molecular contrasts come from melanin and lipofuscin in the retinal pigment epithelium (RPE). Melanin and lipofuscin are two types of pigments and are believed to play opposite roles (protective versus exacerbate) in the RPE in the aging process. We have successfully imaged the retina of pigmented and albino rats at different ages. The experimental results showed that multimodal PAOM system can be a potentially powerful tool in the study of age-related degenerative retinal diseases.

Skin autofluorescence as a measure of advanced glycation endproduct deposition: a novel risk marker in chronic kidney disease.

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Smit, Andries J; Gerrits, Esther G

2010-11-01

Skin autofluorescence (SAF) is a new method to noninvasively assess accumulation of advanced glycation endproducts (AGEs) in a tissue with low turnover. Recent progress in the clinical application of SAF as a risk marker for diabetic nephropathy as well as cardiovascular disease in nondiabetic end-stage kidney disease, less advanced chronic kidney disease, and renal transplant recipients is reviewed. Experimental studies highlight the fundamental role of the interaction of AGEs with the receptor for AGEs (RAGEs), also called the AGE-RAGE axis, in the pathogenesis of vascular and chronic kidney disease. SAF predicts (cardiovascular) mortality in renal failure and also chronic renal transplant dysfunction. Long-term follow-up results from the Diabetes Control and Complications Trial and UK Prospective Diabetes Study suggest that AGE accumulation is a key carrier of metabolic memory and oxidative stress. Short-term intervention studies in diabetic nephropathy with thiamine, benfotiamine and angiotensin-receptor blockers aimed at reducing AGE formation have reported mixed results. SAF is a noninvasive marker of AGE accumulation in a tissue with low turnover, and thereby of metabolic memory and oxidative stress. SAF independently predicts cardiovascular and renal risk in diabetes, as well as in chronic kidney disease. Further long-term studies are required to assess the potential benefits of interventions to reduce AGE accumulation.

Uso da broncoscopia virtual em pacientes pediátricos com suspeita de aspiração de corpo estranho Use of virtual bronchoscopy in children with suspected foreign body aspiration

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Tiago Neves Veras

2009-09-01

Full Text Available A aspiração de corpo estranho (ACE para o trato respiratório é um problema comum em pacientes pediátricos, em especial abaixo dos três anos de idade. Na avaliação radiológica inicial, cerca de 30% dos pacientes apresentam radiograma de tórax normal. A tomografia com broncoscopia virtual (BV pode auxiliar no diagnóstico precoce desse quadro e seu pronto manejo. O tratamento definitivo se dá com a retirada do corpo estranho através de broncoscopia rígida e mediante anestesia geral. O objetivo deste trabalho foi descrever o uso da BV na abordagem de dois pacientes com suspeita de ACE e realizar uma revisão da literatura sobre este tópico. Os dois pacientes tiveram início súbito de sintomas respiratórios e relato de tosse ou engasgo com alimentos antecedendo o quadro. Os pacientes foram submetidos à BV, e foi detectada a presença de corpo estranho endobrônquico em ambos os casos, com remoção posterior por broncoscopia rígida convencional em um caso. A BV é um método não-invasivo recente e com potencial para detectar a presença de corpo estranho na via respiratória em crianças. Em casos selecionados, BV pode auxiliar na localização correta do corpo estranho e até mesmo evitar o procedimento de broncoscopia rígida na ausência de corpo estranho.Foreign body aspiration (FBA into the tracheobronchial tree is a common problem in children, especially in those under three years of age. Preliminary radiological evaluation reveals normal chest X-rays in nearly 30% of such patients. Tomography-generated virtual bronchoscopy (VB can facilitate the early diagnosis and rapid management of these cases. The definitive treatment is the removal of the foreign body by means of rigid bronchoscopy under general anesthesia. The objective of this study was to describe the use of VB in two patients with suspicion of FBA, as well as to review the literature regarding this topic. The two patients presented with sudden onset of respiratory

Foreign body in children?s airways

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Cassol Vitor

2003-01-01

Full Text Available OBJECTIVE: To determine the clinical characteristics and the results of bronchoscopic treatment of children due to foreign body aspiration in a university hospital. METHOD: Time series of children who underwent bronchoscopies for foreign bodies aspirated into the airway between March 1993 and July 2002. Each patient was analyzed for age, sex, initial clinical diagnosis, nature and location of the foreign body, duration of symptoms between aspiration and bronchoscopy, radiological findings, results of bronchoscopic removal, complications of bronchoscopy and presence of foreign bodies in the airways. RESULTS: Thirty-four children, 20 (59% boys, ages ranging from nine months to nine years (median = 23 months. In 32 (94% children the foreign body was removed by rigid bronchoscope, and two resulted in thoracotomy. Foreign bodies were more frequent in children under three years of age (66%. A clinical history of foreign body inhalation was obtained in 27 (80% cases. Most of the foreign bodies removed were organic (65% and more frequently found in the right bronchial tree (59%. Foreign bodies were removed within 24 hours in 18 (53% cases. The most frequent radiographic findings were: unilateral air trapping, atelectasis and radiopac foreign body. Major bronchoscopy complications occurred in seven children (22%, and there were no deaths. CONCLUSIONS: More attention is necessary to the respiratory symptoms of aspirations, mainly in boys at early ages, with clinical history and compatible radiological findings. Most foreign bodies removed were of organic nature. In this case series, therapeutic rigid bronchoscopy was effective with few complications.

Fundus autofluorescence in central serous chorioretinopathy:association with spectral-domain optical coherence tomography and fluorescein angiography

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Peng Zhang

2015-10-01

Full Text Available AIM: To evaluate the correlation among changes in fundus autofluorescence (AF measured using infrared fundus AF (IR-AF and short-wave length fundus AF (SW-AF with changes in spectral-domain optical coherence tomography (SD-OCT and fluorescein angiography (FA in central serous chorioretinopathy (CSC.METHODS:Two hundred and twenty consecutive patients with CSC were included. In addition to AF, patients were assessed by means of SD-OCT and FA. Abnormalities in images of IR-AF, SW-AF, FA were analyzed and correlated with the corresponding outer retinal alterations in SD-OCT findings.RESULTS:Eyes with abnormalities on either IR-AF or SW-AF were found in 256 eyes (58.18%, among them 256 eyes (100% showed abnormal IR-AF, but SW-AF abnormalities were present only in 213 eyes (83.20%. The hypo-IR-AF corresponded to accumulation of sub-retinal liquid, collapse of retinal pigment epithelium (RPE or detachment of RPE with or without RPE leakage point in the corresponding area. The hyper-IR-AF corresponded to the area with loss of the ellipsoid portion of the inner segments and sub-sensory retinal deposits or focal melanogenesis under sensory retina. The hypo-SW-AF corresponded to accumulation of sub-retinal liquid or atrophy of RPE. The hyper-SW-AF associated with sub-sensory retinal deposits, detachment of RPE and focal melanogenesis.CONCLUSION:IR-AF was more sensitive than SW-AF and FA for identifying pathological abnormalities in CSC. The characteristics of IR-AF in CSC were attributable to the modification of melanin in the RPE. IR-AF should be used as a common diagnostic tool for identifying pathological lesion in CSC.KEYWORDS:central serous chorioretinopathy; fluorescein angiography; fundus autofluorescence; optical coherence tomography

Correlation between peripapillary retinal nerve fiber layer thickness and fundus autofluorescence in primary open-angle glaucoma

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Reznicek L

2013-09-01

Full Text Available Lukas Reznicek,* Florian Seidensticker,* Thomas Mann, Irene Hübert, Alexandra Buerger, Christos Haritoglou, Aljoscha S Neubauer, Anselm Kampik, Christoph Hirneiss, Marcus Kernt Department of Ophthalmology, Ludwig-Maximilians-University, Munich, Germany *These authors contributed equally to this work Purpose: To investigate the relationship between retinal nerve fiber layer (RNFL thickness and retinal pigment epithelium alterations in patients with advanced glaucomatous visual field defects. Methods: A consecutive, prospective series of 82 study eyes with primary open-angle glaucoma and advanced glaucomatous visual field defects were included in this study. All study participants underwent a full ophthalmic examination followed by visual field testing with standard automated perimetry as well as spectral-domain optical coherence tomography (SD-OCT for peripapillary RNFL thickness and Optos wide-field fundus autofluorescence (FAF images. A pattern grid with corresponding locations between functional visual field sectors and structural peripapillary RNFL thickness was aligned to the FAF images at corresponding location. Mean FAF intensity (range: 0 = black and 255 = white of each evaluated sector (superotemporal, temporal, inferotemporal, inferonasal, nasal, superonasal was correlated with the corresponding peripapillary RNFL thickness obtained with SD-OCT. Results: Correlation analyses between sectoral RNFL thickness and standardized FAF intensity in the corresponding topographic retina segments revealed partly significant correlations with correlation coefficients ranging between 0.004 and 0.376 and were statistically significant in the temporal inferior central field (r = 0.324, P = 0.036 and the nasal field (r = 0.376, P = 0.014. Conclusion: Retinal pigment epithelium abnormalities correlate with corresponding peripapillary RNFL damage, especially in the temporal inferior sector of patients with advanced glaucomatous visual field defects. A

A New System for Measuring Auto-Fluorescence Changes in Neovascular-AMD after Intravitreal Injection of Bavecizumab

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Mohammad Norouzifard

2011-07-01

Full Text Available Age-Related Macular Degeneration (AMD is the second disease diabetes which causes blindness in aged people. The only remedy for AMD is intravenous injection of bavecizumab. To prove the efficiency of remedy, the degenerated cells in Macula should be measured. In this article, a modern system is introduced to measure Auto-Fluorescence in Macula part of retina in order to obtain number of degenerated cells. The system consists of three main parts: Pre-processing stage is omission of margins and reversion of images in retina. Analysis stage is in charge of classification of images and elicitation of their features. In classification the target areas are identified by methods like morphology, dynamic threshold and connected comportments and the features of target area including Euclidean distance to the center of image and density. In the stage of understanding by gathering the features of each class, we will get the measurable parameter of evaluating Auto Fluorescence by the help of which we can count the number of degenerated cells of Macula area. The results are coming from statistical analysis, including linear regression and correlation of data. Experiments have been done on a database of 34 retina images of AMD patients. The average statistical error rate is equal to76 percent. In clinical reviews, the founded relation to disinflation of Macula has been proved, while there were no proved relations to the vision decreasing or increasing of patients.

Management of dogs and cats with endotracheal tube tracheal foreign bodies

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Nutt, Laura K.; Webb, Jinelle A.; Prosser, Kirsten J.; Defarges, Alice

2014-01-01

Two cats and 3 dogs were treated for an endotracheal tube tracheal foreign body (ETFB) during recovery from general anesthesia. Bronchoscopy was used to remove the ETFB. Animals were clinically normal at discharge. While rare, ETFB can occur upon recovery from anesthesia. Bronchoscopy is an effective way to remove ETFB. PMID:24891640

Autofluorescence imaging endoscopy can distinguish non-erosive reflux disease from functional heartburn: A pilot study.

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Luo, Xi; Guo, Xiao-Xu; Wang, Wei-Feng; Peng, Li-Hua; Yang, Yun-Sheng; Uedo, Noriya

2016-04-14

To investigate whether autofluorescence imaging (AFI) endoscopy can distinguish non-erosive reflux disease (NERD) from functional heartburn (FH). In this prospective observational trial, 127 patients presenting with typical reflux symptoms for > 6 mo were screened. All the participants underwent endoscopy, during which white light imaging (WLI) was followed by AFI. Finally 84 patients with normal esophageal appearance on WLI were enrolled. It was defined as being suggestive of NERD if one or more longitudinal purple lines longer than one centimeter were visualized in the distal part of the esophagus during AFI endoscopy. Ambulatory 24-h multichannel intraluminal impedance and pH monitoring was also performed. After standard proton-pump inhibitor (PPI) tests, subjects were divided into an NERD group and an FH group and the diagnostic performance of AFI endoscopy to differentiate NERD from FH was evaluated. Of 84 endoscopy-negative patients, 36 (42.9%) had a normal pH/impedance test. Of these, 26 patients with favorable responses to PPI tests were classified as having NERD. Finally 10 patients were diagnosed with FH and the others with NERD. Altogether, 68 (81.0%) of the 84 patients were positive on AFI endoscopy. In the NERD group, there were 67 (90.5%) patients with abnormal esophageal findings on AFI endoscopy while only 1 (10%) patient was positive on AFI endoscopy in the FH group. The sensitivity and specificity of AFI in differentiating NERD from FH were 90.5% (95%CI: 81.5%-96.1%) and 90.0% (95%CI: 55.5%-99.7%), respectively. Meanwhile, the accuracy, positive predictive value and negative predictive value of AFI in differentiating between NERD and FH were 90.5% (95%CI: 84.2%-96.8%), 98.5% (95%CI: 92.1%-99.9%) and 56.3% (95%CI: 30.0%-80.2%), respectively. Autofluorescence imaging may serve as a complementary method in evaluating patients with NERD and FH.

Ex Vivo Confocal Spectroscopy of Autofluorescence in Age-Related Macular Degeneration.

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Joel Kaluzny

Full Text Available We investigated the autofluorescence (AF signature of the microscopic features of retina with age-related macular degeneration (AMD using 488 nm excitation.The globes of four donors with AMD and four age-matched controls were embedded in paraffin and sectioned through the macula. Sections were excited using a 488 nm argon laser, and the AF emission was captured using a laser scanning confocal microscope (496-610 nm, 6 nm resolution. The data cubes were then analyzed to compare peak emission spectra between the AMD and the controls. Microscopic features, including individual lipofuscin and melanolipofuscin granules, Bruch's Membrane, as well macroscopic features, were considered.Overall, the AMD eyes showed a trend of blue-shifted emission peaks compared with the controls. These differences were statistically significant when considering the emission of the combined RPE/Bruch's Membrane across all the tissue cross-sections (p = 0.02.The AF signatures of ex vivo AMD RPE/BrM show blue-shifted emission spectra (488 nm excitation compared with the control tissue. The magnitude of these differences is small (~4 nm and highlights the potential challenges of detecting these subtle spectral differences in vivo.

Clinical value of radiological methods in evaluation and therapy of severe thoracic trauma

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Glinz, W.

1987-09-01

Plain chest radiographs allow the diagnosis of most intrathoracic injuries. However, they are only momentary pictures and give no information on the respiratory function. A tension pneumothorax, rib fractures and subcutaneous emphysema should be diagnosed clinically before radiographs are taken. Computed tomography is helpful in evaluation of intrapulmonary lesions, hemothorax, rupture of the diaphragm and dislocation of the heart. Further diagnostic tools include aortography in suspected aortic rupture, sonography in cardiac injuries and hemopericardium, bronchoscopy in suspected bronchial or tracheal rupture, ECG and enzyme determinations in cardiac contusion, and eventually pneumoperitoneum in suspected rupture of the diaphragm.

Clinical value of radiological methods in evaluation and therapy of severe thoracic trauma

International Nuclear Information System (INIS)

Glinz, W.

1987-01-01

Plain chest radiographs allow the diagnosis of most intrathoracic injuries. However, they are only momentary pictures and give no information on the respiratory function. A tension pneumothorax, rib fractures and subcutaneous emphysema should be diagnosed clinically before radiographs are taken. Computed tomography is helpful in evaluation of intrapulmonary lesions, hemothorax, rupture of the diaphragm and dislocation of the heart. Further diagnostic tools include aortography in suspected aortic rupture, sonography in cardiac injuries and hemopericardium, bronchoscopy in suspected bronchial or tracheal rupture, ECG and enzyme determinations in cardiac contusion, and eventually pneumoperitoneum in suspected rupture of the diaphragm. (orig.)

[Argon plasma coagulation combined with cryotherapy via bronchoscopy for the treatment of one child with severe post-intubation tracheal stenosis and literature review].

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Zhou, Kuo; Liang, Jun; Cui, Ai-hua; Fu, Ai-xia; Yang, Qiao-zhi

2013-10-01

To observe the short term effect of argon plasma coagulation (APC) combined with cryotherapy via bronchoscopy for treatment of severe post-intubation tracheal stenosis in a child. A 3-year old boy was admitted for cephalothorax abdominal compound trauma and dyspnea, who had severe post-incubation tracheal stenosis. The agreement about the operation risk was signed by the parents. Endotracheal APC procedure was performed with a bronchoscope under general anesthesia. The APC probe was put into the working channel of the bronchoscope. The stenotic lesion was endoscopically visualized and then coagulated by argon plasma. Such coagulation was carried out several times at the stenotic site until it gradually became dilated. The devitalized tissue was mechanically removed with grasping forceps. Thereafter, bronchoscopic cryosurgery was repeatedly performed at the stenotic site. Clinical symptoms, signs and bronchoscopic manifestations were observed right after operation, after 1 day, 10 days, 1 month and 6 months separately. Tracheal tissue hyperplasia and cyanosis disappeared, laryngeal stridor and dyspnea improved obviously right after the operation. General condition of the patient was well, there was no laryngeal stridor and dyspnea 10 days after operation. The mucosa of the surgical site was smooth and no tracheostenosis was seen under bronchoscope at 1 month and 6 months after the operation. Argon plasma coagulation combined with cryotherapy via bronchoscope is an effective method to treat tracheal stenosis of children, which needs further exploration for the application.

