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1.
Int J Low Extrem Wounds ; 19(2): 125-131, 2020 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-31625431

RESUMO

The most frequent clinical complication is diabetes. Diabetes is characterized by elevated blood glucose levels resulting in sensory nerve damage or lesions. Diabetic foot wounds are often slow to heal and require medical attention and monitoring. This study evaluates the effect of far-infrared radiation on the microcirculation and plantar pressure in the diabetic foot. Ten diabetics and 4 nondiabetics were recruited in this study. The diabetic group was examined before and after the intervention in each month for 3 consecutive months. Four nondiabetic groups were also measured before and after the intervention for 2 weeks in each month. The surface temperature and blood flow in the diabetic foot was significantly improved (temperature: 32.1 ± 2.3°C vs 33.5 ± 2.2°C, P < .05; blood flow image: 118.3 ± 58.1 PU [perfusion unit] vs 50.4 ± 4.3 PU, P < .05). The sympathetic nerve activity index LF also increased from 40.8 ± 18.6% to 61.8 ± 13.5% (P = .07) in the second month. Plantar pressure tended to increase in the third month. This might indicate that far-infrared radiation could affect the mechanical properties of the plantar foot soft tissue. These results indicated that the effects of far-infrared radiation would improve blood circulation and change the soft tissue properties in the diabetic foot.


Assuntos
Diabetes Mellitus Tipo 2/complicações , Pé Diabético , , Raios Infravermelhos/uso terapêutico , Pé Diabético/etiologia , Pé Diabético/fisiopatologia , Pé Diabético/prevenção & controle , Pé Diabético/terapia , Desenho de Equipamento , Feminino , Pé/irrigação sanguínea , Pé/inervação , Humanos , Fluxometria por Laser-Doppler/métodos , Masculino , Teste de Materiais , Microcirculação/efeitos da radiação , Pessoa de Meia-Idade , Fluxo Sanguíneo Regional/efeitos da radiação , Sistema Nervoso Simpático/fisiopatologia , Sistema Nervoso Simpático/efeitos da radiação , Termometria/métodos , Resultado do Tratamento
2.
Sci Rep ; 9(1): 5967, 2019 04 12.
Artigo em Inglês | MEDLINE | ID: mdl-30979930

RESUMO

This study aimed to explore the effects of radiochemotherapy on the neurocognitive function of patients with high-grade gliomas (HGG). The mini-mental state examination (MMSE), Montreal Cognitive Assessment (MoCA), event-related potential P300 (ERP-P300), and specific MRI parameters were compared, and the associations between specific MRI parameters and different doses of radiation were determined for before and up to 12 months after radiotherapy. There were no significant differences in MMSE, MoCA, or ERP-P300 before and after radiotherapy. Compared with pre-radiochemotherapy, fractional anisotropy (FA) in the contralateral hippocampus decreased at 6 and 9 months after radiotherapy. FA in the ipsilateral hippocampus before radiochemotherapy decreased compared with 6 months after radiotherapy. Compared to the end of radiotherapy, as well as 3- and 6-months post-radiotherapy, the regional cerebral blood volume (rCBV) in the genu of the corpus was significantly lower at 12 months post-radiotherapy. Some MRI parameters in different regions of the brain were negatively correlated with the mean and maximum dose. There was no significant effect of radiochemotherapy on the neurocognitive functioning of patients with HGGs found before radiochemotherapy until 12 months after radiotherapy. The radiation-induced FA decrease in the bilateral hippocampus preceded cognitive dysfunction, and DTI of the hippocampus may provide a useful biomarker for predicting radiation-induced neurocognitive impairment in patients with HGGs.


Assuntos
Neoplasias Encefálicas/terapia , Encéfalo/diagnóstico por imagem , Quimiorradioterapia , Cognição , Glioma/terapia , Adolescente , Adulto , Idoso , Encéfalo/efeitos dos fármacos , Encéfalo/fisiopatologia , Encéfalo/efeitos da radiação , Neoplasias Encefálicas/diagnóstico por imagem , Neoplasias Encefálicas/fisiopatologia , Neoplasias Encefálicas/psicologia , Circulação Cerebrovascular/efeitos dos fármacos , Circulação Cerebrovascular/efeitos da radiação , Cognição/efeitos dos fármacos , Cognição/efeitos da radiação , Imagem de Tensor de Difusão/métodos , Potenciais Evocados P300/efeitos dos fármacos , Potenciais Evocados P300/efeitos da radiação , Feminino , Glioma/diagnóstico por imagem , Glioma/fisiopatologia , Glioma/psicologia , Humanos , Masculino , Pessoa de Meia-Idade , Gradação de Tumores , Estudos Prospectivos , Fluxo Sanguíneo Regional/efeitos dos fármacos , Fluxo Sanguíneo Regional/efeitos da radiação , Estudos Retrospectivos , Resultado do Tratamento , Adulto Jovem
3.
Ren Fail ; 39(1): 613-622, 2017 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-28805538

RESUMO

BACKGROUND: Far infrared (FIR) therapy may have a beneficial effect on maturity and function of arteriovenous fistulas (AVFs) in hemodialysis (HD) patients. Therefore, we performed this pooled analysis to assess the protective effects of FIR therapy in HD patients. METHODS: The randomized controlled trials (RCTs) and quasi-RCTs of FIR therapy for HD patients were searched from multiple databases. Relevant studies were screened according to the predefined inclusion criteria. The meta-analyses were performed using RevMan 5.2 software (The Cochrane Collaboration, Oxford, UK). RESULTS: Meta-analysis showed that FIR therapy could significantly increase the vascular access blood flow level (MD, 81.69 ml/min; 95% CI, 46.17-117.21; p < .001), AVFs diameter level (MD, 0.36 mm; 95% CI, 0.22-0.51; p < .001), and the primary AVFs patency (pooled risk ratio = 1.24; 95% CI, 1.12-1.37, p < .001). In addition, therapy with FIR ray radiation could decrease AVFs occlusion rates (pooled risk ratio = 0.20; 95% CI, 0.08-0.46; p < .001) and the level of needling pain (pooled risk ratio = 0.08; 95% CI, 0.06-0.10, p < .001). CONCLUSIONS: FIR therapy can reduce AVFs occlusion rates and needling pain level, while significantly improve the level of vascular access blood flow, AVFs diameter and the primary AVFs patency.


