HUCMSCs transplantation combined with ultrashort wave therapy attenuates neuroinflammation in spinal cord injury through NUR77/ NF-κB pathway.

AIMS: Spinal cord injury (SCI) is a major cause of long-term physical impairment. Currently, treatment for SCI is limited to supportive measures, which can lead to permanent disability, representing a serious social burden. The present study aimed to evaluate the inflammatory microenvironment effects of human umbilical cord mesenchymal stem cells (HUCMSCs)+ Ultrashort Wave (USW) therapy on SCI and reveal possible mechanisms. MAIN METHODS: Low-dose USW was treated one day after SCI, and HUCMSCs suspension was transferred to the lesion using a micro-syringe 7 days after SCI. The functional effects of HUCMSCs and USW, separately and combinedly, were measured, together with the infiltration of CD3+ cells, formation of A1 astrocytes and activation of NUR77/ NF-κB pathway. KEY FINDINGS: Our results showed that HUCMSCs+USW therapy improved motor function of SCI rat, together with decreased infiltration of CD3+ T cells, and decreased induction of microglia and A1 astrocytes. And also USW treatment played a very important role on decreasing the infiltration of CD3+ T cells and IBA-1+ cells. Reduced production of pro-inflammatory cytokines IL-1ß and IL-6 was also observed in rats receiving HUCMSCs+USW therapy, medicated by NUR77/NF-κB pathway. SIGNIFICANCE: These findings indicated that HUCMSCs+USW therapy could attenuate inflammatory microenvironment through NUR77/NF-κB signaling pathway, which might contribute to its better outcome.

Transferrin as a thermosensitizer in radiofrequency hyperthermia for cancer treatment.

One of the main characteristics of cancer tissues is poor development of neovascularization that results in a limited blood circulation. Because of this phenomenon, it is harder for cancer tissues to diffuse their elevated heat into other parts of the body. The scientific principle of radiofrequency hyperthermia relies on this quality of cancer tissues which with higher temperature becomes more apparent. Despite the obvious necessity to selectively heat the cancer tissue for radiofrequency hyperthermia, a proper thermosensitizer has not been developed until now. Here, we show that transferrin containing ferric ion could be an ideal thermosensitizer for the increased efficiency of radiofrequency hyperthermia. In our result, the ferric ion-enriched cancer tissues dramatically react with 13.56 MHz radiofrequency wave to cause cancer-selective dielectric temperature increment. The overall anticancer efficacy of a 13.56 MHz radiofrequency hyperthermia using transferrin as a thermosensitizer was much higher than the oncotherapeutic efficacy of paclitaxel, successfully eradicating cancer in a tumor-xenografted mouse experiment.

Low-energy shock wave preconditioning reduces renal ischemic reperfusion injury caused by renal artery occlusion.

PURPOSE:: To evaluate whether low energy shock wave preconditioning could reduce renal ischemic reperfusion injury caused by renal artery occlusion. METHODS:: The right kidneys of 64 male Sprague Dawley rats were removed to establish an isolated kidney model. The rats were then divided into four treatment groups: Group 1 was the sham treatment group; Group 2, received only low-energy (12 kv, 1 Hz, 200 times) shock wave preconditioning; Group 3 received the same low-energy shock wave preconditioning as Group 2, and then the left renal artery was occluded for 45 minutes; and Group 4 had the left renal artery occluded for 45 minutes. At 24 hours and one-week time points after reperfusion, serum inducible nitric oxide synthase (iNOS), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), creatinine (Cr), and cystatin C (Cys C) levels were measured, malondialdehyde (MDA) in kidney tissue was detected, and changes in nephric morphology were evaluated by light and electron microscopy. RESULTS:: Twenty-four hours after reperfusion, serum iNOS, NGAL, Cr, Cys C, and MDA levels in Group 3 were significantly lower than those in Group 4; light and electron microscopy showed that the renal tissue injury in Group 3 was significantly lighter than that in Group 4. One week after reperfusion, serum NGAL, KIM-1, and Cys C levels in Group 3 were significantly lower than those in Group 4. CONCLUSION:: Low-energy shock wave preconditioning can reduce renal ischemic reperfusion injury caused by renal artery occlusion in an isolated kidney rat model.

