tailieunhanh - Laser Fluorescence Spectroscopy with 5-Aminolevulinic Acid in Operative Gynecology

The speculum should be carefully positioned so the entire cervix is seen. If excess mucus or other secretions obscure the cervix, they should be gently removed using a proctoswab without disturbing the epithelium. Small amounts of blood will not interfere with cytologic evaluation, but large amounts, as occurs during menses, preclude cytologic interpretation by conventional Pap smear. This is considerably less of a problem when liquid based cytology is used. Gross abnormalities of the cervical epithelium (especially friability, plaque-like or cauliflower lesions, or significant ulceration) should prompt referral for colposcopy, regardless of cytology results, because cytology may be unreliable in the setting of carcinoma. Nabothian cysts (Figure 1-5). | Laser Physics Vol. 14 No. 9 2004 pp. 1207-1213. Original Text Copyright 2004 by Astro Ltd. English Translation Copyright 2004 by MAỈK Naukallnterperiodica Russia . BIOPHOTONICS Laser Fluorescence Spectroscopy with 5-Aminolevulinic Acid in Operative Gynecology L. A. Belyaeva1 2 L. V. Adamyan1 A. A. Stepanyan1 K. G. Linkov2 and V. B. Loshchenov2 1 Department of Reproductive Medicine and Surgery Faculty of Postgraduate Education Moscow State University of Medicine and Dentistry Moscow Russia 2 Natural Sciences Center Prokhorov General Physics Institute Russian Academy of Sciences ul. Vavilova 38 Moscow 119991 Russia e-mail l_b@ Received September 10 2003 Abstract A method for the fluorescence intraoperative diagnostics of gynecological diseases using a laserfiber spectrum analyzer and Alasens-induced protoporphyrin IX PP IX is developed and the efficiency of the method is estimated. In the spectroscopic study the fluorescence of PP IX is excited using laser radiation with a wavelength of 633 nm and is measured during laparoscopy laparotomy hysteroscopy physition examination and ex vivo in 75 patients with genital endometriosis and various pathologies of the ovary vulva and cervix and body of the uterus. The spectroscopic results are compared to histological diagnosis. The data obtained show laser fluorescence spectroscopy using Alasens to be very effect in differential diagnostics of ovary diseases cervical and vulvar cancer and metastases. Additional study is needed to estimate the applicability of the method under consideration for intraoperative diagnostics of active peritoneal endometriosis. A target biopsy of visually intact fragments can be realized with the aid of fluorescence diagnostics based on laser fluorescence spectroscopy of the Alasens-induced PP IX in organs and tissues. High accumulation of PP IX in normal and pathological endometrium impedes application of the fluorescence method for purposes of differential diagnostics but opens up prospects .