RESUMO
OBJECTIVE: The objective of this study was to develop a murine system for the delivery of laser interstitial thermotherapy (LITT) with probe-based thermometry as a model for human glioblastoma treatment to investigate thermal diffusion in heterogeneous brain tissue. METHODS: First, the tissue heating properties were characterized using a diode-pumped solid-state near-infrared laser in a homogeneous tissue model. The laser was adapted for use with a repurposed stereotactic surgery frame utilizing a micro laser probe and Hamilton syringe. The authors designed and manufactured a stereotactic frame attachment to work as a temperature probe stabilizer. Application of this novel design was used as a precise method for real-time thermometry at known distances from the thermal ablative center mass during murine LITT studies. RESULTS: Temperature measurements were achieved during LITT that verified the direct thermometry capability of the system without the need for MR-based thermal monitoring. Application of multiple stereotactic design iterations led to an accurately reproducible surgical laser ablation procedure. Histological staining confirmed precise thermal ablation and controllable lesion size based on time and temperature control. Treatment of a syngeneic intracranial glioma model highly resistant to conventional therapy resulted in a modest survival benefit. CONCLUSIONS: The authors have successfully developed a murine model system of LITT with direct in situ thermometry for investigation into the effects of thermal ablation and combinatorial treatments in murine brain tumor models.
Assuntos
Neoplasias Encefálicas , Hipertermia Induzida , Terapia a Laser , Animais , Camundongos , Hipertermia Induzida/métodos , Hipertermia Induzida/instrumentação , Neoplasias Encefálicas/cirurgia , Neoplasias Encefálicas/terapia , Terapia a Laser/métodos , Glioblastoma/terapia , Glioblastoma/cirurgia , Técnicas Estereotáxicas , Termometria/métodos , Modelos Animais de Doenças , HumanosRESUMO
The precise measurement of cell temperature and an in-depth understanding of thermogenic processes are critical in unraveling the complexities of cellular metabolism and its implications for health and disease. This review focuses on the mechanisms of local temperature generation within cells and the array of methods developed for accurate temperature assessment. The contact and noncontact techniques are introduced, including infrared thermography, fluorescence thermometry, and other innovative approaches to localized temperature measurement. The role of thermogenesis in cellular metabolism, highlighting the integral function of temperature regulation in cellular processes, environmental adaptation, and the implications of thermogenic dysregulation in diseases such as metabolic disorders and cancer are further discussed. The challenges and limitations in this field are critically analyzed while technological advancements and future directions are proposed to overcome these barriers. This review aims to provide a consolidated resource for current methodologies, stimulate discussion on the limitations and challenges, and inspire future innovations in the study of cellular thermodynamics.
RESUMO
To address the issue of high-dose treatment agents in magnetic hyperthermia-mediated multi-model tumor therapy, a unique iron-based theranostic nanoenzyme with excellent magnetothermal and catalytic properties was constructed. By using a high-temperature arc method, the iron carbon nanoparticles (MF1-3) with a particle size between 13.7 and 27.6 nm and shell thickness between 1 and 5 nm were prepared. After screening, we selected MF3 as the magnetic core due to its high Ms. value and excellent thermal properties. Under the magneto-photo dual thermal conditions, MF3 exhibited a remarkable specific absorption rate (SAR) of 4917 W/g, which was 20 times more than that of iron oxide. Notably, MF3 also exhibited best peroxidase (POD)-like catalytic in pH 5.0 and maintained stable catalytic performance at 45 °C. Considering the "starvation" strategy of cutting off the energy supply to tumor cells and killing them, the glucose oxidase (GOX) and chitosan oligosaccharide (COS) was further grafted onto MF3, forming the MF3/GOX/COS. This multifunctional therapeutic nanoenzyme not only exhibited significant peroxidase-like activity, but also had glucose decomposition and glutathione (GSH) consumption capabilities. The thermal effect significantly promoted the uptake of MF3/GOX/COS by 4T1 cells, and the IC50 value of MF3/GOX/COS reached low to 3.75 µg/mL. In vivo anti-tumor experiment, compared with single treatment methods, the combined therapy of MF3/GOX/COS mediated magneto-photo thermotherapy (M-PTT) and starvation therapy (ST) exhibited higher tumor inhibition rate of 82.1 % by increased cell apoptosis through the mitochondrial pathway. Overall, MF3/GOX/COS therapeutic nanoenzyme combined the advantages of nano-catalysis, M-PTT and ST, providing a solution for achieving sustained, stable, and effective tumor inhibition rates at lower dose levels.