Fundus autofluorescence in blunt ocular trauma

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Ricardo Luz Leitão Guerra

2014-06-01

Full Text Available Objetivo: Descrever os achados do exame de autofluorescência do fundo de olho (AFF em pacientes vítimas de trauma ocular contuso. Métodos: Estudo retrospectivo, não intervencionista, realizado através da revisão de prontuários e exames de imagem. Os dados analisados foram: sexo, idade, lateralidade, etiologia do trauma, tempo decorrente entre o trauma e a realização do exame, acuidade visual, alterações na periferia da retina, diagnóstico fundoscópico e achados ao exame de AFF (realizada no aparelho Topcon TRC-50DX Retinal Camera. Resultados: Oito olhos de 8 pacientes foram estudados. A idade média foi de 27,6 anos (de 19 a 43 anos, o sexo masculino (n=7 foi mais acometido do que o feminino (n=1, agressão física foi a etiologia mais comum do trauma (n=3, seguido de acidente com fogos de artifício (n=2. Outras causas foram acidente automobilístico (n=1, trauma ocupacional com lixadeira (n=1 e pedrada (n=1. A acuidade visual variou de 20/80 a percepção luminosa. Epiteliopatia pigmentar traumática (EPT foi identificada em 5 casos, rotura de coroide em 3, hemorragia subretiniana em 3 e retinopatia de Purtscher em 1 caso. Hipoautofluorescência foi observada nos casos de rotura de coroide, hemorragia subretiniana recente, hemorragia intrarretiniana e em 2 casos de EPT. Hiperautofluorescência foi visualizada nos casos de hemorragia subretiniana em degradação, na borda de 2 casos de roturas de coroide e discretamente no polo posterior na retinopatia de Purtcher. Três casos de EPT apresentaram hipoautofluorescência com pontos hiperautofluorescentes difusos. Conclusão: O exame de AFF permite avaliar as alterações do segmento posterior do olho decorrentes do trauma ocular contuso de forma não invasiva, somando informações valiosas. Foram descritos achados do exame em casos de epiteliopatia pigmentar traumática, rotura de coroide, hemorragia sub-retiniana e retinopatia de Purtscher.

Autofluorescence Imaging and Spectral-Domain Optical Coherence Tomography in Incomplete Congenital Stationary Night Blindness and Comparison with Retinitis Pigmentosa

Science.gov (United States)

CHEN, ROYCE W. S.; GREENBERG, JONATHAN P.; LAZOW, MARGOT A.; RAMACHANDRAN, RITHU; LIMA, LUIZ H.; HWANG, JOHN C.; SCHUBERT, CARL; BRAUNSTEIN, ALEXANDRA; ALLIKMETS, RANDO; TSANG, STEPHEN H.

2015-01-01

PURPOSE To test the hypothesis that the evaluation of retinal structure can have diagnostic value in differentiating between incomplete congenital stationary night blindness (CSNB2) and retinitis pigmentosa (RP). To compare retinal thickness differences between patients with CSNB2 and myopic controls. DESIGN Prospective cross-sectional study. METHODS Ten eyes of 5 patients diagnosed with CSNB2 (4 X-linked recessive, 1 autosomal recessive) and 6 eyes of 3 patients with RP (2 autosomal dominant, 1 autosomal recessive) were evaluated with spectral-domain optical coherence tomography (SD OCT) and fundus autofluorescence (FAF). Diagnoses of CSNB2 and RP were confirmed by full-field electroretinography (ERG). Manual segmentation of retinal layers, aided by a computer program, was performed by 2 professional segmenters on SD OCT images of all CSNB2 patients and 4 age-similar, normal myopic controls. Seven patients were screened for mutations with congenital stationary night blindness and RP genotyping arrays. RESULTS Patients with CSNB2 had specific findings on SD OCT and FAF that were distinct from those found in RP. CSNB2 patients showed qualitatively normal SD OCT results with preserved photoreceptor inner segment/outer segment junction, whereas this junction was lost in RP patients. In addition, CSNB2 patients had normal FAF images, whereas patients with RP demonstrated a ring of increased autofluorescence around the macula. On SD OCT segmentation, the inner and outer retinal layers of both X-linked recessive and autosomal recessive CSNB2 patients were thinner compared with those of normal myopic controls, with means generally outside of normal 95% confidence intervals. The only layers that demonstrated similar thickness between CSNB2 patients and the controls were the retinal nerve fiber layer and, temporal to the fovea, the combined outer segment layer and retinal pigment epithelium. A proband and his 2 affected brothers from a family segregating X-linked recessive

Clinical value of whole-blood interferon-gamma assay in patients with suspected pulmonary tuberculosis and AFB smear- and polymerase chain reaction-negative bronchial aspirates.

Science.gov (United States)

Lee, Jaehee; Lee, Shin Yup; Yoo, Seung Soo; Cha, Seung Ick; Won, Dong Il; Park, Jae Yong; Lee, Won-Kil; Kim, Chang Ho

2012-07-01

Combining a polymerase chain reaction (PCR) test with bronchoscopy is frequently performed to allow a rapid diagnosis of smear-negative pulmonary tuberculosis (PTB). However, limited data are available concerning clinical judgment in patients with suspected PTB and AFB smear- and PCR-negative bronchial aspirates (BA). The present study evaluated the usefulness of whole-blood QuantiFERON-TB Gold In-Tube (QFT) testing in these patients. Of 166 patients with suspected PTB who had undergone bronchoscopy because of smear-negative sputum or inadequate sputum production, 93 (56%) were diagnosed with culture-positive PTB. Seventy-four patients were either AFB smear- or PCR-positive. In the 75 patients whose BA AFB smear and PCR results were both negative, 19 were finally diagnosed with PTB by culture. The QFT test had a negative predictive value of 91% for PTB. The QFT test may be useful for excluding PTB in patients with suspected PTB whose BA AFB smear and PCR results are both negative. Copyright © 2012 Elsevier Inc. All rights reserved.

Identification of 5-hydroxytryptamine-producing cells by detection of fluorescence in paraffin-embedded tissue sections

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Y. Kaneko

2016-09-01

Full Text Available 5-Hydroxytryptamine (5-HT produced by enterochromaffin (EC cells is an important enteric mucosal signaling ligand and has been implicated in several gastrointestinal diseases, including inflammatory bowel disease and functional disorders such as irritable bowel syndrome. The present study reports a new, simple and rapid visualization method of 5-HT-producing EC cells utilizing detection of autofluorescence in paraffin-embedded tissue sections after formalin fixation. In human samples, there was a high incidence of autofluorescence+ cells in the 5-HT+ cells in the pyloric, small intestinal and colonic glands, while co-localization was lacking between autofluorescence+ and gastrin+ cells in the pyloric and small intestinal glands. Autofluorescence+ EC cells were detected in the colon of mice and rats. Autofluorescence+ cells were also observed in 5-HT+ β cells in the pancreatic islets of Langerhans in pregnant mice, while non-pregnant mouse pancreatic islet cells showed no 5-HT immunoreactivity or autofluorescence. These results suggest that autofluorescence+ cells are identical to 5-HT+ cells, and the source of autofluorescence may be 5-HT itself or molecules related to its synthesis or degradation. This autofluorescence signal detection method may be applicable for monitoring of inflammatory status of inflammatory bowel diseases in both the experimental and clinical settings.

Sedation with midazolam in flexible bronchoscopy – A prospective study

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R. Rolo

2012-09-01

Full Text Available Introduction: Sedatives have been increasingly used to improve patient comfort during flexible bronchoscopy (FOB. Due to its rapid-onset, anxiolytic and amnestic properties, midazolam is one of the most commonly used sedatives. Objectives: To evaluate the effect of sedation with midazolam, including patient tolerance, complications and its potential use on a daily routine basis. Methods: A multi-centre, prospective, randomized, placebo-controlled study was made on 100 patients submitted to FOB in two Pulmonology Departments. Midazolam (0.05 mg/kg was administered to patients in Group 1 and saline solution (0.9% NaCl to patients in Group 2, 5 min before the procedure. The Hospital Anxiety and Depression Scale (HADS-A was used to determine patient anxiety level. Subjective questionnaires concerning main fears and complaints were answered before and after FOB. Results: Mean age was 56.0 ± 14.1 years; 66% were male. Most (65% patients had low score ( 0.05 and pain (4% vs 12%; p > 0.05 were not statistically different.Willingness to repeat the exam was reported in all patients in Group 1 and in 82% in Group 2 (p = 0.003. Conclusion: Sedation with midazolam in FOB improved patient's comfort and decreased complaints, without significant haemodynamic changes. It should be offered to the patient on a routine basis. Resumo: Introdução: Os agentes sedativos têm vindo a ser cada vez mais utilizados na broncofibroscopia (BF para melhorar o conforto do doente. Devido à sua rápida ação, propriedades ansiolíticas e amnésicas, o midazolam é um dos sedativos mais frequentemente usados. Objetivos: Avaliar o efeito da sedação com midazolam na BF, incluindo a tolerância do doente, complicações e a sua potencial aplicação na prática clínica diária. Material e Métodos: Estudo multicêntrico, prospetivo, randomizado, controlado com placebo, com inclusão de 100 indiv

Endoscopic tri-modal imaging for detection of early neoplasia in Barrett's oesophagus: a multi-centre feasibility study using high-resolution endoscopy, autofluorescence imaging and narrow band imaging incorporated in one endoscopy system

NARCIS (Netherlands)

Curvers, W. L.; Singh, R.; Song, L.-M. Wong-Kee; Wolfsen, H. C.; Ragunath, K.; Wang, K.; Wallace, M. B.; Fockens, P.; Bergman, J. J. G. H. M.

2008-01-01

OBJECTIVE: To investigate the diagnostic potential of endoscopic tri-modal imaging and the relative contribution of each imaging modality (i.e. high-resolution endoscopy (HRE), autofluorescence imaging (AFI) and narrow-band imaging (NBI)) for the detection of early neoplasia in Barrett's oesophagus.

Estudo das alterações relacionadas com a idade na pele humana, utilizando métodos de histo-morfometria e autofluorescência

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Oriá Reinaldo B.

2003-01-01

Full Text Available FUNDAMENTOS: O processo de envelhecimento tecidual é evidente nas modificações visíveis na pele, resultando em importantes implicações psicológicas para o indivíduo e crescente interesse científico. OBJETIVOS: O presente trabalho objetivou analisar as alterações da pele normal com o envelhecimento mediante estratégias de histomorfometria e autofluorescência. MÉTODOS: Foram coletadas amostras de pele do abdômen de 18 cadáveres, incluindo cinco indivíduos jovens (menos de 20 anos, sete indivíduos com idade intermediária (20-60 anos e seis indivíduos idosos (mais de 60 anos. Foram feitos cortes histológicos em parafina seguidos de coloração pela Hematoxilina-Eosina (H&E e pelo tricrômio de Van Gieson-elastina. Avaliaram-se a espessura da epiderme e derme, e a superfície de contato epidermo-dérmica. Investigaram-se ainda as modificações qualitativas do aparelho colágeno-elástico, considerando sua disposição espacial na derme. Espécimes corados em H&E também foram utilizados para autofluorescência. RESULTADOS: A espessura da epiderme e derme do grupo idoso foi significativamente diminuída (p<0,05 em relação aos demais grupos. Os grupos idoso e intermediário exibiram acentuada redução na superfície de contato epiderme-derme (p<0,05. Detectaram-se a perda da distribuição em rede das fibras elásticas com sua progressiva fragmentação, alterações da compactação do colágeno e espessamento da membrana basal com o envelhecimento. CONCLUSÃO: O envelhecimento leva à redução da espessura da derme e epiderme, bem como ao aplanamento da junção dermo-epidérmica. As mudanças da pele ao longo da vida nem sempre seguem um perfil linear, mostrando drásticas alterações nas últimas décadas de vida. O método de autofluorescência mostrou-se um instrumento valioso no estudo da complexa relação espacial das fibras elásticas e colágenas.

The Influence of Volume and Anatomic Location of Optic Disc Drusen on the Sensitivity of Autofluorescence

DEFF Research Database (Denmark)

Loft, Frederik Cornelius; Malmqvist, Lasse; Lindberg, Anne-Sofie Wessel

2018-01-01

Optic disc drusen (ODD) are acellular deposits in the optic nerve head. ODD can be diagnosed using different imaging modalities, including enhanced depth imaging optical coherence tomography (EDI-OCT) and autofluorescence (AF). It is unknown which factors determine the sensitivity of AF. The aim...... of this study was to investigate the effect of volume and anatomic location of ODD on the sensitivity of AF. Cross-sectional study. A total of 38 patients (75 eyes) with ODD were included. In 12 of 75 eyes (16%) and in 11 of 38 patients (29%), EDI-OCT detected ODD that were not detected by AF. In 24 distinctly...... solitary ODD, both increase in ODD volume (P = 0.0388) and a more superficial ODD location (P EDI-OCT is superior to AF in the diagnosis of ODD. Volume and anatomic location of ODD have a significant impact...

Congenital Simple Hamartoma of Retinal Pigment Epithelium: Clinical and Imaging Findings

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Mehmet Yasin Teke

2012-01-01

Full Text Available Congenital simple hamartoma of retinal pigment epithelium (CSHRPE is a rare, asymptomatic, and incidentally detected benign lesion. However, it is very important to do the differential diagnosis from other pigmented retinal lesions. Its clinical presentation and imaging findings are very helpful in doing this differentiation. This paper presents clinical and imaging findings of a 56-year-old woman with incidentally detected CSHRPE. The lesion was small, heavily pigmented, well circumscribed, and slightly elevated. Optical coherence tomography (OCT scanning was diagnostic and showed an elevated retina at the site of the lesion, increased optical reflectivity on its inner surface, optical shadowing of deeper structures, and clearly cut tumor margins. Ocular ultrasonography, fluorescein angiography, and fundus autofluorescence imaging which is firstly described in this report did not show any characteristic finding.

Noninvasive Quantification of Retinal Microglia Using Widefield Autofluorescence Imaging.

Science.gov (United States)

Kokona, Despina; Schneider, Nadia; Giannakaki-Zimmermann, Helena; Jovanovic, Joel; Ebneter, Andreas; Zinkernagel, Martin

2017-04-01

To validate widefield autofluorescence (AF) in vivo imaging of the retina in mice expressing green fluorescent protein (gfp) in microglia, and to monitor retinal microglia reconstitution in vivo after lethal irradiation and bone marrow transplantation. Transgenic Cx3cr1gfp/gfp and wildtype Balb/c mice were used in this study. A confocal scanning laser ophthalmoscope was used for AF imaging with a 55° and a widefield 102° lens. Intrasession reproducibility was assessed for each lens. To investigate reconstitution in vivo, bone marrow from Cx3cr1gfp/gfp mice was used to rescue lethally irradiated wildtype mice. Data were compared to confocal microscopy of retinal flat mounts. Both the 55° and the 102° lens produced high resolution images of retinal microglia with similar microglia density. However, compared to the 55° lens, the widefield 102° lens captured approximately 3.6 times more microglia cells (1515 ± 123 cells versus 445 ± 76 cells [mean ± SD], for 102° and 55°, respectively, P < 0.001). No statistical difference in the number of gfp positive cells within corresponding areas was observed within the same imaging session. Imaging of microglia reconstitution showed a similar time course compared to flat mount preparations with an excellent correlation between microglia cell numbers in AF and gfp-stained flat mounts (R = 0.92, P < 0.0001). Widefield AF imaging of mice with gfp expressing microglia can be used to quantify retinal microglia. In vivo microglia counts corresponded very well with ex vivo counts on retinal flat mounts. As such, AF imaging can largely replace ex vivo quantification.

Complications of long-standing foreign body in the airway and their outcomes after endoscopic management: an experience of 20 cases.

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Aggarwal, Satish Kumar; Sinha, Shandip Kumar; Ratan, Simmi K; Dhua, Anjan; Sethi, Gulshan Rai

2015-01-01

To study the outcomes after endoscopic treatment of chronic foreign bodies (FBs) in the airway. A retrospective study (2008-2013) of 20 cases with chronic airway FBs (>2 weeks) was done with emphasis on endoscopic management. All cases were initially evaluated by the pediatric pulmonologist. Flexible and rigid bronchoscopy was done for diagnosis and retrieval, respectively. The techniques of FB retrieval, problems encountered, and their solutions were analyzed. Follow-up flexible bronchoscopy was done in symptomatic cases. Outcomes were assessed in terms of successful removal of the FB, clinical recovery, lung expansion, and need for further procedures. Twenty cases (16 boys, 4 girls) with a mean age of 7 years had a chronic airway FB diagnosed on chest X-ray (n=6) and flexible bronchoscopy (n=14). Six cases had computed tomography evaluation. On rigid bronchoscopy, the FB was successfully retrieved in 16 cases. Two cases required open surgery for FB-induced tracheoesophageal fistula. One case required pneumonectomy because of a battery eroding into the lung parenchyma. One patient died. Of the 16 who had successful retrieval, 11 recovered with full lung expansion. Four recovered after additional bronchoscopic procedures (cauterization of granulation [n=2] and balloon dilatation of bronchial stenoses [n=2]). One case required pneumonectomy for persistent collapse despite multiple dilatations. An airway FB producing chronic respiratory symptoms may be missed because of lack of definite history of an inhaled FB. Clinical suspicion and flexible bronchoscopy are instrumental in diagnosis. Treatment is challenging because of chronicity-related complications and requires innovative ideas to make best use of the available urologic and bronchoscopic equipment. Addition of tracheotomy provides safety in difficult cases. Bronchoscopic removal leads to clinical and radiological recovery in most cases.

The concentrations of clinafloxacin in alveolar macrophages, epithelial lining fluid, bronchial mucosa and serum after administration of single 200 mg oral doses to patients undergoing fibre-optic bronchoscopy.

Science.gov (United States)

Honeybourne, D; Andrews, J M; Cunningham, B; Jevons, G; Wise, R

1999-01-01

The concentrations of clinafloxacin were measured in serum, bronchial mucosa, alveolar macrophages and epithelial lining fluid after single 200 mg oral doses of clinafloxacin had been administered to 15 subjects who were undergoing bronchoscopy. Concentrations were measured using a microbiological assay method. Mean concentrations in serum, bronchial mucosa, alveolar macrophages and epithelial lining fluid at a mean of 1.27 h post-dose were 1.54, 2.65, 15.60 and 2.71 mg/L respectively. These site concentrations exceeded the MIC90 for common respiratory pathogens and indicate that clinafloxacin is likely to be effective in the treatment of a wide range of respiratory tract infections.

