Choroidal lesions in varicella zoster virus uveitis

Purpose: To evaluate choroidal lesions with spectral domain optical coherence tomography (SD?OCT) scan in varicella zoster virus (VZV) uveitis. Methods: VZV?uveitis cases which underwent OCT scan for choroidal lesions were studied. SD?OCT scan passing through these lesions was studied in detail. Subfoveal choroidal thickness (SFCT) during active and resolved stages was studied. Angiogaphic features were studied where available. Results: Thirteen out of 15 cases had same?sided herpes zoster ophthalmicus skin rashes. All except three patients had old or active kerato?uveitis. All eyes demonstrated clear vitreous and a single or multiple hypopigmented orangish?yellow choroidal lesions. The number of lesions remained unchanged during the follow?up on clinical examination. SD?OCT over lesions (n = 11) showed choroidal thinning (n = 5), hyporeflective choroidal elevation during active inflammation (n = 3), transmission effects (n = 4), and ellipsoid zone disruption (n = 7). The mean change in SFCT (n = 9) after resolution of the inflammation was 26.3 ?m (range: 3–90 ?m). Fundus fluorescein angiography showed iso?fluorescence over lesions in all (n = 5), but indocyanine green angiography (n = 3) showed hypofluorescence at lesions. Mean follow?up was 1.38 years (range: 3 months–7 years). De?novo appearance of choroidal lesion during the first relapse of VZV?uveitis was captured in one case. Conclusion: VZV?uveitis can cause focal or multifocal hypopigmented choroidal lesions with thickening or scarring of choroidal tissue, depending on the disease activity.

Effects of ICG-001 on autistic behaviors and the development of hippocampal dendritic spine morphology in rats / 中华实用儿科临床杂志

Objective:To explore the effects of the compound ICG-001 on autism-like behaviors and the morphological development of dendritic spines in hippocampal pyramidal neurons of rats.Methods:Healthy Wistar rats were mated.The offspring were divided into the saline-treated group, ICG-001 control group, Sodium valproate (VPA) group and ICG-001 treatment group by using the random number table method.Each group had 12 rats.Social interaction, repetitive, compulsive and anxiety-like behaviors in rodents were assessed by three-chambered social approach, marble burying, open-field and elevated plus maze tests.The number of neuronal nuclei (NeuN)-positive neurons in the hippocampal CA1 region was calculated by the immunofluorescence method.Golgi staining was carried out to detect the density and morphological changes of dendritic spines in hippocampal pyramidal neurons of rats.The expression of phosphorylated LIM kinase 1(LIMK1), phosphorylated actin binding protein(Cofilin), fibros actin (F-actin) and developmentally-regulated brain protein A (Drebrin A) was examined by Western blot.The univariate analysis was made to examine whether the difference was statistically significant, and the data between groups were compared by the Tukey method. Results:(1) In the three-chambered social approach test, the rats in the saline-treated group, ICG-001 control group, VPA group and ICG-001 treatment group spent (219.42±5.38) s, (218.67±10.12) s, (126.58±5.02) s, and (218.58±6.63) s in the chamber, respectively.The corresponding preference score of the said 4 groups were 0.43±0.05, 0.43±0.04, 0.22±0.01 and 0.42±0.04, respectively.Compared with the VPA group, the ICG-001 treatment group spent longer time in the chamber and had a higher preference score (all P<0.05). (2) In the marble burying experiment, the number of marbles buried in said 4 groups were 9.13±0.52, 9.08±0.64, 15.13±0.82 and 9.42±0.86, respectively.ICG-001-treated rats buried markedly less marbles than VPA-exposed rats ( P<0.05). (3) In the open-field test, the rats in the said 4 groups spent (82.33±1.83) s, (81.32±4.19) s, (45.51±3.02) s and (81.44±3.19) s in the center area, respectively.Administration of ICG-001 significantly increased the time that VPA-exposed rats spent in the center area ( P<0.05). (4)In the elevated plus maze trial, the rats in the said 4 groups spent (107.75±7.23) s, (106.08±7.50) s, (63.42±1.91) s and (106.67±7.07) s in open arms, respectively.ICG-001 treatment notably increased the time that VPA-exposed rats spent in open arms ( P<0.05). (5) Immunofluorescence analysis results revealed that the number of NeuN-positive cells in the hippocampal CA1 region of said 4 groups was (41.83±1.17)×10 4/μm 2, (41.00±0.77)×10 4/μm 2, (27.17±0.95)×10 4/μm 2 and (40.00±0.90)×10 4/μm 2, respectively.ICG-001 treatment normalized the alteration in the number of NeuN-containing neurons in VPA-exposed rats ( P<0.05). (6) Golgi staining showed that the density of dendritic spines in hippocampal CA1 pyramidal neurons of said 4 groups was (0.74±0.04)/μm, (0.73±0.03)/μm, (0.49±0.03)/μm and (0.70±0.02) /μm, respectively.Of all types of dendritic spines, mushroom spines accounted for (0.49±0.02)%, (0.49±0.02)%, (0.33±0.02)% and (0.43±0.02) % in said 4 groups.Thin spines accounted for (0.27±0.02)%, (0.26±0.02)%, (0.34±0.01)% and (0.26±0.01) % in said 4 groups, respectively.Compared with the VPA group, the ICG-001 treatment group showed a significant increase in the density of dendritic spines in hippocampal CA1 pyramidal neurons ( P<0.05). After ICG-001 treatment, the number of mushroom spines greatly increased and the number of thin spines sharply decreased in VPA-exposed rats (all P<0.05). (7) According to Western blot test results, the phosphorylated LIMK1/LIMK1 ratio of the hippocampus in said 4 groups were 100.33±2.30, 99.34±2.28, 57.76±4.10 and 99.13±1.90, respectively.The phosphorylated Cofilin /Cofilin ratio were 100.18±2.43, 100.18±1.70, 57.12±1.88 and 99.53±1.69, respectively.The F-actin/globular actin(G-actin) ratio were 100.07±0.86, 99.99±1.72, 51.19±1.23 and 99.28±3.17, respectively.The expression level of Drebrin A were 100.79±1.19, 100.12±2.04, 52.86±3.26 and 99.97±2.44, respectively.Administration of ICG-001 effectively prevented the decrease of phosphorylated LIMK1, phosphorylated Cofilin, F-actin and Drebrin A in the hippocampus of VPA-exposed rats (all P<0.05). Conclusions:ICG-001 regulates the LIMK1/Cofilin signaling pathway, promotes the generation of F-actin, increases the expression of Drebrin A, and thereby alleviates autistic-associated symptoms.