Assuntos
Derivação Arteriovenosa Cirúrgica/efeitos adversos , Raios Infravermelhos/uso terapêutico , Falência Renal Crônica/terapia , Manejo da Dor/métodos , Fototerapia/métodos , Diálise Renal/efeitos adversos , Grau de Desobstrução Vascular/efeitos da radiação , Cateterismo/efeitos adversos , Cateterismo Periférico/efeitos adversos , Humanos , Dor/etiologia , Ensaios Clínicos Controlados Aleatórios como Assunto , Fluxo Sanguíneo Regional/efeitos da radiação , Cicatrização/efeitos da radiação
4.
J Endod ; 42(6): 886-9, 2016 Jun.
Artigo em Inglês | MEDLINE | ID: mdl-27071975

RESUMO

INTRODUCTION: Radiation therapy (RT) of malignant tumors in the head and neck area may have damaging effects on surrounding tissues. The aim of this investigation was to evaluate the long-term effects of ionizing radiation on pulp vitality by measuring pulp oxygenation levels (%SpO2) in patients with history of RT of intraoral and oropharyngeal tumors 4-6 years after treatment. METHODS: In an experimental group RT (n = 90, history of RT) and a control group CON (n = 90, no history of RT), pulp vitality was assessed by measuring %SpO2 by using pulse oximetry and pulp sensitivity by cold thermal testing. All anterior teeth without history of endodontic therapy of the participants in group RT were measured (n = 693), regardless of the quadrant and the irradiated area. An equal number of anterior teeth were tested in group CON. RESULTS: There was no significant difference between the %SpO2 levels in group RT (92.7%; standard deviation, ± 1.83) and group CON (92.6%; standard deviation, ± 1.80). All teeth in RT and CON groups showed a positive response to the thermal test. All tested teeth were considered vital. CONCLUSIONS: Pulp %SpO2 was found to be within normal limits 4-6 years after RT. This suggests that RT may not have a long-term influence on pulp vitality, and reported short-term changes in pulpal microcirculation because of RT may be temporary.


Assuntos
Teste da Polpa Dentária/métodos , Polpa Dentária/efeitos da radiação , Neoplasias de Cabeça e Pescoço/radioterapia , Oximetria/métodos , Radioterapia/efeitos adversos , Adulto , Idoso , Polpa Dentária/irrigação sanguínea , Feminino , Humanos , Incisivo/efeitos da radiação , Masculino , Microcirculação/efeitos da radiação , Pessoa de Meia-Idade , Neoplasias Orofaríngeas/radioterapia , Oxigênio/análise , Oxigênio/sangue , Radiação Ionizante , Fluxo Sanguíneo Regional/efeitos da radiação
5.
Int J Radiat Oncol Biol Phys ; 94(5): 1173-80, 2016 Apr 01.
Artigo em Inglês | MEDLINE | ID: mdl-26907918

RESUMO

PURPOSE: To characterize the effects of high-dose radiation therapy (HDRT) on neuroblastoma tumor vasculature, including the endothelial cell (EC)-pericyte interaction as a potential target for combined treatment with antiangiogenic agents. METHODS AND MATERIALS: The vascular effects of radiation therapy were examined in a xenograft model of high-risk neuroblastoma. In vivo 3-dimensional contrast-enhanced ultrasonography (3D-CEUS) imaging and immunohistochemistry (IHC) were performed. RESULTS: HDRT significantly reduced tumor blood volume 6 hours after irradiation compared with the lower doses used in conventionally fractionated radiation. There was a 63% decrease in tumor blood volume after 12-Gy radiation compared with a 24% decrease after 2 Gy. Analysis of tumor vasculature by lectin angiography showed a significant loss of small vessel ends at 6 hours. IHC revealed a significant loss of ECs at 6 and 72 hours after HDRT, with an accompanying loss of immature and mature pericytes at 72 hours. CONCLUSIONS: HDRT affects tumor vasculature in a manner not observed at lower doses. The main observation was an early reduction in tumor perfusion resulting from a reduction of small vessel ends with a corresponding loss of endothelial cells and pericytes.


