Fisika Kedokteran

VISION

1. To be a center of excellence in physics and applied physics research and education in the national and international level
2. To produce world-class graduates who are highly innovative and competent in scientific, academic and industrial environments.
3. 
   

Pengantar

Fisika berasal dari bahasa Yunani, physikos yang berarti ‘alamiah’. Karena itu Fisika merupakan suatu ilmu pengetahuan dasar yang mempelajari gejala-gejala alam dan interaksinya yang terjadi di alam semesta ini. Hal-hal yang dibicarakan di dalam fisika, selalu didasarkan pada pengamatan eksperimental dan pengukuran yang bersifat kuantitatif.

Fisika terbagi atas dua bagian yaitu :

1. Fisika klasik yang meliputi bidang : Mekanika, Listrik Magnet, Panas,Bunyi, Optika dan Gelombang.

2. Fisika Modern adalah perkembangan Fisika mulai abad 20 yaitu penemuan Relativitas Einsten. (Atom Inti, Radiasi dll)

Ilmu Fisika mendukung perkembangan teknologi, enginering (teknik sipil, elektro, mesin, pertambangan, dll), bahkan di bidang kesehatan (mis: kebidanan, keperawatan, kedokteran) dan lain-lain.

Dalam kesehatan kajian Fisika, seringkali dicirikan dengan awalan Bio: Biomekanika, Biothermal, Biofluida, Bioakustik, Biolistrik, Biooptik, Bioradiasi, dan lain-lain.

[ Untuk materi dasar-dasar Fisika tentang Besaran Pokok - Turunan, Satuan, Vektor dan Skalar dapat dilihat di Materi Ringkas Fisika Dasar. ]

Berikut ini adalah materi tambahan terkait aspek Kesehatan.

Pengukuran Parameter Fisik

Berikut ini disajikan data standar manusia yang menggunakan sistem satuan internasional, turunan SI dan non SI untuk umur 30 tahun.

Dapat dicermati bahwa satuan dari besaran-besaran yang lazim digunakan dalam pengukuran fisika cukup familiar di gunakan dalam mempelajari fisika kesehatan.

Berikut ini contoh terapan lainnya:

Indeks Massa Tubuh:

yaitu pengukuran antropometri untuk menilai postur tubuh ideal atau apakah komponen tubuh sesuai dengan standard normal atau ideal. Pengukuran antropometri yang paling sering digunakan adalah rasio antara berat badan (dalam kg) dan tinggi badan (dalam m) kuadrat, yang disebut Indeks Massa Tubuh (IMT) sebagai berikut :

IMT = BB (kg) / (TB)^2

—————————————–catatan ————

Anda akan temui kesalahfahaman penggunaan besaran berat, dalam Berat Badan (BB) yang seharusnya adalah massa badan, dengan penggunaan satuan kg ( yang ini sudah benar). Di masyarakat sendiri, hal tersebut seringkali terjadi…. perhatikan di pasar2,

—————————————————————-

obesitas perlu diwaspadai karena biasanya berpotensi juga menderita penyakit degeneratif seperti Diabetes Melitus, hipertensi, hiperkolesterol dan kelainan metabolisme lain yang memerlukan pemeriksaan lanjut baik klinis atau laboratorium

Disebutkan bahwa batas ambang normal untuk laki-laki adalah: 20,1–25,0; dan untuk perempuan adalah : 18,7-23,8. Untuk kepentingan pemantauan dan tingkat defesiensi kalori ataupun tingkat kegemukan, lebih lanjut FAO/WHO menyarankan menggunakan satu batas ambang antara laki-laki dan perempuan. Ketentuan yang digunakan adalah menggunakan ambang batas laki-laki untuk kategori kurus tingkat berat dan menggunakan ambang batas pada perempuan untuk kategorigemuk tingkat berat.

