First-line Therapeutic Modality Research Articles

Endoscopic Hemostasis of Upper Gastrointestinal Bleeding with Histoacryl: Last Resort Before Surgery

Five patients presented with acute upper gastrointestinal bleeding, underwent diagnostic and therapeutic endoscopy. The source of bleeding was identified in each case. Two patients had a large chronic gastric ulcer, one had a stress ulcer, one had a gastric ulcer with hypertrophic gastropathy, and one had a malignant infiltration of the second part of the duodenum. Conventional first-line therapeutic modalities failed to induce hemostasis in these bleeding lesions. Hemostasis was successfully achieved in each case using an endoscopic intralesional injection of Histoacryl. This agent may represent a last resort for endoscopic hemostasis before surgery.

Clinical Applications of Photodynamic Therapy: A Review

In the past two decades, almost a complete revolution has occurred in the management of life-threatening pathologies. Newer and more effective therapeutic regimens have evolved in response to a better understanding of some disease phenomena. Photodynamic therapy (PDT) is one such modality which, due to highly target-specific action, is finding extensive application as a diagnostic and therapeutic tool. The phenomenon has been extremely effective in the complete destruction of a number of bacterial strains and viruses in vitro. However, the most pronounced effect of PDT has been on various classes of tumor cells. Certain photosensitizers bind specifically to tumor cell membranes and, upon exposure to light, can completely destroy the neoplastic cells. Results have been so encouraging that PDT is being used in clinical trials to eliminate malignant cells from bone marrow samples and blood products. The purpose of this communication is to present a brief historical background of photodynamic therapy and to review the applications and potential implications of PDT as a first-line therapeutic modality.