RESUMO
BACKGROUND: One-fourth of men older than 70 years have lower urinary tract symptoms (LUTS) that impair their quality of life. Transurethral resection of the prostate (TURP) is considered the gold standard for surgical treatment of LUTS caused by benign prostatic hyperplasia (BPH) that cannot be managed conservatively or pharmacologically. However, TURP is only an option for patients fit for surgery and can result in complications. Transurethral microwave thermotherapy (TUMT) and prostatic artery embolisation (PAE) are alternative minimally invasive surgical therapies (MISTs) performed in an outpatient setting. Both treatments have shown to reduce LUTS with a similar post-procedure outcome in mean International Prostate Symptom Score (IPSS). It is however still unknown if TUMT and PAE perform equally well as they have never been directly compared in a randomised clinical trial. The objective of this clinical trial is to assess if PAE is non-inferior to TUMT in reducing LUTS secondary to BPH. METHODS: This study is designed as a multicentre, non-inferiority, open-label randomised clinical trial. Patients will be randomised with a 1:1 allocation ratio between treatments. The primary outcome is the IPSS of the two arms after 6 months. The primary outcome will be evaluated using a 95% confidence interval against the predefined non-inferiority margin of + 3 points in IPSS. Secondary objectives include the comparison of patient-reported and functional outcomes at short- and long-term follow-up. We will follow the patients for 5 years to track long-term effect. Assuming a difference in mean IPSS after treatment of 1 point with an SD of 5 and a non-inferiority margin set at the threshold for a clinically non-meaningful difference of + 3 points, the calculated sample size was 100 patients per arm. To compensate for 10% dropout, the study will include 223 patients. DISCUSSION: In this first randomised clinical trial to compare two MISTs, we expect non-inferiority of PAE to TUMT. The most prominent problems with MIST BPH treatments are the unknown long-term effect and the lack of proper selection of candidates for a specific procedure. With analysis of the secondary outcomes, we aspire to contribute to a better understanding of durability and provide knowledge to guide treatment decisions. TRIAL REGISTRATION: ClinicalTrials.gov NCT05686525. Registered on January 17, 2023, https://clinicaltrials.gov/study/NCT05686525 .
Assuntos
Embolização Terapêutica , Estudos de Equivalência como Asunto , Sintomas do Trato Urinário Inferior , Próstata , Hiperplasia Prostática , Humanos , Masculino , Hiperplasia Prostática/complicações , Hiperplasia Prostática/terapia , Embolização Terapêutica/métodos , Embolização Terapêutica/efeitos adversos , Sintomas do Trato Urinário Inferior/etiologia , Sintomas do Trato Urinário Inferior/terapia , Sintomas do Trato Urinário Inferior/diagnóstico , Resultado do Tratamento , Próstata/irrigação sanguínea , Fatores de Tempo , Micro-Ondas/uso terapêutico , Micro-Ondas/efeitos adversos , Ressecção Transuretral da Próstata , Índice de Gravidade de Doença , Hipertermia Induzida/métodos , Qualidade de Vida , Ensaios Clínicos Controlados Aleatórios como Assunto , Estudos Multicêntricos como Assunto , IdosoRESUMO
This bibliometric study analyzes the evolving field of thermotherapy, a medical treatment that utilizes heat to treat various conditions, including cancer, by applying controlled temperatures to targeted tissues. Utilizing bibliographic data from the core collection of Web of Science and analysis software Biblioshiny and VOSviewer, we analyzed several key metrics to gain insights into the development and trends in thermotherapy research. The annual scientific production revealed a significant increase in publications over the past two decades, reflecting growing interest in this field. Analysis of the most relevant authors and sources highlighted key contributors and influential journals. Trend topics demonstrated a shift from early focus areas like hyperthermia and laser-induced thermotherapy to recent advancements involving nanoparticles and combination therapies. The thematic map provided insights into core, emerging, and niche areas within the research landscape. A historiograph traced the chronological development of significant publications, while the co-occurrence of keywords and bibliographic coupling of documents identified major themes and interconnections in the literature. International collaborations were mapped, showing the global nature of thermotherapy research. The study identified several research gaps, including the need for large-scale clinical trials, interdisciplinary approaches, and standardized treatment protocols. Practical implications suggest focusing on targeted delivery systems, expanding cancer research, and fostering collaborative projects to advance the field.