Low-energy shock wave preconditioning reduces renal ischemic reperfusion injury caused by renal artery occlusion

Abstract Purpose: To evaluate whether low energy shock wave preconditioning could reduce renal ischemic reperfusion injury caused by renal artery occlusion. Methods: The right kidneys of 64 male Sprague Dawley rats were removed to establish an isolated kidney model. The rats were then divided into four treatment groups: Group 1 was the sham treatment group; Group 2, received only low-energy (12 kv, 1 Hz, 200 times) shock wave preconditioning; Group 3 received the same low-energy shock wave preconditioning as Group 2, and then the left renal artery was occluded for 45 minutes; and Group 4 had the left renal artery occluded for 45 minutes. At 24 hours and one-week time points after reperfusion, serum inducible nitric oxide synthase (iNOS), neutrophil gelatinase-associated lipocalin (NGAL), kidney injury molecule-1 (KIM-1), creatinine (Cr), and cystatin C (Cys C) levels were measured, malondialdehyde (MDA) in kidney tissue was detected, and changes in nephric morphology were evaluated by light and electron microscopy. Results: Twenty-four hours after reperfusion, serum iNOS, NGAL, Cr, Cys C, and MDA levels in Group 3 were significantly lower than those in Group 4; light and electron microscopy showed that the renal tissue injury in Group 3 was significantly lighter than that in Group 4. One week after reperfusion, serum NGAL, KIM-1, and Cys C levels in Group 3 were significantly lower than those in Group 4. Conclusion: Low-energy shock wave preconditioning can reduce renal ischemic reperfusion injury caused by renal artery occlusion in an isolated kidney rat model.

An over-the-counter central sensitization therapy: a chronic back pain registry study of pain relief, medication use and their adverse effects.

AIM: Back pain, the most prevalent musculoskeletal chronic pain condition, is usually treated with analgesic medications of questionable efficacy and frequent occurrence of adverse side effects. OBJECTIVE: The objective was to determine the effectiveness of the ActiPatch medical devices in reducing chronic back pain, document medication related adverse side effects and establish their impact on quality of life. METHODS: Upon completing a 7-day trial, subjects were contacted via email with an assessment form using the Constant Contact email program. A total of 1394 responses were collected from subjects who used the device for back pain. CONCLUSION: Medication adverse effects are common and impact quality of life in the lay population. ActiPatch is an effective intervention for the majority of subjects for treating chronic back pain, although this requires further investigation in randomized clinical trials.

Pulsed shortwave diathermy and joint mobilizations for achieving normal elbow range of motion after injury or surgery with implanted metal: a case series.

CONTEXT: Regaining full, active range of motion (ROM) after trauma to the elbow is difficult. OBJECTIVE: To report the cases of 6 patients who lacked full ROM in the elbow because of trauma. The treatment regimen was thermal pulsed shortwave diathermy and joint mobilizations. DESIGN: Case series. SETTING: University therapeutic modalities laboratory. PATIENTS OR OTHER PARTICIPANTS: Six patients (5 women [83%], 1 man [17%]) lacked a mean active ROM of 24.5° of extension approximately 4.8 years after trauma or surgery. INTERVENTION(S): Treatment consisted of 20 minutes of pulsed shortwave diathermy at 800 pulses per second for 400 microseconds (40-48 W average power, 150 W peak power) applied to the cubital fossa, immediately followed by 7 to 8 minutes of joint mobilizations. After posttreatment ROM was recorded, ice was applied to the area for about 30 minutes. MAIN OUTCOMES MEASURE(S): Changes in extension active ROM were assessed before and after each treatment. Once the patient achieved full, active ROM or failed to improve on 2 consecutive visits, he or she was discharged from the study. RESULTS: By the fifth treatment, 4 participants (67%) achieved normal extension active ROM, and 2 of the 4 (50%) exceeded the norm. Five participants (83%) returned to normal activities and full use of their elbows. One month later, the 5 participants had maintained, on average, (mean ± SD) 92% ± 6% of their final measurements. CONCLUSIONS: A combination of thermal pulsed shortwave diathermy and joint mobilizations was effective in restoring active ROM of elbow extension in 5 of the 6 patients (83%) who lacked full ROM after injury or surgery.

