Photodynamic therapy (PDT) is a promising new modality that utilizes the combination of a photosensitizing chemical and visible light for the management of various solid malignancies, including gastrointestinal (GI) cancer. PDT has some advantages over chemotherapy in terms of its greater safety and lower toxicity in the treatment of malignant lesions. However, PDT has not been used widely for treating upper GI cancer due to its relatively low cost-effectiveness and anatomical characteristics of the GI system. Nevertheless, PDT may be an effective alternative therapy for early upper-GI cancer patients who are at a high risk of curative surgical resection or systemic chemotherapy. In some clinical studies, PDT for various upper GI cancer showed positiveresults. To improve the efficacy of PDT for upper GI cancer, development of photosensitezer and light delivery system is needed.
Humans ; Light ; Photochemotherapy ; Triazenes

Topical photodynamic therapy (PDT) via topical 5-aminolevulinic acid (ALA) is potentially useful for the treatment of basal cell carcinoma. However, as a photosensitizer used in PDT, methyl aminolevulinate (MAL) can replace ALA, because MAL has more advantages than ALA. We treated two patients with basal cell carcinoma using MAL-PDT. Topical MAL-PDT may be a safe and effective treatment modality for basal cell carcinoma.
Carcinoma, Basal Cell ; Humans ; Photochemotherapy ; Triazenes

Several cases of photodynamic therapy (PDT) for the curative treatment of early gastric cancer have recently been reported. However, PDT has been performed in only limited cases because it is impossible to determine the pathologic subtype or stage of the malignant lesion after the procedure. Nevertheless, PDT combined with endoscopic submucosal dissection (ESD) is expected to enhance the accuracy of the pathologic assessment and enable more effective, safe treatment for early gastric cancer. Furthermore, PDT may exert a complementary and synergetic effect on ESD for the atypical forms of early gastric cancer. From this background, we report here on a case of early gastric cancer that mimicked submucosal tumor, and this was removed by ESD, and then this was followed by adjuvant PDT. The patient had a high risk for operation due to his old age and comorbidity. After the procedure, he achieved complete remission and he is currently under follow up: he is without recurrence of tumor one year after ESD.
Comorbidity ; Humans ; Photochemotherapy ; Recurrence ; Stomach Neoplasms ; Triazenes

Photodynamic therapy (PDT) is a light based therapy used to ablate tumors. As practiced in oncology a photosensitizing agent is applied and then activated by a specific wavelength and energy of light. This light energy in the presence of oxygen will lead to the creation of the photodynamic reaction which is cyto and vasculo toxic. This paper will review the mechanisms of action of PDT and how they may be manipulated to improve clinical outcome in cancer patients.
Humans ; Light ; Oxygen ; Photochemotherapy ; Photosensitizing Agents ; Triazenes

BACKGROUND: Photodynamic therapy (PDT) in the treatment of warts is known to be a relatively effective and safe cure. However, the pain, which occurs during being exposed to a light source and after its exposure, is being reported to be the most frequent and serious limitation in this therapy. OBJECTIVE: The purpose of this study is to examine whether the level of pain can be lowered, by comparing EMLA(R), which is a topical anesthesia, with placebo, during topical ALA-PDT, and to try to compare the range and characteristics in pain. METHODS: Twenty two patients with common warts were treated with ALA-PDT twice in the interval of 4 weeks, and were divided into two groups by the random distribution table. The distribution was made so that the patients, who used EMLA(R) as the topical anesthesia given at the first visit, could use a placebo at the second visit, and so that the patients who used placebo at the first visit, could use EMLA(R) at the second visit. Thus, a randomized, double-blind, placebo-controlled crossover study was carried out. The pain was evaluated during the treatment, right after the treatment, and one day after the treatment by using Visual Analogue Scale (VAS). Also four different ranges of the pain and its six characteristics were evaluated. RESULTS: Of the 22 patients with common warts who underwent this study. 1 patient, was completely cured after the first visit, and did not participate further in the study. The data of the patients with complete recovery wasn't included in the final statistical analysis. As a result of the evaluation of pain, the mean VAS score that was measured during the treatment, right after the treatment, and one day after the treatment was measured to be a little lower in the case of applying EMLA(R) versus placebo, but a statistically significant difference was not observed. Regarding the degree of pain, regardless of applying EMLA(R), most patients felt painful locally on the surface, and the majority complained of burning and shooting pain. CONCLUSION: Dermatologists tend to routinely apply EMLA(R), prior to a procedure in order to decrease pain. However, as a result of this research, the routine use of EMLA(R) given at PDT is thought to be unreasonable.
Anesthesia ; Burns ; Cross-Over Studies ; Humans ; Light ; Photochemotherapy ; Triazenes ; Warts

