BLUE ENDOVASCULAR LASER THERAPY

This picture show multi colour endovascular laser therapy to alleviate acute and/or chronic pain,control blood rheology,stimulate tissue repair in damaged tissue due to inflammation and to promote ulcer healing through increased production of ATP by cellular mitochondria and increased  microcirculation.
Blue laser is usually combined with  other monochromatic (red,green  and others) for specific target tissue/organ,the photon transmission maybe supported by multichannels/ locoregional transcutaneous laser therapy.Technique of acupuncture reveals the bridge of western and oriental medicine.
The colour should be related to the depth of penetration  for the selected tissue/organ to maintain the efficacy of the photonic therapy.

MULTI CHANNELS LASER THERAPY FOR SHOUDER HAND SYNDROME

 Several years ago my colleague (Wyasa Andrianto,MD) had written THESIS  on LASER THERAPY for SHOULDER HAND SYNDROME.
He had been granted specialist in Physical Medicine & Rehabilitation from The School of Medicine University of Indonesia/Dr.Cipto Mangunkusumo Hospital,Jakarta.
This picture show Mr.Warih who is suffering of shoulder hand syndrome and being treated by (multichannels) laser therapy.
The pain was downgraded from 7 to 3  in VAS (Visual Analogue Scale) following 3 session of laser therapy.He needed less insulin to control the blood glucose.
Mr.Warih has voluntarily talked in a public - health info in LITEFM 105,8 broadcasted from its studio in Jakarta recently.(9 th November 2013).
(He had given permission to publish this picture for public health education.)

INTERSTITIAL PDT FOR PRIMARY AND METASTATIC TUMOUR

Photo courtesy of House of Laser

PDT is one of the interesting modalities in cancer treatment.The availability of several photosensitizers and lasers are opening new pathways in photodynamic medicine, leading to a new era in the future of medicine.
(It should be mentioned that PDT will not be an umbrella only in oncology but will cover some areas including infectious and other degenerative processes or diseases as well.)
A technique of interstitial PDT has been offered in conjunction with other modalities in cancer treatment,as shown in this picture.
Selective cancer cells death by apoptosis and necrosis has been proposed to a formation of lysate following cytotoxic process of cancer cells.
Secondly vascular shutdown is another way to the killing of cancer cells.
Positive immune response is another way leading to improvement of patient condition.(see: Immunologic aspect of PDT/Laser therapy,a review by Santoso Cornain,MD,D.Sc, a link in this blog)

LIMFOMA MALIGNUM TONSIL

Tonsil membesar satu sisi mungkin bukan pembesaran tonsil biasa akibat infeksi.Kemungkinan tumor harus difikirkan yaitu limfoma malignum yang melibatkan tonsil dan cincin Waldeyer.
Foto ini menunjukkan limfoma malignum pada tonsil palatina kanan.
Pada endoskopi ternyata dicurigai melibatkan jaringan limfoid nasofaring.
Gangguan menelan diatasi dengan pengangkatan tonsil yang mengandung tumor disusul dengan kemoterapi dan radiasi.

PDT:AFTER 4x24 HOURS

This picture showed tumor condition 4 days after first illumination with laser.
The tumor was seen with prominent parts of necrotic (lower picture)and liquified mass(upper picture) area as result of PDT.
Please view pictures of previous posting.
Posting of PDT cases were also presented in Indonesian language in:
http://cahayamasadepan.blogspot.com

PDT: AFTER 2X24 HOURS

Interstitial technique of PDT is used to debulk huge tumours.
The debulking process started hours after illumination by direct cytotoxic effect of PDT into tumour cells and by vascular shutdown
resulting in tumor apoptosis and necrosis.
In order to treat tumours thicker than 1 cm(limit of light penetration depth into the human tissue),the interstitial illumination technique was invented.
By this technique laser fibres with a light diffuser at the tip are implanted into the tumour tissue.
Laser fibres are feed-through needles,which can be placed under image guidance in the tumour(CT,MRI or US).
In large tumours,several fibres can be placed close to each other(12 cm apart) in order to illuminate the entire tumour volume.
Interstitial light delivery allows PDT to be used in the treatment of large,buried tumours and is particularly suitable for those whose surgery would involve extensive resection or for those who are unsuitable for surgery.
Due to the difficult and non precise light dosimetry in the tumout,interstitial PDT is mainly used with palliativeintention,as stated by Xu et al.
The pictures shown are PDT in large tumour of the neck,before (upper picture)and 2x24 hours (lower picture)after laser interstitial illumination.

PDT:A NOVELL APPROACH TO CANCER TREATMENT

The content of this posting is derived from the review by Kecheng Xu,Guo Zhiqian,Lizhi Niu,from Fuda Cancer Hospital, Guangzhou.

PDT is a promising new approach for the treatment of cancer.