Esofagectomía con linfadenectomía guiada por fluorescencia con verde de indocianina en cáncer de esófago. Experiencia inicial en la Argentina / Esophagectomy with lymphadenectomy guided by fluorescence imaging with indocyanine green in esophageal cancer. Initial experience in Argentina

RESUMEN Antecedentes: en la última década ha comenzado a investigarse el uso de la captación de fluorescencia mediante luz infrarroja para la visualización de ganglios linfáticos en tumores de estómago y esófago. Objetivo: evaluar la factibilidad de la evaluación del drenaje linfático de cáncer de esófago mediante el uso de fluorescencia y verde de indocianina (ICG). Material y métodos: se realizó un estudio prospectivo que incluyó pacientes con tumores de la unión gastroesofágica resecables (estadios I, II y III). Antes de comenzar la cirugía se inyectaron por endoscopia 4 mL de ICG doblemente diluida en agua estéril (1,25 mg/mL = 5 mg) en la submucosa del esófago en los cuatro cuadrantes (1 mL por cuadrante) alrededor del tumor. Resultados: se incluyeron en total 6 pacientes. En todos ellos se logró identificar el drenaje linfático del tumor hacia la primera estación ganglionar: en 6/6 (100%), el drenaje linfático con fluorescencia se detectó en las estaciones ganglionares N°s 3 y 7 (curvatura menor y arteria gástrica izquierda). En ningún paciente se identificó fluorescencia en ganglios mediastinales. Conclusión: la visualización del drenaje linfático de tumores de la unión gastroesofágica mediante el uso de fluorescencia con ICG es factible.