Assuntos
Neuroblastoma/radioterapia , Fluxo Sanguíneo Regional/efeitos da radiação , Angiografia/métodos , Animais , Apoptose , Comunicação Celular , Linhagem Celular Tumoral , Endotélio Vascular/citologia , Endotélio Vascular/efeitos da radiação , Xenoenxertos , Humanos , Lectinas , Camundongos Nus , Neuroblastoma/irrigação sanguínea , Neuroblastoma/diagnóstico por imagem , Pericitos/citologia , Pericitos/efeitos da radiação , Dosagem Radioterapêutica , Distribuição Aleatória , Fatores de Tempo , Ultrassonografia
6.
Life Sci ; 127: 1-11, 2015 Apr 15.
Artigo em Inglês | MEDLINE | ID: mdl-25731700

RESUMO

AIMS: Electromagnetic fields (EMFs) can act as inducers or mediators of stress response through the production of heat shock proteins (HSPs) that modulate immune response and thymus functions. In this study, we analyzed cellular stress levels in rat thymus after exposure of the rats to a 2.45 GHz radio frequency (RF) using an experimental diathermic model in a Gigahertz Transverse Electromagnetic (GTEM) chamber. MAIN METHODS: In this experiment, we used H&E staining, the ELISA test and immunohistochemistry to examine Hsp70 and Hsp90 expression in the thymus and glucocorticoid receptors (GR) of 64 female Sprague­Dawley rats exposed individually to 2.45 GHz (at 0, 1.5, 3.0 or 12.0 W power). The 1 g averaged peak and mean SAR values in the thymus and whole body of each rat to ensure that sub-thermal levels of radiation were being reached. KEY FINDINGS: The thymus tissue presented several morphological changes, including increased distribution of blood vessels along with the appearance of red blood cells and hemorrhagic reticuloepithelial cells. Levels of Hsp90 decreased in the thymus when animals were exposed to the highest power level (12 W), but only one group did not show recovery after 24 h. Hsp70 presented no significant modifications in any of the groups. The glucocorticoid receptors presented greater immunomarking on the thymic cortex in exposed animals. SIGNIFICANCE: Our results indicate that non-ionizing sub-thermal radiation causes changes in the endothelial permeability and vascularization of the thymus, and is a tissue-modulating agent for Hsp90 and GR.


Assuntos
Campos Eletromagnéticos , Proteínas de Choque Térmico/biossíntese , Proteínas de Choque Térmico/efeitos da radiação , Receptores de Glucocorticoides/biossíntese , Receptores de Glucocorticoides/efeitos da radiação , Timo/metabolismo , Timo/efeitos da radiação , Animais , Temperatura Corporal/efeitos da radiação , Endotélio Vascular/efeitos da radiação , Feminino , Proteínas de Choque Térmico HSP70/biossíntese , Proteínas de Choque Térmico HSP70/efeitos da radiação , Proteínas de Choque Térmico HSP90/biossíntese , Proteínas de Choque Térmico HSP90/efeitos da radiação , Ratos , Ratos Sprague-Dawley , Fluxo Sanguíneo Regional/efeitos da radiação , Estresse Fisiológico/efeitos da radiação , Timo/irrigação sanguínea
7.
Brain Res ; 1583: 193-200, 2014 Oct 02.
Artigo em Inglês | MEDLINE | ID: mdl-24953932

RESUMO

The main purpose of the present study was to examine the time-dependent alterations in the endothelial cell density that occur in the first 180 days after irradiation of the spinal cord and the functional role of these alterations in the spinal cord blood flow. An irradiated cervical spinal cord rat model (C2-T2 segment) was generated using a (60)Co irradiator to deliver 30 Gy. A significant loss of forelimb motor function was observed 180 days post-irradiation. The number of neurons in the anterior horn of the spinal cord began to decrease significantly 3 days post-irradiation compared with normal controls, reaching the lowest number at 90 days post-irradiation. A significant reduction in the endothelial cell density was observed from 14 days post-irradiation in the white matter and from 3 days post-irradiation in the gray matter. The lowest endothelial cell density was reached at 30 days post-irradiation in the white matter and at 60 days post-irradiation in the gray matter. A significant reduction in the microvessel density was observed from 3 days post-irradiation in both the white matter and the gray matter. The lowest microvessel density was reached at 90 days post-irradiation in both the white matter and the gray matter. A significant reduction in the relative magnitude of spinal cord blood flow was observed from 21 days post-irradiation. The lowest relative magnitude of spinal cord blood flow was reached at 90 days post-irradiation. We did not find any evidence of demyelination. The results revealed that a single 30-Gy irradiation dose resulted in impaired forelimb motor function, a decreased number of neurons, and reduced endothelial cell density, microvessel density and relative magnitude of spinal cord blood flow. However, a 30-Gy single-dose irradiation was not sufficient to induce demyelination in the rat spinal cord.


Assuntos
Radioisótopos de Cobalto/efeitos adversos , Células Endoteliais/efeitos da radiação , Lesões Experimentais por Radiação/patologia , Lesões Experimentais por Radiação/fisiopatologia , Fluxo Sanguíneo Regional/efeitos da radiação , Medula Espinal/irrigação sanguínea , Medula Espinal/efeitos da radiação , Animais , Vértebras Cervicais , Células Endoteliais/patologia , Feminino , Membro Anterior , Substância Cinzenta/irrigação sanguínea , Substância Cinzenta/patologia , Substância Cinzenta/efeitos da radiação , Imuno-Histoquímica , Microvasos/patologia , Microvasos/fisiopatologia , Microvasos/efeitos da radiação , Atividade Motora/efeitos da radiação , Ratos Sprague-Dawley , Medula Espinal/patologia , Fatores de Tempo , Substância Branca/irrigação sanguínea , Substância Branca/patologia , Substância Branca/efeitos da radiação
8.
Int J Radiat Oncol Biol Phys ; 88(2): 412-8, 2014 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-24411612