Untuk kepentingan Indonesia, batas ambang dimodifikasi lagi berdasarkan pengalam klinis dan hasil penelitian dibeberapa negara berkembang. Pada akhirnya diambil kesimpulan, batas ambang IMT untuk Indonesia adalah sebagai berikut:

Jika seseorang termasuk kategori :

1. IMT 27,0 : keadaan orang tersebut disebut gemuk dengan kelebihan berat badan tingkat berat

Contoh cara menghitung :

Opong dengan tinggi badan 159 cm, mempunyai berat badan 70 kg. Maka IMT Opong adalah :

70 70

——————– = ——– = 27,7

(1,59 X 1,59) m 2,53

Berarti status gizi Opong adalah gemuk tingkat berat, dan Opong dianjurkan menurunkan berat badannya sampai menjadi 47- 63 kg agar mencapai berat badan normal (dengan IMT 18,5 – 25,0).

PERHATIAN !

Seseorang dengan IMT > 25,0 harus berhati-hati agar berat badan tidak naik. Dianjurkan untuk menurnkan berat badannya sampai dalam batas normal.

Berat Badan Ideal :

Atau untuk mengetahui Berat Badan ideal dapat menggunakan rumus Brocca sebagai berikut :

BB ideal = (TB – 100) – 10% (TB – 100)

Batas ambang yang diperbolehkan adalah + 10%. Bila > 10% sudah kegemukan dan bila diatas 20% sudah terjadi obesitas.

Contoh: wanita dengan TB = 161 cm, BB = 58 kg

BB ideal = (161 – 100) – 10% (161 – 100)

= 61 – 6,1 = 54,9 (55 kg)

BB 58 kg masih dalam batas > 10%.

Lila (Lingkar Lengan Kiri Atas):

Pengukuran lain yang dapat dilakukan untuk menilai apakah seseorang tersebut kurus menderita kurang gizi, normal atau gemuk, dengan mengukur Lingkar lengan kiri atas (Lila). Biasanya dilakukan pada wanita usia 15 – 45 tahun. Bila Lila < 23,5 cm, wanita tersebut menderita Kurang Energi Kronis (KEK).

RLPP (Rasio Lingkar Perut dan Lingkar Pinggang):

Pengukuran antropometri lain yang sering digunakan adalah mengukur rasio Lingkar perut dan Lingkar Pinggang (RLPP). Pada wanita RLPP yang disarankan < 0,8 sedangkan pada laki-laki 0,8 pada wanita dan > 1 pada laki-laki mempunyai risiko menderita penyakit jantung lebih besar dari yang RLPP nya dibawah ambang batas.

3 Hal yang menjadi faktor penentu ketepatan tindakan pengukuran, yaitu: (1) Alat, (2) Metode, dan (3) manusia-nya.

Kesalahan Pengukuran dalam Tindakan Medis (False)

Untuk menyatakan seseorang sakit atau tidak, perlu dilakukan pengukuran terhadap besaran fisis tubuh seperti suhu badan, tekanan darah, frekuensi detak jantung dan sebagainya.

Kesalahan dapat terjadi dari proses pengukuran disebabkan: faktor alat, metode maupun human error, sehingga terjadi false positif dan negatif.

False Positif: Error yang terjadi dimana penderita dinyatakan menderita suatu penyakit padahal tidak

False Negatif: Error yang terjadi dimana penderita dinyatakan tidak sakit padahal menderita suatu penyakit

Untuk menghindari :

1. Dalam pengambilan pengukuran

2. Pengulangan pengukuran

3. Penggunaan alat yang dapat dipercaya

4. Kalibrasi terhadap alat.

Sumber:

http://alifis.wordpress.com/2009/10/24/seri-fisika-kesehatan_pendahuluan/

(Alifis@Corner)

Photomedicine

Photomedicine is an interdisciplinary branch of medicine that involves the study and application of light with respect to health and disease. Photomedicine may be related to the practice of various fields of medicine including dermatology, surgery, interventional radiology, optical diagnostics, cardiology, and oncology.

A branch of photomedicine is light therapy.