ABSTRACT Background: Over the past decade, fluorescence imaging with infrared light has been used to visualize lymph nodes in tumors of the stomach and esophagus. Objective: The aim of our study was to evaluate the feasibility of evaluating lymphatic drainage in esophageal cancer using fluorescence and indocyanine green (ICG). Material and methods: We conducted a prospective study of patients with resectable tumors of the gastroesophageal junction (stage I, II and III). Before surgery, 4 mL of ICG double diluted in sterile water (1.25 mg/mL = 5 mg) were injected via endoscopy into the esophageal submucosa in the four quadrants (1 mL per quadrant) around the tumor. Results: A total of 6 patients were included. Lymphatic drainage from the tumor to the first lymph node station was identified in all patients: in 6/6 (100%), fluorescent lymphatic drainage was detected in nodal stations number 3 and 7 (lesser curvature and left gastric artery) Fluorescence was not identified in the mediastinal lymph nodes in any patient. Conclusion: Visualization of lymphatic drainage of gastroesophageal junction tumors to the lesser curvature nodes using fluorescence imaging is feasible.

Application of indocyanine green fluorescence imaging in totally laparoscopic distal-gastrectomy for gastric cancer / 中国肿瘤临床

Objective: To explore the value of indocyanine green fluorescence imaging in tumor localization and lymph node dissection in totally laparoscopic distal gastrectomy. Methods: A retrospective cohort study was used. The clinical and pathological data of 126 patients with distal gastric cancer diagnosed through gastroscopy and pathology dated from August 2017 to August 2019 in Peking University Cancer Hospital & Institute was collected. Among these 126 patients, 62 patients underwent laparoscopy with indocyanine green-labeled near-infrared fluorescence (observation group), and 64 patients underwent conventional laparoscopy (control group). The effects of preoperative indocyanine green-labeled, intraoperative endoscopic positioning and lymph node dissection were compared and evaluated between the two groups. Result: The distance of proximal incision margin was measured in patients with stage T1-2 gastric cancer. The observation group vs. the control group: (4.92±1.65 cm vs. 4.76±1.66 cm, P=0.671). Number of second station lymph node dissection of patients with stage T3-4 gastric cancer in the observation group vs. the control group: (11.09±6.19 vs. 8.89± 4.35, P=0.049); the number of damaged lymph nodes in the observation group vs. the control group: (0.74±0.46 vs. 1.27±1.22, P= 0.009). Conclusions: The preoperative indocyanine green-fluorescence imaging in patients with stage T1-2 gastric cancer can accurately mark the tumor boundary, and its tumor localization effect is comparable with intraoperative gastroscopy in the surgery, which can guide the decision of the appropriate resection line during total laparoscopic surgery. Indocyanine green in the lymphatic navigation of T3-4 gastric cancer can guide the operation precisely and completely in the lymph node dissection, increase the number of lymph nodes dissection, and reduce the damage of lymph nodes during the operation.

Application of ICG fluorescence imaging in surgical treatment of recurrent hepatocellular carcinoma / 中国实用外科杂志

The recurrence rate of primary hepatocellularcarcinoma is very high,and repetitive resection is still the besttreatment for operable recurrent hepatocellular carcinoma.Indocyanine green(ICG) has been widely used andpopularized in resection of hepatocellular carcinoma,providesmore possibilities and diversity for the surgical treatment ofrecurrent hepatocellular carcinoma. Combined withpreoperative imaging,three-dimensional imaging technologyand intraoperative ultrasound,ICG can effectively improve theradical and accuracy of the operation for recurrent hepatocellular carcinoma. ICG-guided hepatectomy isappropriate for the new concept and technical system of liversurgery advocated by modern medical model, and realizesfunctional and anatomical hepatectomy for recurrenthepatocellular carcinoma.

Indocyanine green fluorescence imaging for precise diagnosis and treatment of liver neoplasms:A Meta-analysis / 中国实用外科杂志

OBJECTIVE: To systematically review the safety and effectiveness of indocyanine green(ICG) fluorescence imaging for precise diagnosis and treatment of liver neoplasms.METHODS: PubMed,EMbase,The Cochrane Library,CNKI,WanFang Data and VIP databases were electronically searched to collect cohort Studies which involved ICG fluorescence imaging for precise diagnosis and treatment of liver neoplasms. The retrieval time was from inception of the database to June 2019. Screened the literatures,extracted data,and Meta-analysis was performed by using RevMan 5.3 software.RESULTS: 10 studies were finally included involving 803 patients,with 328 cases in ICG molecular fluorescence imaging group and 475 patients in the control group. The results of meta-analysis showed that in ICG fluorescence imaging group,compared with the control group,the blood transfusion rate was decreased(OR=0.42,95%CI0.22～0.80,P=0.008),the rate of negative incision margin was increased(OR=3.22,95%CI 1.09～9.51,P=0.03),the incidence of postoperative complications was decreased(OR=0.49,95%CI 0.28～0.85,P=0.01). However,there was no statistical differences between the two groups in terms of perioperative blood loss,operation time or hospitalization time(all P>0.05).CONCLUSION: The application of ICG fluorescence imaging in precise diagnosis and treatment of liver neoplasms can effectively reduce the incidence of blood transfusion,the incidence of postoperative complications,and increase the rate of negative incision margin.