RESUMO

PURPOSE: To image the intratumor vascular physiological status of pancreatic tumors xenografts and their response to anti-angiogenic therapy using dynamic contrast-enhanced computed tomography (DCE-CT), and to identify parameters of vascular physiology associated with tumor x-ray sensitivity after anti-angiogenic therapy. METHODS AND MATERIALS: Nude mice bearing human BxPC-3 pancreatic tumor xenografts were treated with 5 Gy of radiation therapy (RT), either a low dose (40 mg/kg) or a high dose (150 mg/kg) of DC101, the anti-VEGF receptor-2 anti-angiogenesis antibody, or with combination of low or high dose DC101 and 5 Gy RT (DC101-plus-RT). DCE-CT scans were longitudinally acquired over a 3-week period post-DC101 treatment. Parametric maps of tumor perfusion and fractional plasma volume (Fp) were calculated and their averaged values and histogram distributions evaluated and compared to controls, from which a more homogeneous physiological window was observed 1-week post-DC101. Mice receiving a combination of DC101-plus-RT(5 Gy) were imaged baseline before receiving DC101 and 1 week after DC101 (before RT). Changes in perfusion and Fp were compared with alternation in tumor growth delay for RT and DC101-plus-RT (5 Gy)-treated tumors. RESULTS: Pretreatment with low or high doses of DC101 before RT significantly delayed tumor growth by an average 7.9 days compared to RT alone (P ≤ .01). The increase in tumor growth delay for the DC101-plus-RT-treated tumors was strongly associated with changes in tumor perfusion (ΔP>-15%) compared to RT treated tumors alone (P=.01). In addition, further analysis revealed a trend linking the tumor's increased growth delay to its tumor volume-to-DC101 dose ratio. CONCLUSIONS: DCE-CT is capable of monitoring changes in intratumor physiological parameter of tumor perfusion in response to anti-angiogenic therapy of a pancreatic human tumor xenograft that was associated with enhanced radiation response.


Assuntos
Inibidores da Angiogênese/uso terapêutico , Anticorpos Monoclonais/uso terapêutico , Neoplasias Pancreáticas/terapia , Tolerância a Radiação/efeitos dos fármacos , Tomografia Computadorizada por Raios X/métodos , Animais , Proliferação de Células , Terapia Combinada/métodos , Meios de Contraste , Feminino , Xenoenxertos , Humanos , Camundongos , Camundongos Nus , Neoplasias Pancreáticas/irrigação sanguínea , Neoplasias Pancreáticas/diagnóstico por imagem , Neoplasias Pancreáticas/patologia , Ratos Sprague-Dawley , Fluxo Sanguíneo Regional/efeitos dos fármacos , Fluxo Sanguíneo Regional/fisiologia , Fluxo Sanguíneo Regional/efeitos da radiação , Resultado do Tratamento , Carga Tumoral
9.
Crit Rev Biomed Eng ; 42(6): 467-92, 2014.
Artigo em Inglês | MEDLINE | ID: mdl-25955712

RESUMO

The application of supraphysiological temperatures (>40°C) to biological tissues causes changes at the molecular, cellular, and structural level, with corresponding changes in tissue function and in thermal, mechanical and dielectric tissue properties. This is particularly relevant for image-guided thermal treatments (e.g. hyperthermia and thermal ablation) delivering heat via focused ultrasound (FUS), radiofrequency (RF), microwave (MW), or laser energy; temperature induced changes in tissue properties are of relevance in relation to predicting tissue temperature profile, monitoring during treatment, and evaluation of treatment results. This paper presents a literature survey of temperature dependence of electrical (electrical conductivity, resistivity, permittivity) and thermal tissue properties (thermal conductivity, specific heat, diffusivity). Data of soft tissues (liver, prostate, muscle, kidney, uterus, collagen, myocardium and spleen) for temperatures between 5 to 90°C, and dielectric properties in the frequency range between 460 kHz and 3 GHz are reported. Furthermore, perfusion changes in tumors including carcinomas, sarcomas, rhabdomyosarcoma, adenocarcinoma and ependymoblastoma in response to hyperthmic temperatures up to 46°C are presented. Where appropriate, mathematical models to describe temperature dependence of properties are presented. The presented data is valuable for mathematical models that predict tissue temperature during thermal therapies (e.g. hyperthermia or thermal ablation), as well as for applications related to prediction and monitoring of temperature induced tissue changes.


Assuntos
Ablação por Cateter , Hipertermia Induzida , Modelos Biológicos , Animais , Condutividade Elétrica , Radiação Eletromagnética , Fígado/irrigação sanguínea , Fígado/efeitos da radiação , Masculino , Micro-Ondas , Próstata/irrigação sanguínea , Próstata/efeitos da radiação , Fluxo Sanguíneo Regional/fisiologia , Fluxo Sanguíneo Regional/efeitos da radiação , Temperatura , Condutividade Térmica
10.
Eur J Vasc Endovasc Surg ; 46(6): 726-32, 2013 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-24119468

RESUMO

OBJECTIVE: To explore the role of far infrared (FIR) radiation therapy for hemodialysis (HD) access maintenance after percutaneous transluminal angioplasties (PTA). METHODS: This was a prospective observational study. Eligible patients were those who received repeated PTA with the last PTA successfully performed within 1 week before the study enrollments. Consecutively enrolled patients undergoing successful HD treatments after PTA were randomly assigned to the FIR-radiated group or control group without radiation. FIR-radiated therapy meaning 40-minute radiation at the major lesion site or anastomosed site three times a week was continued until an end-point defined as dysfunction-driven re-PTA or the study end was reached. RESULTS: Of 216 participants analyzed, including 97 with arteriovenous grafts (AVG) (49 FIR-radiated participants and 48 control participants) and 119 with arteriovenous fistulas (AVF) (69 FIR-radiated participants and 50 control participants), the FIR-radiated therapy compared with free-radiated usual therapy significantly enhanced PTA-unassisted patency at 1 year in the AVG subgroup (16.3% vs. 2.1%; p < .01), but not the AVF subgroup (25.0% vs. 18.4%; p = .50), and this accounted for the overall improved patency rates (21.4% vs. 10.3%; p = .02). CONCLUSIONS: This study suggests FIR-radiated therapy improves PTA-unassisted patency in patients with AVG who have undergone previous PTA.


