Photodynamic endometrial ablation in the nonhuman primate.

OBJECTIVE: To test the effectiveness of 5-aminolevulinic acid (ALA)-induced photodynamic endometrial ablation in the rhesus monkey under varying conditions of light delivery (fractionated versus continuous) and steroid priming. METHODS: Photodynamic endometrial ablation was carried out in 17 rhesus monkeys that were either postmenopausal or in the early proliferative phase. Four hours after intralumenal injection of ALA (250 mg in 1 mL hyskon), a quartz fiber with a diffusing tip was inserted. A KTP tunable dye laser delivered 300 mW of light (635 nm) for 60 minutes in either continuous or fractionated fashion (20 minutes on, 5 minutes off, and 40 minutes on). In some experiments, thermistors were used to monitor temperature in the lumen and myometrium during light treatment. Hysterectomy was performed 3 or 4 days after treatment, and endometrial damage was assessed histologically. Two additional monkeys (one rhesus and one cynomolgus monkey) were exposed to the same protocol, except hyskon was substituted for ALA to control for potential ablative effects due to light treatment alone. RESULTS: Endometrial ablation was evident in all ALA-photosensitized specimens. The degree of ablation around the light fiber ranged from moderate to complete. The depth of ablation ranged from 1.14 +/- 0.54 to 2.15 +/- 1.62 mm (mean +/- standard deviation). Ablation was most complete in uteri of menopausal monkeys. Light treatment after ALA increased lumenal temperature from 36 C to 50 C, whereas temperature was not significantly increased by light treatment in the controls. CONCLUSION: This is the first report of endometrial destruction in the primate using a photodynamic approach. Whereas clinical application of photodynamic therapy (PDT) requires complete endometrial ablation to produce long-lasting amenorrhea, our results suggest that PDT may offer a simple office-based approach to endometrial ablation.

Evaluation of novel nonlaser light source for endometrial ablation using 5-aminolevulinic acid.

BACKGROUND AND OBJECTIVE: This research evaluated the effectiveness of a new nonlaser prototype short-arc lamp to achieve photodynamic ablation of endometrium in a rat. STUDY DESIGN/MATERIALS AND METHODS: Thirty female Sprague-Dawley rats were divided into two groups. 5-Aminolevulinic acid (ALA), the precursor to the photosensitizer protoporphyrin IX, was injected into the left uterine horn and vehicle alone (Hyskon) was injected into the right horn of 23 rats (group 1). An additional seven rats received vehicle only into both uterine horns (group 2). Three hours later, a cylindrical diffusing optical fiber was inserted into the lumen of the uterine horns, and light treatment was delivered from either a laser or a nonlaser light source. Rats in group 1 received either 1 hour (n = 15) or 10 minutes (n = 8) of light treatment into both uterine horns. In rats in group 2, the left horn was exposed to 1 hour of light treatment. Uterine tissues were examined histologically 4 days after light treatment. RESULTS: One hour of light exposure to the uterine horns injected with ALA produced extensive necrosis of the rat uterine wall. No difference in the magnitude of destruction was seen between the groups treated with the laser and nonlaser light sources. Ten minutes of light exposure resulted in endometrial ablation that was comparable in both the laser- and the prototype-treated groups, but the destruction of the deepest layers of the uterine wall was more consistent in the group treated with the nonlaser prototype. One hour of light treatment from either light source did not result in any histological changes in the uterine horns not exposed to ALA. CONCLUSION: The extent of endometrial ablation in the rat uterine horn achieved with the nonlaser prototype was comparable to that achieved with the laser. Thus, the nonlaser prototype may provide a less expensive approach to photodynamic endometrial ablation.

[Pediatric differences in the activity of endothelin 1 in physiology and pathology]. / Odrebnosci pediatryczne w zachowaniu sie poziomu endoteliny 1 w stanach fizjologii i patologii.

In the paper authors gathered hitherto existing opinions concerning endothelin, its structure, biological role and mechanisms of action. A special attention was paid to children and the activity of endothelin in physiology and pathology in various stages of development.

[Complications of renal oligobiopsy with regard to highly selective renal artery embolization as a method treatment--case report]. / Powiklania oligobiopsji nerek z uwzglednieniem wysoce selektywnej embolizacji tetnicy nerkowej jako metody terapeutycznej--opis przypadku.

This report describes complications after renal oligobiopsy performed for verifying the diagnosis of glomerulonephritis (minimal change disease) in 16-year old boy treated since 2 years of age. Macroscopic hematuria with intracystic clotting and hematuria in lower renal pole occurred after the procedure. These complications were caused by arteriovenous fistula which was treated by high selective renal artery embolization.