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Biomedical subjects

B F Overholt

Publications and source records attributed to B F Overholt.

At least 37 records · Page 2Linked to original sources
PubMed1995

Spectroscopic diagnosis of esophageal cancer: new classification model, improved measurement system.

Laser-induced fluorescence spectroscopy was used to measure fluorescence emission of normal and malignant tissue during endoscopy in patients with esophageal cancer and volunteers with normal esophagus. The spectroscopy system consisted of a nitrogen-pumped dye-laser tuned at 410 nm for excitation source, an optical multichannel analyzer for spectrum analysis, and a fiberoptic probe designed for both the delivery of excitation light and the collection of fluorescence emission from tissue. The fluorescence lineshape of each spectrum was determined and sampled at 15-nm intervals from 430 to 716 nm. A calibration set of spectra from normal and malignant spectra was selected. Using stepwise discriminate analysis, significant wavelengths that separated normal from malignant spectra were selected. The intensities at these wavelengths were used to formulate a classification model using linear discriminate analysis. The model was then used to classify additional tissue spectra from 26 malignant and 108 normal sites into either normal or malignant spectra. A sensitivity of 100% and specificity of 98% were obtained.

Algorithms↗
PubMed1994

Photodynamic therapy for esophageal cancer using a 180 degrees windowed esophageal balloon.

Although delivery of uniform circumferential light is desirable during photodynamic therapy of advanced esophageal cancer in humans, early esophageal cancer may need only targeted treatment. Studies were performed in the canine esophagus of eight animals to investigate whether use of a "windowed" (shaded) centering balloon would improve targeted illumination of esophageal mucosa for photodynamic therapy. Shaded balloons were developed with a 2-cm-long, 360 degrees or 180 degrees clear "window." Photofrin 4 mg/Kg was used as the photosensitizer. Light at 630 nm was delivered at 300 J/cm or 600 J/cm. Isotropic probes placed on the balloon wall allowed real-time measurement and verification of relatively uniform light doses delivered to esophageal mucosa during balloon photodynamic therapy. With the windowed balloon, targeted delivery of photodynamic therapy was possible. Using the 180 degrees balloon, mucosa exposed to illumination was destroyed, whereas mucosa protected from light by the balloon shading was undamaged. Healing was complete and strictures did not occur. The shading of the balloon protected normal mucosa and prevents the formation of esophageal strictures. The "windowed" centering balloon provides a technology and technique that allows targeted delivery of uniform light during esophageal PDT.

Animals↗
PubMed1994

Endoscopic ambulatory surgery centers and the corporate partner.

The number of practice-based endoscopic ambulatory endoscopy centers has increased dramatically in the last 5 years as gastroenterologists have recognized the advantages of these centers both for their practice and their patients. A new trend of joining with a corporate partner in ownership of the center is emerging. Such a partnership has clear benefit for physicians, their practice, their patients, and the corporation. Many existing and most forming practice-based endoscopy centers are giving serious consideration to these physician/corporate partnerships. Reasons to consider such a partnership, as well as the risks, are discussed.

Certification↗
PubMed1993

Quantification of phthalocyanine concentration in rat tissue using laser-induced fluorescence spectroscopy.

Quantification of photosensitizer concentration in tissue should improve planning and outcome of photodynamic therapy. Laser-induced fluorescence (LIF) can be used to measure in vivo fluorescence of photosensitizers in tissue. This study was designed to determine if in vivo fluorescence intensity of chloroaluminum phthalocyanine tetrasulfonate correlates with its concentration in different rat tissues. Following LIF measurements, the animals were humanely euthanized and the concentration of phthalocyanine in different tissues was determined using chemical extraction technique. The correlation of phthalocyanine fluorescence intensity and its concentration was determined for each tissue using Pearson product-moment correlation analysis. A strong correlation between in vivo phthalocyanine fluorescence intensity and its concentration was found for spleen, kidney, liver, and chemically induced mammary adenocarcinoma. Low correlation was found for thigh skin and planum of nose. No correlation was found for thigh muscle and tongue.

Animals↗
PubMed1993

Comparative study between pulsed and continuous wave lasers for Photofrin photodynamic therapy.

A study was conducted in the normal canine esophagus to compare continuous wave (CW) and pulsed laser light for photodynamic therapy with Photofrin (4 mg/kg). Forty-eight hours post-injection, 630 nm laser light (CW light from an argon-pumped dye-laser and pulsed light from a KTP/532-pumped dye-laser) was delivered using a 24 mm diameter cylindrical esophageal PDT balloon positioned at either distal or proximal esophagus. A 1.0 cm cylindrical diffuser placed in the center of the balloon delivered 300 J/cm of light at an intensity of 400 mW/cm. Three dogs received CW light proximally and pulsed light distally. Four dogs received CW light distally and pulsed light proximally. The light dose delivered to the esophageal mucosa was measured using three isotropic probes placed on the balloon wall. Laser-induced fluorescence technique was used to compare photosensitizer fluorescence intensities at distal and proximal locations. Similar mucosal light doses and drug fluorescence intensities were verified for sites receiving pulsed or CW laser light. Two days after light delivery, the dogs were endoscoped to evaluate the severity of the lesions. While some response variability was observed among different animals, endoscopic examination of the lesions revealed comparable injury from CW and pulsed light in each subject. The animals were then euthanized and necropsies were performed. Based on the gross and histological examination of the lesions, the CW and pulsed laser-induced injuries could not be distinguished.