Assuntos
Derivação Arteriovenosa Cirúrgica , Oclusão de Enxerto Vascular/terapia , Raios Infravermelhos/uso terapêutico , Grau de Desobstrução Vascular/efeitos da radiação , Idoso , Angioplastia com Balão , Fístula Arteriovenosa/terapia , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Recidiva , Fluxo Sanguíneo Regional/efeitos da radiação , Diálise Renal
11.
Br J Cancer ; 107(3): 469-76, 2012 Jul 24.
Artigo em Inglês | MEDLINE | ID: mdl-22790798

RESUMO

BACKGROUND: Tumour vasculature is an important component of tumour growth and survival. Recent evidence indicates tumour vasculature also has an important role in tumour radiation response. In this study, we investigated ultrasound and microbubbles to enhance the effects of radiation. METHODS: Human bladder cancer HT-1376 xenografts in severe combined immuno-deficient mice were used. Treatments consisted of no, low and high concentrations of microbubbles and radiation doses of 0, 2 and 8 Gy in short-term and longitudinal studies. Acute response was assessed 24 h after treatment and longitudinal studies monitored tumour response weekly up to 28 days using power Doppler ultrasound imaging for a total of 9 conditions (n=90 animals). RESULTS: Quantitative analysis of ultrasound data revealed reduced blood flow with ultrasound-microbubble treatments alone and further when combined with radiation. Tumours treated with microbubbles and radiation revealed enhanced cell death, vascular normalisation and areas of fibrosis. Longitudinal data demonstrated a reduced normalised vascular index and increased tumour cell death in both low and high microbubble concentrations with radiation. CONCLUSION: Our study demonstrated that ultrasound-mediated microbubble exposure can enhance radiation effects in tumours, and can lead to enhanced tumour cell death.


Assuntos
Meios de Contraste/uso terapêutico , Microbolhas , Radiossensibilizantes/farmacologia , Neoplasias da Bexiga Urinária/radioterapia , Animais , Morte Celular/efeitos da radiação , Linhagem Celular Tumoral , Células Endoteliais/efeitos da radiação , Humanos , Estudos Longitudinais , Masculino , Camundongos , Camundongos SCID , Neovascularização Patológica/radioterapia , Doses de Radiação , Fluxo Sanguíneo Regional/efeitos da radiação , Ultrassom , Ultrassonografia , Neoplasias da Bexiga Urinária/irrigação sanguínea , Neoplasias da Bexiga Urinária/diagnóstico por imagem , Neoplasias da Bexiga Urinária/patologia , Ensaios Antitumorais Modelo de Xenoenxerto
12.
Lasers Surg Med ; 44(2): 158-62, 2012 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-22334298

RESUMO

BACKGROUND AND OBJECTIVE: Current treatments of port-wine stain birthmarks typically involve use of a pulsed dye laser (PDL) combined with cooling of the skin. Currently, PDL therapy protocols result in varied success, as some patients experience complete blanching, while others do not. Over the past decade, we have studied the use of photodynamic therapy (PDT) as either a replacement or adjuvant treatment option to photocoagulate both small and large vasculature. The objective of the current study was to evaluate a PDT protocol that involves use of an alternate intravascular photosensitizer mono-L-aspartylchlorin-e6 (NPe6) activated by an array of low-cost light emitting diodes. STUDY DESIGN/MATERIALS AND METHODS: To monitor the microvasculature, a dorsal window chamber model was installed on 22 adult male mice. The light source consisted of a custom-built LED array that emitted 10 W at a center wavelength of 664 nm (FWHM = 20 nm). The light source was positioned at a fixed distance from the window chamber to achieve a fixed irradiance of 127 mW/cm(2). A retroorbital injection of NPe6 (5 mg/kg) was performed to deliver the drug into the bloodstream. Laser irradiation was initiated immediately after injection. To monitor blood-flow dynamics in response to PDT, we used laser speckle imaging. We employed a dose-response experimental design to evaluate the efficacy of NPe6-mediated PDT. RESULTS: We observed three general hemodynamic responses to PDT: (1) At low radiant exposures, we did not observe any persistent vascular shutdown; (2) at intermediate radiant exposures, we observed an acute decrease in blood flow followed by gradual restoration of blood flow over the 7-day monitoring period; and (3) at high radiant exposures, we observed acute vascular shutdown that persisted during the entire 7-day monitoring period. Dose-response analysis enabled identification of 85 J/cm(2) as a characteristic radiant exposure required to achieve persistent vascular shutdown at Day 7 following PDT. CONCLUSION: The experimental data suggest that NPe6-mediated PDT can achieve persistent vascular shutdown of normal microvasculature.