Diagnostic value of optical imaging combined with indocyanine green-guided sentinel lymph node biopsy in gastric cancer: a meta-analysis / 中华胃肠外科杂志

Objective@#To systematically evaluate the diagnostic value of optical imaging combined with indocyanine green (ICG)-guided sentinel lymph node (SLN) biopsy in gastric cancer, and to identify potential factors that would influence diagnostic accuracy.@*Methods@#Study was carried out by searching the electronic database of PubMed, Embase, Medline, Web of Science, and the Cochrane Library with keywords as "gastric/stomach" and "cancer/carcinoma/tumor/tumour/adenocarcinoma/neoplasm" and "sentinel lymph node" and "near-infrared/NIR or fluorescent imaging" and "indocyanine green/ICG" . Literature inclusion criteria: (1) gastric cancer clinical stage was cT0-3; (2) clinical stage determined by at least 2 kinds of imaging modalities; (3) optical imaging (near-infrared or fluorescence imaging) combined with ICG-guided SLN biopsy; (4) prospective study to predict lymph node metastasis; (5) intraoperative or postoperative pathology for all lymph nodes removed; (6) patients number in the literature >10 cases. Exclusion criteria: (1) patients with a history of ICG allergy or chemoradiotherapy; (2) previous history of endoscopic mucosal resection or endoscopic submucosal dissection; (3) patients with a variety of gastrointestinal tumor; (4) case reports, conference abstracts, clinical guidelines, editorials, reviews, meta-analysis and correspondence letters; (5) in vitro or animal experiments; (6) insufficient diagnostic efficacy data. The meta-analysis was performed in the Stata12.0 software using the "bivariate mixed-effects model" combined with the "midas" command to pool the data. Information such as true positive value, false positive value, false negative value, and true negative value of each included articles were extracted. The literature quality assessment map was drawn to describe the overall quality of the articles; the heterogeneity analysis was performed with the forest map, with P<0.01 considered as statistical significance; the funnel plot was used to describe publication bias, with P<0.1 considered as statistically significant. Area under curve (AUC) of summary receiver operator characteristic (SROC) was used to describe the diagnostic accuracy and the AUC closer to 1 indicated higher diagnostic accuracy. If there was heterogeneity (I2>50%) among studies, regression analysis and subgroup analysis were performed. P<0.05 was considered as statistically significant.@*Results@#A total of 15 studies (1020 patients) were included. The optical imaging contained near-infrared (NIR) and fluorescent imaging (FI). The diagnostic value of optical imaging combined with ICG-guided SLN biopsy in gastric cancer was as follows: the pooled sensitivity (Sen) was 0.95 (95% CI: 0.82 to 0.99), specificity (Spe) was 1.00 (95% CI: 0.92 to 1.00), positive likelihood ratio (PLR) was 30.39 (95% CI: 9.14 to 101.06), negative likelihood ratio (NLR) was 0.05 (95% CI:0.01 to 0.20), diagnostic odds ratio (DOR) was 225.54 (95% CI: 88.81 to 572.77), AUC was 1.00 (95% CI: 0.99 to 1.00), threshold value was sensitivity=0.95 (95% CI: 0.82 to 0.99) and specificity=1.00 (95% CI: 0.92 to 1.00). Deeks method revealed DOR funnel plot of SLN biopsy was not asymmetrical obviously with significant difference (P=0.01), which indicated remarkable publishing bias. Meta-subgroup analysis showed that compared to FI, NIR imaging had higher sensitivity (0.98 vs. 0.73); compared to 0 minutes, optical imaging performed 20 minutes after ICG injection had higher sensitivity (0.98 vs. 0.70); compared to mean detected number of SLN of 4, mean detected number≥4 had higher sensitivity (0.96 vs. 0.68); compared to HE stain, immunohistochemistry + HE had higher sensitivity (0.99 vs. 0.84); compared to subserous injection of ICG, submucosa injection of ICG had higher sensitivity (0.98 vs. 0.40); compared to injection of 5 g/L ICG, 0.5 g/L and 0.05 g/L had higher sensitivity (0.98 vs. 0.83); compared to cT2-3 tumor, early stage (cT1) tumor had higher sensitivity (0.96 vs. 0.72); compared to ≤ enrolled 26 cases in the study, > 26 cases had higher sensitivity (0.96 vs. 0.65); compared to papers before 2010, papers after 2010 had higher sensitivity (0.97 vs. 0.81); whose differences were all significant. Sensitivity differences between mean tumor diameter of ≤30 cm and >30 cm, open surgery and laparoscopic surgery, lymph node regional dissection and retrieved dissection were not significant (all P>0.05).@*Conclusions@#Optical imaging combined with ICG-guided SLN biopsy is clinically feasible, and especially suitable for early gastric cancer. However, the ICG being used in current studies may be overdosed. Higher sensitivity may be achieved from NIR imaging when compared with FI method.

