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

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

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

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

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

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

BACKGROUND: The treatment of recalcitrant hand and foot warts is a therapeutic challenge. Aminolevulinic acid-photodynamic therapy (ALA-PDT) has recently been reported to show high curative rates, but there has been relatively little research on this in Korea. OBJECTIVE: The purpose of this study is to evaluate the efficacy and side effects of ALA-PDT with using a light emitting diode (LED) device and 20% 5-aminolevulinic acid for the treatment of recalcitrant hand and foot warts. METHODS: One hundred four warts from 19 patients were selected and then treated with PDT using 20% ALA and a 633-nm LED device until all the lesions had cleared. The light dose was 90~120 J/cm2. RESULTS: The mean number of treatment sessions was 9.1; those for the foot warts and hand warts were 11.2 and 6.5, respectively. After the treatment sessions, a complete response was seen for 55 of 104 warts (52.9%), a partial response-good was seen for 21 of 104 warts (20.2%), a partial response-poor was seen for 18 of 104 warts (17.3%), and no response was seen for 10 of 104 (9.6%). All the patients reported pain during the treatment and 11 patients (57.9%) also had pain at 24 hours after treatment. Post-inflammatory hyperpigmentation occurred in 4 of 19 patients (21.1%). CONCLUSION: ALA-PDT can be a non-invasive and effective treatment modality for recalcitrant hand and foot warts.
Enzyme Multiplied Immunoassay Technique ; Foot ; Hand ; Humans ; Hyperpigmentation ; Light ; Photochemotherapy ; Triazenes ; Warts

PURPOSE: To evaluate the clinical features of subretinal hemorrhage after photodynamic therapy in eyes with exudative age-related macular degeneration. METHODS: We retrospectively reviewed data for 267 eyes of 243 patients who had undergone PDT for the treatment of ARMD between January 2005 and December 2006. Best corrected visual acuity, fundus photography, fluorescein angiography, and ICG angiography were performed before and after treatment. We followed up the patients at 1 week, 1 month, and 3 months after treatment and at 3-month intervals thereafter. RESULTS: Postoperative subretinal hemorrhage was seen in 36 (13.4%) of 267 eyes. The pretreatment and post-treatment mean visual acuities were logMAR 0.80 and logMAR 1.05 respectively, representing a decrease of 2.05 lines. On FAG, two eyes were predominantly classic, four eyes were minimally classic, and 30 eyes were occult. The laser irradiation spot size was under 3,000 micrometer in one case and from 3,000 micrometer to 5,000 micrometer in 19 cases and over 5,000 micrometer in 16 eyes. CONCLUSIONS: Subretinal hemorrhage after PDT for ARMD can be a common complication in patients who have been treated for larger irradiation spot sizes and for pigment epithelial detachment (PED), so doctors should be aware of the risk of serious hemorrhagic complications in such situations.
Angiography ; Eye ; Fluorescein Angiography ; Hemorrhage ; Humans ; Macular Degeneration ; Photochemotherapy ; Photography ; Retrospective Studies ; Triazenes ; Visual Acuity

Actinic cheilitis is a pathologic condition affecting mainly the lower lip caused by long term exposure of the lips to UV radiation in sunlight. Analogous to actinic keratosis of the skin, actinic cheilitis is considered as a precancerous lesion and may develop into squamous cell carcinoma. Photodynamic therapy (PDT) is a treatment modality involving the use of a photosensitizing agent, oxygen, and light of a specific wavelength to produce controlled cell death. Photodynamic therapy (PDT) using the new highly selective photosensitizer methyl aminolevulinate (MAL) (Metvix(R), Galderma, U.K.) is a promising new treatment modality for premalignant and malignant skin lesions. We report a case of actinic cheilitis treated with PDT using MAL, with satisfactory outcome in both clinical and pathological aspects.
Actins ; Carcinoma, Squamous Cell ; Cell Death ; Cheilitis ; Keratosis, Actinic ; Light ; Lip ; Oxygen ; Photochemotherapy ; Skin ; Sunlight ; Triazenes