[Prophylaxis of adhesive process in patients with extended peritonitis].

The results of treatment of 378 patients, suffering extended peritonitis, were analyzed. For prophylaxis of adhesions formation intraoperatively an adequate surgical correction and measures, directed on elimination of endotoxicosis, were applied; postoperatively--the preparations, suppressing the adhesions formation, were applied. Conduction of intracorporeal and extracorporeal therapy extremely high frequency irradiation in complex of treatment have promoted a trustworthy improvement of motor-evacuatory function stomach and intestinal due to impact on system of coagulation and blockade of the oxidative reactions cascade, as well as due to bacteriostatic effect.

Noninvasive therapy for the management of patients with advanced coronary artery disease.

OBJECTIVES: To determine the efficacy of cardiac shock wave therapy (CSWT) in the management of patients with end-stage coronary artery disease (CAD). INTRODUCTION: Patients with end-stage CAD have symptoms such as recurrent angina, breathlessness, and other debilitating conditions. End-stage CAD patients are usually those who have angina pectoris following a coronary artery bypass surgery or a percutaneous coronary intervention. These patients are refractory to optimal medical therapy and not fit for a redo procedure, and are often termed as 'no option' patients. METHODS: We carried out a prospective cohort study to examine the effects of CSWT application in patients who had end-stage CAD and were no option patients. Characteristics such as angina class scores and functional status scores among cases (patients with end-stage CAD who received CSWT) and controls (patients with end-stage CAD who did not receive CSWT) were compared at baseline and at 6 months after CSWT therapy. RESULTS: There were 43 patients in the case group and 43 patients in the control group. The mean age of the patients was 58.7 ± 9.5 years in the case group and 56.6 ± 11.6 years in the control group. Other characteristics such as the prevalence of diabetes, hypertension, coronary artery bypass graft and percutaneous coronary intervention were similar in both groups. Clinical results showed a significant improvement in exercise time between the cases and the controls 6 months after treatment with CSWT (20.1 ± 15.7 min in cases vs. 10.1 ± 4.2 min in controls; P<0.0001), and symptomatic improvement in the CCS class scores (1.95 ± 0.80 in cases and 2.63 ± 0.69 in controls; P<0.0001) and NYHA class scores (1.95 ± 0.80 in cases vs. 2.48 ± 0.59 in controls; P<0.001). In the control group, there was no improvement in angina class, functional class and exercise time. CONCLUSION: The present study shows that CSWT application to the ischemic myocardium in patients with refractory angina pectoris improved symptoms and reduced the severity of ischemic areas at 6 months after CSWT treatment compared with the baseline. No side effects were observed with this therapy.

Making liver transection even safer: a novel use of microwave technology.