CLASSIFICATION OF SEVERAL SKIN CANCER TYPES BASED ON AUTOFLUORESCENCE INTENSITY OF VISIBLE LIGHT TO NEAR INFRARED RATIO

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Aryo Tedjo

2009-12-01

Full Text Available Skin cancer is a malignant growth on the skin caused by many factors. The most common skin cancers are Basal Cell Cancer (BCC and Squamous Cell Cancer (SCC. This research uses a discriminant analysis to classify some tissues of skin cancer based on criterion number of independent variables. An independent variable is variation of excitation light sources (LED lamp, filters, and sensors to measure Autofluorescence Intensity (IAF of visible light to near infrared (VIS/NIR ratio of paraffin embedded tissue biopsy from BCC, SCC, and Lipoma. From the result of discriminant analysis, it is known that the discriminant function is determined by 4 (four independent variables i.e., Blue LED-Red Filter, Blue LED-Yellow Filter, UV LED-Blue Filter, and UV LED-Yellow Filter. The accuracy of discriminant in classifying the analysis of three skin cancer tissues is 100 %.

Correlação entre a Autofluorescência de Fundo e o SD-OCT na Degenerescência Macular Ligada à Idade Exsudativa

OpenAIRE

Miranda, Ana Filipa

2016-01-01

Introdução: Estudos têm mostrado que na degenerescência macular ligada à idade (DMLI) exsudativa uma maior área de alteração do epitélio pigmentar retiniano (EPR) na autofluorescência de fundo (FAF) está associada a perda da acuidade visual (AV). Não existe, no entanto, nenhum estudo realizado nestes doentes que integre as alterações verificadas na FAF com a informação anatómica da tomografia de coerência óptica spectral domain (SD-OCT). Objectivo: Investigar a correlação entre a FAF e os res...

Turban pin aspiration: new fashion, new syndrome.

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Ilan, Ophir; Eliashar, Ron; Hirshoren, Nir; Hamdan, Kasem; Gross, Menachem

2012-04-01

Turban pin aspiration syndrome is a new clinical entity afflicting young Islamic girls wearing a turban.The goal of this study was to present our experience in diagnosis and treatment of this new entity, define its clinical and epidemiologic features, and shed a new light on the role of fashion in the increased incidence. A retrospective study in a tertiary university hospital. Review of clinical parameters and epidemiologic features of 26 patients diagnosed with turban pin aspiration syndrome admitted to the Hadassah-Hebrew University Hospitals in Jerusalem from 1990 to 2010. All patients were Muslim females with an average age of 16 years. In all cases, the history was positive for accidental aspiration. Most of the pins were located in the trachea (42%). In 20 cases, the pins were extracted by rigid bronchoscopy without major complications. Fluoroscopy-assisted rigid bronchoscopy was used successfully in three cases. In one case, the object was self-ejected by coughing before the bronchoscopy, and two patients were referred to the chest unit for thoracotomy. Clinicians should be aware of this distinct form of foreign body aspiration, its method of diagnosis, and extraction techniques. A cultural investigation showed a difference in the turban-fastening technique of young girls as compared with their mothers. Removal by rigid bronchoscopy is a safe method with a high success rate and should be considered as the preferred extraction method of choice. Copyright © 2012 The American Laryngological, Rhinological, and Otological Society, Inc.

Tracheobronchial foreign bodies in children: importance of accurate history and plain chest radiography in delayed presentation

Energy Technology Data Exchange (ETDEWEB)

Tokar, B. E-mail: btokar@ogu.edu.trbarantokar@hotmail.com; Ozkan, R.; Ilhan, H

2004-07-01

AIM: To evaluate the factors associated with delayed diagnosis of foreign body aspiration (FBA) in children and to compare clinical, radiological and bronchoscopic findings in the patients with suspected FBA. MATERIAL AND METHODS: The medical records of 214 children who underwent bronchoscopy for suspected FBA were reviewed. The data were analysed in three groups: the patients with negative bronchoscopy for FBA (group I), early (group II) and delayed diagnosis (group III). RESULTS: The majority of the patients with FBA were between 1 and 3 years of age. Choking episodes, coughing and decreased breath sounds were determined in a significantly higher number of the patients with FBA. The plain chest radiography revealed radio-opaque foreign bodies (FBs) in 19.7% of all patients with FBA. Emphysema was more common in children with FBA. Clinical and radiological findings of pneumonia and atelectasis were significantly more common in the groups with negative bronchoscopy and with delayed diagnosis (p<0.01). The FBs were most frequently of vegetable origin, such as seeds and peanuts. A significant tissue reaction with inflammation was more common in the delayed cases. CONCLUSION: To prevent delayed diagnosis, characteristic symptoms, signs and radiological findings of FBA should be checked in all suspected cases. As clinical and radiological findings of FBA in delayed cases may mimic other disorders, the clinician must be aware of the likelihood of FBA. Regardless of radiological findings, bronchoscopy should be considered in patients with an appropriate history.

Quantitative fundus autofluorescence in mice: correlation with HPLC quantitation of RPE lipofuscin and measurement of retina outer nuclear layer thickness.

Science.gov (United States)

Sparrow, Janet R; Blonska, Anna; Flynn, Erin; Duncker, Tobias; Greenberg, Jonathan P; Secondi, Roberta; Ueda, Keiko; Delori, François C

2013-04-17

Our study was conducted to establish procedures and protocols for quantitative autofluorescence (qAF) measurements in mice, and to report changes in qAF, A2E bisretinoid concentration, and outer nuclear layer (ONL) thickness in mice of different genotypes and age. Fundus autofluorescence (AF) images (55° lens, 488 nm excitation) were acquired in albino Abca4(-/-), Abca4(+/-), and Abca4(+/+) mice (ages 2-12 months) with a confocal scanning laser ophthalmoscope (cSLO). Gray levels (GLs) in each image were calibrated to an internal fluorescence reference. The bisretinoid A2E was measured by quantitative high performance liquid chromatography (HPLC). Histometric analysis of ONL thicknesses was performed. The Bland-Altman coefficient of repeatability (95% confidence interval) was ±18% for between-session qAF measurements. Mean qAF values increased with age (2-12 months) in all groups of mice. qAF was approximately 2-fold higher in Abca4(-/-) mice than in Abca4(+/+) mice and approximately 20% higher in heterozygous mice. HPLC measurements of the lipofuscin fluorophore A2E also revealed age-associated increases, and the fold difference between Abca4(-/-) and wild-type mice was more pronounced (approximately 3-4-fold) than measurable by qAF. Moreover, A2E levels declined after 8 months of age, a change not observed with qAF. The decline in A2E levels in the Abca4(-/-) mice corresponded to reduced photoreceptor cell viability as reflected in ONL thinning beginning at 8 months of age. The qAF method enables measurement of in vivo lipofuscin and the detection of genotype and age-associated differences. The use of this approach has the potential to aid in understanding retinal disease processes and will facilitate preclinical studies.

Preferred retinal locus in macular disease: characteristics and clinical implications.

Science.gov (United States)

Greenstein, Vivienne C; Santos, Rodrigo A V; Tsang, Stephen H; Smith, R Theodore; Barile, Gaetano R; Seiple, William

2008-10-01

To investigate the location and fixation stability of preferred retinal locations (PRLs) in patients with macular disease, and the relationship among areas of abnormal fundus autofluorescence, the PRL and visual sensitivity. Fifteen patients (15 eyes) were studied. Seven had Stargardt disease, 1 bull's eye maculopathy, 5 age-related macular degeneration, 1 Best disease, and 1 pattern dystrophy. All tested eyes had areas of abnormal fundus autofluorescence. The PRL was evaluated with fundus photography and the Nidek microperimeter. Visual field sensitivity was measured with the Nidek microperimeter. Of the 15 eyes, 4 had foveal and 11 had eccentric fixation. Eccentric PRLs were above the atrophic lesion and their stability did not depend on the degree of eccentricity from the fovea. Visual sensitivity was markedly decreased in locations corresponding to hypofluorescent areas. Sensitivity was not decreased in hyperfluorescent areas corresponding to flecks but was decreased if hyperfluorescence was in the form of dense annuli. Eccentric PRLs were in the superior retina in regions of normal fundus autofluorescence. Fixation stability was not correlated with the degree of eccentricity from the fovea. To assess the outcomes of treatment trials it is important to use methods that relate retinal morphology to visual function.

Skin autofluorescence as a novel marker of vascular damage in children and adolescents with chronic kidney disease.

Science.gov (United States)

Makulska, Irena; Szczepańska, Maria; Drożdż, Dorota; Polak-Jonkisz, Dorota; Zwolińska, Danuta

2015-05-01

Skin autofluorescence (sAF) was examined as a marker of the accumulation of advanced glycation end products (AGEs) in tissues of children with chronic kidney disease (CKD) in relation to renal function, dialysis modality and markers of endothelial inflammation and dysfunction. A total of 76 children with CKD were enrolled in the study, of whom 20 children were on hemodialysis (HD), 20 were on peritoneal dialysis (PD) and 36 were treated conservatively. A control group of 26 healthy subjects was also included in the study. In all children, sAF intensity, carotid intima-media (cIMT) thickness and plasma concentrations of sE-selectin, matrix metalloproteinase 9 (MMP-9), tissue inhibitor of metalloproteinase 1 (TIMP-1), asymmetric dimethylarginine (ADMA), symmetric dimethylarginine (SDMA) and plasminogen activator inhibitor type 1 (PAI-1) were measured. Compared to the controls, children with CKD had significantly elevated sAF levels. sAF in the children with CKD was positively correlated with sE-selectin, MMP-9, TIMP-1, ADMA, SDMA and PAI-1 levels. In the predialysis group (conservative treatment) sAF levels were positively correlated with sE-selectin and ADMA levels and negatively correlated with glomerular filtration rate. Multiple regression analysis showed a significant association of sAF with sE-selectin and MMP-9 in CKD children. The results reveal that AGEs were accumulated in the children with CKD. This accumulation was related to early vascular changes and a number of biochemical vascular risk markers. sAF measurement, as a noninvasive method, may be useful for identification of clinical risk factors of vascular disease in CKD children.

Survey of clinical infant lung function testing practices.

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Peterson-Carmichael, Stacey L; Rosenfeld, Margaret; Ascher, Simon B; Hornik, Christoph P; Arets, H G M; Davis, Stephanie D; Hall, Graham L

2014-02-01

Data supporting the clinical use of infant lung function (ILF) tests are limited making the interpretation of clinical ILF measures difficult. To evaluate current ILF testing practices and to survey users regarding the indications, limitations and perceived clinical benefits of ILF testing. We created a 26-item survey hosted on the European Respiratory Society (ERS) website between January and May 2010. Notifications were sent to members of the ERS, American Thoracic Society and the Asian Pacific Society of Respirology. Responses were sought from ILF laboratory directors and pediatric respirologists. The survey assessed the clinical indications, patient populations, equipment and reference data used, and perceived limitations of ILF testing. We received 148 responses with 98 respondents having ILF equipment and performing testing in a clinical capacity. Centers in North America were less likely to perform ≥50 studies/year than centers in Europe or other continents (13% vs. 41%). Most respondents used ILF data to either "start a new therapy" (78%) or "help decide about initiation of further diagnostic workup such as bronchoscopy, chest CT or serological testing" (69%). Factors reported as limiting clinical ILF testing were need for sedation, uncertainty regarding clinical impact of study results and time intensive nature of the study. Clinical practices associated with ILF testing vary significantly; centers that perform more studies are more likely to use the results for clinical purposes and decision making. The future of ILF testing is uncertain in the face of the limitations perceived by the survey respondents. © 2013 Wiley Periodicals, Inc.

Clinical multiphoton FLIM tomography

Science.gov (United States)

König, Karsten

2012-03-01

This paper gives an overview on current clinical high resolution multiphoton fluorescence lifetime imaging in volunteers and patients. Fluorescence lifetime imaging (FLIM) in Life Sciences was introduced in Jena/Germany in 1988/89 based on a ZEISS confocal picosecond dye laser scanning microscope equipped with a single photon counting unit. The porphyrin distribution in living cells and living tumor-bearing mice was studied with high spatial, temporal, and spectral resolution. Ten years later, time-gated cameras were employed to detect dental caries in volunteers based on one-photon excitation of autofluorescent bacteria with long fluorescence lifetimes. Nowadays, one-photon FLIM based on picosecond VIS laser diodes are used to study ocular diseases in humans. Already one decade ago, first clinical twophoton FLIM images in humans were taken with the certified clinical multiphoton femtosecond laser tomograph DermaInspectTM. Multiphoton tomographs with FLIM modules are now operating in hospitals at Brisbane, Tokyo, Berlin, Paris, London, Modena and other European cities. Multiple FLIM detectors allow spectral FLIM with a temporal resolution down to 20 ps (MCP) / 250 ps (PMT) and a spectral resolution of 10 nm. Major FLIM applications include the detection of intradermal sunscreen and tattoo nanoparticles, the detection of different melanin types, the early diagnosis of dermatitis and malignant melanoma, as well as the measurement of therapeutic effects in pateints suffering from dermatitis. So far, more than 1,000 patients and volunteers have been investigated with the clinical multiphoton FLIM tomographs DermaInspectTM and MPTflexTM.

Simultaneous optical coherence tomography and lipofuscin autofluorescence imaging of the retina with a single broadband light source at 480nm.

Science.gov (United States)

Jiang, Minshan; Liu, Tan; Liu, Xiaojing; Jiao, Shuliang

2014-12-01

We accomplished spectral domain optical coherence tomography and auto-fluorescence microscopy for imaging the retina with a single broadband light source centered at 480 nm. This technique is able to provide simultaneous structural imaging and lipofuscin molecular contrast of the retina. Since the two imaging modalities are provided by the same group of photons, their images are intrinsically registered. To test the capabilities of the technique we periodically imaged the retinas of the same rats for four weeks. The images successfully demonstrated lipofuscin accumulation in the retinal pigment epithelium with aging. The experimental results showed that the dual-modal imaging system can be a potentially powerful tool in the study of age-related degenerative retinal diseases.

Ultra-widefield fundus autofluorescence in age-related macular degeneration.

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Abhilash Guduru

Full Text Available Establish accuracy and reproducibility of subjective grading in ultra-widefield fundus autofluorescence (FAF imaging in patients with age-related macular degeneration (AMD, and determine if an association exists between peripheral FAF abnormalities and AMD.This was a prospective, single-blinded case-control study. Patients were consecutively recruited for the study. Patients were excluded if there was a history of prior or active ocular pathology other than AMD or image quality was insufficient for analysis as determined by two independent graders. Control patients were those without any evidence of AMD or other ophthalmic disease apart from cataract. Using the Optos 200Tx (Optos, Marlborough, MA, USA, a ResMax central macula and an ultra-widefield peripheral retina image was taken for each eye in both normal color and short wavelength FAF. Ultra-widefield photographs were modified to mask the macula. Each ResMax and ultra-widefield image was independently graded by two blinded investigators.There were 28 AMD patients and 11 controls. There was a significant difference in the average age between AMD patients and control groups (80 versus 64, respectively P<0.001. There was moderate, statistically significant agreement between observers regarding image interpretation (78.4%, K = 0.524, P<0.001, and 69.0% (K = 0.49, P<0.001 agreement between graders for FAF abnormality patterns. Patients with AMD were at greater risk for peripheral FAF abnormalities (OR: 3.43, P = 0.019 and patients with FAF abnormalities on central macular ResMax images were at greater risk of peripheral FAF findings (OR: 5.19, P = 0.017.Subjective interpretation of FAF images has moderate reproducibility and validity in assessment of peripheral FAF abnormalities. Peripheral FAF abnormalities are seen in both AMD and control patients. Those with AMD, poor visual acuity, and macular FAF abnormalities are at greater risk.

Hybrid 3D visualization of the chest and virtual endoscopy of the tracheobronchial system: possibilities and limitations of clinical application.

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Seemann, M D; Claussen, C D

2001-06-01

A hybrid rendering method which combines a color-coded surface rendering method and a volume rendering method is described, which enables virtual endoscopic examinations using different representation models. 14 patients with malignancies of the lung and mediastinum (n=11) and lung transplantation (n=3) underwent thin-section spiral computed tomography. The tracheobronchial system and anatomical and pathological features of the chest were segmented using an interactive threshold interval volume-growing segmentation algorithm and visualized with a color-coded surface rendering method. The structures of interest were then superimposed on a volume rendering of the other thoracic structures. For the virtual endoscopy of the tracheobronchial system, a shaded-surface model without color coding, a transparent color-coded shaded-surface model and a triangle-surface model were tested and compared. The hybrid rendering technique exploit the advantages of both rendering methods, provides an excellent overview of the tracheobronchial system and allows a clear depiction of the complex spatial relationships of anatomical and pathological features. Virtual bronchoscopy with a transparent color-coded shaded-surface model allows both a simultaneous visualization of an airway, an airway lesion and mediastinal structures and a quantitative assessment of the spatial relationship between these structures, thus improving confidence in the diagnosis of endotracheal and endobronchial diseases. Hybrid rendering and virtual endoscopy obviate the need for time consuming detailed analysis and presentation of axial source images. Virtual bronchoscopy with a transparent color-coded shaded-surface model offers a practical alternative to fiberoptic bronchoscopy and is particularly promising for patients in whom fiberoptic bronchoscopy is not feasible, contraindicated or refused. Furthermore, it can be used as a complementary procedure to fiberoptic bronchoscopy in evaluating airway stenosis and

Blinded evaluation of interrater reliability of an operative competency assessment tool for direct laryngoscopy and rigid bronchoscopy.