The principle of PDT is based on photochemical reaction,which is initiated by light activation of a photosensitizing drug causing tumour cell death.

Light is mainly applied by superficial illumination of the tumour and the surrounding tissue causing drug activation followed by tumour cell death.

The PDT is mostly used for superficial and endoluminal lesions like skin or bladder malignancies and also more frequently applied for the treatment of lung,esophageal,and head and neck cancer.

With the help of specially designed application systems,PDT is now becoming a practiceable option for solid lesions,including those in parenchymal organs such as the liver.

New techniques use glass fibres,which are stabbed into the tumour,leading the light directly into the tumour tissue.

The intra-operative application of PDT to treat and "mop-up" the tumour bed of any remaining tumour cells has been reported.

PDT damage heals mainly by regeneration rather than by scarring.
Due to the organ preserving principle of PDT,important structures are maintained with good functional and cosmetic outcome.

The principle of PDT and different indications for PDT were reviewed.

(Pictures show PDT procedure done in Gading Pluit Hospital,Jakarta,Indonesia. Photo courtesy of this blog author)

ACUPUNCTURE &HN CANCER

ScienceDaily (Jun. 5, 2008) — New data from a randomized, controlled trial found that acupuncture provided significant reductions in pain, dysfunction, and dry mouth in head and neck cancer patients after neck dissection. The study was led by David Pfister, MD, Chief of the Head and Neck Medical Oncology Service, and Barrie Cassileth, PhD, Chief of the Integrative Medicine Service, at Memorial Slo an-Kettering Cancer Center (MSKCC). Dr. Pfister presented the findings May 30 at the annual meeting of the American Society for Clinical Oncology.(as reported by ScienceDaily to my desk)
My personal experience with surgery,radiotherapy,chemotherapy and PDT showed effectiveness of acupuncture (electro-acupuncture and laser-acupuncture) to control side effects and adverse events of cancer treatments.

PICTURE FROM BERLIN

The picture showed author of this blog in front of the building where Max Planck lectured The Quantum Theory.
(Berlin,autumn,2006)

SURGERY FOR SNORING:TONSILLECTOMY AND UVULOPLASTY

Snorer may have choices for surgical intervention.The type of surgery should be defined by an ENT Surgeon after clinical history and examination,including procedure name of sleep endoscopy.
This procedure of upper aerodigestive tract endoscopy examination while sleeping (through artificial sleep induced by medication)
The examination- using flexible endoscope(fiber endoscopy)- will look /locate the problem(s)(soft palate,uvula,tonsil,lateral pharyngeal wall,epiglottis etc).
The problem(s) of an individual case will be revealed and the surgery will be done based on these objective findings.

More than one finding or multi level obstruction maybe defined.
The picture of this posting show the patient following tonsillectomy and uvuloplasty,assisted by an Argon Beam Coagulator.(a medical device to coagulate/stop the bleeding during surgery).
This posting is only for public information.
You have to consult your doctor if you have problem of your health,including snoring.
One type of snoring is OSA(Obstructive Sleep Apnea), which is one of the major public health problem in the world.

PHOTODYNAMIC THERAPY IN NASOPHARYNX CANCER

L.S.Handikin

ORL&HN Surgery

Photodynamic Therapy (PDT) is a (relatively) new modality in cancer therapy.

It is based on the selectivity of cancer cells to retain a number of photosensitizers (in comparison to normal cells).

Following activation of the drugs (photosensitizer) by a light of a specific wavelength delivered through fiber optic, a selective necrosis will take effect only on cancerous tissue.

The tumour is selectively destructed by fiber optic delivery of relatively low light energy.

There is interval time of the photosensitizer injected intravenously and light illumination due to the longer capacity of cancer cells to retain the drug.

The normal cells will escape the photochemical destruction of PDT.

The author will describe application of PDT in nasopharyngeal cancer which nowadays could be considered as an effective local treatment for recurrent or persistent nasopharyngeal carcinoma.

Keywords: photodynamic therapy,nasopharyngeal cancer,photosensitizer,light energy

Abstract of paper presented to Scientific Symposium of Recent Advances in Cancer Diagnosis&Therapy, multi-disciplinary aproach
in conjunction with the Grand Opening of Gading Cancer Center,March 14-16,2008,Gading Pluit Hospital,Jakarta,Indonesia

Slide:Post PDT endoscopy of nasopharynx cancer with necrosis

THE ROLE OF ACUPUNCTURE IN CANCER THERAPY

The role of acupuncture in cancer therapy is evidenced.
It controls nausea,vomiting following chemotherapy and/or radiotherapy.
It alleviate cancer pain.
It should be integrated in cancer therapy : before,during and after any kind of treatment modality.
You may see smile on his/her face.

