• Journal of Gastric Cancer
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• v.20 no.3
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• pp.290-299
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• 2020

Purpose: Recently, totally laparoscopic gastrectomy has been gradually accepted by surgeons worldwide for gastric cancer treatment. Complete dissection of the lymph nodes and the establishment of the surgical margin are the most important considerations for curative gastric cancer surgery. Previous studies have demonstrated that indocyanine green (ICG)-traced laparoscopic gastrectomy significantly improves the completeness of lymph node dissection. However, it remains difficult to identify the tumor location intraoperatively for gastric cancers that are staged ≤T3. Here, we investigated the feasibility of ICG fluorescence for lymph node mapping and tumor localization during totally laparoscopic distal gastrectomy. Materials and Methods: Preoperative and perioperative data from consecutive patients with gastric cancer who underwent a totally laparoscopic distal gastrectomy were collected and analyzed. The patients were categorized into the ICG (n=61) or the non-ICG (n=75) group based on whether preoperative endoscopic mucosal ICG injection was performed. Results: The ICG group had a shorter operation time and less intraoperative blood loss. Moreover, significantly more lymph nodes were harvested in the ICG group than the non-ICG group. No pathologically positive margin was found and there was no significant difference in either the proximal or distal surgical margins between the 2 groups. Conclusions: Near-infrared fluorescence imaging with ICG can be successfully used in totally laparoscopic distal gastrectomy, and it contributes to both the completeness of D2 lymph node dissection and confirmation of the gastric transection line. Well-designed prospective randomized studies are needed in the future to fully validate our findings.

• Archives of Pharmacal Research
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• v.21 no.4
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• pp.411-417
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• 1998

In order to investigate the effect of the pretreatment with various doses of diltiazem (DTZ) on the pharmacokinetics of indocyanine green (ICG) at steady state, especially the hepatic blood clearance due to the change of hepatic blood flow, the following experiments were carried out with ICG, a hepatic function test marker, not metabolized in liver and only excreted in bile. The intravenous bolus injection ($3,780\mu\textrm{g}$/kg) and the constant-rate infusion ($10,100\mu\textrm{g}$/kg/hr) of ICG into the left femoral vein were made in order to check the steady-state plasma concentration ($C_{ss} of $10\mu\textrm{g}$/ml) of ICG at 20, 25 and 30 min. Following a 90-min washout period, the intravenous bolus injection (108, 430, 860 and $1,720\mu\textrm{g}$/kg) and the constant-rate infusion (108, 433, 866 and $1,730\mu\textrm{g}$/kg/hr) of DTZ into the right femoral vein were made and the achievement of the steady-state plasma levels ($C_{ss} of 50, 200, 400 and 800 ng/ml) of DTZ were conformed at 60, 70 and 80 min. During the steady state of DTZ, the intravenous bolus injection ($3,780\mu\textrm{g}$/kg) and the constant-rate infusion ($10,200\mu\textrm{g}$/kg/hr) of ICG into the left femoral vein were made and also the steady-state plasma concentration of ICG was checked at 20, 25 and 30 min. The plasma concentrations of DTZ and ICG were determined using a high performance liquid chromatographic technique. At the steady state, the hepatic blood clearance of ICG was obtained from the plasma concentration and blood-to-plasma concentration ratio ($R_B$) of ICG. The pretreatment with various doses of DTZ did not influence the plasma concentrations, $R_B$ and plasma free fraction ($f_p$) of ICG. So the hepatic blood clearance of ICG was independent of concentration of DTZ. The hepatic blood clearance of ICG could be affected by both hepatic bood flow and hepatic intrinsic clearance. But there was no change of the hepatic blood clearance of ICG between the control and the DTZ-pretreated rats in this study. So it may be suggested that DTZ does not influence hepatic blood flow.

• Archives of Pharmacal Research
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• v.28 no.1
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• pp.115-119
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• 2005

The clearance of ICG, a known hepatic blood flow marker was investigated in rats in order to examine whether DDB-S influences hepatic blood flow. The effect of DDB-S on the protein binding and blood-to-plasma partition of ICG was measured. The steady-state plasma concentration of ICG was monitored before and after co-administration of various concentration of DDB-S, and ICG clearance was estimated from the steady-state concentration and the infusion rate of ICG. There was no significant difference in protein binding and blood-to-plasma partition of ICG with and without addition of DDB-S (10, 20, and 40 ${\mu}g/mL)$. When ICG was infused into DDB-S pretreated rats, the steady-state concentrations of ICG decreased and the calculated ICG clearance increased. However, no dose-dependency of ICG Css on DDB-S Css was observed. Since DDB-S did not affect the protein binding and blood-to-plasma partition of ICG, the increased clearance of ICG with co-administration of DDB-S seems to be due to the increased hepatic blood flow by DDB-S.

