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This thesis scrutinizes CLE technology for its ability to provide real-time intraoperative in vivo and ex vivo visualization of histopathological features of the normal and tumor brain tissues. First, the optimal settings for CLE imaging are studied in an animal model along with a generational comparison of CLE performance. Second, the ability of CLE to discriminate uninjured normal brain, injured normal brain and tumor tissues is demonstrated. Third, CLE was used to investigate cerebral microvasculature and blood flow in normal and pathological conditions. Fourth, the feasibility of CLE for providing optical biopsies of brain tumors was established during the fluorescence-guided neurosurgical procedures. This study established the optimal workflow and confirmed the high specificity of the CLE optical biopsies. Fifth, the feasibility of CLE was established for endoscopic endonasal approaches and interrogation of pituitary tumor tissue. Finally, improved and prolonged near wide-field fluorescent visualization of brain tumor margins was demonstrated with a scanning fiber endoscopy and 5-aminolevulinic acid.
These studies suggested a novel paradigm for neurosurgery-pathology workflow when the noninvasive intraoperative optical biopsies are used to interrogate the tissue and augment intraoperative decision making. Such optical biopsies could shorten the time for obtaining preliminary information on the histological composition of the tissue of interest and may lead to improved diagnostics and tumor resection. This work establishes a basis for future in vivo optical biopsy use in neurosurgery and planning of patient-related outcome studies. Future studies would lead to refinement and development of new confocal scanning technologies making noninvasive optical biopsy faster, convenient and more accurate.
Through my personal travels and peer interviews, I have found that this project gave me the opportunity to expand my knowledge on different cultures and regions of the North America and explore how local foods contribute to the cultures in that setting. Additionally, this thesis helped me self-teach myself how to develop a fully published website and practice my web design skills.
Alginate microspheres have recently become increasingly popular in the realm of drug delivery for their biocompatibility, nontoxicity, inexpensiveness, among other factors. Recent strict regulations on microsphere size have drastically increased manufacturing cost and waste, even though the effect of size variance on drug delivery and subsequent performance is unclear. If sphere size variance does not significantly affect drug release profiles, it is possible that future ordinances may loosen tolerances in manufacturing to limit waste produced and expenditures. We use a mathematical model developed by Nickel et al. [12], to theoretically predict drug delivery profiles based on sphere size, and correlate the expected release with experimental data. This model considers diffusion as the key component for drug delivery, which is defined by Fick’s Laws of Diffusion. Alginate, chosen for its simple fabrication method and biocompatibility, was formed into microspheres with a modified extrusion technique and characterized by size. Size variance was introduced in batches and delivery patterns were compared to control groups of identical size. Release patterns for brilliant blue dye, the mock drug chosen, were examined for both groups via UV spectrometry. The absorbance values were then converted to concentration value using a calibration curve done prior to experimentation. The concentration values were then converted to mass values. These values then produced curves representing the mass of the drug released over time. Although the control and experimental values were statistically significantly different, the curves were rather similar to each other. However, when compared to the predicted release pattern, the curves were not the same. Unexpected degradation caused this dissimilarity between the curves. The predictive model was then adjusted to account for degradation by changing the diffusion coefficient in the code to a reciprocal first order exponent. The similarity between the control and experimental curves can insinuate the notion that size tolerances for microsphere production can be somewhat lenient, as a batch containing fifteen beads of the same size and one with three different sizes yields similar release patterns.