Assuntos
Microvasos/efeitos dos fármacos , Fotoquimioterapia/métodos , Fármacos Fotossensibilizantes/farmacologia , Porfirinas/farmacologia , Fluxo Sanguíneo Regional/efeitos dos fármacos , Pele/irrigação sanguínea , Animais , Relação Dose-Resposta à Radiação , Masculino , Camundongos , Microvasos/efeitos da radiação , Fluxo Sanguíneo Regional/efeitos da radiação , Pele/efeitos dos fármacos , Pele/efeitos da radiação
13.
Int J Radiat Oncol Biol Phys ; 82(2): e119-27, 2012 Feb 01.
Artigo em Inglês | MEDLINE | ID: mdl-21669502

RESUMO

PURPOSE: To measure changes in perfusion of the pharyngeal constrictor muscles (PCM) using CT perfusion (CTP) imaging during a course of definitive radiotherapy (RT) in head-and-neck cancer (HNC) patients and correlate with dysphagia outcome after RT. METHODS AND MATERIALS: Fifteen HNC patients underwent CTP imaging of the PCM at baseline and Weeks 2, 4, and 6 during RT and 6 weeks after RT. Blood flow and blood volume were measured in the PCM, and percentage change from baseline scan was determined. A single physician-based assessment of dysphagia was performed every 3 months after RT using the Common Terminology Criteria for Adverse Events, version 3.0 grading system. RESULTS: With a median follow-up of 28 months (range, 6-44 months), Grade 3 dysphagia was present in 7 of 15 patients, and 8 patients experienced Grade 0-2 dysphagia. The CTP parameters at Week 2 of RT demonstrated an increase in mean PCM blood flow of 161.9% vs. 12.3% (p = 0.007) and an increase in mean PCM blood volume of 96.6% vs. 8.7% (p = 0.039) in patients with 6-month post-RT Grade 3 dysphagia and Grade 0-2 dysphagia, respectively. On multivariate analysis, when adjusting for smoking history, tumor volume, and baseline dysphagia status, an increase in blood flow in the second week of RT was significant for 3- and 6-month Grade 3 dysphagia (p < 0.05). CONCLUSIONS: Perfusion changes in the PCM during Week 2 of RT in the PCM may predict the severity of dysphagia after HNC RT.


Assuntos
Transtornos de Deglutição/etiologia , Neoplasias de Cabeça e Pescoço/radioterapia , Músculos Faríngeos/efeitos da radiação , Idoso , Volume Sanguíneo/fisiologia , Volume Sanguíneo/efeitos da radiação , Quimiorradioterapia , Transtornos de Deglutição/diagnóstico por imagem , Transtornos de Deglutição/fisiopatologia , Feminino , Seguimentos , Neoplasias de Cabeça e Pescoço/tratamento farmacológico , Neoplasias de Cabeça e Pescoço/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Tomografia Computadorizada Multidetectores , Análise Multivariada , Músculos Faríngeos/irrigação sanguínea , Músculos Faríngeos/diagnóstico por imagem , Estudos Prospectivos , Radioterapia de Intensidade Modulada , Fluxo Sanguíneo Regional/fisiologia , Fluxo Sanguíneo Regional/efeitos da radiação , Fumar , Fatores de Tempo , Carga Tumoral
14.
Int J Immunopathol Pharmacol ; 24(1 Suppl 2): 29-37, 2011.
Artigo em Inglês | MEDLINE | ID: mdl-21669135

RESUMO

Radiation therapy and chemotherapy, while they remain an essential part of the multidisciplinary treatment of cancers, they have led to unwanted complications. Radiation-induced complications include wound and bone, growth, nervous system, tumorigenic, lung, gastrointestinal, hepatic and other complications. In this article we review the side effects of radiation therapy in musculoskeletal oncology emphasizing on bone, present our long experience, and discuss the current literature regarding radiation-induced bone complications and their management and outcome.


Assuntos
Neoplasias Ósseas/complicações , Neoplasias Ósseas/radioterapia , Fraturas Ósseas/etiologia , Neoplasias Musculares/complicações , Neoplasias Musculares/radioterapia , Doenças Musculoesqueléticas/complicações , Doenças Musculoesqueléticas/radioterapia , Radioterapia/efeitos adversos , Adulto , Idoso , Pinos Ortopédicos , Neoplasias Ósseas/secundário , Osso e Ossos/irrigação sanguínea , Neoplasias da Mama/patologia , Feminino , Fraturas Ósseas/diagnóstico por imagem , Fraturas Ósseas/patologia , Humanos , Masculino , Pessoa de Meia-Idade , Neoplasias Musculares/secundário , Procedimentos Ortopédicos , Implantação de Prótese , Radiografia , Fluxo Sanguíneo Regional/efeitos da radiação , Adulto Jovem
15.
Lasers Med Sci ; 26(5): 627-32, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21455785

RESUMO

The objective of this study was to examine skin blood flow in diabetic patients having disease-related skin lesions, and to evaluate possible improvement imposed by low-intensity laser therapy (LILT) as a new treatment modality. Thirty patients (in addition to 15 controls receiving conventional treatment = group II and 15 others receiving no treatment = group III) having diabetes-related skin lesions were tested for skin blood flow by laser Doppler flowmetry. Group I patients received LILT by a specified dosimetry. This was by combined uniform He-Ne and infrared lasers delivered by a scanner over the affected area. This study used a paired t test to determine the significance of blood flow recovery after treatment within each group while Independent t test compared results between the three groups. The level of significance was p < 0.05. The most frequently detected diabetes specific skin lesions were dryness, nail changes, hair loss, infections, itching, and frank eczema-like reactions, mostly in combinations (76%). This pattern appears specific for Egyptians as it is different from data registered in foreign literature. The minimum perfusion flow improved from 16.45 before LILT to 25.94 after, while maximum flow recovered from 32.91 to 48.47 and basal perfusion changed from 24.68 to 34.84 blood perfusion units. The percentage change in perfusion values was 23.17. All these were statistically significant. The study demonstrates that diabetes-linked skin lesions have a special pattern in Egyptians and are apparently caused by deranged skin blood flow .The deficit is measurable by laser flowmetry and can be partially reversed by LILT.