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Ishman, Stacey L; Benke, James R; Johnson, Kaalan Erik; Zur, Karen B; Jacobs, Ian N; Thorne, Marc C; Brown, David J; Lin, Sandra Y; Bhatti, Nasir; Deutsch, Ellen S

2012-10-01

OBJECTIVES To confirm interrater reliability using blinded evaluation of a skills-assessment instrument to assess the surgical performance of resident and fellow trainees performing pediatric direct laryngoscopy and rigid bronchoscopy in simulated models. DESIGN Prospective, paired, blinded observational validation study. SUBJECTS Paired observers from multiple institutions simultaneously evaluated residents and fellows who were performing surgery in an animal laboratory or using high-fidelity manikins. The evaluators had no previous affiliation with the residents and fellows and did not know their year of training. INTERVENTIONS One- and 2-page versions of an objective structured assessment of technical skills (OSATS) assessment instrument composed of global and a task-specific surgical items were used to evaluate surgical performance. RESULTS Fifty-two evaluations were completed by 17 attending evaluators. The instrument agreement for the 2-page assessment was 71.4% when measured as a binary variable (ie, competent vs not competent) (κ = 0.38; P = .08). Evaluation as a continuous variable revealed a 42.9% percentage agreement (κ = 0.18; P = .14). The intraclass correlation was 0.53, considered substantial/good interrater reliability (69% reliable). For the 1-page instrument, agreement was 77.4% when measured as a binary variable (κ = 0.53, P = .0015). Agreement when evaluated as a continuous measure was 71.0% (κ = 0.54, P formative feedback on operational competency.

Concentrations of moxifloxacin in serum and pulmonary compartments following a single 400 mg oral dose in patients undergoing fibre-optic bronchoscopy.

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Soman, A; Honeybourne, D; Andrews, J; Jevons, G; Wise, R

1999-12-01

The concentrations of moxifloxacin achieved after a single 400 mg dose were measured in serum, epithelial lining fluid (ELF), alveolar macrophages (AM) and bronchial mucosa (BM). Concentrations were determined using a microbiological assay. Nineteen patients undergoing fibre-optic bronchoscopy were studied. Mean serum, ELF, AM and BM concentrations at 2.2, 12 and 24 h were as follows: 2.2 h: 3.2 mg/L, 20.7 mg/L, 56.7 mg/L, 5.4 mg/kg; 12 h: 1.1 mg/L, 5.9 mg/L, 54.1 mg/L, 2.0 mg/kg; 24 h: 0.5 mg/L, 3.6 mg/L, 35.9 mg/L, 1.1 mg/kg, respectively. These concentrations exceed the MIC(90)s for common respiratory pathogens such as Streptococcus pneumoniae (0.25 mg/L), Haemophilus influenzae (0.03 mg/L), Moraxella catarrhalis (0.12 mg/L), Chlamydia pneumoniae (0.12 mg/L) and Mycoplasma pneumoniae (0. 12 mg/L) and indicate that moxifloxacin should be effective in the treatment of community-acquired, lower respiratory tract infections.

Skin autofluorescence and the association with renal and cardiovascular risk factors in chronic kidney disease stage 3.

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McIntyre, Natasha J; Fluck, Richard J; McIntyre, Christopher W; Taal, Maarten W

2011-10-01

Tissue advanced glycation end products (AGE) accumulation is a measure of cumulative metabolic stress. Assessment of tissue AGE by skin autofluorescence (SAF) correlates well with cardiovascular (CV) outcomes in diabetic, transplant, and dialysis patients, and may be a useful marker of CV risk in earlier stages of chronic kidney disease (CKD). 1707 patients with estimated GFR 59 to 30 ml/min per 1.73 m(2) were recruited from primary care practices for the Renal Risk In Derby (RRID) study. Detailed medical history was obtained, and each participant underwent clinical assessment as well as urine and serum biochemistry tests. SAF was assessed (mean of three readings) as a measure of skin AGE deposition using a cutaneous AF device (AGE Reader™, DiagnOptics, Groningen, The Netherlands). Univariate analysis revealed significant correlations between AF readings and several potential risk factors for cardiovascular disease (CVD) and progression of CKD. SAF readings (arbitrary units) were also significantly higher among males (2.8 ± 0.7 versus 2.7 ± 0.6), diabetics (3.0 ± 0.7 versus 2.7 ± 0.6), patients with evidence of self-reported CVD (2.9 ± 0.7 versus 2.7 ± 0.6), and those with no formal educational qualifications (2.8 ± 0.6 versus 2.6 ± 0.6; P < 0.01 for all). Multivariable linear regression analysis identified hemoglobin, diabetes, age, and eGFR as the most significant independent determinants of higher SAF (standardized coefficients -0.16, 0.13, 0.12, and -0.10, respectively; R(2) = 0.17 for equation). Increased SAF is independently associated with multiple CV and renal risk factors in CKD 3. Long-term follow-up will assess the value of SAF as a predictor of CV and renal risk in this population.

Utility of 67Ga scintigraphy and bronchial washings in the diagnosis and treatment of Pneumocystis carinii pneumonia in patients with the acquired immune deficiency syndrome

International Nuclear Information System (INIS)

Tuazon, C.U.; Delaney, M.D.; Simon, G.L.; Witorsch, P.; Varma, V.M.

1985-01-01

Twenty patients with the acquired immune deficiency syndrome (AIDS) and suspected Pneumocystis carinii pneumonia were evaluated by 67 Ga scintigraphy and fiberoptic bronchoscopy for initial diagnosis and response to therapy. Lung uptake of 67 Ga was demonstrated in 100% of AIDS patients with P. carinii pneumonia, including those with subclinical infection. Fiberoptic bronchoscopy identified P. carinii in the bronchial washings of 100% of cases (19 patients), whereas only 13 of 16 (81%) patients had P. carinii in lung tissue obtained by transbronchial biopsy. Repeat fiberoptic bronchoscopy was performed in 16 of 20 patients. After 2 to 4 wk of therapy, P. carinii was identified in bronchial washings in 8 of 16 (50%) patients and in transbronchial biopsy in 1 of 10 (10%) patients examined. Bronchial washing has a higher yield than transbronchial biopsy in demonstrating P. carinii in patients with AIDS and may evolve as the procedure of choice in such patients. Based on the clinical course and results of 67 Ga scintigraphy and fiberoptic bronchoscopy in AIDS patients with P. carinii pneumonia, optimal therapy may require at least 3 wk of treatment

Polarized near-infrared autofluorescence imaging combined with near-infrared diffuse reflectance imaging for improving colonic cancer detection.

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Shao, Xiaozhuo; Zheng, Wei; Huang, Zhiwei

2010-11-08

We evaluate the diagnostic feasibility of the integrated polarized near-infrared (NIR) autofluorescence (AF) and NIR diffuse reflectance (DR) imaging technique developed for colonic cancer detection. A total of 48 paired colonic tissue specimens (normal vs. cancer) were measured using the integrated NIR DR (850-1100 nm) and NIR AF imaging at the 785 nm laser excitation. The results showed that NIR AF intensities of cancer tissues are significantly lower than those of normal tissues (ppolarization conditions gives a higher diagnostic accuracy (of ~92-94%) compared to non-polarized NIR AF imaging or NIR DR imaging. Further, the ratio imaging of NIR DR to NIR AF with polarization provides the best diagnostic accuracy (of ~96%) among the NIR AF and NIR DR imaging techniques. This work suggests that the integrated NIR AF/DR imaging under polarization condition has the potential to improve the early diagnosis and detection of malignant lesions in the colon.

The role of fluorescence diagnosis in clinical practice

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Sieroń A

2013-07-01

Full Text Available Aleksander Sieroń,1 Karolina Sieroń-Stołtny,1 Aleksandra Kawczyk-Krupka,1 Wojciech Latos,1 Sebastian Kwiatek,1 Dariusz Straszak,1 Andrzej M Bugaj1,2 1Clinical Department of Internal Diseases, Angiology and Physical Medicine, Center for Laser Diagnostics and Therapy, Silesian Medical University, Bytom, 2College of Health, Beauty Care and Education, Poznan, Poland Abstract: Fluorescence diagnosis is a fast, easy, noninvasive, selective, and sensitive diagnostic tool for estimation of treatment results in oncology. In clinical practice the use of photodynamic diagnosis is focused on five targets: detection for prevention of malignant transformation precancerous changes, detection of neoplasmatic tissue in the early stages for fast removal, prevention of expansion and detection of recurrence of the cancer, monitoring therapy, and the possibility of excluding neoplasmatic disease. In this article, selected applications of fluorescence diagnosis at the Center for Laser Diagnostics and Therapy in Bytom, Poland, for each of these targets are presented. Keywords: autofluorescence, cancer, fluorescence, imaging, photodynamic diagnosis, photodynamic therapy 

Comparison of fundus autofluorescence with photopic and scotopic fine matrix mapping in patients with retinitis pigmentosa: 4- to 8-year follow-up.

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Robson, Anthony G; Lenassi, Eva; Saihan, Zubin; Luong, Vy A; Fitzke, Fred W; Holder, Graham E; Webster, Andrew R

2012-09-14

To assess the significance and evolution of parafoveal rings of high-density fundus autofluorescence (AF) in 12 patients with retinitis pigmentosa (RP). Twelve patients with autosomal recessive RP or Usher syndrome type 2 were ascertained who had a parafoveal ring of high-density AF and a visual acuity of 20/30 or better at baseline. Photopic and scotopic fine matrix mapping (FMM) were performed to test sensitivity across the macula. AF imaging and FMM were repeated after 4 to 8 years and optical coherence tomography (OCT) performed. The size of the AF ring reduced over time and disappeared in one subject. Photopic thresholds were normal over the fovea; thresholds were elevated by 0.6 log units over the ring and by 1.2 log units external to the ring at baseline and differed by less than 0.1 log unit at follow-up. Mild photopic losses close to the internal edge of the ring were detected at baseline or follow-up in all. Mean scotopic thresholds over parafoveal areas within the ring were markedly elevated in 8 of 10 at baseline and were severely elevated in 9 of 11 at follow-up. The eccentricity of the inner edge of the AF ring corresponded closely with the lateral extent of the inner segment ellipsoid band in the OCT image. Ring constriction was largely coincident with progressive centripetal photopic threshold elevation led by worsening of rod photoreceptor function. The rate of constriction differed across patients, and a ring may reach a critical minimum before disappearing, at which stage central visual loss occurs. The structural and functional changes associated with rings of increased autofluorescence confirm that they provide an objective index of macular involvement and may aid the management of RP patients and the monitoring of future treatment efficacy.

SU-C-BRA-07: Virtual Bronchoscopy-Guided IMRT Planning for Mapping and Avoiding Radiation Injury to the Airway Tree in Lung SAbR

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Sawant, A; Modiri, A; Bland, R; Yan, Y; Ahn, C; Timmerman, R [University of Texas SouthWestern Medical Center, Dallas, TX (United States)

2015-06-15

Purpose: Post-treatment radiation injury to central and peripheral airways is a potentially important, yet under-investigated determinant of toxicity in lung stereotactic ablative radiotherapy (SAbR). We integrate virtual bronchoscopy technology into the radiotherapy planning process to spatially map and quantify the radiosensitivity of bronchial segments, and propose novel IMRT planning that limits airway dose through non-isotropic intermediate- and low-dose spillage. Methods: Pre- and ∼8.5 months post-SAbR diagnostic-quality CT scans were retrospectively collected from six NSCLC patients (50–60Gy in 3–5 fractions). From each scan, ∼5 branching levels of the bronchial tree were segmented using LungPoint, a virtual bronchoscopic navigation system. The pre-SAbR CT and the segmented bronchial tree were imported into the Eclipse treatment planning system and deformably registered to the planning CT. The five-fraction equivalent dose from the clinically-delivered plan was calculated for each segment using the Universal Survival Curve model. The pre- and post-SAbR CTs were used to evaluate radiation-induced segmental collapse. Two of six patients exhibited significant segmental collapse with associated atelectasis and fibrosis, and were re-planned using IMRT. Results: Multivariate stepwise logistic regression over six patients (81 segments) showed that D0.01cc (minimum point dose within the 0.01cc receiving highest dose) was a significant independent factor associated with collapse (odds-ratio=1.17, p=0.010). The D0.01cc threshold for collapse was 57Gy, above which, collapse rate was 45%. In the two patients exhibiting segmental collapse, 22 out of 32 segments showed D0.01cc >57Gy. IMRT re-planning reduced D0.01cc below 57Gy in 15 of the 22 segments (68%) while simultaneously achieving the original clinical plan objectives for PTV coverage and OAR-sparing. Conclusion: Our results indicate that the administration of lung SAbR can Result in significant injury to

FREQUENT SUBCLINICAL MACULAR CHANGES IN COMBINED BRAF/MEK INHIBITION WITH HIGH-DOSE HYDROXYCHLOROQUINE AS TREATMENT FOR ADVANCED METASTATIC BRAF MUTANT MELANOMA: Preliminary Results From a Phase I/II Clinical Treatment Trial.

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Nti, Akosua A; Serrano, Leona W; Sandhu, Harpal S; Uyhazi, Katherine E; Edelstein, Ilaina D; Zhou, Elaine J; Bowman, Scott; Song, Delu; Gangadhar, Tara C; Schuchter, Lynn M; Mitnick, Sheryl; Huang, Alexander; Nichols, Charles W; Amaravadi, Ravi K; Kim, Benjamin J; Aleman, Tomas S

2018-01-10

To assess the potential ocular toxicity of a combined BRAF inhibition (BRAFi) + MEK inhibition (MEKi) + hydroxychloroquine (HCQ) regime used to treat metastatic BRAF mutant melanoma. Patients with stage IV metastatic melanoma and BRAF V600E mutations (n = 11, 31-68 years of age) were included. Treatment was with oral dabrafenib, 150 mg bid, trametinib, 2 mg/day, and HCQ, 400 mg to 600 mg bid. An ophthalmic examination, spectral domain optical coherence tomography, near-infrared and short-wavelength fundus autofluorescence, and static perimetry were performed at baseline, 1 month, and q/6 months after treatment. There were no clinically significant ocular events; there was no ocular inflammation. The only medication-related change was a separation of the photoreceptor outer segment tip from the apical retinal pigment epithelium that could be traced from the fovea to the perifoveal retina noted in 9/11 (82%) of the patients. There were no changes in retinal pigment epithelium melanization or lipofuscin content by near-infrared fundus autofluorescence and short-wavelength fundus autofluorescence, respectively. There were no inner retinal or outer nuclear layer changes. Visual acuities and sensitivities were unchanged. BRAFi (trametinib) + MEKi (dabrafenib) + HCQ causes very frequent, subclinical separation of the photoreceptor outer segment from the apical retinal pigment epithelium without inner retinal changes or signs of inflammation. The changes suggest interference with the maintenance of the outer retinal barrier and/or phagocytic/pump functions of the retinal pigment epithelium by effective MEK inhibition.

Direct noninvasive observation of near infrared photobleaching of autofluorescence in human volar side fingertips in vivo

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Deng, Bin; Wright, Colin; Lewis-Clark, Eric; Shaheen, G.; Geier, Roman; Chaiken, J.

2010-02-01

Human transdermal in vivo spectroscopic applications for tissue analysis involving near infrared (NIR) light often must contend with broadband NIR fluorescence that, depending on what kind of spectroscopy is being employed, can degrade signal to noise ratios and dynamic range. Such NIR fluorescence, i.e. "autofluorescence" is well known to originate in blood tissues and various other endogenous materials associated with the static tissues. Results of recent experiments on human volar side fingertips in vivo are beginning to provide a relative ordering of the contributions from various sources. Preliminary results involving the variation in the bleaching effect across different individuals suggest that for 830 nm excitation well over half of the total fluorescence comes from the static tissues and remainder originates with the blood tissues, i.e. the plasma and the hematocrit. Of the NIR fluorescence associated with the static tissue, over half originates with products of well-known post-enzymatic glycation reactions, i.e. Maillard chemistry, in the skin involving glucose and other carbohydrates and skin proteins like collagen and cytosol proteins.

Application of phasor plot and autofluorescence correction for study of heterogeneous cell population

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Szmacinski, Henryk; Toshchakov, Vladimir; Lakowicz, Joseph R.