BACKGROUND: Photodynamic therapy (PDT) is useful for treating basal cell carcinoma (BCC), and the incidence of nodular type BCC is high among Koreans. However, only one case on the treatment of nodular BCC using methyl aminolevulinate (MAL)-PDT has been reported in Korea. OBJECTIVE: We investigated the efficacy and tolerability of PDT for treating nodular BCC in Korean patients. METHODS: Fifteen patients with nodular BCC were treated. We conducted three MAL-PDT sessions separated by a 1 week interval and assessed the clinical therapeutic effects after 3 months. Then, we performed a histopathological assessment of the lesions in patients who showed complete clinical responses (CR) and surgical procedures for lesions in patients who showed no clinical response (NR). We prescribed three more MAL-PDT sessions to the patients who showed partial clinical responses (PR), and decided whether to carry out a histopathological evaluation or to treat with surgery according to the clinical therapeutic assessment after 3 months. RESULTS: After the first three MAL-PDT sessions, three patients showed CR, eight patients showed PR, and four patients showed NR. One of the eight patients, who had been treated repeatedly, showed CR. CONCLUSION: BCC occurs mainly as the nodular type in Korea, so MAL-PDT may be the main treatment for BCC in Korean patients. However, it could be used as an alternative treatment for selected nodular BCCs when it is difficult to use conventional therapy or when a serious cosmetic defect is expected.
Carcinoma, Basal Cell ; Cosmetics ; Humans ; Incidence ; Korea ; Photochemotherapy ; Triazenes

The purpose of this study was to assess the efficacy of photodynamic therapy (PDT) using erythrosine and a halogen light source to treat a biofilm formed on a machined surface titanium disk in vivo. Ten volunteers carried an acrylic appliance containing six machined surface titanium disks on the upper jaw over a period of five days. After the five days of biofilm formation period, the disks were removed. PDT using 20 microM erythrosine and halogen light was then applied to the biofilms formed on the disks. Experimental samples were divided into a negative control group (no erythrosine and no irradiation), E0 group (erythrosine 60s + no irradiation), E30 group (erythrosine 60s + halogen light 30s), and E60 group (erythrosine 60s + halogen light 60s). Following PDT, the bacteria in the biofilm were found to be detached from each disk. Each suspension with detached bacteria were diluted and cultivated on a blood-agar plate for five days under anaerobic conditions. The cultivated bacterial counts in the E60 group were significantly lower than the control group (86.4%) or E0 group (76.7%). In the experimental groups also, the light exposure time and bacterial counts showed a negative correlation. In conclusion, PDT using erythrosine and halogen light has bactericidal effects on biofilms formed on a titanium disk in vivo. Notably, applying 20 microM erythrosine and 60 seconds of halogen light irradiation had a significantly potent effect.
Bacteria ; Bacterial Load ; Biofilms ; Erythrosine ; Jaw ; Light ; Photochemotherapy ; Titanium ; Triazenes

PURPOSE: To evaluate the results of half-dose photodynamic therapy (PDT) and determine the correlation between morphological changes measured by spectral-domain optical coherence tomography (SD-OCT) and visual acuity in patients with chronic central serous chorioretinopathy (CSC). METHODS: Twenty-five eyes of 25 patients with chronic CSC who had received half-dose verteporfin PDT were enrolled in the present study. The best-corrected visual acuity (BCVA), outer nuclear layer (ONL) thickness, and the integrity of the photoreceptor inner and outer segment junction (IS/OS) using SD-OCT were evaluated at baseline and at 3 and 6 months after treatment. RESULTS: The neurosensory retinal detachment disappeared in all eyes 6 months after treatment. The BCVA improved significantly from 0.50 +/- 0.32 to 0.31 +/- 0.29 log MAR at 6 months (p < 0.001). The average ONL thickness at the central fovea was 88.76 +/- 19.95 microm at 6 months and the ONL thickness was well correlated with the BCVA (gamma = -0.64; p = 0.001). There was no significant correlation between the status of IS/OS and the BCVA. CONCLUSIONS: Half-dose PDT is effective in treating chronic CSC resulting in visual improvement and complete resolution of neurosensory retinal detachment. The ONL thickness which was positively correlated with the BCVA could be an indicator for visual prognosis of chronic CSC.
Central Serous Chorioretinopathy* ; Humans ; Photochemotherapy* ; Porphyrins ; Prognosis ; Retinal Detachment ; Tomography, Optical Coherence* ; Triazenes ; Visual Acuity