Hepatic surgery has evolved significantly in the past decade. The current article describes the largest series of patients in United States undergoing liver resective therapy with the use of microwave technology for liver precoagulation. Glisson's capsule was incised after securing inflow and outflow control. Two antennae, 2 cm apart, connected to a 915-MHz generator, were inserted 5 cm into liver parenchyma at a 130° angle. Once the parenchyma was firm and changed its color to gray, the antennae were advanced along the line of transection. The parenchyma was divided with electrocautery. Intra- and postoperative data were analyzed. Thirty-five patients (24 men) underwent liver resections. Diseases treated were colorectal metastases (n = 9), hepatic adenoma (n = 3), gallbladder cancer (n = 3), hepatocellular carcinoma (n = 4), neuroendocrine tumor (n = 2), cholangiocarcinoma (n = 5), hemangioma (n = 2), focal nodular hyperplasia (n = 2), metastatic gastrointestinal stromal tumor (n = 1), hydatid cyst (n = 1), hepatoid carcinoma (n = 1), hepatolithiasis (n = 1), and suspected metastatic breast cancer (n = 1). Resections done were right hepatectomy (n = 19), segmental resection (n = 5), left hepatectomy (n = 4), extended right hepatectomy (n = 4), Segment IVb and Segment V resections during radical cholecystectomy (n = 2), and left lateral sectionectomy (n = 1). Median operative time for major resection was 188 and 251 minutes for minor resection. There was one postoperative mortality. Bile leak needing stenting occurred in one patient. Median blood loss for major resection was 500 mL and 265 mL for minor resection. Intraoperative transfusion was required in nine major and one minor resections. Other complications were ileus in four, deep vein thrombosis in two, intra-abdominal abscess in one, and cardiac events in two patients. Liver precoagulation with microwave technology is a novel and efficient technique with minimal morbidity and mortality for liver transection.

[Extremely high frequency therapy for the prevention of acute respiratory diseases in children with chronic ENT and allergic diseases].

Extremely high frequency (EHF) therapy (42.19 +/- 0.10 GHz; 5.6 mm) is an efficacious method for the prevention of acute respiratory diseases (ARD) in frequently ill children presenting with chronic ENT diseases (chronic tonsillitis, chronic sinusitis) and allergic reactions (allergic rhinitis, atopic dermatitis). It helped to reduce ARD morbidity, duration of a single ARD episode, and frequency of bacterial complications per one child during the 6 and 12 month-long observation periods in comparison with the patients of the placebo group. It is believed that prophylactic effect of EHF therapy in frequently ill children is due to positive effect of extremely high frequency electromagnetic radiation on the adaptive capacity of the organism, improvement of both cellular and humoral immunity, correction of the initial vegetative tone and vegetative dysfunction.

Experimental study of low dose ultrashortwave promoting nerve regeneration after acellular nerve allografts repairing the sciatic nerve gap of rats.

OBJECTIVES: To observe the effect of ultrashortwave (USW) therapy on nerve regeneration after acellular nerve allografts(ANA) repairing the sciatic nerve gap of rats and discuss its acting mechanisms. METHODS: Sixteen Wistar rats weighing 180-220 g were randomly divided into four groups with four rats in each group: normal control group; acellular group (ANA, treated by hypotonic-chemical detergent, was applied for bridging a 10 mm-long sciatic nerve defect); USW group (After 24 h of ANA repairing the sciatic nerve gap, low dose USW was administrated for 7 min, once a day, 20 times a course of treatment, three courses of treatment in all); and autografts group. 12 weeks after operation, a series of examinations was performed, including electrophysiological methods, the restoring rate of tibialis anterior muscle wet weight, histopathological observation (myelinated nerve number, myelin sheath thickness, and axon diameter), vascular endothelial growth factor (VEGF) mRNA expression of spinal cord, and muscle at injury site, and analyzed statistically. RESULTS: Compared to acellular nerve allografts alone, USW therapy can increase nerve conductive velocity, the restoring rate of tibialis anterior muscle wet weight, myelinated nerve number, axon diameter, VEGF mRNA expression of spinal cord, and muscle at injury site, the difference is significant. There were no differences between USW group and autografts group except myelin sheath thickness. CONCLUSIONS: USW therapy can promote nerve axon regeneration and Schwann cells proliferation after ANA repairing the sciatic nerve gap of rats, the upregulation of VEGF mRNA expression of spinal cord and muscle may play an important role.