2014-01-01

Abstract. Protein-protein interactions in cells are often studied using fluorescence resonance energy transfer (FRET) phenomenon by fluorescence lifetime imaging microscopy (FLIM). Here, we demonstrate approaches to the quantitative analysis of FRET in cell population in a case complicated by a highly heterogeneous donor expression, multiexponential donor lifetime, large contribution of cell autofluorescence, and significant presence of unquenched donor molecules that do not interact with the acceptor due to low affinity of donor-acceptor binding. We applied a multifrequency phasor plot to visualize FRET FLIM data, developed a method for lifetime background correction, and performed a detailed time-resolved analysis using a biexponential model. These approaches were applied to study the interaction between the Toll Interleukin-1 receptor (TIR) domain of Toll-like receptor 4 (TLR4) and the decoy peptide 4BB. TLR4 was fused to Cerulean fluorescent protein (Cer) and 4BB peptide was labeled with Bodipy TMRX (BTX). Phasor displays for multifrequency FLIM data are presented. The analytical procedure for lifetime background correction is described and the effect of correction on FLIM data is demonstrated. The absolute FRET efficiency was determined based on the phasor plot display and multifrequency FLIM data analysis. The binding affinity between TLR4-Cer (donor) and decoy peptide 4BB-BTX (acceptor) was estimated in a heterogeneous HeLa cell population. PMID:24770662

SHOX2 DNA Methylation is a Biomarker for the diagnosis of lung cancer based on bronchial aspirates

International Nuclear Information System (INIS)

Schmidt, Bernd; Lewin, Jörn; Tetzner, Reimo; Weickmann, Sabine; Wille, Ulrike; Liloglou, Triantafillos; Raji, Olaide; Walshaw, Martin; Fleischhacker, Michael; Witt, Christian; Field, John K; Liebenberg, Volker; Dietrich, Dimo; Schlegel, Thomas; Kneip, Christoph; Seegebarth, Anke; Flemming, Nadja; Seemann, Stefanie; Distler, Jürgen

2010-01-01

This study aimed to show that SHOX2 DNA methylation is a tumor marker in patients with suspected lung cancer by using bronchial fluid aspirated during bronchoscopy. Such a biomarker would be clinically valuable, especially when, following the first bronchoscopy, a final diagnosis cannot be established by histology or cytology. A test with a low false positive rate can reduce the need for further invasive and costly procedures and ensure early treatment. Marker discovery was carried out by differential methylation hybridization (DMH) and real-time PCR. The real-time PCR based HeavyMethyl technology was used for quantitative analysis of DNA methylation of SHOX2 using bronchial aspirates from two clinical centres in a case-control study. Fresh-frozen and Saccomanno-fixed samples were used to show the tumor marker performance in different sample types of clinical relevance. Valid measurements were obtained from a total of 523 patient samples (242 controls, 281 cases). DNA methylation of SHOX2 allowed to distinguish between malignant and benign lung disease, i.e. abscesses, infections, obstructive lung diseases, sarcoidosis, scleroderma, stenoses, at high specificity (68% sensitivity [95% CI 62-73%], 95% specificity [95% CI 91-97%]). Hypermethylation of SHOX2 in bronchial aspirates appears to be a clinically useful tumor marker for identifying subjects with lung carcinoma, especially if histological and cytological findings after bronchoscopy are ambiguous

Review of adult tracheomalacia and its relationship with chronic obstructive pulmonary disease.

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Kandaswamy, Chitra; Balasubramanian, Vijay

2009-03-01

This review summarizes the literature on adult or acquired tracheobronchomalacia (TBM) and explores its association with chronic obstructive pulmonary disease (COPD). Dynamic imaging of central airways, a noninvasive test as effective as bronchoscopy to diagnose TBM, has increased the recognition of this disorder. Airway stabilization techniques using stents placed via bronchoscopy have also furthered the interest in TBM. The association of TBM with COPD is of growing interest particularly in the face of worldwide rise in COPD incidence. The pathobiology behind this condition may share significant common ground with COPD. Despite the lack of uniformly accepted diagnostic criteria and the uncertain correlation to clinical manifestations and course, technologic advances in imaging and interventional bronchoscopy have spurred clinicians' interest in TBM. In exploring the association of TBM and COPD, an intriguing consideration is whether TBM could be an extension of peripheral airway disease.

The utility of the fiberoptic bronchoscopy in the esophageal cancer; Utilidad de la fibrobroncoscopia en el cancer de esofago

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Reyes O, Leonardo; Garcia-Herreros, Plutarco; Rivas P, Pilar; Posso, Hector; L, Sandoval Rafael

1998-04-01

The paper establishes the utility of the fiber- optic bronchoscopy (FOB) studies performed in patients with esophageal cancer (EC) and confirm the possibility of tracheo-bronchial compromise. We carry out a descriptive study in 226 patients with esophageal cancer during 1991 to 1996 in the Instituto Nacional de Cancerologia of Colombia (INC). We excluded the patients with previous treatments: radiotherapy or surgery, and others primary cancers with metastases on the esophagus. We analyzed gastric, intestinal and general symptoms, smoking habits, primary cancer location, histological types, radiologic findings, fob findings, micro and macroscopes, and results of the samples: transbronchial, endobronchial biopsies, bronchi alveolar lavage and brush. We included 158 patients, 110 male and 48 female, with age between 32 and 83 years, symptoms duration average of 5,2 months. The most significant were cough, dysphonia and sputum. The location of EC was statistics significance only in the upper third escamocelular type. The significant radiological findings were: parenchymal nodules and interstitial infiltrates, the significant fob findings were: fistula endobronchial infiltration endobronchial mass and vocal cords palsy. The zones with more compromise were trachea, principal bronchi and vocal cords. Only 17 patients were positives in the samples; comparing the histopathologic findings (biopsies) as the gold standard with fob findings the sensitivity was 100%, specificity 35%, positive predictive value 15.6% and negative predictive value 100%.

Fundus autofluorescence and colour fundus imaging compared during telemedicine screening in patients with diabetes.

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Kolomeyer, Anton M; Baumrind, Benjamin R; Szirth, Bernard C; Shahid, Khadija; Khouri, Albert S

2013-06-01

We investigated the use of fundus autofluorescence (FAF) imaging in screening the eyes of patients with diabetes. Images were obtained from 50 patients with type 2 diabetes undergoing telemedicine screening with colour fundus imaging. The colour and FAF images were obtained with a 15.1 megapixel non-mydriatic retinal camera. Colour and FAF images were compared for pathology seen in nonproliferative and proliferative diabetic retinopathy (NPDR and PDR, respectively). A qualitative assessment was made of the ease of detecting early retinopathy changes and the extent of existing retinopathy. The mean age of the patients was 47 years, most were male (82%) and most were African American (68%). Their mean visual acuity was 20/45 and their mean intraocular pressure was 14.3 mm Hg. Thirty-eight eyes (76%) did not show any diabetic retinopathy changes on colour or FAF imaging. Seven patients (14%) met the criteria for NPDR and five (10%) for severe NPDR or PDR. The most common findings were microaneurysms, hard exudates and intra-retinal haemorrhages (IRH) (n = 6 for each). IRH, microaneurysms and chorioretinal scars were more easily visible on FAF images. Hard exudates, pre-retinal haemorrhage and fibrosis, macular oedema and Hollenhorst plaque were easier to identify on colour photographs. The value of FAF imaging as a complementary technique to colour fundus imaging in detecting diabetic retinopathy during ocular screening warrants further investigation.

Advanced glycation end products assessed by skin autofluorescence: a new marker of diabetic foot ulceration.

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Vouillarmet, Julien; Maucort-Boulch, Delphine; Michon, Paul; Thivolet, Charles

2013-07-01

Accumulation of advanced glycation end products (AGEs) may contribute to diabetic foot ulceration (DFU). Our goal was to determine whether AGEs measurement by skin autofluorescence (SAF) would be an additional marker for DFU management. We performed SAF analysis in 66 patients with a history of DFU prospectively included and compared the results with those of 84 control patients with diabetic peripheral neuropathy without DFU. We then assessed the prognostic value of SAF levels on the healing rate in the DFU group. Mean SAF value was significantly higher in the DFU group in comparison with the control group, even after adjustment for other diabetes complications (3.2±0.6 arbitrary units vs. 2.9±0.6 arbitrary units; P=0.001). In the DFU group, 58 (88%) patients had an active wound at inclusion. The mean DFU duration was 14±13 weeks. The healing rate was 47% after 2 months of appropriate foot care. A trend for a correlation between SAF levels and healing time in DFU subjects was observed but was not statistically significant (P=0.06). Increased SAF levels are associated with neuropathic foot complications in diabetes. Use of SAF measurement to assess foot vulnerability and to predict DFU events in high-risk patients appears to be promising.

Detection of early metabolic alterations in the ocular fundus of diabetic patients by time-resolved autofluorescence of endogenous fluorophores

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Schweitzer, D.; Klemm, M.; Quick, S.; Deutsch, L.; Jentsch, S.; Hammer, M.; Dawczynski, J.; Kloos, C. H.; Mueller, U. A.

2011-07-01

Measurements of time-resolved autofluorescence (FLIM) at the human ocular fundus of diabetic patients permit the detection of early pathologic alterations before signs of diabetic retinopathy are visible. The measurements were performed by the Jena Fluorescence Lifetime Laser Scanner Ophthalmoscope applying time-correlated single photon counting (TCSPC) in two spectral channels (K1: 490-560 nm, K2:560-700ps). The fluorescence was excited by 70 ps pulses (FWHM) at 448 nm. The decay of fluorescence intensity was triple-exponentially approximated. The frequency of amplitudes, lifetimes, and relative contributions was compared in fields of the same size and position in healthy subjects and in diabetic patients. The most sensitive parameter was the lifetime T2 in the short-wavelength channel, which corresponds to the neuronal retina. The changes in lifetime point to a loss of free NADH and an increased contribution of protein-bound NADH in the pre-stage of diabetic retinopathy.

The potential regimen of target-controlled infusion of propofol in flexible bronchoscopy sedation: a randomized controlled trial.

Directory of Open Access Journals (Sweden)

Ting-Yu Lin

Full Text Available Target-controlled infusion (TCI provides precise pharmacokinetic control of propofol concentration in the effect-site (Ce, eg. brain. This pilot study aims to evaluate the feasibility and optimal TCI regimen for flexible bronchoscopy (FB sedation.After alfentanil bolus, initial induction Ce of propofol was targeted at 2 μg/ml. Patients were randomized into three titration groups (i.e., by 0.5, 0.2 and 0.1 μg/ml, respectively to maintain stable sedation levels and vital signs. Adverse events, frequency of adjustments, drug doses, and induction and recovery times were recorded.The study was closed early due to significantly severe hypoxemia events (oxyhemoglobin saturation <70% in the group titrated at 0.5 μg/ml. Forty-nine, 49 and 46 patients were enrolled into the 3 respective groups before study closure. The proportion of patients with hypoxemia events differed significantly between groups (67.3 vs. 46.9 vs. 41.3%, p = 0.027. Hypotension events, induction and recovery time and propofol doses were not different. The Ce of induction differed significantly between groups (2.4±0.5 vs. 2.1±0.4 vs. 2.1±0.3 μg/ml, p = 0.005 and the Ce of procedures was higher at 0.5 μg/ml titration (2.4±0.5 vs. 2.1±0.4 vs. 2.2±0.3 μg/ml, p = 0.006. The adjustment frequency tended to be higher for titration at 0.1 μg/ml but was not statistically significant (2 (0∼6 vs. 3 (0∼6 vs. 3 (0∼11. Subgroup analysis revealed 14% of all patients required no further adjustment during the whole sedation. Comparing patients requiring at least one adjustment with those who did not, they were observed to have a shorter induction time (87.6±34.9 vs. 226.9±147.9 sec, p<0.001, a smaller induction dose and Ce (32.5±4.1 vs. 56.8±22.7 mg, p<0.001; 1.76±0.17 vs. 2.28 ±0.41, p<0.001, respectively, and less hypoxemia and hypotension (15.8 vs.56.9%, p = 0.001; 0 vs. 24.1%, p = 0.008, respectively.Titration at 0.5 μg/ml is risky for FB sedation. A

Ultrasound-Guided Percutaneous Dilational Tracheostomy: A Systematic Review of Randomized Controlled Trials and Meta-Analysis.

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Gobatto, André L N; Besen, Bruno A M P; Cestari, Mino; Pelosi, Paolo; Malbouisson, Luiz M S

2018-01-01

Percutaneous dilational tracheostomy (PDT) is a common and increasingly used procedure in the intensive care unit (ICU). It is usually performed with bronchoscopy guidance. Ultrasound has emerged as a useful tool in order to assist PDT, potentially improving its success rate and reducing procedural-related complications. To investigate whether the ultrasound-guided PDT is equivalent or superior to the bronchoscopy-guided or anatomical landmarks-guided PDT with regard to procedural-related and clinical complications. A systematic review of randomized clinical trials was conducted comparing an ultrasound-guided PDT to the control groups (either a bronchoscopy-guided PDT or an anatomical landmark-guided PDT) in patients undergoing a PDT in the ICU. The primary outcome was the incidence of major procedural-related and clinical complication rates. The secondary outcome was the incidence of minor complication rates. Random-effect meta-analyzes were used to pool the results. Four studies fulfilled the inclusion criteria and they were analyzed. The studies included 588 participants. There were no differences in the major complication rates between the patients who were assigned to the ultrasound-guided PDT when compared to the control groups (pooled risk ratio [RR]: 0.48; 95% confidence interval [CI]: 0.13-1.71, I 2 = 0%). The minor complication rates were not different between the groups, but they had a high heterogeneity (pooled RR: 0.49; 95% CI 0.16-1.50; I 2 = 85%). The sensitivity analyzes that only included the randomized controlled trials that used a landmark-guided PDT as the control group showed lower rates of minor complications in the ultrasound-guided PDT group (pooled RR: 0.55; 95% CI: 0.31-0.98, I 2 = 0%). The ultrasound-guided PDT seems to be safe and it is comparable to the bronchoscopy-guided PDT regarding the major and minor procedural-related or clinical complications. It also seems to reduce the minor complications when compared to the anatomical

Concentrations of levofloxacin (HR 355) in the respiratory tract following a single oral dose in patients undergoing fibre-optic bronchoscopy.

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Andrews, J M; Honeybourne, D; Jevons, G; Brenwald, N P; Cunningham, B; Wise, R

1997-10-01

Concentrations of levofloxacin were measured in bronchial biopsies, alveolar macrophages (AM), epithelial lining fluid (ELF) and serum following a single oral dose. Concentrations were measured by a microbiological assay method. A total of 35 patients undergoing fibre-optic bronchoscopy were studied. Mean serum, AM, ELF and biopsy concentrations were as follows. 0.5 h: 4.73 mg/L, 19.1 mg/L, 4.74 mg/L and 4.3 mg/kg; 1 h: 6.6 mg/L, 32.5 mg/L, 10.8 mg/L and 8.3 mg/kg; 2 h: 4.9 mg/L, 41.9 mg/L, 9.0 mg/L and 6.5 mg/kg; 4 h: 4.1 mg/L, 27.7 mg/L, 10.9 mg/L and 6.0 mg/kg; and 6-8 h: 4.0 mg/L, 38.4 mg/L, 9.6 mg/L and 4.0 mg/kg respectively. Mean serum and AM concentrations at 12-24 h were 1.2 and 13.9 mg/L respectively (concentrations in biopsy and ELF were only measurable in three of the six patients). These concentrations exceed the MIC90s of the common respiratory pathogens, Haemophilus influenzae (0.015 mg/L), Moraxella catarrhalis (0.06 mg/L) and Streptococcus pneumoniae (1 mg/L) and suggest that levofloxacin should be efficacious in the treatment of community- and hospital-acquired respiratory infection.

Association of age and macular pigment optical density using dual-wavelength autofluorescence imaging.

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Lima, Verônica Castro; Rosen, Richard B; Prata, Tiago Santos; Dorairaj, Syril; Spielberg, Leigh; Maia, Mauricio; Sallum, Juliana M

2013-01-01

Several lines of evidence suggest that macular pigment may play a protective role against age-related macular degeneration, but the influence of age on macular pigment density levels remains unclear. This study was designed to investigate the relationship between age and the normal distribution of macular pigment optical density (MPOD) values surrounding the fovea. Consecutive healthy subjects with no evidence of ocular disease were enrolled in this study. After inclusion, MPOD values were measured at specific eccentricities (0.5, 1, and 2 degrees) from the foveal center using a dual-wavelength autofluorescence method employing a modified confocal scanning laser ophthalmoscope. Whenever both eyes were eligible, one was randomly selected for analysis. The correlation between age and MPOD values was investigated using regression analysis. Thirty subjects (30 eyes) were included (mean age 48.6 ± 16.4 [range 23-77] years). Significant differences were found between MPOD values measured at 0.5, 1, and 2 degrees from the center of the fovea (0.49 ± 0.12 density units, 0.37 ± 0.11 density units, and 0.13 ± 0.05 density units, respectively, P < 0.05). Significant correlations between age and MPOD values at 0.5 and 1 degree were found (P ≤ 0.02). Values measured at 2 degrees did not correlate significantly with age (P = 0.06). In healthy subjects, MPOD values were highest near the foveal center. These values appeared to increase during adulthood (peak at 45-50 years), followed by a gradual reduction after 60 years of age.

CLINICAL PROFILE OF PRIMARY LUNG CANCER AND ROLE OF BRONCHOSCOPY

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Bharate

2015-08-01

Full Text Available INTRODUCTION: Cancer is a Latin word meaning "A CRAB". The Greek word for a crab is "KARKINES" and Sanskrit word is "KARKARA ” . (1 Lung cancer is one of the commonest fatal neoplastic disease s in the world . It is at the first place at central and North India and at second place at south India. It is estimated that, every year in India, about 30,000 new lung cancer cases are registered .

[Clinical features, diagnosis and surgical treatment of solitary air cysts of the lungs].

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Gudovskiĭ, L M; Platov, I I; Korenev, A E

2001-01-01

86 cases of solitary air cysts of the lung (6.83% of all maldevelopments) were analyzed. This maldevelopment of bronchial tree is found most often in men (10:7) and more often in the right lung than in the left (18:13). There were no clinical symptoms in 33 (38.37%) patients. Uncomplicated course of the disease was in 51 (59.3%) patients, the disease was complicated by infection in 28 (32.56%) patients. Solitary bronchial cysts were complicated by spontaneous pneumothorax in 8.14% cases, by hemoptysis--in 6.98%. Roentgenography of the chest thorax on two projections and tomography (including CT) are enough for diagnosis of solitary air bronchial cysts. Bronchoscopy, bronchography and APG are not much informative in diagnosis of cysts and should be used on special indications. Cystectomy or cystectomy with partial resection of lung tissue were performed in 67.14% patients with good results.

Principle component analysis and linear discriminant analysis of multi-spectral autofluorescence imaging data for differentiating basal cell carcinoma and healthy skin

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Chernomyrdin, Nikita V.; Zaytsev, Kirill I.; Lesnichaya, Anastasiya D.; Kudrin, Konstantin G.; Cherkasova, Olga P.; Kurlov, Vladimir N.; Shikunova, Irina A.; Perchik, Alexei V.; Yurchenko, Stanislav O.; Reshetov, Igor V.

