Anaesthesiological experiences with whole body hyperthermia.

OBJECTIVE: In order to investigate the safety of whole body hyperthermia (WBH) within the context of systemic Cancer Multistep Therapy (sCMT) in patients with disseminated malignancies, cardiopulmonary changes and various organ functions were examined. METHODS AND PROCEDURES: Fifty-seven sCMT treatments were performed in 22 patients. WBH with a plateau phase of 1 h at 41.8 degrees C was induced by an IRATHERM 2000 device. Cardiopulmonary parameters were measured at 37, 40, 41.8 and 39 degrees C by use of a pulmonary artery catheter, femoral oxymetry and a radial artery catheter. Organ functions of the liver, kidney, cardiovascular and central nervous system were evaluated before and after treatment. RESULTS: Compared with the initial values, significant alterations were found of most cardiopulmonary parameters in the sense of hypercirculation at 41.8 degrees C. With the exception of extra vascular lung water index, all parameters showed a clear tendency towards the pre-treatment levels at 39 degrees C. In eight out of 57 sCMT treatments, reversible organ dysfunctions were observed. Comparison of radial and femoral arterial blood pressure showed significantly different values at 40 and 41.8 degrees C. CONCLUSIONS: WBH induces cardiovascular stress, but by careful selection of patients and appropriate anaesthesiological monitoring it can be performed safely using general anaesthesia. This enables further evaluation of WBH in multimodal treatment concepts.

Effects of fibroblast growth factor and chondroitin sulfate on predamaged corneal endothelium. An organ culture study.

Fibroblast growth factor (FGF) and chondroitin sulfate (CDS) were used as supplements in organ culture medium to compare the regeneration ability of corneal endothelium with scattered damages. After 1 week of culturing, cell densities in both FGF-supplemented and FGF + CDS-supplemented groups were not higher than the densities of the control groups. Cells in both groups showed polymorphism. In both CDS-supplemented groups, the corneas were thinner. The cell density in the group supplemented with only CDS was higher than that of the control group, but in the CDS + FGF-supplemented group the cell density was not higher than that of the control and the morphology was even worse. Combining of FGF and CDS in culture medium appeared to be disadvantageous.