Examples

• PUVA for the treatment of psoriasis
• Photodynamic therapy (PDT) for treatment of cancer and macular degeneration
• Photoluminescence Therapy
• Free electron laser
• Laser hair removal
• Photobiomodulation
• Optical diagnostics, for example optical coherence tomography of coronary plaques using infrared light
• Confocal microscopy and fluorescence microscopy of in vivo tissue
• Diffuse reflectance spectroscopy for in vivo quantification of pigments i(normal and cancerous), and hemoglobin
• Perpendicular-polarized flash photography and fluorescence photography of the skin

See also

• Laser hair removal
• Rox Anderson
• Blood irradiation therapy

External links

Journals and Societies

• The Photomedicine Society
• Photomedicine and Laser Surgery journal
• Photodermatology, Photoimmunology, and Photomedicine

Miscellaneous

• Wellman Center for Photomedicine at Massachusetts General Hospital MGH and Harvard Medical School
• Article: Role of Photomedicine in Gynecological Ontology

Interventional radiology

Interventional radiology (abbreviated IR or sometimes VIR for vascular and interventional radiology, also known as Image-Guided Surgery or Surgical Radiology) is a subspecialty of radiology, or in Europe a separate subspecialty of medicine in its own right, in which minimally invasive procedures are performed using image guidance. Some of these procedures are done for purely diagnostic purposes (e.g., angiogram), while others are done for treatment purposes (e.g., angioplasty).

The basic concept behind interventional radiology is to diagnose or treat pathology with the most minimally invasive technique possible. Images are used to direct interventional procedures, which are usually done with needles and narrow tubes called catheters. The images provide road maps that allow the interventional radiologist to guide these instruments through the body to the areas containing disease. By minimizing the physical trauma to the patient, peripheral interventions can reduce infection rates and recovery time as well as shorten hospital stays.^[1]

History

The advancements in the field of radiological imaging such as the Seldinger technique, together with innovations in instrumentation, led to a rapid development in interventional procedures in the 1970s.Cardiovascular procedures were found to be particularly well-suited for guided and minimally invasive operations, and catheterization remains as one of the main applications for interventional radiology.

Nobel nominee Charles Dotter is considered the "father of angioplasty and interventional radiology".^[2]

See also: Interventional cardiology

Training

As in most medical specialties, training varies depending on varying rules and regulations from country to country. In the United States, interventional radiologists are physicians whose education and training traditionally includes completing a college degree, four years of medical school, a year of training in general medicine and/or surgery (internship), a four year diagnostic radiology residency program, and then a one or two year fellowship in vascular & interventional radiology. Alternative pathways exist.

Imaging Modalities

Common interventional imaging modalities include fluoroscopy, computed tomography (CT), ultrasound (US), and magnetic resonance imaging (MRI). Fluoroscopy and computed tomography use ionizing radiation that may be potentially harmful to the patient and the interventional radiologist. However, both methods have the advantages of being fast and geometrically accurate. Ultrasound suffers from image quality and tissue contrast problems, but is also fast and inexpensive. Magnetic resonance imaging provides superior tissue contrast, at the cost of being expensive and requiring specialized instruments that will not interact with the magnetic fields present in the imaging volume.

Procedures

Common IR procedures are:

• Angiography: imaging the blood vessels to look for abnormalities with the use of various contrast media, including iodinated contrast, gadolinium based agents, and CO2 gas.

• Balloon angioplasty/stent: opening of narrow or blocked blood vessels using a balloon; may include placement of metallic stents as well (both self-expanding and balloon expandable).

• Chemoembolization: delivering cancer treatment directly to a tumour through its blood supply, then using clot-inducing substances to block the artery, ensuring that the delivered chemotherapy is not "washed out" by continued blood flow.

• Cholecystostomy: placement of a tube into the gallbladder to remove infected bile in patients with cholecystitis, an inflammation of the gallbladder, who are too frail or too sick to undergo surgery

• Drain insertions: placement of tubes into different parts of the body to drain fluids (e.g., abscess drains to remove pus, pleural drains)

• Embolization: blocking abnormal blood (artery) vessels (e.g., for the purpose of stopping bleeding) or organs (to stop the extra function e.g. embolization of the spleen for hypersplenism) including uterine artery embolization for percutaneous treatment of uterine fibroids. Various embolic agents are used, including alcohol, glue, metallic coils, poly-viny alcohol particles, Embospheres, encapsulated chemo-microsphere, and gelfoam.