THE FATE OT FAT CELLS AFTER LASER LIPOLYSIS

Laser can induce lipolysis using pulsed Nd:YAG laser.The laser has a 1064 nm wavelength and the fat cells will undergo cell wall destruction.You will get the end-product of an oily liquid in the target area where you can aspirate if you want.
The aesthetical aspect of the targeted part of the body in the laser lipolysis is to make the body in a balanced and a harmony condition.Healthy and beauty in a body will make you happy.
I hope that I can show you the end product of laser lipolysis in this blog.

THE FATE OF CANCER CELLS AFTER PDT

Illumination of the cancer cells by laser light will selectively destroy these patological cells while normal cells will remain intact.The pictures show the illumination procedure and the end product(the liquid) with no more cancer cells(cytology show no cancer cells).

These pictures show you:
* the procedure of PDT and
* the end product of PDT in a syringe .
The aspirate shows no cancer cells by cytology examination.

A CEREMONY FOR GADING PLUIT CANCER CENTER

Gading Pluit Cancer Center was officially opened(Wednesday,March 12,2008).A public education program on breast cancer,followed by a press conference to media representing the center activities.
A seminar named The Recent Advances in Cancer Diagnosis&Therapy, multidisiplinary approach were conducted on March 14-16,2008.

HPD-PDT SOME TECHNICAL CONSIDERATION

HPD is abbreviation of Hematoporphyrin Derivative
It is a name of a photosensitizer,a chemical compound which will be sensitized and reacted to light.
The pathological cells which retain photosensitizer molecules will be dead due to direct cytotoxic process.
The bloodvessels nurturing the cancer will be shut down.
The necrotic cancer will stimulate the immunity of cancer patient.

The laser:

The machine generates the red visible laser light with a wavelength of 630 nm.The deviation of output wavelength is +/- 5 nm.
The output power of each way (of 3 ways) is from 100 mW to 1000 mw( 1 W),continuously adjustable.
The instability of output power is less or the same of +/- 10 %
The semiconductor laser beam,as the output power is less than 1 Watt,it may lead to three-degree burns on;ly in the situation of focusing or less than 10 mm distance to light extraction end
in using flat-head fiber.

Safety conduct

-Do not look directly at laser beam and its reflex.The visible red light is harmful to eyes.
-All field operator should wear protective glasses
-The protective glasses are specific in its optical density to the laser wavelength which provide enough protection to radiation of 630 nm laser beam
-Patient should wear protective glasses or putting mask on patient's face
-The exposed parts of patient's body should be covered with cloth cover
-Possible explosive matters should be forbidden (alcohol,gasoline,organic solvent.)
-Clothing,gauze and other flammable substances should be removed from the optical path
-A fire extingusher should be placed in the laser area
-Reliable grounding is very important to operation
-Warning labels should be placed to make personsaware of laser operation

LASER FOR POST-RADIATION DERMATITIS

Laser may support healing process of post radiation dermatitis as you can see in the above pictures..

For nasopharyngeal cancer,the golden standard is radiation( eitther external radiation only or maybe combined with internal radiation(brachytherapy).

Most of the patients were diagnosed at the the late stage where a combination with chemotherapy were needed.

A new modality of treating nasopharyngeal cancer using laser and photosensitizer named Photodynamic Therapy is now going into popularity among cancer centers.A new generation of photosensitizer which is more potent is now available in the market.

LASER FOR DOUBLE CHIN

Laser is offering treatment for double chin,a procedure as part of what is called laser lipolysis.Usually there is no suction procedure during or after lipolysis in this special area.

Tumescent anaesthesia is a special technique for this kind of minimal invasive procedure which is suitable to be done in the doctor office but should be done under strict aseptic and antiseptic control.

A small canulla for laser delivery to disrupt fat cell's wall will need small incission only.Therefore it does not necessary to do suctioning of the lysis product of the fat in this area and stitching of small incission.

TRANSNASAL LASER IRRADIATION

If you sneeze after waking up in the morning you may have allergic rhinitis.You can go to a drugstore and take antihistamin (OTC,not under doctor prescription drugs) or you see your famili physician or your ENT doctor.They may prescribe another medication which should be under strict medical supervisison,for possible side effects like drowsiness or dry mouth.If the medicine does not help you ,the doctor will change the medication to nasal vasoconstrictor or steroid nasal spray.

The anti inflammatory of low power laser has been known very well among doctors and laymen.Laser will give you bonuses:biostimulation effect,local endorphin production to reduce pain,more ATP production antiseptic etc.

LASER FOR STROKE

Laser has a role in the prevention,treatment and stroke rehabilitation.

You can see your blood condition under the microscope.

If you look your red blood cells clustering each other or making a "military parade", it means that your blood is not efficient bringing oxygen to your tissue or organ.

You should be aware of this condition ,because you might have a problem with your blood circulation.

If you are brought into laser irradiation under your doctor recommendation and supervision ,your organ will have more oxygen and they will work more efficiently.