RESUMO
Intelligent wearable textiles have garnered attention and advancement, particularly in the realms of thermotherapy and health monitoring. As a critical component of intelligent wearable textiles, conductive fibers are expected to have long-term stable and durable conductivity. In this work, a highly stretchable and conductive fiber based on tannic acid/polypyrrole was developed. The conductive network was formed by doping TA into PPy, resulting in enhanced stretchability of PPy on the surface of PU. TA also improves the interface interaction between PPy and PU to gain more firm attachment of PPy, which achieves high conductivity (0.89 ± 0.23 S/cm) and durability. Furthermore, the stretchable conductive fiber also exhibited intelligent responses to electricity, light, and deformation. They can serve as heat sources under the action of electricity and light (temperature was raised to 42 °C under 4 V and 54 °C under solar radiation stimuli) and can also monitor the movements of humans, making them potential applications in thermotherapy textiles and intelligent sensing equipment. A PU/TA/PPy-based all-in-one smart wearable system was fabricated using textile molding technology capable of all-weather thermal therapy and motion detection. This fiber fabrication technology and integrated system offer insights for the future development of smart wearable devices.
Assuntos
Condutividade Elétrica , Polímeros , Pirróis , Taninos , Têxteis , Dispositivos Eletrônicos Vestíveis , Taninos/química , Pirróis/química , Polímeros/química , Humanos , Hipertermia Induzida , PolifenóisRESUMO
PURPOSE: To assess the effect of whole-body cryotherapy (WBC) on postmatch recovery in basketball. METHODS: Using a crossover design, 17 youth male players (age 16.2 [1.2] y, stature 190.5 [9.4] cm, body mass 79.2 [9.6] kg, experience 9.9 [3.9] y) completed 2 simulated matches, followed by WBC (4 min, -75 to - 85 °C) or a placebo intervention (CON). Countermovement-jump height, change-of-direction performance, 10- and 20-m sprint times, heart-rate variability (log-transformed squared root of the mean sum of the squared differences between R-R intervals [Ln-rMSSD]), muscle soreness, and perceived recovery (Perceived Recovery Status Scale [PRS]) were recorded at prematch, postmatch, postrecovery, and 24 hours postmatch. Additionally, Ln-rMSSD was recorded upon awakening on match day and the following morning. RESULTS: Compared with CON, higher PRS values were reported in WBC at prematch and postrecovery (P ≤ .026), while no significant between-interventions differences were found for any other measure (P > .05). Regarding the effect of time, our findings revealed that 20-m sprint times, Ln-rMSSD, and PRS deteriorated in both interventions from prematch to postmatch (ie, acute changes, P ≤ .045), while muscle soreness worsened in WBC only (P ≤ .003). Conversely, countermovement-jump height, change-of-direction, and 10-m sprint performance were unaffected by match play in the acute phase (P > .05), while none of the investigated measures showed impairments at 24 hours postmatch, compared with prematch (P > .05). CONCLUSIONS: Overall, these findings suggest that WBC was mostly ineffective for improving postexercise recovery in the investigated sample, with benefits observed for perceived recovery being potentially influenced by the participants' status at baseline (ie, higher prematch PRS scores in WBC compared with CON).
Assuntos
Desempenho Atlético , Basquetebol , Estudos Cross-Over , Crioterapia , Mialgia , Humanos , Crioterapia/métodos , Masculino , Adolescente , Basquetebol/fisiologia , Mialgia/terapia , Desempenho Atlético/fisiologia , Frequência Cardíaca/fisiologiaRESUMO
Microwave thermotherapy (MWTT), as a treatment for tumors, lacks specificity and requires sensitizers. Most reported microwave sensitizers are single metal-organic frameworks (MOFs), which must be loaded with ionic liquids to enhance the performance in MWTT. Meanwhile, MWTT is rarely combined with other treatment modalities. Here, we synthesized a novel Fe-Cu bimetallic organic framework FeCuMOF (FCM) by applying a hydrothermal method and further modified it with methyl polyethylene glycol (mPEG). The obtained FCM@PEG (FCMP) showed remarkable heating performance under low-power microwave irradiation; it also acted as a novel nanospheres enzyme to catalyze H2O2 decomposition, producing abundant reactive oxygen species (ROS) to deplete glutathione (GSH) and prevent ROS clearance from tumor cells during chemodynamic treatment. The FCMP was biodegradable and demonstrated excellent biocompatibility, allowing it to be readily metabolized without causing toxic effects. Finally, it was shown to act as a suitable agent for T2 magnetic resonance imaging (MRI) in vitro and in vivo. This new bimetallic nanostructure could successfully realize two tumor treatment modalities (MWTT and chemodynamic therapy) and dual imaging modes (T2 MRI and microwave thermal imaging). Our findings represent a breakthrough for integrating the diagnosis and treatment of tumors and provides a reference for developing new microwave sensitizers.