• Journal of Biomedical Engineering Research
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• v.36 no.1
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• pp.16-21
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• 2015

Indocyanine green(ICG) and 5-aminolevulinic acid(5-ALA) have been widely used to mark blood vessels or tumors. However, fluorescent dye detection systems were designed to use one type of dyes only. In this study, we proposed a detection system capable of detecting Indocyanine green and 5-aminolevulinic acid. Multiple filters and light sources are integrated into a single system. In this study, we performed analysis of fluorescent dyes and configured a detection system. During the analysis, it was found that Indocyanine green and 5-aminolevulinic acid have the maximum intensity at $40{\mu}M$. We designed light source for fluorescent dyes and conducted compatibility test using a commercial surgical microscope. The fluorescent dye detection system was configured based on the experimental results. The developed system successfully detects Indocyanine green and 5-aminolevulinic acid. Therefore, more efficient surgical operations can be achieved using both fluorescent dyes at the same time. We expect that the developed system can increase the survival rate of patients.

• Journal of Pharmaceutical Investigation
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• v.22 no.1
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• pp.11-21
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• 1992

The effects of colchicine on the plasma elimination and biliary excretion of various organic anions in rats were examined. Elimination of indocyanine green (ICG) or rose bengal (RB) from plasma was significantly delayed when rats were treated with colchicine (3 mg/kg body weight) 3 hr prior to the administration of the dye. On the other hand, disappearance of sulfobromophthalein (BSP) or bromophenol blue (BPB) from plasma was not influenced by colchicine. The plasma disappearance and biliary excretion of organic anions were kinetically analyzed based on a compartment model, in which the deep compartment and the unknown disposition are incorporated. The transfer rate constants of ICG or RB, $k_{23}$ (from the liver to the deep compartment) and $k_{3B}$ (from the deep compartment to the bile), were decreased by colchicine, but those of BSP or BPB were not changed. A mechanism for the decrease in the $k_{23}$ and $k_{3B}$ values for ICG and RB might be explained by a inhibition of colchicine to the intracellular cytoskeleton. The hepatocellular distribution of RB or BPB was then determined. BPB mainly distributed to the cytosolic fraction, but RB distributed to each hepatocyte organelle. Taken together. it was suggested that ICG or RB is transported through hepatocytes into bile with the aid of the cytoskeleton, whereas BSP or BPB is handled by hepatocytes in a different way.

• Journal of Biomedical Engineering Research
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• v.42 no.3
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• pp.116-124
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• 2021

It is important to differentiate between the target tissue (or organ) and the rest of the tissue before incision during surgery. And when it is necessary to preserve the differentiated tissues, the blood vessels connected to the tissue must be preserved together. Various non-invasive medical imaging methods have been developed for this purpose. We aimed to develop a medical imaging system that can simultaneously apply fluorescence imaging using indocyanine green (ICG) and laser speckle contrast imaging (LSCI) using laser speckle patterns. We designed to collect images directed to the two cameras on a co-axial optical path and to compensate equal optical path length for two optical designs. The light source used for fluorescence and LSCI the same 785 nm wavelength. This system outputs real-time images and is designed to intuitively distinguish target tissues or blood vessels. This system outputs LSCI images up to 37 fps through parallel processing. Fluorescence for ICG and blood flow in animal models were observed throughout the experiment.

• Korean Journal of Optics and Photonics
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• v.26 no.1
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• pp.23-29
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• 2015

In this paper, we propose a microscope system for detecting both a tumor and blood vessels in brain tumor surgery as fluorescence images by using multiple light sources and a beam-splitter module. The proposed method displays fluorescent images of the tumor and blood vessels on the same display device and also provides accurate information about them to the operator. To acquire a fluorescence image, we utilized 5-ALA (5-aminolevulinic acid) for the tumor and ICG (Indocyanine green) for blood vessels, and we used a beam-splitter module combined with a microscope for simultaneous detection of both. The beam-splitter module showed the best performance at 600 nm for 5-ALA and above 800 nm for ICG. The beam-splitter is flexible to enable diverse objective setups and designed to mount a filter easily, so beam-splitter and filter can be changed as needed, and other fluorescent dyes besides 5-ALA and ICG are available. The fluorescent images of the tumor and the blood vessels can be displayed on the same monitor through the beam-splitter module with a CCD camera. For ICG, a CCD that can detect the near-infrared region is needed. This system provides the acquired fluorescent image to an operator in real time, matching it to the original image through a similarity transform.

