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  • 1
    Electronic Resource
    Electronic Resource
    Fluorescence detection and photodynamic treatment of photosensitized tumours in special consideration of urology (1990)
    Springer
    Lasers in medical science 5 (1990), S. 207-212 
    Details
    ISSN: 1435-604X
    Keywords: Bladder tumour ; Diagnosis ; Fluorescence ; Photodynamic therapy ; Photosensitization
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine , Physics , Technology
    Notes: Abstract Most methods of modern laser tumour therapy are physically based on the conversion of light to heat. Recently tumours have also been treated using ionizing processes for tissue ablation. Photodynamic laser therapy (PDT), however, involves light-induced non-thermal biochemical processes and the use of a photosensitizer. Several drugs are known to be stored selectively in tumours after systemic application. This transient marking can be used for diagnostic and therapeutic procedures. The marker most commonly used is dihaematoporphyrin ether/ester (DHE) intravenously injected at doses of 0.2–3.0 mg/kg bodyweight for diagnosis and therapy, respectively. The corresponding clearance intervals after injection of DHE range from 3–48 h to 25–75 h. Detection of photosensitized tumours might offer great advantages. The highly sensitive two-wavelength laser excitation method with computerized fluorescence imaging recently has been transferred to the hospital for clinical tests. Photoinduced production of singlet oxygen is claimed to be the initial process which leads to later tumour destruction and therapy. PDT has been applied to 20 patients suffering from superficial tumours (TIS GII–III) recurred after application of other treatments. The results after PDT were evaluated by three-monthly check-ups (endoscopy, cytology, bladder mapping, renal ultrasonography) as well as by computed tomography (CT) examination at 8–13 month intervals. In six patients treated by PDT no tumour recurrence has been found over the whole observation period of up to 5 years. Four patients have remained free of tumour (12 and 14 months) after repeated transurethral resection (TUR) and Nd-YAG laser therapy following PDT. Due to an initial application of insufficient irradiation four patients required a second PDT. In one patient a circumscribed dysplasia appeared at the left ostium 26 months following PDT and was treated successfully by means of thermal Nd-YAG laser irradiation following TUR. In six patients slight mucosal atypia persisted for a period of at least 2.5 years. One cystectomy had to be performed because of bladder shrinkage. The dissected bladder, however, was free of tumour. These preliminary results suggest that PDT is justified in patients who are in a worst-case situation with cystectomy recommended in case of recurrent superficial TIS bladder carcinoma and indicate the future potential of photodynamic therapy of tumours. Homogeneous irradiation of the area to be treated and a reliable light dosimetry are prerequisites for an effective tumour therapy. Standard instruments for a routine application do not exist, but are under development.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/BF02031384
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  • 2
    Electronic Resource
    Electronic Resource
    Complications of extracorporeal shock wave lithotripsy using portable equipment: a multicenter study (1997)
    Springer
    Der Urologe 36 (1997), S. 217-221 
    Details
    ISSN: 1433-0563
    Keywords: Key words Extracorporeal shock wave lithotripsy • Complications • Mobile unit lithotripsy ; Schlüsselwörter Extrakorporale Stoßwellenlithotripsie • Komplikationen • Transportable ESWL
    Source: Springer Online Journal Archives 1860-2000
    Topics: Medicine
    Description / Table of Contents: Zusammenfassung Transportable Lithotripsiegeräte werden in zunehmendem Maße in urologischen Kliniken zur Harnsteinbehandlung eingesetzt, wenn kein festinstallierter Lithotriptor vorhanden ist bzw. eine solche Anschaffung als unrentabel angesehen wird. In der vorliegenden Studie wird überprüft, inwieweit die Komplikationsrate bei diskontinuierlicher Anwendung der ESWL mit transportablen Lithotripsiesystemen von den bekannten Komplikationsdichten aus etablierten Zentren verschieden ist. An bis zu 54 Kliniken wurde die Komplikationsrate bei diskontinuierlicher Anwendung transportabler Lithotripsiesysteme von 1993–1995 bei insgesamt 12 901 Therapien erfaßt. Schwerwiegende Komplikationen ergaben sich in insgesamt 85 Fällen (0,66 %). Die Mehrzahl davon (n = 64) waren intra- oder perirenale Hämatome; 3mal mußte nephrektomiert werden. Die Mortalität lag bei 0 %. Für die einzelnen Komplikationen lassen sich aus diesen Fallzahlen Wahrscheinlichkeiten ihres Auftretens berechnen. Insgesamt zeigt die Untersuchung, daß die ESWL mit mobilen Systemen mit der gleichen geringen Komplikationsrate angewendet werden kann, wie sie von etablierten Steinzentren bekannt ist.
    Notes: Summary An increasing number of urological departments are taking advantage of portable lithotripsy units if a system is not available in their clinic or purchase does not seem feasible; however, infrequent application of ESWL in such a setting should not increase the rate of complications. From 1993 to 1995, up to 54 urological departments using mobile lithotripsy units collected data concerning all major complications. A total of 12 901 treatments were performed which led to 85 major complications (0.66 %). Of them 64 were intrarenal or perirenal hematomas. There was no fatal complication. In three patients nephrectomy had to be performed subsequently. The probability of complications can be calculated according to these data. Overall, less frequent application of ESWL does not yield higher complication rates than those at ESWL centers where larger numbers of treatments are performed.
    Type of Medium: Electronic Resource
    URL: http://dx.doi.org/10.1007/s001200050092
    Library Location Call Number Volume/Issue/Year Availability
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    Paper (German National Licenses)
    Fulltext
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