RESUMO
The article discusses the experience of complex therapy of rhinitis and sinusitis in children of various age groups, confirming the effectiveness of the combined effects of local thermotherapy, pulsed red light and low-frequency magnetic field. This combination of physical factors has an anti-inflammatory, decongestant, stimulating local cellular activity effect and helps to increase the effectiveness and reduce the overall treatment time for these diseases. The purpose of the study is to evaluate the effectiveness of the combined use of heat, red spectrum phototherapy and magnetic field in the treatment of children with rhinitis and sinusitis. Materials and methods. The observation included 30 children with rhinitis and 40 children with sinusitis aged 2-18 years, receiving combined physiotherapy procedures as part of the main treatment. Results and its discussion. The positive effect of the combined effects of thermotherapy, pulsed light radiation in the red range and low-frequency magnetic field on clinical symptoms and functional indicators of nasal breathing in children with rhinitis and sinusitis has been confirmed. Conclusions. The use of a course of procedures combined with the effects of local thermotherapy, pulsed red light and low-frequency magnetic field against the background of the main treatment helps to increase the effectiveness of the treatment of respiratory infections of the upper respiratory tract in children of various age groups.
Assuntos
Sinusite , Humanos , Criança , Masculino , Feminino , Pré-Escolar , Adolescente , Resultado do Tratamento , Sinusite/terapia , Rinite/terapia , Infecções Respiratórias/terapia , Hipertermia Induzida/métodos , Magnetoterapia/métodos , Terapia CombinadaRESUMO
Objectives: We aim to compare efficacy and safety of water vapour therapy (Rezum), transurethral needle ablation (TUNA) and transurethral microwave therapy (TUMT) for treating men with moderate to severe benign prostatic hyperplasia (BPH) symptoms. Materials: PubMed/MEDLINE, EMBASE and Cochrane Library were searched from inception to 30 July 2023, followed by reference searching and dual-independent study selection. We analysed only randomized clinical trials. RoB-2, NIH-quality assessment tool and GRADE guidelines were used for quality-of-evidence (QoE) assessment. Relevant prospective studies without a critical risk-of-bias were included. Results: At 12 months, Rezum showed similar efficacy to TUNA and TUMT for improvement in International Prostate Symptoms Score - Rezum versus TUMT: 1.33 points (95% CI: -1.66 to 4.35) favouring TUMT (QoE: Moderate) and Rezum versus TUNA: 0.07 points (95% CI: -3.64 to 3.88) favouring TUNA (QoE: Low). Rezum had similar outcomes to TUNA and TUMT for Maximum Peak-Flow Rate (Qmax): Rezum versus TUMT: 1.05 mL/s (95% CI: -4.88 to 2.82) favouring Rezum (QoE: Low) and Rezum versus TUNA: 0.37 mL/s (95% CI: -4.61 to 4.21) favouring TUNA (QoE: Low). Furthermore, post-void residual volume (PVR) comparisons demonstrated that Rezum was similar, or inferior to other techniques at 12 months - Rezum versus TUMT: 11.20 mL (95% CI: -32.40 to 10.30) favouring TUMT (QoE: Low) and Rezum versus TUNA: 24.10 mL (95% CI: 2.81 to 45.10) favouring TUNA (QoE: Low). Rezum also had a similar surgical retreatment rate with TUMT and TUNA up to 3-years - TUMT versus Rezum RR: 1.21 (95% CI: 0.20 to 15.90) (QoE: Low) and TUNA versus Rezum showed RR: 1.81 (95% CI: 0.2 to 24.60) (QoE: Low). In the first 12 months after treatment, Rezum had a higher rate of serious adverse events (Clavien-Dindo ≥ Grade 3) than TUMT and TUNA. TUMT versus Rezum with RR = 0.53 (95% CI: 0.13 to 3.14) (QoE: Low) and TUNA versus Rezum with RR = 0.38 (95% CI: 0.04 to 3.49) (QoE: Low). Conclusions: Moderate to weak evidence suggests that Rezum is not superior to TUNA and TUMT in all domains studied.