2016-09-01

In present paper, an ability to differentiate basal cell carcinoma (BCC) and healthy skin by combining multi-spectral autofluorescence imaging, principle component analysis (PCA), and linear discriminant analysis (LDA) has been demonstrated. For this purpose, the experimental setup, which includes excitation and detection branches, has been assembled. The excitation branch utilizes a mercury arc lamp equipped with a 365-nm narrow-linewidth excitation filter, a beam homogenizer, and a mechanical chopper. The detection branch employs a set of bandpass filters with the central wavelength of spectral transparency of λ = 400, 450, 500, and 550 nm, and a digital camera. The setup has been used to study three samples of freshly excised BCC. PCA and LDA have been implemented to analyze the data of multi-spectral fluorescence imaging. Observed results of this pilot study highlight the advantages of proposed imaging technique for skin cancer diagnosis.

Spectral characteristics of caries-related autofluorescence spectra and their use for diagnosis of caries stage

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Son, Sung-Ae; Jung, Kyeong-Hoon; Ko, Ching-Chang; Kwon, Yong Hoon

2016-01-01

The purpose of the present study was to identify factors useful for diagnosis of the caries stage from laser-induced autofluorescence (AF) spectra. Affected teeth were accurately staged and allocated to four groups: sound, stage II, stage III, or stage IV. A 405-nm laser was used to produce AF spectra. The spectrum factors analyzed were spectrum slope at 550 to 600 nm, spectral area from 500 and 590 nm, and intensity ratio of peaks 625 and 667 nm (625/667 nm). DIAGNOdent was used as control measurement. AF spectra of sound teeth had a peak near 500 nm followed by a smooth decline to 800 nm. As caries progressed, some specimens in stages II to IV showed one or two peak(s) near 625 and 667 nm. Slopes at 550 to 600 nm and areas under the curve at 500 to 590 nm were significantly different (p<0.001) for each stage. Two-peak ratios were also significantly different (p<0.001) except for stage III and stage IV. DIAGNOdent readings for sound and stage II and stage III and IV were not significantly different. Among the studied factors, the spectrum slope at 550 to 600 nm and area under curve at 500 to 590 nm could be useful treatment decision-making tools for carious lesions.

Conjunctival Ultraviolet Autofluorescence as a Measure of Past Sun Exposure in Children.

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Sun, Cong; Pezic, Angela; Mackey, David A; Carlin, John B; Kemp, Andrew; Ellis, Justine A; Cameron, Fergus J; Rodda, Christine P; Dwyer, Terence; Coroneo, Minas T; Ponsonby, Anne-Louise

2017-07-01

Background: Conjunctival ultraviolet autofluorescence (CUVAF) area detected from UVAF photographs is a recently developed potential marker for past sun exposure, but its relationship with sun-related factors has not been fully investigated. Methods: The study included 339 healthy children ages 5 to 15 years in Melbourne, Australia. Data were collected by questionnaire and examination at school. CUVAF area was measured using a computer program and analyzed as a continuous and dichotomous outcome (any/none). Results: Fifty-three children (15.6%) had detectable CUVAF, and the youngest age at which a child showed sun damage was 8 years. Compared with silicone skin cast score, there was good inter-grader agreement on CUVAF grading, with Cohen kappa 0.85 [95% confidence interval (CI), 0.65-1.00] for total CUVAF area using both eye photographs. Perfect intra-grader agreement was achieved. Fairer pigmentation, including medium/fair skin color [adjusted odds ratio (AOR), 3.42; 95% CI, 1.02-11.48 vs. dark/olive] and blue/gray eye color (AOR, 4.07; 95% CI, 1.73-9.55 vs. brown) was associated with increased odds of CUVAF. Increasing lifetime sunburn number (e.g., AOR, 2.89; 95% CI, 1.14-7.35 and 4.29; 1.04-17.76 for sunburns 2 to 4 and ≥ 5 times, respectively, vs. no sunburns, trend P = 0.004) and freckling by the end of last summer were associated with increased odds of CUVAF. Conclusions: CUVAF area can be an a priori objective measure of past sun exposure in pediatric populations for future research. Impact: To our knowledge, this is the first pediatric study that evaluated associations of sun-related risk factors with CUVAF. Cancer Epidemiol Biomarkers Prev; 26(7); 1146-53. ©2017 AACR . ©2017 American Association for Cancer Research.

A Rare Case of Idiopathic Plastic Bronchitis

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Mohammed Raoufi

2017-01-01

Full Text Available Plastic bronchitis is a rare disorder characterized by formation of large, branching bronchial casts, which are often expectorated. We present an interesting case of a 35-year-old woman who presented for evaluation of a chronic cough productive of voluminous secretions. Clinical and radiological examination confirmed a total left lung atelectasis without any pathological mediastinal node. Flexible bronchoscopy demonstrated tenacious, thick, and sticky whitish secretions blocking the left stem bronchus. This material was extracted, and inspection demonstrated a bronchial cast, whose pathological analysis revealed necrotic epithelial cells, some eosinophils, and Charcot-Leyden crystals. Two days after bronchoscopy, the patient rejected more bronchial casts, and dyspnea improved. Control of chest x-ray revealed complete left lung aeration and the diagnosis of idiopathic plastic bronchitis was obtained. This article shows the interest in clinical practice to evoke the diagnosis of plastic bronchitis in front of a productive chronic cough. Our case illustrates a rare clinical presentation represented by an atelectasis of an entire lung.

Cushing's like syndrome in typical bronchial carcinoid a case report and review of the literature.

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Pedicelli, Ilaria; Patriciello, Giuseppina; Scala, Giovanni; Sorrentino, Antonietta; Gravino, Gennaro; Patriciello, Pasquale; Zeppa, Pio; Di Crescenzo, Vincenzo; Vatrella, Alessandro

2016-01-01

Cushing's syndrome occurred in 1-5% of cases of bronchial carcinoids. In this paper we describe a case of typical bronchial carcinoid in a nonsmoker young male with clinical manifestations mimicking a Cushing's syndrome. The patient performed chest radiograph and computed tomography. Fiberoptic bronchoscopy revealed the presence of an endobronchial mass occluding the bronchus intermedius. A rigid bronchoscopy was necessary for the conclusive diagnosis and for partial resection of the intraluminal tumor. Despite of the presence of Cushingoid features, the normal blood levels of ACTH and cortisol excluded the coexistence of a Cushing's syndrome. Copyright © 2016 The Authors. Published by Elsevier Ltd.. All rights reserved.

THE EFFECT OF PHOTOPIGMENT BLEACHING ON FUNDUS AUTOFLUORESCENCE IN ACUTE CENTRAL SEROUS CHORIORETINOPATHY.

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Choi, Kwang-Eon; Yun, Cheolmin; Kim, Young-Ho; Kim, Seong-Woo; Oh, Jaeryung; Huh, Kuhl

2017-03-01

To evaluate the effect of photobleaching on fundus autofluorescence (FAF) images in acute central serous chorioretinopathy. We obtained prephotobleaching and postphotobleaching images using an Optomap 200Tx, and photobleaching was induced with a Heidelberg Retina Angiograph 2. Degrees of photobleaching were assessed as grayscale values in Optomap images. Concordances among the three kinds of images were analyzed. Hyper-AF lesions in prephotobleaching images were classified as Type 1 (changed to normal-AF after photobleaching) and Type 2 (unchanged after photobleaching). The FAF composite patterns of central serous chorioretinopathy lesions were classified as diffuse or mottled. Initial and final best-corrected visual acuity, central retinal thickness, and disease duration were compared according to fovea FAF type. Forty-one eyes of 41 patients were analyzed. The lesion brightness of postphotobleaching Optomap FAF showed greater concordance with Heidelberg Retina Angiograph 2 FAF (94.74%) than the prephotobleaching Optomap FAF (80.49%). Eyes with Type 1 fovea had greater initial and final best-corrected visual acuity (20/23 vs. 20/41, 20/21 vs. 20/32, P < 0.0001, P = 0.001, respectively) and shorter disease duration (19.68 ± 12.98 vs. 51.55 ± 44.98 days, P = 0.043) than those with Type 2 fovea. However, eyes with diffuse Type 2 fovea had only lower initial and final best-corrected visual acuity (20/23 vs. 20/45, 20/21 vs. 20/36, P < 0.0001, P < 0.0001, respectively) than those with Type 1 fovea. Understanding the photobleaching effect is necessary for the accurate interpretation of FAF images. Furthermore, comparing prephotobleaching and postphotobleaching FAF images may be helpful for estimation of lesion status in central serous chorioretinopathy.

An evaluation of fundus photography and fundus autofluorescence in the diagnosis of cuticular drusen.

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Høeg, Tracy B; Moldow, Birgitte; Klein, Ronald; La Cour, Morten; Klemp, Kristian; Erngaard, Ditte; Ellervik, Christina; Buch, Helena

2016-03-01

To examine non-mydriatic fundus photography (FP) and fundus autofluorescence (FAF) as alternative non-invasive imaging modalities to fluorescein angiography (FA) in the detection of cuticular drusen (CD). Among 2953 adults from the Danish Rural Eye Study (DRES) with gradable FP, three study groups were selected: (1) All those with suspected CD without age-related macular degeneration (AMD) on FP, (2) all those with suspected CD with AMD on FP and (3) a randomly selected group with early AMD. Groups 1, 2 and 3 underwent FA and FAF and group 4 underwent FAF only as part of DRES CD substudy. Main outcome measures included percentage of correct positive and correct negative diagnoses, Cohen's κ and prevalence-adjusted and bias-adjusted κ (PABAK) coefficients of test and grader reliability. CD was correctly identified on FP 88.9% of the time and correctly identified as not being present 83.3% of the time. CD was correctly identified on FAF 62.0% of the time and correctly identified as not being present 100.0% of the time. Compared with FA, FP has a PABAK of 0.75 (0.60 to 1.5) and FAF a PABAK of 0.44 (0.23 to 0.95). FP is a promising, non-invasive substitute for FA in the diagnosis of CD. FAF was less reliable than FP to detect CD. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/

Structural and functional changes associated with normal and abnormal fundus autofluorescence in patients with retinitis pigmentosa.

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Greenstein, Vivienne C; Duncker, Tobias; Holopigian, Karen; Carr, Ronald E; Greenberg, Jonathan P; Tsang, Stephen H; Hood, Donald C

2012-02-01

To analyze the structure and visual function of regions bordering the hyperautofluorescent ring/arcs in retinitis pigmentosa. Twenty-one retinitis pigmentosa patients (21 eyes) with rings/arcs and 21 normal individuals (21 eyes) were studied. Visual sensitivity in the central 10° was measured with microperimetry. Retinal structure was evaluated with spectral-domain optical coherence tomography. The distance from the fovea to disruption/loss of the inner outer segment (IS/OS) junction and thicknesses of the total receptor plus retinal pigment epithelial complex and outer segment plus retinal pigment epithelial complex layers were measured. Results were compared with measurements of the distance from the fovea to the inner and outer borders of the ring/arc seen on fundus autofluorescence. Disruption/loss of the inner outer segment junction occurred closer to the inner border of the ring/arc and it was closer to the fovea in eight eyes. For 19 eyes, outer segment plus and receptor plus RPE complex thicknesses were significantly decreased at locations closer to the fovea than the appearance of the inner border of hyperautofluorescence. Mean visual sensitivity was decreased inside, across, and outside the ring/arc by 3.5 ± 3.8, 8.9 ± 4.8, and 17.0 ± 2.4 dB, respectively. Structural and functional changes can occur inside the hyperfluorescent ring/arc in retinitis pigmentosa.

Airway foreign body in children

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Marina GONZÁLEZ-HERRERO

2018-03-01

Full Text Available Introduction and objective: The aspiration of a foreign body in children is a frequent emergency in pediatrics, being potentially lethal. Method: Narrative review. Results: This pathology mainly affects children under 5 years of age with a peak of incidence between the first and third years of life. The clinic will depend on the type of foreign body (size, shape, possibility of breaking, organic or not, the age of the child and the location of the object. In our environment, the most frequent is the aspiration of nuts (peanuts and sunflower seeds. After the initial picture, an asymptomatic period tends to occur, which favors delayed diagnosis and leads to possible errors in the diagnosis. Discussion: An adequate clinical history and a high diagnostic suspicion are fundamental to favor an early treatment. The presence of a normal chest X-ray does not exclude the presence of a foreign body in the airway, so a bronchoscopy is indicated if the diagnostic suspicion is high. The treatment of choice is extraction by rigid bronchoscopy, being controversial the use of flexible fibrobronchoscope. Conclusions: Conclusions: The aspiration of a foreign body is a pediatric emergency that requires a diagnosis and early treatment. The highest incidence occurs in children under 3 years and more frequently in men. The most commonly aspirated material in our environment are nuts, mainly located in the bronchial tree. The initial episode may go unnoticed, delaying the diagnosis and may lead to progressive respiratory distress in the child. A detailed clinical history and suspicion of this pathology are essential in children at risk age who present with cough and dyspnea of sudden onset. The existence of a normal chest radiograph should not postpone bronchoscopy when there is high clinical suspicion. The treatment of choice for the extraction of foreign bodies in airways in children is rigid bronchoscopy, being controversial the use of the flexible fibrobronchoscope

A Case of Pulmonary Foreign Body Reviewed as Mass

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Sayed Javad Sayedi

2016-08-01

Full Text Available Foreign Body Aspiration (FBA is a common and sometimes life-threatening problem in children and in higher age groups. FBA highest incidence rate is during the second year in children and the sixth decade of life in adults, and often foreign bodies due to their shape and size pass through larynx and trachea and place in bronchi. The most common aspirated body by children are nuts. Symptoms of aspiration can be asphyxia, cough, or cyanosis. Although in some cases patients may have no symptoms, an accurate and positive history even without clinical signs must be suspected doctor to a foreign body aspiration. However, in some cases, radiological intervention is normal and helps to diagnose and should be performed in all suspected cases to FBA. FBA definite diagnosis is by bronchoscopy, and to prevent complications and possibly death, timely removing of foreign body is vital and necessary. Most of the complications of delayed diagnosis and treatment and early detection are associated with few complications. FBA potential complications include pneumomediastinum, pneumothorax, atelectasis, bronchiectasis, lung abscess, and recurrent pneumonia. Most of these complications are irreversible in people with problems diagnosed too late. Technological advances and clinical application of bronchoscopy have caused the majority of foreign bodies are removed from the respiratory system are without sequela. The removal of foreign body through undergone rigid bronchoscopy is the preferred method of treatment, but in certain cases may require surgical intervention to remove the foreign body. This report is a case of 17-month-old infant with fever, coryza, and cough symptoms with a diagnosis of pneumonia was hospitalized due to suspected pulmonary mass by chest x-ray or chest CT scan and bronchoscopy was performed and the seed was removed from the right lung.

Cramers Court Nursing Home, Belgooly, Cork.

LENUS (Irish Health Repository)

Marathe, N

2016-02-01

The study illustrates advantages of Fiberoptic Bronchoscopy, a new service started at St. Luke’s General Hospital in patient care since April 2014. Retrospective review of Bronchoscopies and referrals to Tertiary care unit for Bronchoscopy, prior and after initiation of service at St. Luke’s Hospital were studied. In total, 106 procedures were performed out of which 103(98%) were for diagnostic purpose. Common indications for bronchoscopy were functional airway assessment in 38 cases (35%) of chronic cough, 26 cases (24.8%) of suspected malignancy. The average time taken for procedure was 15 + 1 minute with overall rate of complication recorded in 1 case (0.95%). 32(30%) inpatients were referred before bronchoscopy services were started locally. Fifteen (14%) patients were referred for Endobronchial Ultrasound (EBUS) after diagnostic procedure performed at St. Luke’s Hospital. To conclude, Bronchoscopy is a safe procedure used for diagnosis of various Lung conditions. The services offered locally reduced the time and cost involved in referrals. The diagnostic bronchoscopies performed for malignancy at St. Luke’s Hospital have rightly increased references for EBUS at Tertiary care Unit

Clinical Evaluation of Endoscopic Trimodal Imaging for the Detection and Differentiation of Colonic Polyps

NARCIS (Netherlands)

van den Broek, Frank J. C.; Fockens, Paul; van Eeden, Susanne; Kara, Mohammed A.; Hardwick, James C. H.; Reitsma, Johannes B.; Dekker, Evelien

2009-01-01

Background & Aims: Endoscopic trimodal imaging (ETMI) incorporates high-resolution endoscopy (HRE) and autofluorescence imaging (AFI) for adenoma detection, and narrow-band imaging (NBI) for differentiation of adenomas from nonneoplastic polyps. The aim of this study was to compare AFI with HRE for

Optically-tracked handheld fluorescence imaging platform for monitoring skin response in the management of soft tissue sarcoma

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Chamma, Emilie; Qiu, Jimmy; Lindvere-Teene, Liis; Blackmore, Kristina M.; Majeed, Safa; Weersink, Robert; Dickie, Colleen I.; Griffin, Anthony M.; Wunder, Jay S.; Ferguson, Peter C.; DaCosta, Ralph S.

2015-07-01

Standard clinical management of extremity soft tissue sarcomas includes surgery with radiation therapy. Wound complications (WCs) arising from treatment may occur due to bacterial infection and tissue breakdown. The ability to detect changes in these parameters during treatment may lead to earlier interventions that mitigate WCs. We describe the use of a new system composed of an autofluorescence imaging device and an optical three-dimensional tracking system to detect and coregister the presence of bacteria with radiation doses. The imaging device visualized erythema using white light and detected bacterial autofluorescence using 405-nm excitation light. Its position was tracked relative to the patient using IR reflective spheres and registration to the computed tomography coordinates. Image coregistration software was developed to spatially overlay radiation treatment plans and dose distributions on the white light and autofluorescence images of the surgical site. We describe the technology, its use in the operating room, and standard operating procedures, as well as demonstrate technical feasibility and safety intraoperatively. This new clinical tool may help identify patients at greater risk of developing WCs and investigate correlations between radiation dose, skin response, and changes in bacterial load as biomarkers associated with WCs.

