Generating and monitoring mild hyperthermia using a ring array ultrasound transducer.

OBJECTIVE: To demonstrate the feasibility of using a ring array ultrasound (US) transducer, guided by ultrasound tomography (UST), for generating and monitoring mild hyperthermia (MHTh). METHODS: In silico and in vitro experiments were designed to evaluate the efficacy of a ring array US transducer for generating MHTh and monitoring changes in temperature. In a series of in silico studies, we compared the acoustic focal profiles produced by a ring array US transducer transmitting at different frequencies and further investigated the effectiveness of UST-guidance in implementing aberration correction to enhance the focal profile. In vitro experiments evaluated the capability of using a ring array US transducer to generate and maintain MHTh and the accuracy of using UST to monitor temperature changes. RESULTS: The simulations demonstrated that a ring array US transducer achieves symmetrical and localized acoustic focusing. In a heterogenous tissue model, a ring array US transducer achieved a superior acoustic focus by implementing aberration correction with guidance from UST. In vitro experiments demonstrated the capability of a ring array US transducer to generate MHTh in a tissue-mimicking phantom in an average of 117 ± 18 s and subsequently maintain MHTh. Lastly, a ring array US transducer utilized UST to track temperature changes in a preheated water-filled inclusion while it passively cooled from 45 °C to 25 °C, with a maximum error of 0.58 °C. CONCLUSION: A ring array US transducer can noninvasively generate and monitor MHTh, overcoming many limitations of current clinical systems. The closed geometry of the transducer is optimal for acoustic focusing and UST-guidance allows for improved aberration correction in a heterogenous medium. Utilizing UST thermometry with the same ring array US transducer will allow for implementing an image-guided, temperature-controlled, all-acoustic MHTh system.

Exploring and validating heating dynamics in a radio-frequency electromagnetic field-based resonant chamber for mouse hyperthermia research.

Mild whole-body hyperthermia has been shown to have anti-tumor effects through an immune-modulating mechanism. Before it is widely applied in the clinic, tremendous mechanistic research in animals is necessary to adhere to evidence-based principles. The radio frequency electromagnetic field (RF-EMF) based heating facility could be a good choice for hyperthermia treatment, but the heating characteristics of a facility, including structure design, electromagnetic and thermal dosimetry, and the biologic effects of hyperthermia, need to be well elucidated. Here, we reported the heating characteristic study on a resonant chamber (RC) excited by a 1800 MHz solid source. The EMF in the RC was stirred by 24 static reflectors, which resulted in the standard deviation of electric field intensity being below 3 dB in the EM homogeneity evaluation. For the exposure scenario, six free-moving mice were loaded into separate cases and exposed simultaneously in the RC. The EMF energy absorption and distribution in exposed mice were calculated with the 12-plane-waves method of numerical simulation. Different levels of core body temperature increment in exposed mice were achieved through regulation of the source output power. Overexpression of heat shock proteins (HSPs) was detected in the liver, lung and muscle, but not in the brain of the exposed mice. The levels of representative inflammatory cytokines in the serum, TNF-α and IL-10 increased post RC exposure. Based on the heating characteristic study and validation, the applied RC would be a qualified heating system for mild whole-body hyperthermia effect research in mice.

Mild whole-body hyperthermia has potential anti-tumor effects by modulating the immune system. A radio frequency electromagnetic field (RF-EMF)-based heating facility emerges as a suitable option for hyperthermia treatment. However, a qualified heating facility for scientific research must elucidate its heating characteristics and validate the biological effects associated with hyperthermia. In this study, we report the characteristics of a rodent heating chamber using EMF energy. The special structure of the chamber not only achieved efficient EMF usage but also ensured the homogeneity in EMF spatial distribution, animal EM absorption, and EMF-caused biological effects. Our work may offer insights for designing a low-cost yet reliable heating facility for scientific research.

Energy-Based Devices for the Treatment of Cutaneous Verrucae: A Systematic Review.