Applications advance of indocyanine green florescence imaging in colorectal cancer patients undergoing hepatectomy for liver metastasis / 中华肝胆外科杂志

It is difficult to detect micrometastasis of liver cancer with conventional imaging techniques,which leads to high recurrence rate after surgical excision in patients with colorectal cancer liver metastasis.The emergence of indocyanine green fluorescence imaging technology solves this problem.This article reviews the mechanism of this new technology,its clinical application in liver cancer resection and also discussed the advantages and limitations for indocyanine green fluorescence imaging technology.

Laparoscopic liver tumor resection under indocyanine green fluorescent navigation: A single center experience of 60 patients to study the optimal preoperative injection timing of indocyanine green / 中华肝胆外科杂志

Objective To study the optimal timing of preoperative injection of indocyanine green in laparoscopic liver tumor resection under indocyanine green fluorescent navigation to obtain the most satisfactory fluorescence imaging effects.Methods 60 patients with liver tumors who underwent laparoscopic hepatectomy from April 2017 to October 2018 were retrospectively studied on the intraoperative fluorescence imaging effects.A simple grading of the fluorescence imaging effects was developed.The ICG R15 and preoperative injection times of ICG were correlated with the intraoperative fluorescence imaging effects.Results Of 60 patients with liver tumors,59 patients underwent laparoscopic liver resection and one patient was converted to open surgery.The overall satisfaction rate of intraoperative fluorescence imaging was 73.4％ (44/60).In the patients with an ICG R15 rate ≤ 7％,it was easier to obtain good fluorescence imagings when the preoperative administration time was longer than 48 hours.Even when the preoperative administration time was longer than 5 days,satisfactory fluorescence imaging effect could still be obtained in these patients.In the patients with an ICG R15 rate ＞ 7％,intraoperative fluorescence imagings were unsatisfactory when the administration time was less than 6 days.Relative better imagings were obtained in these patients when the preoperative administration time was more than 6 days.Conclusions When the pre-operative ICG injection dose was not changed,the preoperative administration time should be adjusted according to the value of the ICG R15 to obtain better intraoperative fluorescence imaging effects of the liver tumors.The optimal timing needs to be further studied by a large case study.

Diagnosis of primary lymphedema with indocyanine green lymphography / 中华整形外科杂志

Objective@#To evaluate the diagnostic value of indocyanine green(ICG)lymphography in primary lymphedema of extremities.@*Methods@#61 patients with limb lymphedema were enrolled in the study. The contralateral healthy limbs were used as controls. After intradermal injection of Indocyanine Green, dynamic observation of lymphatic vessels and lymph flow was performed using PDE near-infrared fluorescent instrument. The frequency of lymphatic contraction was calculated.@*Results@#Lymphatic vessel images were clearly visualized in healthy limbs. Inguinal or axillary lymph nodes can be visualized when examined 30 minutes after injection. Lymphatic contraction frequency was 1(0.33-5.00)time per minute. 94.8% lymphedematous limb demonstrated delayed lymphatic vessel or lymph nodes. "Dermal backflow" and diffused shadow pattern can be observed in all affected limbs. Abnormal lymphatic vasculature and contraction can be visualized. The frequency of lymphatic contraction in the affected limb was higher compared to controls: 2.5(0.5-7.0) times per minute.@*Conclusions@#ICG lymphography possess high sensitivity for lymphedema diagnosis. ICG lymphography furthers our understanding of pathophysiological alterations of lymphatic disorders.