Airway segmentation and centerline extraction from thoracic CT : Comparison of a new method to state of the art commercialized methods

NARCIS (Netherlands)

Reynisson, P.J.; Scali, M.; Smistad, E.; Hofstad, E.F.; Leira, H.O.; Lindseth, F.; Nagelhus Hernes, T.A.; Amundsen, T.; Sorger, H.; Lango, T.

2015-01-01

Our motivation is increased bronchoscopic diagnostic yield and optimized preparation, for navigated bronchoscopy. In navigated bronchoscopy, virtual 3D airway visualization is often used to guide a bronchoscopic tool to peripheral lesions, synchronized with the real time video bronchoscopy.

Oxygen general saturation after bronchography under general ...

African Journals Online (AJOL)

Thirty-six patients undergoing bronchography or bronchoscopy under general anaesthesia were continuously monitored by pulse oximetry for 5 hours after these procedures. Significant falls in oxygen saturation were observed in the first hour and were of most clinical relevance in patients with preexisting pulmonary ...

Tracheal web

International Nuclear Information System (INIS)

Legasto, A.C.; Haller, J.O.; Giusti, R.J.

2004-01-01

Congenital tracheal web is a rare entity often misdiagnosed as refractory asthma. Clinical suspicion based on patient history, examination, and pulmonary function tests should lead to its consideration. Bronchoscopy combined with CT imaging and multiplanar reconstruction is an accepted, highly sensitive means of diagnosis. (orig.)

Management of benign stenoses of the large airways in the university hospital in Prague, Czech Republic, in 1998-2003.

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Marel, Miloslav; Pekarek, Zdenek; Spasova, Irena; Pafko, Pavel; Schutzner, Jan; Betka, Jan; Pospisil, Ronald

2005-01-01

Clinically significant benign stenoses of the large airways develop in about 1% of patients after intubation. The management of benign stenoses is not unified around the world, nor are there any accepted methods for their screening. The purpose of this study is to describe and compare results of interventional bronchoscopy and surgical therapy of benign stenoses as well as to propose an algorithm for the management of this airways disorder. Prospective study on 80 consecutive patients with benign stenoses of the large airways admitted to the Pulmonary Department of the University Hospital of Prague-Motol. Sixty-two patients developed stenoses after endotracheal intubation or tracheostomy, in 18 patients the stenosis was caused by other diseases or pathological situations. Thirty-eight patients were sent for surgical resection of the stenotic part of the airways. 2 surgically treated patients developed recurrence of the stenosis and had to be reoperated on. Narrowing of the trachea at the site of end-to-end anastomosis developed in 6 other patients and was cured by interventional bronchoscopy. The remaining 42 patients were treated by interventional bronchoscopy (Nd-YAG laser, electrocautery, stent) which was curative in 35 patients. Sixty-five patients were alive at the time of evaluation, 15 patients died. Five of them died between 3 and 14 (median 4) months after surgery from a disease other than airway stenosis. Ten nonresected patients also died, with 1 exception, due to a disease other than airway stenosis; the median survival was 9 months. We recommend to assess the patient for surgery after the initial diagnosis and therapeutic bronchoscopy with dilatation of the stenosis. If the patient is not a suitable candidate for resection, interventional bronchoscopy is an appropriate alternative for the management of benign stenoses of the large airways. Copyright (c) 2005 S. Karger AG, Basel.

Autofluorescence Imaging With Near-Infrared Excitation:Normalization by Reflectance to Reduce Signal From Choroidal Fluorophores

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Cideciyan, Artur V.; Swider, Malgorzata; Jacobson, Samuel G.

2015-01-01

Purpose. We previously developed reduced-illuminance autofluorescence imaging (RAFI) methods involving near-infrared (NIR) excitation to image melanin-based fluorophores and short-wavelength (SW) excitation to image lipofuscin-based flurophores. Here, we propose to normalize NIR-RAFI in order to increase the relative contribution of retinal pigment epithelium (RPE) fluorophores. Methods. Retinal imaging was performed with a standard protocol holding system parameters invariant in healthy subjects and in patients. Normalized NIR-RAFI was derived by dividing NIR-RAFI signal by NIR reflectance point-by-point after image registration. Results. Regions of RPE atrophy in Stargardt disease, AMD, retinitis pigmentosa, choroideremia, and Leber congenital amaurosis as defined by low signal on SW-RAFI could correspond to a wide range of signal on NIR-RAFI depending on the contribution from the choroidal component. Retinal pigment epithelium atrophy tended to always correspond to high signal on NIR reflectance. Normalizing NIR-RAFI reduced the choroidal component of the signal in regions of atrophy. Quantitative evaluation of RPE atrophy area showed no significant differences between SW-RAFI and normalized NIR-RAFI. Conclusions. Imaging of RPE atrophy using lipofuscin-based AF imaging has become the gold standard. However, this technique involves bright SW lights that are uncomfortable and may accelerate the rate of disease progression in vulnerable retinas. The NIR-RAFI method developed here is a melanin-based alternative that is not absorbed by opsins and bisretinoid moieties, and is comfortable to view. Further development of this method may result in a nonmydriatic and comfortable imaging method to quantify RPE atrophy extent and its expansion rate. PMID:26024124

Association between follicular tracheitis and gastroesophageal reflux.

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Duval, Melanie; Meier, Jeremy; Asfour, Fadi; Jackson, Daniel; Grimmer, J Fredrik; Muntz, Harlan R; Park, Albert H

2016-03-01

Follicular tracheitis (also known as tracheal cobblestoning) is an entity that is poorly described and of unclear significance. The objective of this study was to better define follicular tracheitis and determine the association between the clinical finding of follicular tracheitis on bronchoscopy and objective evidence of gastroesophageal reflux disease. Retrospective chart review of children with recurrent croup having undergone a rigid bronchoscopy and an investigation for gastroesophageal reflux between 2001 and 2013. 117 children with recurrent croup children age 6-144 months were included in the study. Follicular tracheitis was noted on 41% of all bronchoscopies. Fifty-nine percent of all children who underwent bronchoscopy were diagnosed with gastroesophageal reflux on at least one investigation. Forty-nine of 117 children underwent a pH probe study, and 51% were found to have evidence of reflux on this study. Nine children were diagnosed with eosinophilic esophagitis. Three patients underwent a biopsy of the follicular tracheitis lesions, which revealed chronic inflammation. There was no evidence of an association between findings of follicular tracheitis and a positive test for gastroesophageal reflux (p=0.52) or a positive pH probe study (p=0.64). There was no association between follicular tracheitis and subglottic stenosis (p=0.33) or an history of asthma and/or atopy (p=0.19). In children with recurrent croup, follicular tracheitis remains an unspecific finding associated with an inflammatory disorder of unknown etiology. Copyright © 2015 Elsevier Ireland Ltd. All rights reserved.

Virtual reality simulation of basic pulmonary procedures

DEFF Research Database (Denmark)

Konge, Lars; Arendrup, Henrik; von Buchwald, Christian

2011-01-01

Background: Virtual reality (VR) bronchoscopy simulators have been available for more than a decade, and have been recognized as an important aid in bronchoscopy training. The existing literature has only examined the role of VR simulators in diagnostic bronchoscopy. The aim of this study...

The use of light-based (optical) detection systems as adjuncts in the detection of oral cancer and oral potentially malignant disorders: a systematic review.

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Rashid, A; Warnakulasuriya, S

2015-05-01

In recent decades, optical techniques utilising the principles of chemiluminescence and tissue autofluorescence have emerged to facilitate the early detection of any oral mucosal changes suspicious of cancer. To evaluate the effectiveness of devices that utilise the principles of chemiluminescence and tissue autofluorescence as adjuncts in the detection of oral cancer and oral potentially malignant disorders (OPMDs). A systematic review of the published literature to evaluate the effectiveness of the ViziLite(®) and ViziLite(®) Plus with toluidine blue, MicroLux™/DL and the VELscope™ as aids in the detection of oral cancer and OPMDs. Twenty-five primary studies published between 2004 and 2013 satisfied our criteria for selection - 13 utilised chemiluminescence and 12 tissue autofluorescence. Some had utilised both study methods on the same population. Chemiluminescence shows good sensitivity at detecting any OPMDs and oral cancer. However, it preferentially detects leukoplakia and may fail to spot red patches. The additive use of toluidine blue may improve specificity. Tissue autofluorescence is sensitive at detecting white, red and white and red patches, and the area of fluorescence visualisation loss (FVL) often extends beyond the clinically visible lesion. However, in addition to OPMDs, VELScope may detect erythematous lesions of benign inflammation resulting in false-positive test results. There is limited evidence for their use in primary care, and these tools are better suited to specialist clinics in which there is a higher prevalence of disease and where experienced clinicians may better discriminate between benign and malignant lesions. © 2014 John Wiley & Sons A/S. Published by John Wiley & Sons Ltd.

Imaging of Mucosal Inflammation: Current Technological Developments, Clinical Implications, and Future Perspectives

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Maximilian J. Waldner

2017-10-01

Full Text Available In recent years, various technological developments markedly improved imaging of mucosal inflammation in patients with inflammatory bowel diseases. Although technological developments such as high-definition-, chromo-, and autofluorescence-endoscopy led to a more precise and detailed assessment of mucosal inflammation during wide-field endoscopy, probe-based and stationary confocal laser microscopy enabled in vivo real-time microscopic imaging of mucosal surfaces within the gastrointestinal tract. Through the use of fluorochromes with specificity against a defined molecular target combined with endoscopic techniques that allow ultrastructural resolution, molecular imaging enables in vivo visualization of single molecules or receptors during endoscopy. Molecular imaging has therefore greatly expanded the clinical utility and applications of modern innovative endoscopy, which include the diagnosis, surveillance, and treatment of disease as well as the prediction of the therapeutic response of individual patients. Furthermore, non-invasive imaging techniques such as computed tomography, magnetic resonance imaging, scintigraphy, and ultrasound provide helpful information as supplement to invasive endoscopic procedures. In this review, we provide an overview on the current status of advanced imaging technologies for the clinical non-invasive and endoscopic evaluation of mucosal inflammation. Furthermore, the value of novel methods such as multiphoton microscopy, optoacoustics, and optical coherence tomography and their possible future implementation into clinical diagnosis and evaluation of mucosal inflammation will be discussed.

Bronchoscopic Cryotherapy. Clinical Applications of the Cryoprobe, Cryospray, and Cryoadhesion.

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DiBardino, David M; Lanfranco, Anthony R; Haas, Andrew R

2016-08-01

Cryotherapy is an evolving therapeutic and diagnostic tool used during bronchoscopy. Through rapid freeze-thaw cycles, cryotherapy causes cell death and tissue necrosis or tissue adherence that can be used via the flexible or rigid bronchoscope. This extreme cold can be used through the working channel of the bronchoscope via a specialized cryoprobe or directly with the use of spray cryotherapy. These properties allow for multiple bronchoscopic techniques, each with its own equipment and procedural, safety, and efficacy considerations. Bronchoscopic cryotherapy can be used in a variety of clinical scenarios, including the treatment of malignant and benign central airway obstruction and low-grade airway malignancy, foreign body removal or cryoextraction, endobronchial biopsy, and transbronchial biopsy. The bulk of the experience with bronchoscopic cryotherapy consists of uncontrolled case series of malignant central airway obstruction. There are also controlled data supporting the use of cryoadhesion for endobronchial biopsies, albeit with an increased risk of controllable bleeding. The use of cryoadhesion for transbronchial biopsies is an active area of investigation with limited controlled data. In addition, there are promising future directions using bronchoscopic cryotherapy, including chemosensitizing malignancy with cryotherapy and capitalizing on the synergy between cryotherapy and radiation.

Outcomes after Bronchoscopic Procedures for Primary Tracheobronchial Amyloidosis: Retrospective Study of 6 Cases

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Ihsan Alloubi

2012-01-01

Full Text Available Respiratory amyloidosis is a rare disease which refers to localized aberrant extracellular protein deposits within the airways. Tracheobronchial amyloidosis (TBA refers to the deposition of localized amyloid deposits within the upper airways. Treatments have historically focused on bronchoscopic techniques including debridement, laser ablation, balloon dilation, and stent placement. We present the outcomes after rigid bronchoscopy to remove the amyloid protein causing the airway obstruction in 6 cases of tracheobronchial amyloidosis. This is the first report of primary diffuse tracheobronchial amyloidosis in our department; clinical features, in addition to therapy in the treatment of TBA, are reviewed. This paper shows that, in patients with TBA causing airway obstruction, excellent results can be obtained with rigid bronchoscopy and stenting of the obstructing lesion.

Outcomes after bronchoscopic procedures for primary tracheobronchial amyloidosis: retrospective study of 6 cases.

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Alloubi, Ihsan; Thumerel, Matthieu; Bégueret, Hugues; Baste, Jean-Marc; Velly, Jean-François; Jougon, Jacques

2012-01-01

Respiratory amyloidosis is a rare disease which refers to localized aberrant extracellular protein deposits within the airways. Tracheobronchial amyloidosis (TBA) refers to the deposition of localized amyloid deposits within the upper airways. Treatments have historically focused on bronchoscopic techniques including debridement, laser ablation, balloon dilation, and stent placement. We present the outcomes after rigid bronchoscopy to remove the amyloid protein causing the airway obstruction in 6 cases of tracheobronchial amyloidosis. This is the first report of primary diffuse tracheobronchial amyloidosis in our department; clinical features, in addition to therapy in the treatment of TBA, are reviewed. This paper shows that, in patients with TBA causing airway obstruction, excellent results can be obtained with rigid bronchoscopy and stenting of the obstructing lesion.

Tracheobronchial Amyloidosis Mimicking Tracheal Tumor

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Elif Tanrıverdi

2016-01-01

Full Text Available Tracheobronchial amyloidosis is a rare presentation and accounts for about 1% of benign tumors in this area. The diagnosis of disease is delayed due to nonspecific pulmonary symptoms. Therapeutic approaches are required to control progressive pulmonary symptoms for most of the patients. Herein, we report a case of a 68-year-old man admitted with progressive dyspnea to our institution for further evaluation and management. He was initially diagnosed with and underwent management for bronchial asthma for two years but had persistent symptoms despite optimal medical therapy. Pulmonary computed tomography scan revealed severe endotracheal stenosis. Bronchoscopy was performed and showed endotracheal mass obstructing 70% of the distal trachea and mimicking a neoplastic lesion. The mass was successfully resected by mechanical resection, argon plasma coagulation (APC, and Nd-YAG laser during rigid bronchoscopy. Biopsy materials showed deposits of amorphous material by hematoxylin and eosin staining and these deposits were selectively stained with Congo Red. Although this is a rare clinical condition, this case indicated that carrying out a bronchoscopy in any patient complaining of atypical bronchial symptoms or with uncontrolled asthma is very important.

Bronchoalveolar lavage in patients with interstitial lung diseases: side effects and factors affecting fluid recovery.

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Dhillon, D P; Haslam, P L; Townsend, P J; Primett, Z; Collins, J V; Turner-Warwick, M

1986-05-01

One hundred and seventy patients with interstitial lung diseases undergoing bronchoalveolar lavage (BAL), were contrasted with 51 patients undergoing fibreoptic bronchoscopy alone to define the factors which predispose to post-lavage side-effects. Transient post-bronchoscopy fall in the peak expired flow (PEF) greater than or equal to 20% occurred in both groups (24% and 23% respectively), and thus was probably related to the bronchoscopy procedure. Post-lavage pyrexia (greater than or equal to 1 degree C) occurred only in the patients undergoing BAL (26%), p less than 0.001. Only 4% with pyrexia required antibiotics, and only 2% with falls in PEF needed bronchodilator therapy. The only significant clinical association was more frequent pyrexia in patients on treatment with prednisolone, particularly in women (p less than 0.01). Pyrexia was also associated with higher lavage fluid introduction volumes (greater than 240 ml). Side effects did not relate to the percentages of lavage fluid recovered, although smokers had lower recoveries and, recoveries tended to be higher in sarcoidosis than cryptogenic fibrosing alveolitis. Serial lavages in 25 patients caused no significant increase in side effects.

Comparison of Narrowband Imaging with Autofluorescence Imaging for Endoscopic Visualization of Superficial Squamous Cell Carcinoma Lesions of the Esophagus

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Haruhisa Suzuki

2012-01-01

Full Text Available Aim. To compare narrowband imaging (NBI and autofluorescence imaging (AFI endoscopic visualization for identifying superficial esophageal squamous cell carcinoma (SCC. Methods. Twenty-four patients with superficial esophageal carcinomas diagnosed at previous hospitals were enrolled in this study. Lesions were initially detected using white-light endoscopy and then observed with both NBI and AFI. Endoscopic images documented each method, and three endoscopists experienced in esophageal imaging retrospectively reviewed respective images of histologically confirmed esophageal SCCs. Images were assessed for quality in identifying superficial SCCs and rated as excellent, fair, or poor by the three reviewers with interobserver agreement calculated using kappa (κ statistics. Results. Thirty-one lesions histologically confirmed as superficial esophageal SCCs were detected in 24 patients. NBI images of 27 lesions (87% were rated as excellent, three as fair, and one as poor compared to AFI images of 19 lesions (61% rated as excellent, 10 as fair and two as poor (P<0.05. Moderate interobserver agreement (κ=0.42, 95% CI 0.24–0.60 resulted in NBI while fair agreement (κ=0.35, 95% CI 0.18–0.51 was achieved using AFI. Conclusion. NBI may be more effective than AFI for visualization of esophageal SCC.