BACKGROUND: Warts are one of the most common benign neoplasms caused by human papillomavirus infection and often pose a therapeutic challenge. OBJECTIVE: To summarize the current evidence on the safety and efficacy of laser and energy-based devices for the treatment of cutaneous verrucae. METHODS: A comprehensive systematic review of the literature on laser and energy-based devices for the treatment of cutaneous verrucae was performed. RESULTS: A total of 904 unique studies were identified, of which 109 were included in this review. The most commonly used lasers as a single treatment modality for verrucae included the long-pulsed Nd:Yag (n = 20) and pulsed dye (n = 18) lasers. Other modalities included the CO2 ablative laser (n = 10), photodynamic therapy (n = 11), local hyperthermia (n = 11), microwave therapy (n = 2), and nanopulse stimulation (n = 1). Other studies combined energy-based modalities with additional treatments, such as retinoids, imiquimod, and intralesional bleomycin. Overall, such devices were generally well-tolerated, with only a mild side effect profile. CONCLUSION: Overall, the use of laser and energy-based devices is a safe and well-tolerated option for cutaneous verrucae that is relatively less invasive than surgical interventions. Future studies using more consistent outcome assessment tools will be valuable to help clinicians develop device-specific protocols and treatment regimens to ensure replicable and effective outcomes.

Kirigami-enabled stretchable laser-induced graphene heaters for wearable thermotherapy.

Flexible and stretchable heaters are increasingly recognized for their great potential in wearable thermotherapy to treat muscle spasms, joint injuries and arthritis. However, issues like lengthy processing, high fabrication cost, and toxic chemical involvement are obstacles on the way to popularize stretchable heaters for medical use. Herein, using a single-step customizable laser fabrication method, we put forward the design of cost-effective wearable laser-induced graphene (LIG) heaters with kirigami patterns, which offer multimodal stretchability and conformal fit to the skin around the human body. First, we develop the manufacturing process of the LIG heaters with three different kirigami patterns enabling reliable stretchability by out-of-plane buckling. Then, by adjusting the laser parameters, we confirm that the LIG produced by medium laser power could maintain a balance between mechanical strength and electrical conductivity. By optimizing cutting-spacing ratios through experimental measurements of stress, resistance and temperature profiles, as well as finite element analysis (FEA), we determine that a larger cutting-spacing ratio within the machining precision will lead to better mechanical, electrical and heating performance. The optimized stretchable heater in this paper could bear significant unidirectional strain over 100% or multidirectional strain over 20% without major loss in conductivity and heating performance. On-body tests and fatigue tests also proved great robustness in practical scenarios. With the advantage of safe usage, simple and customizable fabrication, easy bonding with skin, and multidirectional stretchability, the on-skin heaters are promising to substitute the traditional heating packs/wraps for thermotherapy.

LipiFlow for the treatment of dry eye disease.