RESUMO
Despite the implementation of multimodal treatments after surgery, glioblastoma (GBM) remains an incurable disease, posing a significant challenge in neuro-oncology. In this clinical setting, local therapy (LT), a developing paradigm, has received significant interest over time due to its potential to overcome the drawbacks of conventional therapy options for GBM. The present review aimed to trace the historical development, highlight contemporary advances and provide insights into the future horizons of LT in GBM management. In compliance with the Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols criteria, a systematic review of the literature on the role of LT in GBM management was conducted. A total of 2,467 potentially relevant articles were found and, after removal of duplicates, 2,007 studies were screened by title and abstract (Cohen's κ coefficient=0.92). Overall, it emerged that 15, 10 and 6 clinical studies explored the clinical efficiency of intraoperative local treatment modalities, local radiotherapy and local immunotherapy, respectively. GBM recurrences occur within 2 cm of the radiation field in 80% of cases, emphasizing the significant influence of local factors on recurrence. This highlights the urgent requirement for LT strategies. In total, three primary reasons have thus led to the development of numerous LT solutions in recent decades: i) Intratumoral implants allow the blood-brain barrier to be bypassed, resulting in limited systemic toxicity; ii) LT facilitates bridging therapy between surgery and standard treatments; and iii) given the complexity of GBM, targeting multiple components of the tumor microenvironment through ligands specific to various elements could have a synergistic effect in treatments. Considering the spatial and temporal heterogeneity of GBM, the disease prognosis could be significantly improved by a combination of therapeutic strategies in the era of precision medicine.
RESUMO
Nowadays, the increasing electromagnetic waves generated by wearable devices are becoming an emerging issue for human health, so stretchable electromagnetic interference (EMI) shielding materials are highly demanded. Elephant trunks are capable of grabbing fragile vegetation and tearing trees thanks not only to their muscles but also to their folded skins. Inspired by the wrinkled skin of the elephant trunks, herein, we propose a winkled conductive film based on single-walled carbon nanotubes (SWCNTs) for multifunctional EMI applications. The conductive film has a sandwich structure, which was prepared by coating SWCNTs on both sides of the stretched elastic latex cylindrical substrate. The shrinking-induced winkled conductive network could withstand up to 200% tensile strain. Typically, when the stretching direction is parallel to the polarization direction of the electric field, the total EMI shielding effectiveness could surprisingly increase from 38.4 to 52.7 dB at 200% tensile strain. It is mainly contributed by the increased connection of the SWCNTs. In addition, the film also has good Joule heating performance at several voltages, capable of releasing pains in injured joints. This unique property makes it possible for strain-adjustable multifunctional EMI shielding and wearable thermotherapy applications.
RESUMO
Portal vein tumor thrombus (PVTT) formed by cancer cell invasion is a major cause of high mortality in hepatocellular carcinoma (HCC), and the formation of thrombus will be accelerated by bacterial colonization on the surface of the implant after surgery. In this work, Polypyrrole-coated arsenic-loaded layered double hydroxide films were in situ constructed on the nickel-titanium alloy for the efficient killing of tumour cells by thermo-therapeutic synergistic chemotherapy. The good near-infrared photothermal conversion ability of polypyrrole enables the sample surface temperature to be raised to about 51 °C at a low photothermal power (0.5 w/cm2), while the elevated temperature could further accelerate the release of drug arsenic. In addition, when NIR light is not applied, the polypyrrole coating also cleverly acts as a "barrier layer" to reduce the natural release of arsenic in normal tissues to avoid toxicity issues. In vivo and in vitro experiments have demonstrated that the platform exhibits excellent antitumor and antibacterial abilities. In contrast to the systemic toxicity issues associated with systemic circulation of nanotherapeutic drugs, this in situ functional film is expected to be used in localised interventions for precise drug delivery, and is also more suitable for surgical treatment scenarios in PVTT surgeries.