Animals↗
PubMed1993

Office endoscopy or an endoscopic ambulatory surgery center?

Gastroenterologists are examining alternatives that allow delivery of effective and efficient care. Office endoscopy once provided such opportunities. Time efficiency, control of practice outcomes, and enhanced patient relationships were powerful incentives to perform office endoscopy. However, newly imposed physician procedural fee reductions and heightened concerns about quality of care are strong negatives for performing quality office endoscopy. These issues necessitate consideration of an office-based endoscopic ambulatory surgery center (EASC), where licensure, peer review, and credentialing essentially guarantee a high level of quality in the provision of endoscopy. Furthermore, state-licensed and Medicare-certified EASCs offer the advantages of office endoscopy and allow collection of a facility fee to offset the costs of providing the service. This article details the advantages and risks of developing an office-based EASC.

Ambulatory Care↗
PubMed1992

Centering balloon to improve esophageal photodynamic therapy.

A cylindrical balloon was developed to improve delivery of circumferential light for photodynamic therapy (PDT) of esophageal carcinoma. The balloon consisted of a 36-mm-long clear cylindrical membrane and a central tube to hold a cylindrical diffuser in the center of the lumen. Three isotropic probes were placed on the outside of the balloon to allow measurement of delivered light dose to the esophageal mucosa. The balloon was tested in the normal esophagus of 8 dogs that were injected with 4.0 mg/kg of PHOTOFRINR. Endoscopy was performed 48 hours following the injection, and under endoscopic observation the balloon assembly was passed, fixed in place, and inflated. A 1-cm cylindrical diffuser was passed into the central tube and 150, 300, and 600 Joules/cm of 630 nm laser light was delivered at 25 cm, 15 cm, and 5 cm proximal to the gastroesophageal junction. One control dog was illuminated using the cylindrical diffuser alone at doses of 300 and 600 Joules/cm of diffuser. Complete circumferential tissue response was obtained when the balloon was used. Relatively uniform light intensities were measured around the lumen. In contrast, noncircumferential and unpredictable PDT responses were generated when the cylindrical diffuser was used without the balloon.

Animals↗
PubMed1992

Comparative pharmacokinetics of the photosensitizer tin-etiopurpurin in dogs and rats.

Photodynamic therapy is a promising new treatment for local eradication of cancer. Little work has been done to define the pharmacokinetics of photodynamic drugs or the variability in drug disposition that may occur between different species and pathophysiological states of tissues. Pharmacokinetic studies of tin-etiopurpurin (SnET2), a lipophilic photosensitizer, were conducted on six Beagle dogs and six Sprague-Dawley rats. Blood was collected up to 24 h following drug administration for measurement of tin-etiopurpurin concentration. Dogs and rats were euthanatized 24 h post-administration and tissues were collected for drug analyses. The plasma drug concentrations were best described by a 2-compartment model (Ct = Ae-alpha t + Be-beta t). Median distribution and elimination half-lives were 0.24 and 0.34 h and 10.21 and 5.25 h for dogs and rats, respectively. The apparent volumes of distribution were 4.26 +/- 1.75 L/kg for dogs and 1.84 +/- 0.36 L/kg for rats. Systemic clearance was 7.56 +/- 2.45 ml/kg/min and 6.63 +/- 0.91 ml/kg/min for dogs and rats, respectively. Drug was detected in all tissues analyzed 24 h after drug administration. Drug was detected only sporadically in skin and muscle and was generally below the limit of detection of the assay. Where comparisons could be made, concentrations of SnET2 were significantly greater in all tissues except jejunum of rats compared to dogs 24 h after drug administration.

Animals↗
PubMed1991

Nd:YAG laser-induced hyperthermia treatment of spontaneously occurring veterinary head and neck tumors.

Conventional hyperthermia treatment of superficial tumors in the oral cavity is troublesome due to difficulty in accessing the lesion. A new hyperthermia technique employing near-infrared radiation delivered through a flexible silica optical fiber is described. The system consisted of an Nd:YAG laser for tissue heating, a He-Ne laser for aiming beam, a computer-controlled optical shutter, an interstitial thermometer, computer, and a printer. A 3-m-long 600-microns silica fiber delivered laser energy to the tumor via surface illumination. Using the aiming beam, the spot size was adjusted to include 5 mm of surrounding normal tissue. A thermocouple implanted in the tumor base provided temperature feedback to maintain desired hyperthermic temperature within the lesion. Three spontaneously occurring canine (two squamous cell carcinomas on the gum, one pigmented melanoma on the hard palate) and one feline tumor (squamous cell carcinoma on the nose) have been treated with Nd:YAG laser hyperthermia. Hyperthermia was delivered at 43.5 degrees C for 1 h. All animals received standard radiation treatment prior to hyperthermia. Nd:YAG laser hyperthermia allowed effective and efficient delivery of heat to veterinary nasal and oral lesions otherwise not treatable with conventional heating techniques.