Assuntos
Pé Diabético/radioterapia , Raios Infravermelhos/uso terapêutico , Lasers de Gás/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Adulto , Pé Diabético/fisiopatologia , Egito , Feminino , Humanos , Fluxometria por Laser-Doppler , Perna (Membro)/irrigação sanguínea , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional/efeitos da radiação , Pele/irrigação sanguínea , Pele/efeitos da radiação
16.
Int J Radiat Oncol Biol Phys ; 78(3): 897-903, 2010 Nov 01.
Artigo em Inglês | MEDLINE | ID: mdl-20832188

RESUMO

PURPOSE: To evaluate the effect of irradiation on microvascular endothelial cells in miniature pig parotid glands. METHODS AND MATERIALS: A single 25-Gy dose of irradiation (IR) was delivered to parotid glands of 6 miniature pigs. Three other animals served as non-IR controls. Local blood flow rate in glands was measured pre- and post-IR with an ultrasonic Doppler analyzer. Samples of parotid gland tissue were taken at 4 h, 24 h, 1 week, and 2 weeks after IR for microvascular density (MVD) analysis and sphingomyelinase (SMase) assay. Histopathology and immunohistochemical staining (anti-CD31 and anti-AQP1) were used to assess morphological changes. MVD was determined by calculating the number of CD31- or AQP1-stained cells per field. A terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL) apoptosis assay was used to detect apoptotic cells. The activity of acid and neutral Mg(2+)-dependent SMase (ASMase and NSMase, respectively) was also assayed. RESULTS: Local parotid gland blood flow rate decreased rapidly at 4 h post-IR and remained below control levels throughout the 14-day observation period. Parotid MVD also declined from 4 to 24 hours and remained below control levels thereafter. The activity levels of ASMase and NSMase in parotid glands increased rapidly from 4 to 24 h post-IR and then declined gradually. The frequency of detecting apoptotic nuclei in the glands followed similar kinetics. CONCLUSIONS: Single-dose IR led to a significant reduction of MVD and local blood flow rate, indicating marked damage to microvascular endothelial cells in miniature pig parotid glands. The significant and rapid increases of ASMase and NSMase activity levels may be important in this IR-induced damage.


Assuntos
Células Endoteliais/efeitos da radiação , Microvasos/efeitos da radiação , Glândula Parótida/irrigação sanguínea , Lesões Experimentais por Radiação/patologia , Animais , Apoptose , Aquaporina 1/análise , Biomarcadores/análise , Biomarcadores/metabolismo , Marcação In Situ das Extremidades Cortadas , Masculino , Microvasos/citologia , Glândula Parótida/enzimologia , Glândula Parótida/patologia , Glândula Parótida/efeitos da radiação , Molécula-1 de Adesão Celular Endotelial a Plaquetas/análise , Doses de Radiação , Lesões Experimentais por Radiação/enzimologia , Fluxo Sanguíneo Regional/fisiologia , Fluxo Sanguíneo Regional/efeitos da radiação , Esfingomielina Fosfodiesterase/análise , Esfingomielina Fosfodiesterase/metabolismo , Suínos , Porco Miniatura
17.
Int J Hyperthermia ; 26(4): 404-11, 2010.
Artigo em Inglês | MEDLINE | ID: mdl-20367556

RESUMO

PURPOSE: Hyperthermia treatment might increase tumour oxygenation and perfusion, as has been reported for experimental tumours. The present study was performed to investigate this hypothesis in patients undergoing regional hyperthermia treatment. METHODS: Thirteen patients with primary or recurrent pelvic tumours were included in this study. Prior to and up to one hour after regional hyperthermia, perfusion was quantitatively determined by H(2)(15)O-PET. The fused CT-PET images were used to extract tumour time-activity curves and to identify the catheter position. Perfusion was calculated from the total tumour time-activity curves and for the time-activity curves at the catheter site. Additionally, perfusion was calculated from the temperature-time curves measured using temperature probes. RESULTS: Perfusion values calculated using H(2)(15)O-PET and those deduced from temperature probe measurements are significantly correlated with a correlation coefficient, R = 0.21. The perfusion values deduced from the temperature measured in a body cavity do not provide information about average tumour perfusion. Perfusion values deduced from the temperature are overestimated for very poorly perfused tissues and underestimated for highly perfused tissues. CONCLUSIONS: Temperature measurement during hyperthermia may allow only determination of intermediate perfusion values.


Assuntos
Temperatura Corporal , Hipertermia Induzida , Neoplasias Pélvicas/irrigação sanguínea , Neoplasias Pélvicas/terapia , Tomografia por Emissão de Pósitrons/métodos , Fluxo Sanguíneo Regional/efeitos da radiação , Água , Adulto , Idoso , Velocidade do Fluxo Sanguíneo/efeitos da radiação , Temperatura Corporal/efeitos da radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Radioisótopos de Oxigênio/química , Terapia por Radiofrequência , Neoplasias Retais/irrigação sanguínea , Neoplasias Retais/terapia , Tomografia Computadorizada por Raios X/métodos , Neoplasias do Colo do Útero/irrigação sanguínea , Neoplasias do Colo do Útero/terapia , Água/química
18.
Vet J ; 186(1): 58-63, 2010 Oct.
Artigo em Inglês | MEDLINE | ID: mdl-19692273