Assuntos
Antineoplásicos , Arsênio , Hidróxidos , Raios Infravermelhos , Hidróxidos/química , Hidróxidos/farmacologia , Humanos , Camundongos , Antineoplásicos/química , Antineoplásicos/farmacologia , Arsênio/química , Arsênio/farmacologia , Animais , Polímeros/química , Polímeros/farmacologia , Pirróis/química , Pirróis/farmacologia , Ensaios de Seleção de Medicamentos Antitumorais , Antibacterianos/farmacologia , Antibacterianos/química , Liberação Controlada de Fármacos , Propriedades de Superfície , Camundongos Endogâmicos BALB C , Tamanho da Partícula , Proliferação de Células/efeitos dos fármacos , Sobrevivência Celular/efeitos dos fármacos , Testes de Sensibilidade MicrobianaRESUMO
PURPOSE: To review long-term outcomes of circumscribed choroidal hemangioma (CCH). METHODS: Hospital charts of all CCH cases diagnosed from 2008 to 2019 were retrospectively reviewed. RESULTS: All 172 patients were managed with either observation, transpupillary thermotherapy, argon laser photocoagulation, photodynamic therapy, plaque brachytherapy or stereotactic radiosurgery. The most common 3 modes of management were clinical observation (30.2%), transpupillary thermotherapy (52.9%) and argon laser photocoagulation (8.7%). Median follow-up time was 10 months (range: 3, 160). Anatomical outcomes were stable in 87.1% of observation group and improved in 60.5% of thermotherapy group. Quantified optical coherence tomography angiography findings showed statistical differences in vascular and perfusion densities in fellow eyes of hemangioma patients. CONCLUSION: Circumscribed choroidal hemangioma can be treated in various ways. Transpupillary thermotherapy is an anatomically effective treatment in selected cases. The diagnosis of CCH may have vascular implications in fellow eyes of the patients.
Assuntos
Neoplasias da Coroide , Angiofluoresceinografia , Hemangioma , Centros de Atenção Terciária , Tomografia de Coerência Óptica , Acuidade Visual , Humanos , Neoplasias da Coroide/terapia , Neoplasias da Coroide/diagnóstico , Feminino , Masculino , Estudos Retrospectivos , Pessoa de Meia-Idade , Tomografia de Coerência Óptica/métodos , Angiofluoresceinografia/métodos , Adulto , Centros de Atenção Terciária/estatística & dados numéricos , Hemangioma/terapia , Hemangioma/diagnóstico , Idoso , Seguimentos , Fotoquimioterapia/métodos , Hipertermia Induzida/métodos , Fundo de Olho , Adulto Jovem , Corioide/patologia , Corioide/irrigação sanguíneaRESUMO
OBJECTIVES: A fast, simple, versatile, and reliable method to record light emission intensity profiles of cylindrical light diffusers (CDFs) in air and transparent liquids has been developed. METHODS: A fluorescent color glass filter (RG695) converts red light emitted by a cylindrical diffuser fiber into near-infrared light in an emission angle-independent manner. The red light was provided from a diode laser system at 635 nm. Near-infrared fluorescence from the RG695 was imaged with a camera. Images from this camera were processed to obtain emission intensity profiles. Cylindrical diffuser fiber profiles of four different manufacturers were compared. RESULTS: The proposed method provides angle-independent intensity profiles of cylindrical diffuser fibers with a single camera shot. It could be demonstrated that dependent on the underlying principle of how the diffuser fiber tips emit light, the emission profile can change significantly in media with different refractive indices. CONCLUSIONS: By converting the light emitted by a diffuser fiber tip into fluorescence light one can eliminate the dependence of the recorded profile on the emission angle from the diffusor. This approach allows for easily taking into account refraction-index (mis)matching by placing the equipment into a suitable liquid. The proposed measurement principle bears potential for quality assurance measurements of CDFs used for interstitial laser thermotherapy or photodynamic therapy.