BACKGROUND: Photodynamic therapy (PDT) with methyl 5-aminolaevulinate (MAL) has proven to be useful for the treatment of a wide variety of benign and malignant dermatologic conditions. More recently, this therapeutic modality has emerged as an alternative therapy for viral wart. OBJECTIVE: The purpose of this study was to evaluate the efficacy and safety of PDT for treating viral warts with using a light-emitting diode (LED) device and MAL. METHODS: Fifteen patients with a total of 34 warts were treated with MAL under an occlusive dressing for 3 hours and this was followed by irradiation with a LED device at a wavelength of 633+/-3 nm and a fluence of 37 J/cm2. The treatment was repeated at 1~2 weeks until all the lesions cleared. The side effects, including pain, hyperpigmentation and pruritus, were recorded on a progress chart. The intensity of pain was assessed by using a 5-point verbal rating scale (VRS). RESULTS: A total of 34 warts from 15 patients (9 males and 6 females) were treated with MAL-PDT. The sites of the lesion were classified as periungal (26%), sole (18%) and others (56%). After an average of 2.15+/-0.61 therapeutic sessions (MAL+PDT) for 34 warts, the number of complete, partial and no responses were 27/34 (79.4%), 7/34 (20.6%) and 0/34 (0%), respectively. The overall complete response rates were 66.7% for the periungal warts, 50% for the sole warts and 94.7% for the others. The pain after the first treatment was more intense and deeper as compared with that after the second treatment. There were no recurrences of the warts that had a complete response during the follow-up period (from 6 to 12 months). CONCLUSION: We suggest that MAL-PDT is an effective and safe alternative therapy for viral warts.
Aminolevulinic Acid ; Follow-Up Studies ; Humans ; Hyperpigmentation ; Male ; Occlusive Dressings ; Photochemotherapy ; Pruritus ; Recurrence ; Triazenes ; Warts

OBJECTIVE: To verify the influence of sour taste on swallowing and the presence of reflex cough when sour material was swallowed in patients with dysphagia secondary to brain injury. METHOD: Fifty dysphagic brain injury patients who underwent videofluoroscopic swallowing study (VFSS) were recruited. The patients who had shown severe aspiration at 2 ml of liquid were excluded. The dysphagic patients were given 5 ml each of a sour tasting liquid (SOUR) and a thin liquid barium (LIQUID) in random order. An expert analyzed the result of VFSS by reviewing recorded videotapes. Analysis components consisted of the Penetration-Aspiration-Scale (PAS) score, oral transit time (OTT), pharyngeal transit time (PTT), pharyngeal delay time (PDT) and the reflex cough presence. RESULTS: The PAS score for SOUR was significantly lower than the one for LIQUID (p=0.03). The mean OTT for SOUR was significantly shortened compared to that for LIQUID (p=0.03). The mean PTT and PDT were also shortened in SOUR, although the differences were not statistically significant (p=0.26 and p=0.32, respectively). There was no significant difference between SOUR and LIQUID regarding the presence of reflex cough (p=1.00). CONCLUSION: The sour taste could enhance sensorimotor feedback in the oropharynx, thus lowering the chances of penetration-aspiration caused by shortening of the oropharyngeal passage times. There was no significant difference in the presence of reflex cough produced between LIQUID and SOUR.
Barium ; Brain ; Brain Injuries ; Cough ; Deglutition ; Deglutition Disorders ; Feedback, Sensory ; Humans ; Oropharynx ; Reflex ; Triazenes ; Videotape Recording