• Thrombolysis: treatment aimed at dissolving blood clots (e.g., pulmonary emboli, leg vein thrombi, thrombosed hemodialysis accesses) with both pharmaceutical (TPA) and mechanical means

• Biopsy: taking of a tissue sample from the area of interest for pathological examination from a percutaneous or transjugular approach

• Radiofrequency ablation (RF/RFA): localized destruction of tissue (e.g., tumours) by heating

• Cryoablation - localized destruction of tissue by freezing

• Line insertion: Vascular access and management of specialized kinds of intravenous devices (IVs) (e.g. PIC lines, Hickman lines,subcutaneous ports including translumbar and transhepatic venous lines)

• IVC filters: - metallic filters placed in the inferior vena cavae to prevent propagation of deep venous thrombus, both temporary and permanent.

Inferior vena cava filter

• Vertebroplasty: percutaneous injection of biocompatible bone cement inside fractured vertebrae

• Nephrostomy placement: Placing a catheter directly into the kidney to drain urine in situations where normal flow of urine is obstructed. NUS catheters are nephroureteral stents which are placed through the ureter and into the bladder.

• Radiologically Inserted Gastrostomy or RIG: Placement of a feeding tube percutaneously into the stomach and/or jejunum.

• Dialysis access and related intervention: Placement of tunneled hemodialysis catheters, peritoneal dialysis catheters, and revision/thrombolysis of poorly functioning surgically placed AV fistulas and grafts.

• TIPS : Placement of a Transjugular Intrahepatic Porto-systemic Shunt (TIPS) for management of select patients with critical end-stage liver disease and portal hypertension

• Biliary intervention - Placement of catheters in the biliary system to bypass biliary obstructions and decompress the biliary system. Also placement of permanent indwelling biliary stents.

• Endovenous laser treatment of varicose veins - Placement of thin laser fiber in varicose veins for non-surgical treatment of venous insufficiency

• Radioembolization: Embolization of liver with radioactive microspheres of glass or plastic, to kill tumors while minimizing exposure to healthy cells.

Tools

There are a number of catheters used in interventional radiology that can be loosely divided into five types:

• Diagnostic angiographic catheters

• Micro catheters

• Drainage catheters

• Balloon catheters

• Central venous catheters

See also

• Interventional neuroradiology
• MRI Robot: MRI Stealth Robot Technology
• URobotics: New technologies for image-guided intervention
• Radiation protection

References

1. ^ Society of Interventional Radiology -- Global Statement Defining Interventional radiology.http://www.sirweb.org/news/newsPDF/IR_Global_Statement.pdf
2. ^ Lakhan SE, Kaplan A, Laird C, Leiter Y (2009). "The interventionalism of medicine: interventional radiology, cardiology, and neuroradiology". International Archives of Medicine 2 (27): 27. doi:10.1186/1755-7682-2-27. PMC 2745361. PMID 19740425.

• Rösch J, Keller F, Kaufman J (2003). "The birth, early years, and future of interventional radiology". J Vasc Interv Radiol 14 (7): 841–53. PMID 12847192.

External links

• Society of Interventional Radiology
• Cardiovascular and Interventional Radiological Society of Europe
• Interventional Neuroradiology at Johns Hopkins Medicine

Photodynamic Therapy

Close up of surgeons' hands in an operating room with a "beam of light" traveling along fiber optics for photodynamic therapy. Its source is a laser beam which is split at two different stages to create the proper "therapeutic wavelength". A patient would be given a photo sensitive drug (photofrin) containing cancer killing substances which are absorbed by cancer cells. During the surgery, the light beam is positioned at the tumor site, which then activates the drug that kills the cancer cells, thus photodynamic therapy (PDT).

Photodynamic therapy (PDT), matured as a feasible medical technology in the 1980s at several institutions throughout the world, is used to eradicate premalignant and early-stage cancer and reduce the tumour size in end-stage cancers^[1] involving three key components: a photosensitizer, light (wavelength appropriate for the photosensitzer), and tissue oxygen. The light causes the photosensitizer to cause the oxygen to damage and kill the tissues exposed to the light.

It is an approved treatment for wet macular degeneration, and is also being investigated for treatment of psoriasis.

Treatment of internal organs may be achieved through the use of endoscopes and fiber optic catheters to deliver light, and intravenously-administered photosensitizers.