Educational Benefits of Intraoperative Indocyanine Green Angiography for Surgical Beginners During Laparoscopic Colorectal Surgery

PURPOSE: The aim of this study is to evaluate the safety and usefulness of indocyanine green (ICG) angiography in laparoscopic colorectal surgery and to explore its educational benefits in surgical beginners. METHODS: From July to October of 2015, a total of 21 patients with colorectal cancer underwent laparoscopic surgery using the fluorescence-guided imaging system, IMAGE1 S™ (Karl Storz, Germany). Real-time ICG fluorescence images and red inversion images were juxtaposed with standard white-light images for assessment of colonic perfusion. A surgical beginner group comprised of medical students (n=11) and surgical residents (n=11) were then questioned postoperatively about the colonic transection line and mesenteric vascular integrity across various image modes to determine the most proper view for surgical decision. RESULTS: A total of 21 patients underwent laparoscopic colorectal surgery using ICG angiography. Mean patient age was 69.7 years (52~77 years). Mean time-to-detection for the marginal arteries and colonic wall were 26.7 (range, 4~45) and 47.3 (range, 20~77) seconds, respectively. No injection-related adverse events were observed. Rate of change in the colonic transection line across modes was 59.9% (33.3~66.7%) in the surgical beginners. Decisions made by surgical beginners on the transection line were varied with the standard image, but converged to 81.8% in the ICG with red inversion mode. Surgical beginners preferred ICG with red inversion mode for assessment of mesenteric vascular integrity. CONCLUSION: ICG angiography seems to be safe and useful in evaluating colonic perfusion for transection decisions and could have educational benefits for surgical beginners in training to make surgical decisions.

Adaptación del Inventario de Duelo Complicado en población colombiana / Adaptation of the Complicated Grief Inventory to the Colombian Population / Adaptação do Inventário de Luto Complicado na População Colombiana

Resumen Se realizó la adaptación del Inventario de Duelo Complicado (IDC) en población colombiana. Cinco jurados evaluaron el contenido y ajuste cultural del cuestionario y luego éste fue aplicado a una muestra de 120 adultos que experimentaron el fallecimiento de un familiar. Los análisis psicométricos indicaron una consistencia interna similar a la de la prueba original y superior a la de la adaptación española, buena estabilidad temporal, asociaciones positivas con pruebas de depresión y ansiedad usadas para evaluar la validez convergente y tres factores significativos. Se concluye que la versión adaptada del IDC tiene propiedades psicométricas adecuadas por lo que puede ser usada en población colombiana, pero se recomienda realizar una validación con una muestra más grande y usar herramientas como una entrevista clínica para establecer el alcance diagnóstico del inventario.

Abstract The Inventory of Complicated Grief (ICG) was adapted to Colombian people. Five juries evaluated the language and cultural adjustment of the Spanish version and then, the questionnaire was applied to 120 adults who had lost a family member. Psychometrical analysis showed an internal consistency similar to that one found in the original ICG, but higher than the one found in the Spain application. Convergent validity showed positive correlations between ICG and depression and anxiety tests, and three significant factors were identified. In brief, this adapted spanish version of the ICG has good psychometric properties and it can be used with Colombian people, but a validation study with a larger sample and using tools such as a clinical interview to determine the diagnostic power of this inventory is recommended.

Resumo Realizou-se a adaptação do Inventário de Luto Complicado (IDC, em espanhol) na população colombiana. Cinco jurados avaliaram o conteúdo e o ajuste cultural do questionário e, em seguida, este foi aplicado a uma amostra de 120 adultos que experimentaram o falecimento de um familiar. As análises psicométricas indicaram uma consistência interna semelhante à do teste original e superior à da adaptação espanhola, boa estabilidade temporal, associações positivas com testes de depressão e ansiedade usados para avaliar a validade convergente e três fatores significativos. Conclui-se que a versão adaptada do idc tem propriedades psicométricas adequadas, portanto pode ser usada na população colombiana, mas se recomenda realizar uma validação com uma amostra maior e usar ferramentas como uma entrevista clínica para estabelecer o alcance diagnóstico do inventário.