Aluminum Silicates↗
PubMed1991

Nd:YAG laser hyperthermia treatment of rat mammary adenocarcinoma in conjunction with surface cooling.

Electromagnetic radiation ranging from radiofrequency to microwave has classically been used to induce hyperthermia for treatment of cancer. This paper presents a new technique using near infrared radiation from an Nd:YAG laser in conjunction with surface cooling to induce hyperthermia in a rat tumor model. A CW Nd:YAG laser hyperthermia system was used to induce hyperthermic temperatures in chemically (DMBA) induced rat mammary adenocarcinomas. The laser was interfaced to a computer and a thermometry unit that provided feedback to control the tumor temperature between 43.2-43.5 degrees C. A thermocouple was placed at the base of the tumor and its temperature was used to control laser exposure. All tumors were 10 to 20 mm in diameter. Surface cooling methods investigated included forced air flow from a fan, forced oxygen flow plus an IV drip, and forced moist oxygen flow from a nebulizer. Twelve rat mammary adenocarcinomas have been treated with Nd:YAG laser hyperthermia. In 4 treatments, no surface cooling was employed. In one treatment the surface was cooled using oxygen flow plus IV drip. In 7 treatments the skin was cooled using the nebulizer technique. The nebulization provided the most effective and reproducible surface cooling. Nd:YAG laser hyperthermia delivered in conjunction with nebulizer surface cooling produced efficient heating of rat mammary adenocarcinomas. A mean temperature of 42.1 degrees C was obtained at the base of the tumors while the mean surface temperature was 37.0 degrees C.

9,10-Dimethyl-1,2-benzanthracene↗
PubMed1990

Nd:YAG laser-induced interstitial hyperthermia using a long frosted contact probe.

The heating potential of a closed loop interstitial hyperthermia system employing 1,064 nm laser light in conjunction with a long frosted contact probe was investigated in hind limb muscle of anesthetized dogs. The laser system was an Nd:YAG surgical laser modified with a single channel thermometry unit, a computer, a printer, and a computer-controlled laser exposure shutter. The long frosted laser probe was implanted into the muscle, and 3.12-5.00 Watts of laser power was delivered interstitially. Temperature distribution was measured in three dimensions around the frosted probe. The temperature distributions generated by this technique were satisfactory for producing desired hyperthermia temperatures in an approximately 3.5 cm3 cylindrical tissue volume. A multiple laser delivery system is needed to induce interstitial hyperthermia in large tumors. A significant potential for the long frosted contact probe may be its use in combining interstitial hyperthermia and interstitial photodynamic therapy. Using this technique, both modalities may be delivered while employing the same treatment setup.

Animals↗
PubMed1987

Primary panendoscopy.

Primary panendoscopy is defined as a limited-consultative, diagnostic, UGI endoscopic examination that provides, in non-critically ill patients with dyspeptic symptoms, an accurate and cost-effective alternative to the standard UGI x-ray examination. The procedure was instituted at St. Mary's Medical Center's hospital in February 1985. During the first 12 months, a total of 321 patients were examined: 212 inpatients and 109 outpatients. In those patients with complete information, primary panendoscopy changed the diagnosis in 67% and the treatment in 52%. As expected, the number of esophagogastroduodenoscopies decreased during this time, but the combined numbers of primary panendoscopies and esophagogastroduodenoscopies exceeded the projected increase of esophagogastroduodenoscopies. Similarly, the number of UGI x-ray examinations fell sharply. With a physician fee of $150.00 and a facility fee of $50.00, theoretical savings of some $117,000.00 to the patients were estimated. The authors conclude that primary panendoscopy provides a cost-effective and beneficial patient service that warrants broad consideration by gastroenterologists as they face the cost constraints being imposed within the health care system of the 1980s.

Adolescent↗
PubMed1985

Laser treatment of upper gastrointestinal hemorrhage.

The goal of laser treatment of the visible vessel or bleeding ulcer is to stop the bleeding to allow healing of the ulcer base. Adjuvant techniques including the use of vasoconstrictive agents, tissue adhesives, and tissue injection hold future promise in complementing laser therapy. Laser photocoagulation appears to be an effective method of treatment. At this time, however, the therapy of this serious clinical problem is evolving. As experience increases and as new technology and techniques are applied, the development of an effective treatment for the bleeding peptic ulcer or visible vessel is even more promising.

Aged↗