Outcomes of radiofrequency in advanced keratoconus.

PURPOSE: To evaluate the use of radiofrequency energy to correct advanced keratoconus. SETTING: Universidade Federal de Minas Gerais, Belo Horizonte, and Universidade de Ciências da Saúde de Alagoas, Maceió, Brazil. METHODS: In this prospective comparative study, radiofrequency was applied to 25 eyes of 21 consecutive patients. One group comprised patients with a K-reading between 54.0 diopters (D) and 58.0 D; 8 thermal spots were placed at the 4.0 mm optical zone. The other group comprised patients with a K-reading greater than 58.0 D; 16 spots were applied at the 4.0 mm and 5.0 mm optical zones. The minimum follow-up was 18 months in all patients. Differences between preoperative and postoperative uncorrected visual acuity, best spectacle-corrected visual acuity (BSCVA), manifest refraction, and K-readings were clinically and statistically evaluated. RESULTS: At end of the 18-month follow-up, the mean BSCVA in the 8-spot group improved from 20/100 (0.71+/-0.25 logMAR) preoperatively to 20/40 (0.32+/-0.11 logMAR) and in the 16-spot group, from 20/200 (1.03+/-0.30 logMAR) to 20/60 (0.62+/-0.22 logMAR). The mean manifest refractive spherical equivalent (MRSE) improved from -7.70 D+/-5.20 (SD) preoperatively to -6.82+/-4.41 D after 18 months in the 8-spot group and from -11.33+/-6.70 to -8.38+/-5.12 D, respectively, in the 16-spot group. The mean best contact lens-corrected visual acuity was 20/30 (0.18+/-0.24 logMAR) in the 8-spot group and 20/40 (0.31+/-0.19 logMAR) in the 16-spot group. A dense corneal scar was seen in 1 patient in the 16-spot group at the 6-month follow-up. CONCLUSIONS: Radiofrequency appeared safe for the treatment of advanced keratoconus. Contact lens fitting was stable in all cases.

Second-generation treatment: microwave.

Microwave endometrial ablation is an effective treatment for heavy menstrual loss that achieves high satisfaction rates, is acceptable to patients, and is recommended by the National Institute of Clinical Excellence. It has been evaluated extensively in randomized trials against first- and second-generation endometrial ablative techniques. Its simplicity of use and short treatment time make it suitable for outpatient treatments, whilst it can also treat larger and irregular cavities. This article reviews the available clinical research and scientific basis of this endometrial ablation technique.

Ondas de choque focalizadas en el tratamiento de la sesamoiditis del hallux: 44 casos: Centro de Especialidades Traumatológicas de Venezuela (CETVEN) Valencia Estado Carabobo / Shock waves focalizadas in the treatment of the sesamoiditis of the hallux: 44 cases: Centro de Especialidades Traumatológicas de Venezuela (CETVEN) Valencia State Carabobo

Los sesamoides del hallux ubicados dentro del tendón del flexor corto del hallux reciben fibras del abductor y el aductor del hallux. La sesamoiditis es causa de dolor en la base del primer metatarsiano que esta oculta en muchas oportunidades. Puede estar asociada a otras patologías del pie como hallux valgus y fascitis plantar. Es causa frecuente de disminución de rendimiento deportivo y laboral. Su manejo ha sido difícil y los tratamientos AINES, fisioterapia, ortesis y cirugía con pobres resultados. Estudio experimental realizado en la Unidad de Ondas de Choque del Centro de Especialidades Traumatológicas de Venezuela (CENTVEN), Septiembre 2004 febrero 2005 en una serie completa de 44 pacientes con diagnóstico de sesamoiditis que recibieron tratamiento por ondas de choque focalizadas con equipo ORTHOSPEC clase IIA, intensidad de 0,04 a 0,16 mj/mm2, frecuencia de la onda 120 ondas por minuto con técnica multifocal. Se realiza evaluación inicial clínica e imagenológica, se emplea escala visual análoga (E.A.V.) y nivel de satisfacción del paciente. Valoración clínica control cada seis semanas posterior al tratamiento durante 12 meses. Se realiza análisis estadístico descriptivo e inferencial fundamentado con una diferencia entre medidas y técnicas Chi Cuadrado, usando nivel de significación de 0,05. Predomino sexo masculino con edad promedio 47 años. El 54 por ciento asociado a fascitis plantar proximal y 18 por ciento a hallux valgus; el 45 por ciento fueron atletas; inicio de analgesia promedio de 494 desviación de 262 ondas, total de ondas por sesión promedio de 930 con desviación estándar de 570 ondas, la diferencia entre medidas de las variables EAV Inicial y EAV Final y la asociación entre EA V Final y nivel de satisfacción a los doce meses resultaron significativas al nivel del 0,05. Concluyéndose que la efectividad de este procedimiento lo hace una opción terapéutica útil, y no invasivo para el manejo de la sesamoiditis.