A great deal of research and clinical study is now underway to determine optimal combinations of photosensitizers, light sources, and treatment parameters for a wide variety of different cancers.

It is currently being tested as a treatment for severe acne.^[2][3][4]

History

The German physician Friedrich Meyer–Betz performed the first study with what was first called photoradiation therapy (PRT) with porphyrins in humans in 1913. Meyer–Betz tested the effects of haematoporphyrin-PRT on his own skin.^[5]

Thomas Dougherty of Roswell Park Cancer Center, among others worldwide, became a highly visible advocate and educator. Early patients were treated at Roswell, Los Angeles Children's Hospital, Los Angeles County Hospital, and other clinics and Hospitals in the USA and overseas.^[6]

It was John Toth, as product manager for Cooper Medical Devices Corp/Cooper Lasersonics, who acknowledged the "photodynamic chemical effect" of the therapy with early clinical argon dye lasers and wrote the first "white paper" renaming the therapy as "Photodynamic Therapy" (PDT). This was done to support efforts in setting up 10 clinical sites in Japan where the term "radiation" had negative connotations. PDT received even greater interest as result of Thomas Dougherty helping expand clinical trials and forming theInternational Photodynamic Association, in 1986.

Despite excellent results it is only slowly being adopted in the UK as compared to say Italy - in part due to lack of suitable equipment and training.

Mechanism of action

A photosensitizer is a chemical compound that can be excited by light of a specific wavelength. This excitation uses visible or near-infrared light. In photodynamic therapy, either a photosensitizer or the metabolic precursor of one is administered to the patient. The tissue to be treated is exposed to light suitable for exciting the photosensitizer. Usually, the photosensitizer is excited from a groundsinglet state to an excited singlet state. It then undergoes intersystem crossing to a longer-lived excited triplet state. One of the few chemical species present in tissue with a ground triplet state is molecular oxygen. When the photosensitizer and an oxygen molecule are in proximity, an energy transfer can take place that allows the photosensitizer to relax to its ground singlet state, and create an excited singlet state oxygen molecule. Singlet oxygen is a very aggressive chemical species and will very rapidly react with any nearby biomolecules. (The specific targets depend heavily on the photosensitizer chosen.) Ultimately, these destructive reactions will kill cells through apoptosis or necrosis.

This mechanism is identical to the mechanism of the disease erythropoietic protoporphyria, which causes blistering in response to sun exposure due to a genetic defect in the same metabolic pathway.

Example treatment of skin cancer

As an example, consider PDT as a treatment for basal cell carcinoma (BCC). BCC is the most common form of skin cancer in humans. Conventional treatment of BCC involves surgical excision, cryogenic treatment with liquid nitrogen, or localized chemotherapy with 5-fluorouracil or other agents.

A PDT treatment would involve the following steps.

• A photosensitizer precursor (aminolevulinic acid (ALA) or methyl aminolevulinate (MAL) or levulinic acid (LA)) is applied.
• A waiting period of a few hours is allowed to elapse, during which time
  
  • ALA will be taken up by cells, and
  • ALA will be converted by the cells to protoporphyrin IX, a photosensitizer (see Porphyrin).
• The physician shines a bright red light (from an array of light-emitting diodes or a diode laser) on the area to be treated. The light exposure lasts a few minutes to a few tens of minutes.
  
  • Protoporphyrin IX absorbs light, exciting it to an excited singlet state;
  • Intersystem crossing occurs, resulting in excited triplet protoporphyrin IX;
  • Energy is transferred from triplet protoporphyrin IX to triplet oxygen, resulting in singlet (ground state) protoporphyrin IX and excited singlet oxygen;
  • Singlet oxygen reacts with biomolecules, fatally damaging some cells in the treatment area.
• Within a few days, the exposed skin and carcinoma will scab over and flake away.
• In a few weeks, the treated area has healed, leaving healthy skin behind. For extensive malignancies, repeat treatments may be required. It is also common to experience pain from the area treated.
• After the treatment the patient will need to avoid excessive exposure to sunlight for a period of time.

Advantages and limitations

Unlike chemotherapy for cancer the effect of PDT can be localised. Specificity of treatment is achieved in three ways.

