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Clinical Photodynamic Therapy: The Continuing Evolution
Published in Barbara W. Henderson, Thomas J. Dougherty, Photodynamic Therapy, 2020
Lofgren and co-workers [100] have reported on transthoracic endoscopic PDT as treatment for malignant mesothelioma in a patient. A model of the pleural cavity was used to determine light dosimetry; the patient was given Photofrin 2 mg/kg, and 48 hr after injection thoracoscopy was performed. The entire surface of the pleural cavity (as could be reached by thorascopy and a fiberoptic probe) was reportedly exposed to a total light dose of 20 J/cm2 from a gold vapor laser. The entire procedure took 6 hr under epidural anesthesia; in situ dosimetry was performed using a probe inserted through a separate puncture in the thoracic wall. Initial patient reactions to the procedure included fatigue, a transient elevation in serum creatinine, and an elevation in erythrocyte sedimentation rate to 100 mm/hr. Prophylactic antibiotic therapy was given. A computed tomography scan of the chest 2 weeks after PDT revealed a “striking reduction” in the size of pleural tumors. The patient has now been followed for 10 months without signs of tumor progression; all laboratory values returned to normal.
Bronchiolitis obliterans organizing pneumonia induced by drugs or radiotherapy
Published in Philippe Camus, Edward C Rosenow, Drug-induced and Iatrogenic Respiratory Disease, 2010
Nitrofurantoin BOOP was reported in a 71-year-old woman who had taken nitrofurantoin for 6 months prior to developing unproductive cough, fever and shortness of breath.9 This represented the seventh reported case. She had bilateral inspiratory crackles, and the chest CT showed peripheral infiltrates and effusions. A video-assisted thoracoscopy (VATS) biopsy showed proliferating fibromyomatous connective tissue with organization within the air-spaces consistent with BOOP. There was complete resolution of symptoms and lung volumes with prednisone therapy which was discontinued after 16 months; however, the diffusing capacity remained abnormal at 53 per cent predicted.
Development and Validation for Extended Reality-Based MIS Simulator Using Cumulative Summation
Published in International Journal of Human–Computer Interaction, 2022
Zhibao Qin, Yinjia Wang, Junzhen Du, Yonghang Tai, Junsheng Shi
In recent years, Minimally Invasive Surgery (MIS), as one of the surgical procedures, compared with traditional open surgery, MIS has the advantages of less trauma, less pain, shorter recovery cycle and so on. Laparoscopy and thoracoscopy are the two major operations in minimally invasive surgery. The surgical skills are essential, 1–4 small holes are usually opened to place surgical instruments and endoscopes on the MIS. There are certain differences between laparoscopy and thoracoscopy, such as the site of operation, surgical instruments, opening position, etc. But there are similarities between the two, such as gripping objects, stitching, etc. The traditional surgical skills training includes mostly an autopsy, video teaching, observation in the operating room, etc. These methods also have many shortcomings, which include the lack of cadaver resources and few practical opportunities. Therefore, a large number of simulators have been developed for novices to train their surgical skills, the novice can carry out different surgical skills by practicing anytime and anywhere, such as hand-eye coordination, hands coordination, and depth perception abilities. At the same time, the simulator can also be used to evaluate the subjects’ surgical skills. At present, Box simulators and VR simulators are the main ones used for surgical skills training in the market, the laparoscopic simulator training system and the accompanying surgical skill assessment system are relatively mature. Currently, video-assisted thoracoscopic surgery (VATS) is the primary surgical method used to treat thoracic diseases (Hansen et al., 2011; Solomon et al., 2011). However, the system for assessing the skills of thoracoscopic surgery is currently lacking (Jensen et al., 2018).