• Medical Lasers
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• v.10 no.3
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• pp.123-131
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• 2021

Optical imaging modalities with properties of real-time, non-invasive, in vivo, and high resolution for image-guided surgery have been widely studied. In this review, we introduce two optical imaging systems, that could be the core of image-guided surgery and introduce the system configuration, implementation, and operation methods. First, we introduce the optical coherence tomography (OCT) system implemented by our research group. This system is implemented based on a swept-source, and the system has an axial resolution of 11 ㎛ and a lateral resolution of 22 ㎛. Second, we introduce a fluorescence imaging system. The fluorescence imaging system was implemented based on the absorption and fluorescence wavelength of indocyanine green (ICG), with a light-emitting diode (LED) light source. To confirm the performance of the two imaging systems, human malignant melanoma cells were injected into BALB/c nude mice to create a xenograft model and using this, OCT images of cancer and pathological slide images were compared. In addition, in a mouse model, an intravenous injection of indocyanine green was used with a fluorescence imaging system to detect real-time images moving along blood vessels and to detect sentinel lymph nodes, which could be very important for cancer staging. Finally, polarization-sensitive OCT to find the boundaries of cancer in real-time and real-time image-guided surgery using a developed contrast agent and fluorescence imaging system were introduced.

• Journal of Dental Rehabilitation and Applied Science
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• v.40 no.2
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• pp.55-63
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• 2024

Purpose: This study aimed to assess the antimicrobial efficacy of an 810-nm infrared diode laser with indocyanine green (ICG) against Staphylococcus aureus on sandblasted, large grit, and acid-etched (SLA) titanium surfaces, comparing its effectiveness with alternative chemical decontamination modalities. Materials and Methods: Biofilms of S. aureus ATCC 25923 were cultured on SLA titanium disks for 48 hours. The biofilms were divided into five treatment groups: control, chlorhexidine gluconate (CHX), tetracycline (TC), ICG, and 810-nm infrared diode laser with ICG (ICG-PDT). After treatment, colony-forming units were quantified to assess surviving bacteria, and viability was confirmed through confocal laser-scanning microscope (CLSM) imaging. Results: All treated groups exhibited a statistically significant reduction in S. aureus (P < 0.05), with notable efficacy in the CHX, TC, and ICG-PDT groups (P < 0.01). While no statistical difference was observed between TC and CHX, the ICG-PDT group demonstrated superior bacterial reduction. CLSM images revealed a higher proportion of dead bacteria stained in red within the ICG-PDT groups. Conclusion: Within the limitations, ICG-PDT effectively reduced S. aureus biofilms on SLA titanium surfaces. Further investigations into alternative decontamination methods and the clinical impact of ICG-PDT on peri-implant diseases are warranted.

• Archives of Plastic Surgery
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• v.45 no.2
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• pp.152-157
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• 2018

Background Intraoperative indocyanine green (ICG) lymphography can effectively detect functioning lymph vessels in edematous limbs. However, it is sometimes difficult to clearly identify their course in later-stage edematous limbs. For this reason, many surgeons rely on experience when they decide where to make the skin incision to locate the lymphatic vessels. The purpose of this study was to elucidate lymphatic vessel flow patterns in healthy upper extremities in a Korean population and to use these findings as a reference for lymphedema treatment. Methods ICG fluorescence lymphography was performed by injecting 1 mL of ICG into the second web space of the hand. After 4 hours, fluorescence images of lymphatic vessels were obtained with a near-infrared camera, and the lymphatic vessels were marked. Three landmarks were designated: the radial styloid process, the mid-portion of the cubital fossa, and the lower border of the deltopectoral groove. A straight line connecting the points was drawn, and the distance between the connected lines and the marked lymphatic vessels was measured at 8 points. Results There were 30 healthy upper extremities (15 right and 15 left). The average course of the main lymph vessels passed $26.0{\pm}11.6mm$ dorsal to the styloid process, $5.7{\pm}40.7mm$ medial to the mid-cubital fossa, and $31.3{\pm}26.1mm$ medial to the three-quarters point of the upper landmark line. Conclusions The main functioning lymphatic vessel follows the course of the cephalic vein at the forearm level, crosses the mid-cubital point, and travels medially toward the mid-axilla.