• First, light is delivered only to tissues that a physician wishes to treat. In the absence of light, there is no activation of the photosensitizer and no cell killing.
• Second, photosensitizers may be administered in ways that restrict their mobility.
• Finally, photosensitizers may be chosen which are selectively absorbed at a greater rate by targeted cells. ALA is taken up much more rapidly by metabolically active cells. Since malignant cells tend to be growing and dividing much more quickly than healthy cells, the ALA targets the unhealthy cells.

PDT can be much cheaper than the alternative radiotherapy or surgical operation and after care. Post operative recovery is typically hours or days rather than weeks.

A major limitation of PDT is that the light needed to activate most photosensitizers can not penetrate through more than one third of an inch (1 cm) of tissue using standard laser technology and low powered LED technology. Laser application of PDT is generally limited to the treatment of tumours on or under the skin, or on the lining of some internal organs. Moreover it is less effective in treatment of large tumours and metastasis for the same reason. However, new high-powered LED technology has been lab-tested to provide a depth of 2 inches from surface in a simulated breast tissue. Also, hollow needles have been used by some units to get the light into deeper tissues.^[7]

Photosensitizers

A wide array of photosensitizers for PDT exist. They can be divided into porphyrins, chlorophylls and dyes.^[8] Some examples includeaminolevulinic acid (ALA), Silicon Phthalocyanine Pc 4, m-tetrahydroxyphenylchlorin (mTHPC), and mono-L-aspartyl chlorin e6 (NPe6).

Several photosensitizers are commercially available for clinical use, such as Photofrin, Visudyne, Levulan, Foscan, Metvix, Hexvix®,Cysview™, and Laserphyrin, with others in development, e.g. Antrin, Photochlor, Photosens, Photrex, Lumacan, Cevira, Visonac, BF-200 ALA.^[8][9] Amphinex.^[10] Also Azadipyrromethenes.

Although these photosensitizers can be used for wildly different treatments, they all aim to achieve certain characteristics^[11]:

• High absorption at long wavelengths
  
  • Tissue is much more transparent at longer wavelengths (~700-850 nm). Absorbing at longer wavelengths would allow the light to penetrate deeper,^[10] and allow the treatment of larger tumors.
• High singlet oxygen quantum yield
• Low photobleaching
• Natural fluorescence
  
  • Many optical dosimetry techniques, such as fluorescence spectroscopy, depend on the drug being naturally fluorescent^[12]
• High chemical stability
• Low dark toxicity
  
  • The photosensitizer should not be harmful to the target tissue until the treatment beam is applied.
• Preferential uptake in target tissue

The major difference between different types of photosensitizers is in the parts of the cell that they target. Unlike in radiation therapy, where damage is done by targeting cell DNA, most photosensitizers target other cell structures. For example, mTHPC has been shown to localize in the nuclear envelope and do its damage there.^[13] In contrast, ALA has been found to localize in the mitochondria^[14] andMethylene Blue in the lysosomes.^[15]

Targeted PDT

Some photosensitisers naturally accumulate in the endothelial cells of vascular tissue allowing 'vascular targeted' PDT, but there is also research to target the photosensitiser to the tumour (usually by linking it to antibodies or antibody fragments). It is currently only in pre-clinical studies.^[16][17] Some photosensitizers in development are linked to antibodies to target them at the tumour cells.

Other research

To allow treatment of deeper tumours some researchers are using internal chemiluminescence to activate the photosensitiser.^[18]

PDT is currently in clinical trials to be used as a treatment for severe acne. Initial results show have shown for it to be effective as a treatment only for severe acne,^[19] though some question whether it is better than existing acne treatments. The treatment causes severe redness and moderate to severe pain and burning sensation. (see also: Levulan)