The study of a novel tracer for breast cancer sentinel lymph node biopsy in an animal model / 中国癌症杂志

Background and purpose:Sentinel lymph node biopsy has replaced axillary lymph node dissec-tion as the standard staging procedure in early breast cancer patients with clinically negative axillary lymph nodes. It is a critical step for staging and treatment. This study investigated the localization effect of a novel tracer for breast cancer sentinel lymph node biopsy [indocyanine green (ICG)-rituximab (R)], using the hind limb drainage in mice as an animal model.Methods:For exploring the optimal dose and imaging time, different doses of ICG-R were injected subcutane-ously to the dorsum of the foot in the BALB/c mice. Then the lfuorescence vasculature imaging instrument was used continuously to observe the popliteal fossa lymph node (as sentinel lymph node) from the injection to 3 h after injection. For exploring the sustained localization effect, the optimal dose of ICG-R was injected and the imaging instrument was used from imaging to 24 h after injection.Results:The time from injection to imaging and the time from injection to the optimal imaging were shortened with the increased doses, and the imaging rate of the second or third level node increased accordingly. The best dosage of the novel tracer was 0.12 μg (dosage of indocyanine green) and the time from injection to the optimal imaging was about 34 min. After the observation for 24 h, the imaging rate of sentinel lymphnode was maintained at 100%, and the imaging rate of the second and the third level lymph node increased from 0% to 20% and 10%, respectively.Conclusion:ICG-R could clearly locate the sentinel lymph node. There is no imaging of the second level lymph node within 6 h. The novel tracer has high value in the clinical application.

Advance of indocyanine-green in fluorescent staining tumor in surgical operation / 国际外科学杂志

Surgery is so far the most widely used and effective treatment of neoplastic diseases.However,residual tumour cells during surgery remain a major trigger of cancer recurrence and matastasis.Although intraoperative rapid pathological R0 resection can be achieved based on preoperative imageological examination,but for small satellite lesions and the naked eye can not find the error quickly and so often cause pathological presence of residual tumour cells.Thus,quick and accurate identification of residual cancer cells is crucial for prognosis of cancer patients.Indocyanine green (ICG) is a new type of fluorochrome that can stain tumours under the near-infrared fluorescence during surgery,the paper will be reviewed latest developments in the reagent for fluorescence in tumours.

Indocyanine Green Videoangiography for Confirmation of Bypass Graft Patency

OBJECTIVE: The aim of the study is to determine the efficacy of indocyanine green (ICG) videoangiography for confirmation of vascular anastomosis patency in both extracranial-intracranial and intracranial-intracranial bypasses. METHODS: Intraoperative ICG videoangiography was used as a surgical adjunct for 56 bypasses in 47 patients to assay the patency of intracranial vascular anastomosis. These patients underwent a bypass for cerebral ischemia in 31 instances and as an adjunct to intracranial aneurysm surgery in 25. After completion of the bypass, ICG was administered to assess the patency of the graft. The findings on ICG videoangiography were then compared to intraoperative and/or postoperative imaging. RESULTS: ICG provided an excellent visualization of all cerebral arteries and grafts at the time of surgery. Four grafts were determined to be suboptimal and were revised at the time of surgery. Findings on ICG videoangiography correlated with intraoperative and/or postoperative imaging. CONCLUSION: ICG videoangiography is rapid, effective, and reliable in determining the intraoperative patency of bypass grafts. It provides intraoperative information allowing revision to reduce the incidence of technical errors that may lead to early graft thrombosis.

Effects of Whole Body Warm Water Immersion on Indocyanine Green (ICG) Excretion Test in Healthy Human / 日本温泉気候物理医学会雑誌

Objective: Warm water immeresion (WWI) has been customary in Japan as useful thermal therapy. However, a comprehensive investigation of the effects of WWI on internal organs has never been undertaken. The purpose of this study was to examine the effects of single WWI on indocyanine green (ICG) excretion in healthy humans. Subjects: 23 healthy males. (32.6±1.9 [mean±SEM] years) Methods: 1CG was administered intravenously (0.5mg/kg) to calculate excretion rate (ER). ICG injection was given before and after WWI (10min at 41°C). Sublingual temperature (ST), blood pressure (BP), heart rate (HR), and cardiac output (CO) were simultaneously measured by noninvasive methods. Results: Significant changes were observed after WWI. These included an increase in ST, HR, and CO and a decrease in systolic BP (p<0.01). ER significantly decreased from 0.210±0.015 to 0.168±0.009 (p<0.01). Front-back ratio of ICG-ER which was calculated in order to evaluate the effect of aging increased significantly with age (R=0.582, p<0.0001). Conclusion: These results indicate that although CO increased due to the vasodilating effects of WWI, hepatic blood flow decreased after WWI and its response reduced with age even in before middle age.