Segmentation of the geographic atrophy in spectral-domain optical coherence tomography and fundus autofluorescence images.

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Hu, Zhihong; Medioni, Gerard G; Hernandez, Matthias; Hariri, Amirhossein; Wu, Xiaodong; Sadda, Srinivas R

2013-12-30

Geographic atrophy (GA) is the atrophic late-stage manifestation of age-related macular degeneration (AMD), which may result in severe vision loss and blindness. The purpose of this study was to develop a reliable, effective approach for GA segmentation in both spectral-domain optical coherence tomography (SD-OCT) and fundus autofluorescence (FAF) images using a level set-based approach and to compare the segmentation performance in the two modalities. To identify GA regions in SD-OCT images, three retinal surfaces were first segmented in volumetric SD-OCT images using a double-surface graph search scheme. A two-dimensional (2-D) partial OCT projection image was created from the segmented choroid layer. A level set approach was applied to segment the GA in the partial OCT projection image. In addition, the algorithm was applied to FAF images for the GA segmentation. Twenty randomly chosen macular SD-OCT (Zeiss Cirrus) volumes and 20 corresponding FAF (Heidelberg Spectralis) images were obtained from 20 subjects with GA. The algorithm-defined GA region was compared with consensus manual delineation performed by certified graders. The mean Dice similarity coefficients (DSC) between the algorithm- and manually defined GA regions were 0.87 ± 0.09 in partial OCT projection images and 0.89 ± 0.07 in registered FAF images. The area correlations between them were 0.93 (P segment GA regions in both SD-OCT and FAF images. This approach demonstrated good agreement between the algorithm- and manually defined GA regions within each single modality. The GA segmentation in FAF images performed better than in partial OCT projection images. Across the two modalities, the GA segmentation presented reasonable agreement.

Multiphoton tomography of the human eye

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König, Karsten; Batista, Ana; Hager, Tobias; Seitz, Berthold

2017-02-01

Multiphoton tomography (MPT) is a novel label-free clinical imaging method for non-invasive tissue imaging with high spatial (300 nm) and temporal (100 ps) resolutions. In vivo optical histology can be realized due to the nonlinear excitation of endogenous fluorophores and second-harmonic generation (SHG) of collagen. Furthermore, optical metabolic imaging (OMI) is performed by two-photon autofluorescence lifetime imaging (FLIM). So far, applications of the multiphoton tomographs DermaInspect and MPTflex were limited to dermatology. Novel applications include intraoperative brain tumor imaging as well as cornea imaging. In this work we describe two-photon imaging of ex vivo human corneas unsuitable for transplantation. Furthermore, the cross-linking (CXL) process of corneal collagen based on UVA exposure and 0.1 % riboflavin was studied. The pharmacokinetics of the photosensitizer could be detected with high spatial resolution. Interestingly, an increase in the stromal autofluorescence intensity and modifications of the autofluorescence lifetimes were observed in the human corneal samples within a few days following CXL.

Cough quality in children: a comparison of subjective vs. bronchoscopic findings

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Cox Nancy C

2005-01-01

Full Text Available Abstract Background Cough is the most common symptom presenting to doctors. The quality of cough (productive or wet vs dry is used clinically as well as in epidemiology and clinical research. There is however no data on the validity of cough quality descriptors. The study aims were to compare (1 cough quality (wet/dry and brassy/non-brassy to bronchoscopic findings of secretions and tracheomalacia respectively and, (2 parent's vs clinician's evaluation of the cough quality (wet/dry. Methods Cough quality of children (without a known underlying respiratory disease undergoing elective bronchoscopy was independently evaluated by clinicians and parents. A 'blinded' clinician scored the secretions seen at bronchoscopy on pre-determined criteria and graded (1 to 6. Kappa (K statistics was used for agreement, and inter-rater and intra-rater agreement examined on digitally recorded cough. A receiver operating characteristic (ROC curve was used to determine if cough quality related to amount of airway secretions present at bronchoscopy. Results Median age of the 106 children (62 boys, 44 girls enrolled was 2.6 years (IQR 5.7. Parent's assessment of cough quality (wet/dry agreed with clinicians' (K = 0.75, 95%CI 0.58–0.93. When compared to bronchoscopy (bronchoscopic secretion grade 4, clinicians' cough assessment had the highest sensitivity (0.75 and specificity (0.79 and were marginally better than parent(s. The area under the ROC curve was 0.85 (95%CI 0.77–0.92. Intra-observer (K = 1.0 and inter-clinician agreement for wet/dry cough (K = 0.88, 95%CI 0.82–0.94 was very good. Weighted K for inter-rater agreement for bronchoscopic secretion grades was 0.95 (95%CI 0.87–1. Sensitivity and specificity for brassy cough (for tracheomalacia were 0.57 and 0.81 respectively. K for both intra and inter-observer clinician agreement for brassy cough was 0.79 (95%CI 0.73–0.86. Conclusions Dry and wet cough in children, as determined by clinicians and

Skin autofluorescence based decision tree in detection of impaired glucose tolerance and diabetes.

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Andries J Smit

Full Text Available Diabetes (DM and impaired glucose tolerance (IGT detection are conventionally based on glycemic criteria. Skin autofluorescence (SAF is a noninvasive proxy of tissue accumulation of advanced glycation endproducts (AGE which are considered to be a carrier of glycometabolic memory. We compared SAF and a SAF-based decision tree (SAF-DM with fasting plasma glucose (FPG and HbA1c, and additionally with the Finnish Diabetes Risk Score (FINDRISC questionnaire±FPG for detection of oral glucose tolerance test (OGTT- or HbA1c-defined IGT and diabetes in intermediate risk persons.Participants had ≥1 metabolic syndrome criteria. They underwent an OGTT, HbA1c, SAF and FINDRISC, in adition to SAF-DM which includes SAF, age, BMI, and conditional questions on DM family history, antihypertensives, renal or cardiovascular disease events (CVE.218 persons, age 56 yr, 128M/90F, 97 with previous CVE, participated. With OGTT 28 had DM, 46 IGT, 41 impaired fasting glucose, 103 normal glucose tolerance. SAF alone revealed 23 false positives (FP, 34 false negatives (FN (sensitivity (S 68%; specificity (SP 86%. With SAF-DM, FP were reduced to 18, FN to 16 (5 with DM (S 82%; SP 89%. HbA1c scored 48 FP, 18 FN (S 80%; SP 75%. Using HbA1c-defined DM-IGT/suspicion ≥6%/42 mmol/mol, SAF-DM scored 33 FP, 24 FN (4 DM (S76%; SP72%, FPG 29 FP, 41 FN (S71%; SP80%. FINDRISC≥10 points as detection of HbA1c-based diabetes/suspicion scored 79 FP, 23 FN (S 69%; SP 45%.SAF-DM is superior to FPG and non-inferior to HbA1c to detect diabetes/IGT in intermediate-risk persons. SAF-DM's value for diabetes/IGT screening is further supported by its established performance in predicting diabetic complications.

Variability of skin autofluorescence measurement over 6 and 12 weeks and the influence of benfotiamine treatment.

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Stirban, Alin; Pop, Alexandra; Fischer, Annelie; Heckermann, Sascha; Tschoepe, Diethelm

2013-09-01

Measurements of skin autofluorescence (SAF) allow for a simple and noninvasive quantification of tissue advanced glycation end-products (AGEs), a marker linked to the risk of diabetes complications. The aim of this study was to test the repeatability of SAF over 6 and 12 weeks and to test whether benfotiamine, a thiamine prodrug suggested to reduce AGEs formation under hyperglycemic conditions, is able to attenuate SAF when administered over 6 weeks. In a double-blind, placebo-controlled, randomized, crossover study, 22 patients with type 2 diabetes mellitus (T2DM) received 900 mg/day benfotiamine or placebo for 6 weeks (washout period of 6 weeks between). At the beginning and at the end of each treatment period, SAF was assessed in the fasting state, as well as 2, 4, and 6 h following a mixed test meal. The respective intra-individual and inter-individual variability of fasting SAF was 6.9% and 24.5% within 6 weeks and 10.9% and 23.1% within 12 weeks. The respective variability calculated for triplicate comparisons was 9.9% and 27.7%. A short-term therapy with benfotiamine did not influence SAF significantly, nor did we find a significant postprandial SAF increase. In patients with T2DM, repeated, timely spaced SAF measurements have an intra-subject variability of below 11%. Using these data, sample sizes were calculated for interventional studies aiming at reducing SAF. Benfotiamine treatment for 6 weeks did not significantly influence SAF; for this, a longer-term therapy is probably needed.

Everything that wheezes… Late presentation of an aspirated foreign body as a cause of near fatal respiratory distress

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L. Hindle*

2013-12-01

Discussion: This case illustrates the difficulty doctors may have when there is delayed presentation or unwitnessed aspiration of a foreign body. History, clinical symptoms and the X-ray findings may provide clues but are not diagnostic. In cases where a FB aspiration is suspected, bronchoscopy is both diagnostic and potentially curative.

The characteristics of patients with pulmonary Mycobacterium avium-intracellulare complex disease diagnosed by bronchial lavage culture compared to those diagnosed by sputum culture.

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Maekawa, Koichi; Naka, Megumi; Shuto, Saki; Harada, Yuka; Ikegami, Yumiko

2017-09-01

The utility of bronchoscopy for the diagnosis of pulmonary Mycobacterium avium-intracellulare complex (MAC) disease has been reported; however, which patients require bronchoscopy remains unclear. Our objective was to identify the characteristics of the patients in whom bronchoscopy is needed for the diagnosis of MAC disease. Fifty-four patients with pulmonary MAC disease were divided into two groups according to established diagnostic criteria: 39 patients were diagnosed by sputum culture and 15 patients were diagnosed by bronchial lavage culture. We analysed the differences in demographic and clinical characteristics as well as microbiological and radiological data between the two groups. There were no significant differences in age, sex, smoking status, MAC species, underlying diseases, or steroid use. Significantly more patients diagnosed by sputum culture than bronchial lavage culture had a positive sputum smear for acid-fast bacilli (79.5% vs. 0.0%, respectively; p disease, bronchiectasis, and cavities. However, more patients diagnosed by sputum culture than bronchial lavage culture had abnormalities in the left upper division (48.7% vs. 13.3%, respectively; p = 0.017) and higher numbers of affected lobes (4.3 ± 1.4 vs. 3.3 ± 1.6, respectively; p = 0.034). If patients suspected of having pulmonary MAC disease have a negative sputum smear, no symptoms, no abnormal findings in the left upper division, or fewer affected lobes on computed tomography, bronchoscopy might be needed for the diagnosis. Copyright © 2017 Japanese Society of Chemotherapy and The Japanese Association for Infectious Diseases. Published by Elsevier Ltd. All rights reserved.

Optical skin biopsies by clinical CARS and multiphoton fluorescence/SHG tomography

International Nuclear Information System (INIS)

König, K; Breunig, H G; Bückle, R; Kellner-Höfer, M; Weinigel, M; Büttner, E; Sterry, W; Lademann, J

2011-01-01

The ultimate challenge for early diagnostics is label-free high-resolution intratissue imaging without taking physical biopsies. A novel hybrid femtosecond laser tomograph provides in vivo optical biopsies of human skin based on non-linear excitation of autofluorescence and the detection of lipids and water by CARS. Applications include skin cancer detection, biosafety tests of intradermal nanoparticles, and the testing of anti-aging products

Endogenous and exogenous fluorescence of gastrointestinal tumors: initial clinical observations

Science.gov (United States)

Borisova, Ekaterina; Plamenova, Lilia; Keremedchiev, Momchil; Vladimirov, Borislav; Avramov, Latchezar

2013-03-01

The limitations of standard endoscopy for detection and evaluation of cancerous changes in gastrointestinal tract (GIT) are significant challenge and initiate development of new diagnostic modalities. Therefore many spectral and optical techniques are applied recently into the clinical practice for obtaining qualitatively and quantitatively new data from gastrointestinal neoplasia with different level of clinical applicability and diagnostic success. One of the most promising approaches is fluorescence detection using naturally existing fluorescent molecules or added fluorescent markers. Deltaaminolevulinic acid / protoporphyrin IX is applied for exogenous fluorescent tumor detection in the upper part of gastrointestinal tract. The 5-ALA is administered per os six hours before measurements at dose 20mg/kg weight. Highpower light-emitting diode at 405 nm is used as a source and the excitation light is passed through the light-guide of standard video-endoscopic system to obtain 2-D visualization. Both kinds of spectra - autofluorescence signals and protoporphyrin IX signal are recorded and stored using a fiber-optic microspectrometer, as in endoscopy instrumental channel a fiber is applied to return information about fluorescence signals. In such way 1-D detection and 2-D visualization of the lesions' fluorescence are received. The results from in vivo detection show significant differentiation between normal and abnormal tissues in 1-D spectroscopic regime, but only moderate discrimination in 2-D imaging.

Unusual cause of respiratory distress misdiagnosed as refractory asthma

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Al-Otair Hadil

2006-01-01

Full Text Available We report a young lady, who was labeled as a case of refractory asthma for a few years, based on history of shortness of breath on minimal exertion, noisy breathing and normal chest radiograph. Repeated upper airway exam by an otolaryngologist and computerized tomography scan, were normal. On presentation to our hospital, she was diagnosed to have fixed upper airway obstruction, based on classical flow-volume loop findings. Fibroptic bronchoscopy revealed a web-shaped subglottic stenosis. The histopathology of a biopsy taken from that area, showed non-specific inflammation. No cause for this stenosis could be identified. The patient was managed with rigid bronchoscopy dilatation, without recurrence. We report this case as idiopathic subglottic stenosis, that was misdiagnosed as refractory bronchial asthma, stressing the importance of performing spirometry in the clinic.

Multimodal imaging of the disease progression of birdshot chorioretinopathy

NARCIS (Netherlands)

Teussink, M.M.; Veld, P.I. Huis In Het; Vries, L.A.M. de; Hoyng, C.B.; Klevering, B.J.; Theelen, T.

2016-01-01

PURPOSE: To study outer retinal deterioration in relation to clinical disease activity in patients with birdshot chorioretinopathy using fundus autofluorescence and spectral-domain optical coherence tomography (OCT). METHODS: A single-centre retrospective cohort study was carried out on 42 eyes of

Autofluorescence and diffuse reflectance patterns in cervical spectroscopy

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Marin, Nena Maribel

Fluorescence and diffuse reflectance spectroscopy are two new optical technologies, which have shown promise to aid in the real time, non-invasive identification of cancers and precancers. Spectral patterns carry a fingerprint of scattering, absorption and fluorescence properties in tissue. Scattering, absorption and fluorescence in tissue are directly affected by biological features that are diagnostically significant, such as nuclear size, micro-vessel density, volume fraction of collagen fibers, tissue oxygenation and cell metabolism. Thus, analysis of spectral patterns can unlock a wealth of information directly related with the onset and progression of disease. Data from a Phase II clinical trial to assess the technical efficacy of fluorescence and diffuse reflectance spectroscopy acquired from 850 women at three clinical locations with two research grade optical devices is calibrated and analyzed. Tools to process and standardize spectra so that data from multiple spectrometers can be combined and analyzed are presented. Methodologies for calibration and quality assurance of optical systems are established to simplify design issues and ensure validity of data for future clinical trials. Empirically based algorithms, using multivariate statistical approaches are applied to spectra and evaluated as a clinical diagnostic tool. Physically based algorithms, using mathematical models of light propagation in tissue are presented. The presented mathematical model combines a diffusion theory in P3 approximation reflectance model and a 2-layer fluorescence model using exponential attenuation and diffusion theory. The resulting adjoint fluorescence and reflectance model extracts twelve optical properties characterizing fluorescence efficiency of cervical epithelium and stroma fluorophores, stromal hemoglobin and collagen absorption, oxygen saturation, and stromal scattering strength and shape. Validations with Monte Carlo simulations show that adjoint model extracted

Detection of Parathyroid Autofluorescence Using Near-Infrared Imaging: A Multicenter Analysis of Concordance Between Different Surgeons.

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Kahramangil, Bora; Dip, Fernando; Benmiloud, Fares; Falco, Jorge; de La Fuente, Martin; Verna, Silvina; Rosenthal, Raul; Berber, Eren

2018-04-01

Parathyroid glands (PGs) exhibit autofluorescence (AF) when excited by near-infrared laser. This multicenter study aims to analyze how this imaging could facilitate the detection of PGs during thyroidectomy and parathyroidectomy procedures. This was a retrospective Institutional Review Board-approved analysis of prospectively collected data at three centers. Near-infrared fluorescence imaging (NIFI) was used to detect AF from PGs during thyroidectomy and parathyroidectomy procedures. Logistic regression analysis was performed to assess the utility of NIFI to identify PGs and concordance at these centers. Overall, 210 patients underwent total thyroidectomy (n = 95), thyroid lobectomy (n = 41), and parathyroidectomy (n = 74) (n = 70 per center). Using NIFI, AF was detected from 98% of visually identified PGs. Upon initial exploration, 46% of PGs were not visible to the naked eye due to coverage by soft tissue, but AF from these glands could be detected by NIFI without any further dissection. Overall, a median of one PG per patient was detected by NIFI in this fashion before being identified visually (p = nonsignificant between centers). On logistic regression, smaller PGs were more likely to be missed visually, but localized by AF on NIFI (odds ratio with increasing size, 0.91; p = 0.02). In our experience, NIFI facilitated PG identification by detecting their AF, before conventional recognition by the surgeon, in 37-67% of the time. Despite the variability in this rate across centers, there was a concordance in detecting AF from 97 to 99% of the PGs using NIFI. We suggest the incorporation of AF on NIFI alongside conventional visual cues to aid identification of PGs during neck operations.