Assuntos
Desenho de Equipamento , Lasers Semicondutores/uso terapêutico , Fluorescência , Fibras Ópticas , Tecnologia de Fibra Óptica/instrumentaçãoRESUMO
PURPOSE: To investigate the swept-source optical coherence tomography (SS-OCT) and SS-OCT angiography (SS-OCTA) findings in circumscribed choroidal hemangioma (CCH) before and after treatment with transpupillary thermotherapy (TTT). METHODS: The clinical records of 21 eyes having CCH imaged with SS-OCT/SS-OCTA between September 2018 and December 2022 were evaluated. RESULTS: SS-OCT examination in CCH showed dome-shaped appearance (100%), choroidal shadowing (100%), expansion of choroidal structures (100%), subretinal fluid (66.7%), intraretinal edema/schisis (33.3%), retinal pigment epithelium (RPE) atrophy (19.0%), hyperreflective dots (19.0%), and epiretinal membrane (4.8%). Internal arborizing tumor vessels showing hyperreflectivity were observed in the choriocapillaris slab on SS-OCTA in all eyes. In the deep capillary plexus (DCP), flow void changes were seen in 7 eyes with intraretinal schisis/cystoid macular edema. Four CCHs > 2 mm in thickness showed outer retinal involvement due to unmasking of flow in intratumoral vessels related to RPE atrophy. Following TTT/indocyanine green-enhanced TTT (ICG-TTT) of CCH, SS-OCT findings included total/partial resolution of subretinal fluid (57.1%), complete/partial regression of the tumor (52.4%), and RPE atrophy (33.3%). After treatment; loss of choriocapillaris, decrease in tumor vascularity together with increase in the fibrous component and flow void areas were detected on SS-OCTA. CONCLUSIONS: SS-OCT/SS-OCTA are useful non-invasive tools for imaging the structural/vascular changes in CCHs managed with TTT or ICG-TTT. On SS-OCTA, hyporeflective spaces localizing to edema/schisis in the DCP and arborizing tumor vessels within a hyporeflective stromal background in the choriocapillaris slab were observed. After TTT/ICG-TTT, a decrease in tumor vessels and an increase in the fibrous component and flow-void areas inside the CCH were detected on SS-OCTA.
Assuntos
Neoplasias da Coroide , Hemangioma , Hipertermia Induzida , Tomografia de Coerência Óptica , Humanos , Tomografia de Coerência Óptica/métodos , Neoplasias da Coroide/terapia , Neoplasias da Coroide/diagnóstico por imagem , Neoplasias da Coroide/patologia , Feminino , Pessoa de Meia-Idade , Masculino , Hemangioma/terapia , Hemangioma/diagnóstico por imagem , Hemangioma/patologia , Adulto , Hipertermia Induzida/métodos , Idoso , Angiofluoresceinografia/métodos , Estudos Retrospectivos , Corioide/diagnóstico por imagem , Corioide/irrigação sanguínea , Corioide/patologiaRESUMO
Although the moderate thermal stimulation of articular cartilage exerts chondroprotective effects, it is difficult to effectively heat deep articular cartilage with conventional methods. Photosensitizers increase the ambient temperature using near-infrared (NIR) radiation, which has high tissue permeability. We hypothesized that the intra-articular administration of photosensitizers and NIR irradiation would exert a greater heating effect on articular cartilage. We aimed to evaluate the heating effect of this method on cultured chondrocytes and rat knee cartilage. In vitro, we irradiated a photosensitizer-containing medium with NIR and measured changes in the medium temperature, cytotoxicity, and gene expression of heat shock protein (HSP) 70 and aggrecan (ACAN). In vivo, the knee joints of rats treated with photosensitizers were irradiated with NIR, and changes in intra-articular temperature and gene expression were measured, alongside histological analysis. The results showed that the medium and intra-articular temperature were raised to approximately 40 °C with no apparent disruption to articular cartilage or the immunohistochemically enhanced staining of HSP70 in chondrocytes. The gene expression of HSP70 and ACAN was increased in both cultured and articular cartilage. In summary, this method can safely heat joints and enhance cartilage metabolism by inducing HSP70 expression in articular cartilage. It presents a new hyperthermia therapy with effective cartilage protection.
Assuntos
Cartilagem Articular , Condrócitos , Proteínas de Choque Térmico HSP70 , Fármacos Fotossensibilizantes , Animais , Ratos , Cartilagem Articular/metabolismo , Condrócitos/metabolismo , Fármacos Fotossensibilizantes/farmacologia , Proteínas de Choque Térmico HSP70/metabolismo , Proteínas de Choque Térmico HSP70/genética , Agrecanas/metabolismo , Agrecanas/genética , Masculino , Células Cultivadas , Ratos Sprague-Dawley , Raios Infravermelhos , Hipertermia Induzida/métodosRESUMO
OBJECTIVE: To characterize the clinical and imaging features of circumscribed choroidal hemangioma (CCH), and to evaluate individualized treatment efficiency of photodynamic therapy (PDT), transpupillary thermotherapy (TTT), or their combination, followed by retrobulbar injection of betamethasone on CCH resolvement. METHODS: Forty-nine patients with CCHs who underwent PDT, TTT or PDT+TTT treatments were retrospectively analyzed. Their treatment efficacy was compared by analyzing the change of best corrected visual acuity (BCVA), subretinal fluid (SRF) and CCH lesion characteristics. RESULTS: PDT, TTT and PDT+TTT were respectively administrated in 17, 11 and 21 patients. No significant difference in age, gender, affected eyes and tumor location across the three groups. Baseline BCVA were 0.41 ± 0.28, 0.62 ± 0.30 and 0.24 ± 0.24 for PDT, TTT and PDT+TTT groups, respectively (F = 6.572, P = 0.003). CCH treated by three strategies showed significant difference in maximum tumor basal diameter, SRF areas and macula involvement prior to the treatment (P < 0.05). Patients receiving PDT+TTT exhibited larger tumor basal diameter, more SRF, higher ratio of macular involvement than other groups. A total of 38 (77.6 %) cases had good visual acidity with final BCVA ≥0.5 after treatments. PDT and PDT+TTT treatment groups acquired more vision improvement (0.27 ± 0.23 and 0.31 ± 0.26) in BCVA than TTT group (0.09 ± 0.13). All SRF were resolved within two weeks of treatment and no recurrent SRF were found. CONCLUSION: The three treatments showed good performance in improving visual function and controlling SRF, and individualized treatment should be selected primarily by the tumor location, and then the tumor size and presence of SRF.