BACKGROUND: Meibomian gland dysfunction (MGD) is the most common underlying cause of dry eye disease (DED). MGD leads to pathological alteration of the composition or quantity of meibum, or both, which subsequently results in tear evaporation and the typical signs and symptoms associated with DED. The LipiFlow Thermal Pulsation System (LipiFlow) is a medical device used to treat MGD in office; however, it is unclear if LipiFlow can outperform other DED treatments. OBJECTIVES: To evaluate the effectiveness of LipiFlow for treating DED signs and symptoms and the safety of LipiFlow compared with sham or other available treatments for MGD in adults. SEARCH METHODS: The Cochrane Eyes and Vision Information Specialist searched the electronic databases for randomized controlled trials. There were no restrictions on language or date of publication. We searched the Cochrane Central Register of Controlled Trials (CENTRAL, including the Cochrane Eyes and Vision Trials Register; 2022, Issue 6), MEDLINE Ovid, Embase.com, PubMed, LILACS (Latin American and Caribbean Health Science Information database), ClinicalTrials.gov, and World Health Organization International Clinical Trials Registry Platform (WHO ICTRP) electronic databases. We also examined the reference lists of identified trials, review articles, and guidelines for information about relevant trials that may not have been identified by our search strategy. We contacted investigators regarding ongoing trials. The last database search was performed on 24 October 2022. SELECTION CRITERIA: We included studies conducted in adults (over 18 years of age) with DED or MGD as defined by the primary trial investigators. We imposed no restrictions on race, ethnicity, or sex. We considered trials involving contact lens wearers if they were equally represented between groups. DATA COLLECTION AND ANALYSIS: We applied standard Cochrane methodology. MAIN RESULTS: We included 13 trials that randomized a total of 1155 participants (28 to 236 participants randomized per study). Six trials were conducted in the USA, three in China, two in Thailand, one in France, and one in Italy. Eight trials were of single-center design, while four trials were of multicenter design; one trial did not report the number of participating centers. Study characteristics The study population of the included trials was 66% female (range 48% to 80%), with an age range of 19 to 86 years. LipiFlow, used as a stand-alone intervention, was compared with basic warm compresses in five studies, thermostatic device in five studies, oral intervention in one trial, and topical dry eye medications in one trial. LipiFlow was also evaluated together with eyelid hygiene product versus eyelid hygiene products alone in one trial. Findings Five trials compared LipiFlow with a basic warm compress applied for varying durations and frequencies during the trial period; only one of these trials combined a warm compress with eyelid massage. Analyzing symptom scores by different questionnaires (Ocular Surface Disease Index [OSDI] and Standard Patient Evaluation of Eye Dryness [SPEED]) yielded conflicting evidence of a difference in symptoms between LipiFlow and basic warm compresses after four weeks. There was no evidence of a difference in meibomian gland expression, meibum quality, or tear breakup time when comparing LipiFlow with basic warm compresses. Another five trials compared LipiFlow with thermostatic devices. Analysis of symptom scores at four weeks showed that thermostatic devices had reduced OSDI scores by a mean difference (MD) of 4.59 (95% confidence interval [CI] 1.23 to 7.95; I2 = 0, P = 0.007; 553 participants; very low certainty evidence) as compared with LipiFlow. When we compared LipiFlow plus eyelid hygiene with eyelid hygiene alone, there was no evidence of difference in signs or symptoms at any time point evaluated. Only one trial compared LipiFlow with a topical DED medication (lifitegrast 5%). The single-trial estimate suggested that 5% lifitegrast may increase meibomian gland expression scores compared with LipiFlow at day 42 (MD -1.21, 95% CI -2.37 to -0.05; 50 participants; low certainty evidence) by using a meibomian gland expression scale of 0 to 8. One trial compared LipiFlow with an oral intervention (doxycycline), finding that LipiFlow may result in significantly better SPEED scores than doxycycline at three months (MD -4.00, 95% CI -7.33 to -0.67; 24 participants; very low certainty evidence). No other significant differences in signs or symptoms were found between LipiFlow and doxycycline at three months. We did not find any other statistically significant differences in symptoms or signs for any other analysis performed in this review at the one- to four-week time point. Adverse events No trial reported any intervention-related, vision-threatening adverse events. AUTHORS' CONCLUSIONS: LipiFlow performs similarly to other commonly used DED treatments with regard to DED signs and symptoms. The best available evidence was deemed to have a high level of bias, leading to low or very low certainty evidence. Additional research with adequate masking, a standardized testing methodology, and a sample representative of the MGD population is therefore needed before any firm conclusions can be drawn regarding comparative benefits and harms.

Appendiceal tumours and pseudomyxoma peritonei: Literature review with PSOGI/EURACAN clinical practice guidelines for diagnosis and treatment

Pseudomyxoma Peritonei (PMP) is a rare peritoneal malignancy, most commonly originating from a perforated epithelial tumour of the appendix. Given its rarity, randomized controlled trials on treatment strategies are lacking, nor likely to be performed in the foreseeable future. However, many questions regarding the management of appendiceal tumours, especially when accompanied by PMP, remain unanswered. This consensus statement was initiated by members of the Peritoneal Surface Oncology Group International (PSOGI) Executive Committee as part of a global advisory role in the management of uncommon peritoneal malignancies. The manuscript concerns an overview and analysis of the literature on mucinous appendiceal tumours with, or without, PMP. Recommendations are provided based on three Delphi voting rounds with GRADE-based questions amongst a panel of 80 worldwide PMP experts.