Treatment of chronic pain with millimetre wave therapy (MWT) in patients with diffuse connective tissue diseases: a pilot case series study.

BACKGROUND: Pain relief is reported to be the most common clinical application of electromagnetic millimetre waves. AIM: To evaluate safety and pain relief effect of millimetre wave therapy (MWT) for treatment of chronic joint pain in a group of patients with diffuse connective tissue diseases. METHODS: Twelve patients with diffuse connective tissue diseases received MWT in addition to their analgesic medication with non-steroidal anti-inflammatory drugs. MWT procedure included the exposure of tender points around the painful joints to electromagnetic waves with frequency 54-78GHz and power density of 2.5mW/cm(2). The time of exposure was 35 +/-5 min and the total number of sessions ranged from 5 to 10 (median 6). Intensity of pain, medication requirement, joint stiffness and subjective assessment of therapy success were measured before, during and immediately after the treatment, and after a 6-months follow-up. RESULTS: No adverse effects of MWT were noted. Pain intensity and required medication decreased significantly after the treatment (p<0.05) and remained at the same level throughout the follow-up period. The joint stiffness decreased and the subjective assessment of the treatment success after 6 month did not change except in only one patient. CONCLUSION: MWT applied to tender points around the affected joints was safe under the conditions of our study and after an appropriate full-scale double-blind clinical study, may be recommended as an effective adjunct therapy for chronic pain treatment in patients with diffuse connective tissue diseases.

Pulsed short-wave diathermy effects on human fibroblast proliferation.

OBJECTIVES: To investigate the influence of pulsed short-wave diathermy (PSWD) on fibroblast and chondrocyte cell proliferation rates and to establish the influences of different dosages applied. DESIGN: Four single-blind trials. SETTING: Laboratory, in vitro study. SPECIMENS: Human adult dermal fibroblast and chondrocyte cells were plated at known concentrations and incubated for 5 days. INTERVENTION: Exposure to PSWD, twice daily, on days 2, 3, and 4. MAIN OUTCOME MEASURE: After crystal violet staining (day 5), optical density (cell number) was determined spectrophotometrically. RESULTS: PSWD, given at mean power of 48W for 10 minutes, increased fibroblast proliferation compared with control groups (P<.001). There was a relationship between cell proliferation and the amount of energy given (P<0.001). The optimal mean power for proliferation was estimated to be 13.8W. While keeping mean power constant at 6W, altering pulse duration and pulse repetition rate dosage parameters did not have a significant effect on proliferation (P=.519). Chondrocyte proliferation also increased with PSWD exposure of 6W at 10 minutes duration (P=.015). In addition, treatment time was significantly associated with chondrocyte proliferation (P<.001). CONCLUSION: PSWD is associated with increased rates of fibroblast and chondrocyte proliferation in vitro, which is dose dependent. These results contribute to an understanding of the physiologic mechanisms underlying the therapeutic effects of PSWD.