Assuntos
Neoplasias da Coroide , Hemangioma , Hipertermia Induzida , Fotoquimioterapia , Fármacos Fotossensibilizantes , Acuidade Visual , Humanos , Fotoquimioterapia/métodos , Feminino , Neoplasias da Coroide/terapia , Neoplasias da Coroide/tratamento farmacológico , Masculino , Pessoa de Meia-Idade , Estudos Retrospectivos , Hipertermia Induzida/métodos , Hemangioma/terapia , Hemangioma/tratamento farmacológico , Fármacos Fotossensibilizantes/uso terapêutico , Adulto , Terapia Combinada , Betametasona/uso terapêutico , Idoso , Verteporfina/uso terapêutico , Líquido Sub-RetinianoRESUMO
The aim of this study was to analyze the long-term results of different locoregional treatments for colorectal cancer liver metastases (CRLM), including transarterial chemoembolization (TACE), laser-induced thermotherapy (LITT) and microwave ablation (MWA). A total of 2140 patients with CRLM treated at our department between 1993 and 2020 were included in this retrospective study. The patients were divided into the following groups: LITT (573 patients; median age: 62 years), TACE + LITT (346 patients; median age: 62 years), MWA (67 patients; median age: 59 years), TACE + MWA (152 patients; median age: 65 years), and TACE (1002 patients; median age: 62 years). Median survival was 1.9 years in the LITT group and 1.7 years in the TACE + LITT group. The median survival times in the MWA group and TACE + MWA group were 3.1 years and 2.1 years, respectively. The median survival in the TACE group was 0.8 years. The 1-, 3-, and 5-year survival rates were 77%, 27%, and 9% in the LITT group and 74%, 18%, and 5% in the TACE + LITT group, respectively. The corresponding survival rates were 80%, 55%, and 33% in the MWA group, 74%, 36%, and 20% in the TACE + MWA group and 37%, 3%, and 0% in the TACE group, respectively. The long-term results of this study demonstrate the efficacy of locoregional treatments in treating patients with CRLM. The longest survival was found in the MWA group, followed by the combination therapy of TACE and MWA.
RESUMO
Laser Interstitial Thermotherapy is a minimally invasive treatment option in neurosurgery for intracranial tumors, including recurrent gliomas. The technique employs the thermal ablation of target tissue to achieve tumor control with real-time monitoring of the extent by magnetic resonance thermometry, allowing targeted thermal injury to the lesion. Laser Interstitial Thermotherapy has gained interest as a treatment option for recurrent gliomas due to its minimally invasive nature, shorter recovery times, ability to be used even in patients with numerous comorbidities, and potential to provide local tumor control. It can be used as a standalone treatment or combined with other therapies, such as chemotherapy or radiation therapy. We describe the most recent updates regarding several studies and case reports that have evaluated the efficacy and safety of Laser Interstitial Thermotherapy for recurrent gliomas. These studies have reported different outcomes, with some demonstrating promising results in terms of tumor control and patient survival, while others have shown mixed outcomes. The success of Laser Interstitial Thermotherapy depends on various factors, including tumor characteristics, patient selection, and the experience of the surgical team, but the future direction of treatment of recurrent gliomas will include a combined approach, comprising Laser Interstitial Thermotherapy, particularly in deep-seated brain regions. Well-designed prospective studies will be needed to establish with certainty the role of Laser Interstitial Thermotherapy in the treatment of recurrent glioma.