See also

• Photomedicine
• Sonodynamic therapy
• Blood irradiation therapy

References

1. ^ http://www.clinuvel.com/skin-conditions/photodynamic-therapy-pdt-and-phototoxicity
2. ^ http://clinicaltrials.gov/ct2/show/NCT00706433?term=photodynamic+therapy+acne&rank=1
3. ^ Inglis, Leslie (June 23, 2005). "Acne sufferer finally sees the light; Early treatment can reduce scarring".
4. ^ "Laser therapy combo effectively clears acne, reduces oil production". The Times Of India.
5. ^ Meyer-Betz, Friedrich (1913). "Untersuchungen uber die Biologische (photodynamische) Wirkung des hamatoporphyrins und anderer Derivative des Blut-und Gallenfarbstoffs.". Dtsch. Arch. Klin. Med. 112: 476–503.
6. ^ Moan, J.; Q. Peng (2003). "An outline of the history of PDT". In Thierry Patrice. Photodynamic Therapy. Comprehensive Series in Photochemistry and Photobiology. 2. The Royal Society of Chemistry. pp. 1–18. doi:10.1039/9781847551658.
7. ^ "A Phase 3 Study of Talaporfin Sodium and Interstitial Light Emitting Diodes Treating Hepatocellular Carcinoma (HCC)".ClinicalTrials.gov. Retrieved October 4, 2008.
8. ^ ^a b Allison, Ron R; et al. (2004). "Photosensitizers in clinical PDT" (PDF). Photodiagnosis and Photodynamic Therapy (Elsevier) 1: 27–42. doi:10.1016/S1572-1000(04)00007-9.
9. ^ http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1317568/ "A Review of Progress in Clinical Photodynamic Therapy" 2005
10. ^ ^a b O'Connor, Aisling E, Gallagher, William M, Byrne, Annette T (2009). "Porphyrin and Nonporphyrin Photosensitizers in Oncology: Preclinical and Clinical Advances in Photodynamic Therapy. Photochemistry and Photobiology, Sep/Oct 2009". Photochemistry and Photobiology.
11. ^ Wilson, Brian C; Michael S Patterson (2008). "The physics, biophysics, and technology of photodynamic therapy". Physics in Medicine and Biology 53 (9): R61–R109. doi:10.1088/0031-9155/53/9/R01. PMID 18401068.
12. ^ Lee, Tammy K; Elma D Baron, Thomas H Foster (2008). "Monitoring Pc4 photodynamic therapy in clinical trials of cutaneous T-cell lymphoma using noninvasive spectroscopy". Journal of Biomedical Optics 13 (3): 030507. doi:10.1117/1.2939068. PMC 2527126.PMID 18601524.
13. ^ Foster, TH; BD Pearson, S Mitra, CE Bigelow (2005). "Fluorescence anisotropy imaging reveals localization of meso-tetrahydroxyphenyl chlorin in the nuclear envelope.". Photochemistry and Photobiology 81 (6): 1544–1547. doi:10.1562/2005-08-11-RN-646.PMID 16178663.
14. ^ Wilson, JD; CE Bigelow, DJ Calkins, TH Foster (2005). "Light scattering from intact cells reports oxidative-stress-induced mitochondrial swelling.". Biophysical Journal (Biophysical Society) 88 (4): 2929–2938. doi:10.1529/biophysj.104.054528. PMC 1305387.PMID 15653724.
15. ^ Mellish, Kirste; Russell Cox, David Vernon, John Griffiths, Stanley Brown (2002). "In Vitro Photodynamic Activity of a Series of Methylene Blue Analogues". Photochemistry and Photobiology (American Society for Photobiology) 75 (4): 392–397. doi:10.1562/0031-8655.PMID 12003129.
16. ^ http://cat.inist.fr/?aModele=afficheN&cpsidt=18046718 "Synthesis, characterization and preclinical studies of two-photon- activated targeted PDT therapeutic triads" 2006
17. ^ http://www.ncbi.nlm.nih.gov/pubmed/15249365 "Selective photodynamic therapy by targeted verteporfin delivery to experimental choroidal neovascularization mediated by a homing peptide to vascular endothelial growth factor receptor-2." July 2004
18. ^ http://www.nature.com/bjc/journal/v95/n2/full/6603241a.html "Intracellular chemiluminescence activates targeted photodynamic destruction of leukaemic cells" 2006
19. ^ http://clinicaltrials.gov/ct2/show/NCT00706433?term=photodynamic+therapy&cond=acne&rank=1

External links

• Photochemical and Photobiological Sciences
• 'TV Cancer treatment' - Article on physics.org, February 2009