Highly efficient magnetic ablation and the contrast of various imaging using biocompatible liquid-metal gallium.

BACKGROUND: Although the powerful clinical effects of radiofrequency and microwave ablation have been established, such ablation is associated with several limitations, including a small ablation size, a long ablation time, the few treatment positioning, and biosafety risks. To overcome these limitations, biosafe and efficient magnetic ablation was achieved in this study by using biocompatible liquid gallium as an ablation medium and a contrast medium for imaging. RESULTS: Magnetic fields with a frequency (f) lower than 200 kHz and an amplitude (H) × f value lower than 5.0 × 109 Am-1 s-1 were generated using the proposed method. These fields could generate an ablation size of 3 cm in rat liver lobes under a temperature of approximately 300 °C and a time of 20 s. The results of this study indicate that biomedical gallium can be used as a contrast medium for the positioning of gallium injections and the evaluation of ablated tissue around a target site. Liquid gallium can be used as an ablation medium and imaging contrast medium because of its stable retention in normal tissue for at least 3 days. Besides, the high anticancer potential of gallium ions was inferred from the self-degradation of 100 µL of liquid gallium after around 21 days of immersion in acidic solutions. CONCLUSIONS: The rapid wireless ablation of large or multiple lesions was achieved through the simple multi-injection of liquid gallium. This approach can replace the currently favoured procedure involving the use of multiple ablation probes, which is associated with limited benefits and several side effects. METHODS: Magnetic ablation was confirmed to be highly efficient by the consistent results obtained in the simulation and in vitro tests of gallium and iron oxide as well as the electromagnetic specifics and thermotherapy performance comparison detailed in this study Ultrasound imaging, X-ray imaging, and magnetic resonance imaging were found to be compatible with the proposed magnetic ablation method. Self-degradation analysis was conducted by mixing liquid gallium in acidic solutions with a pH of approximately 5-7 (to imitate a tumour-containing microenvironment). X-ray diffraction was used to identify the gallium oxides produced by degraded gallium ions.

Curcumin nanoparticles are a promising anti-bacterial and anti-inflammatory agent for treating periprosthetic joint infections.

BACKGROUND: Periprosthetic joint infections (PJIs) have a high incidence of recurrence after total joint replacement and are difficult to treat by debridement or antibiotic treatment. Curcumin is a natural product with anti-inflammatory and anti-bacterial properties. The low bioactivity of curcumin in water restricts its clinical application. Curcumin nanoparticles (CURN) were developed to overcome this limitation. METHODS: In this study, the therapeutic effects of CURN and their anti-inflammatory functions were investigated in a Staphylococcus aureus biofilm-induced PJIs model. RESULTS: CURN first attenuated the biofilm-induced expansion of myeloid-derived suppressor cells (MDSCs) and then regulated M1- and M2-phenotypic MDSC expression. Down-regulation of cytokines and reactive oxygen species was considered as the mechanism of CURN in reversing the suppression of T cell proliferation. The recovery of bone permeative destruction demonstrated that CURN enhanced therapeutic potency of vancomycin in vivo. CONCLUSION: This is the first study to demonstrate that CURN may be useful for treating PJIs.

Hyperbaric oxygen therapy in orthopedic conditions: an evaluation of safety.

BACKGROUND: Because of the documented cellular and biochemical benefits of hyperbaric oxygen (HBO), HBO therapy is applied now with increasing frequency to various orthopedic conditions. Many traumatologists and orthopedic surgeons might refer their patients for adjuvant HBO therapy. However, the potential risks and risk-benefit ratio have often been underemphasized in therapeutic trials. METHODS: From October 2002 to September 2004, 240 patients with a total of 4,638 treatments received HBO therapy at the hyperbaric medicine center of our institution on an identical treatment protocol. HBO therapy patient treatment logs were reviewed to analyze the incidence of complications during HBO treatment. RESULTS: The overall incidence of complications was 1.83%. Over 94% of treatment complications were mild to moderate and designated as minor complications; fewer than 6% were severe or life threatening and designated as major complications. The incidence of major complications (central nervous system [CNS] oxygen toxicity in this series) was 0.109%. There was no mortality. Two patients with unusual presentation of CNS oxygen toxicity were observed during the study period. CONCLUSIONS: HBO therapy in orthopedic conditions is considered as a safe treatment because of a very low complication rate; however, analysis of patients with CNS oxygen toxicity revealed its unpredictability and inevitability. Although it is common sense that patients who develop a seizure in the hospital need help from the medical staff, it cannot be done in a monoplace hyperbaric chamber because of pressure unequalization. Therefore, a multiplace chamber equipped with an antechamber for medical contingency is possibly the better facility in consideration of safety.