RESUMO

Radiation therapy does not only target tumour cells but also affects tumour vascularity. In the present study, changes in tumour vascularity and blood volume were investigated in five grade 1 oral fibrosarcomas, eight other sarcomas (non-oral soft tissue and bone sarcomas) and 12 squamous cell carcinomas in dogs during fractionated radiation therapy (total dose, 45-56 Gy). Contrast-enhanced power Doppler ultrasound was performed before fraction 1, 3, 6, 8, 10, 12, 14 and 15 or 16 (sarcomas) or 17 (squamous cell carcinomas). Prior to treatment, median vascularity and blood volume were significantly higher in squamous cell carcinomas (P=0.0005 and 0.001), whereas measurements did not differ between oral fibrosarcomas and other sarcomas (P=0.88 and 0.999). During the course of radiation therapy, only small, non-significant changes in vascularity and blood volume were observed in all three tumour histology groups (P=0.08 and P=0.213), whereas median tumour volume significantly decreased until the end of treatment (P=0.04 for fibrosarcomas and other sarcomas, P=0.008 for squamous cell carcinomas). It appeared that there was a proportional decrease in tumour volume, vascularity and blood volume. Doppler measurements did not predict progression free interval or survival in any of the three tumour groups (P=0.06-0.86). However, the number of tumours investigated was small and therefore, the results can only be considered preliminary.


Assuntos
Carcinoma de Células Escamosas/veterinária , Doenças do Cão/radioterapia , Neoplasias Bucais/veterinária , Sarcoma/veterinária , Ultrassonografia Doppler em Cores/veterinária , Animais , Volume Sanguíneo/efeitos da radiação , Volume Sanguíneo/veterinária , Neoplasias Ósseas/irrigação sanguínea , Neoplasias Ósseas/diagnóstico por imagem , Neoplasias Ósseas/radioterapia , Neoplasias Ósseas/veterinária , Carcinoma de Células Escamosas/irrigação sanguínea , Carcinoma de Células Escamosas/diagnóstico por imagem , Carcinoma de Células Escamosas/radioterapia , Meios de Contraste , Doenças do Cão/diagnóstico por imagem , Cães , Feminino , Fibrossarcoma/irrigação sanguínea , Fibrossarcoma/diagnóstico por imagem , Fibrossarcoma/radioterapia , Fibrossarcoma/veterinária , Aumento da Imagem , Masculino , Neoplasias Bucais/irrigação sanguínea , Neoplasias Bucais/diagnóstico por imagem , Neoplasias Bucais/radioterapia , Fluxo Sanguíneo Regional/efeitos da radiação , Sarcoma/irrigação sanguínea , Sarcoma/diagnóstico por imagem , Sarcoma/radioterapia , Resultado do Tratamento , Ultrassonografia Doppler em Cores/métodos
19.
Int J Radiat Oncol Biol Phys ; 77(3): 851-7, 2010 Jul 01.
Artigo em Inglês | MEDLINE | ID: mdl-20018457

RESUMO

PURPOSE: We used computed tomography (CT) perfusion to evaluate the acute and late effect of radiation therapy (RT) on spinal cord (SC) hemodynamics in patients without symptoms of myelopathy. We hypothesized that SC perfusion could be acutely altered during RT. METHODS AND MATERIALS: We analyzed neck CT perfusion studies of 36 head-and-neck cancer patients (N1), 16 of whom had previously undergone RT. In a separate group of 6 patients (N2), CT perfusion studies were obtained before RT, after 40 Gy, and after treatment completion. RESULTS: In the N1 group, SC blood flow (BF), blood volume (BV), mean transit time (MTT), and capillary permeability (CP) maps were not significantly different between RT-treated and RT-naive patients. In the N2 group, BF and CP were significantly increased during treatment compared with the baseline and post-RT studies. CONCLUSIONS: Radiation therapy of the head and neck may cause transient perturbations of SC perfusion that seem to reverse after treatment. There are no definite chronic effects of RT on SC perfusion observeable at the typical doses administered during treatment of head and neck malignancies.


Assuntos
Neoplasias de Cabeça e Pescoço/radioterapia , Medula Espinal/irrigação sanguínea , Medula Espinal/efeitos da radiação , Tomografia Computadorizada por Raios X/métodos , Adulto , Idoso , Idoso de 80 Anos ou mais , Velocidade do Fluxo Sanguíneo/fisiologia , Velocidade do Fluxo Sanguíneo/efeitos da radiação , Volume Sanguíneo/fisiologia , Volume Sanguíneo/efeitos da radiação , Permeabilidade Capilar/fisiologia , Permeabilidade Capilar/efeitos da radiação , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Estudos Prospectivos , Fluxo Sanguíneo Regional/fisiologia , Fluxo Sanguíneo Regional/efeitos da radiação
20.
Artigo em Russo | MEDLINE | ID: mdl-19886021

RESUMO

This work was designed to study effect of low-intensity infrared laser radiation (LIIRR) on orbital circulation in children with progressive progressive short-handedness. Parameters of the blood flow in the orbital artery, central retinal artery, and posterior ciliary artery were evaluated in a total of 88 patients at the age from 6 to 14 years. The study group (group 1) comprised 66 children with moderately severe progressive myopia (112 eyes), the control one (group 2) included 22 patients without visual disturbances (44 eyes). Patients of group 1 received physiotherapy for the treatment of significantly deteriorated hemodynamics in the orbital region. Indirect action of LIIRR on the orbital region promoted stabilization of short-handedness in 78.8% of the treated patients. It is concluded that the method described in this paper is clinically efficient and may be recommended for the prevention of progressive myopia in children.


Assuntos
Raios Infravermelhos/uso terapêutico , Terapia com Luz de Baixa Intensidade/métodos , Miopia/radioterapia , Órbita/irrigação sanguínea , Fluxo Sanguíneo Regional/efeitos da radiação , Adolescente , Criança , Técnicas de Diagnóstico Oftalmológico , Feminino , Humanos , Masculino , Miopia/diagnóstico , Miopia/etiologia , Órbita/efeitos da radiação , Resultado do Tratamento
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