Measurement of Hemodynamic Variables using Impedance Cardiography on Remifentanil-Propofol Infusion during Anesthetic Induction / 대한마취과학회지

BACKGROUND: Remifentanil-propofol combination is used to minimize the cardiovascular responses during anesthetic induction; however, it may generate side effects such as hypotension or bradycardia. The authors investigated the changes of stroke volume and cardiac output using impedance cardiography (ICG) when hypotension or bradycardia is generated during propofol-remifentanil anesthetic induction. METHODS: Ninety ASA physical status class I patients who were scheduled to undergo elective ambulatory surgery were randomly assigned to one of three groups (n = 30 each). Normal saline (Group S), remifentanil 0.25microgram/kg/min (Group R0.25), or remifentanil 0.5microgram/kg/min (Group R0.5) was infused intravenously. Propofol was slowly administered two minutes after the administration of remifentanil or normal saline. Heart rate, mean arterial pressure, cardiac output and stroke volume were measured at preinduction (baseline), preintubation and postintubation. RESULTS: Mean arterial pressure in Group R0.5 at preintubation decreased compared to that of the baseline, however, the stroke volume index was sustained. The stroke volume index at postintubation decreased proportionally as heart rate increased in heart rate in all groups, and then cardiac index was preserved. CONCLUSIONS: Hypotension was generated during induction of anesthesia when remifentanil 0.5microgram/kg/min and propofol 1.0 mg/kg were used, however, the stroke volume index was sustained.

Indocyanine Green Angiographic Features of Myopic Subfoveal Choroidal Neovascularization as a Prognostic Factor after Photodynamic Therapy

PURPOSE: To determine the influence of clinical features and Indocyanine green (ICG) angiographic features on the visual outcome of patients with myopic sub-foveal choroidal neovascularization (CNV) who received photodynamic therapy (PDT). METHODS: Thirty-six consecutive patients (39 eyes) with myopic CNV who were followed up for more than one year after PDT were enrolled in this study. Clinical features included age, gender, refractive error, great linear dimension, and subretinal hemorrhage. ICG features included the lesion size, lacquer cracks, hypofluorescence surrounding the CNV (dark rim), peripapillary atrophy size, and visible prominent choroidal veins under the macula. Linear regression analysis was performed using the change in visual acuity (delta logMAR) as the dependent variable and the above factors as independent variables. RESULTS: At one-year follow-up after PDT, a younger age (p=0.002) and the presence of a dark rim (p=0.002) were significantly correlated with an improvement of visual acuity (decrement in logMAR) after PDT. Other factors had no significant influence on changes in visual acuity. CONCLUSIONS: Younger patients and patients with a dark rim on ICG angiography had a higher chance of visual improvement after PDT in myopic CNV.

PFCL and ILM peeling in macular hole with retinal detachment / 国际眼科杂志(Guoji Yanke Zazhi)

● AIM: To demonstrate the operative technique and surgical outcome of using perfluorocarbon liquids (PFCL) in internal limiting membrane (ILM) peeling of eyes with macular hole associated with retinal detachment.● METHODS: The study consists of 8 consecutive eyes of 8 patients diagnosed to have total retinal detachment (RD) with macular hole between December 2001 and October 2002.The age ranged from 13 to 65 years (mean 39 years). The male female ratio was 5:3. Four eyes were in Non-myopic Group and 4 eyes in Myopic Group. The patients underwent vitrectomy, ICG dye to stain the ILM,PFCL to flatten the retina intraoperatively, ILM peeling,fluid air exchange and endolaser was performed around the peripheral breaks. Tamponade with either silicone oil or C3F8was used.● RESULTS: The follow-up ranged from 6 to 9mo (mean 6.5mo). In Non-myopic Group. Macular hole was completely closed at the end of follow-up in 3 eyes (75%)and decreased size with flat edge in 1 eye (25%). In Myopic Group. All 4 eyes had successful closure of macular hole at the end of the follow-up. Comparing the groups,complete closure of macular hole was achieved in 7 eyes (88%) and open hole with flat edge was seen in 1 eye (12%) at the end of follow-up.● CONCLUSION: Using PFCL is helpful in the peeling of ILM for macular hole associated with retinal detachment.