Efectos de dos métodos de termoterapia sobre la respuesta vascular aguda y parámetros hemodinámicos en un grupo de sujetos sanos / Effects of two methods of heat therapy on the acute vascular response and hemodynamics in healthy subjects

Objetivo. Recientemente determinados recursos no farmacológicos, como el paquete caliente (PC) y los ultrasonidos (US), son utilizados en el alivio del dolor con alto grado de aceptación en la práctica clínica. Sin embargo, la evidencia experimental que apoye los posibles mecanismos por los que se producen estos beneficios es escasa. El objetivo de este estudio fue comprobar los efectos de dos métodos de termoterapia (PC y US) sobre la respuesta vascular aguda y parámetros hemodinámicos en sujetos sanos. Materiales y métodos. Estudio experimental en 20 sujetos sanos (10 hombres y 10 mujeres; edad media, 22,54±1,70 años). Se aplicaron dos intervenciones de forma aleatoria: a) PC (n=10): 15min a 60°C, y b) US (n=10): 15min a 1Mhz, y se realizaron mediciones vasculares mediante ecografía doppler con transductor de 7Mhz, antes y después de cada intervención. Parámetros vasculares: distensibilidad arterial (Da), módulo elástico (Ep), índice beta de rigidez (β), diámetro arterial sistólico y diastólico, velocidad del flujo sistólico (Vfs) y diastólico (Vfd), relación sístole/diástole (RSD), índice de resistencia (IR) e índice de pulsatilidad (IP) en la arteria braquial, y monitorización hemodinámica de la frecuencia cardiaca y de las presiones arteriales sistólica, diastólica y media. Resultados. Se encontraron diferencias en la Vfd y en el IP (p<0,05), en la intervención con PC, mientras que la intervención con US mostró cambios en la Vfd, la RSD, el IR y la Da (p<0,05). No se encontraron cambios en los parámetros hemodinámicos. Conclusiones. La fisiología del sistema vascular se modifica por la aplicación del PC y los US, sin afectar los parámetros hemodinámicos en sujetos sanos(AU)

Objective. Recently, non-pharmacological resources to relieve pain like hot packs and ultrasound (US) have become common in clinical practice. However, little experimental evidence is available about the possible mechanisms through which these methods bring about pain relief. We aimed to determine the effects of hot packs and US on the acute vascular response and on hemodynamic parameters in healthy subjects. Materials and methods. We conducted an experimental study in 20 healthy subjects (10 men and 10 women; mean age, 22.54±1.70 years). The two interventions were randomly applied: a) hot packs (n=10): 15min at 60°C and b) US (n=10): 15min at 1Mhz. Before and after each intervention, the following vascular parameters were measured in the brachial artery using Doppler ultrasonography with a 7MHz probe: arterial compliance, elastic modulus, beta stiffness index, systolic and diastolic arterial diameters, systolic flow velocity and diastolic flow velocity, systolic/diastolic ratio, resistance index, and pulsatility index. The following hemodynamic parameters were monitored: heart rate and blood pressure (systolic, diastolic, and mean). Results. After the application of hot packs, we observed changes in diastolic flow velocity and in the pulsatility index (P<05). After the application of US, we observed changes in diastolic flow velocity, systolic/diastolic ratio, resistance index, and arterial compliance (P<05). No changes in hemodynamic parameters were observed after either intervention. Conclusions. Applying hot packs or US modifies the physiology of the vascular system but does not affect hemodynamic parameters in healthy subjects(AU)

Active cutaneous warming systems to prevent intraoperative hypothermia: a systematic review / Métodos ativos de aquecimento cutâneo para a prevenção de hipotermia no período intraoperatório: revisão sistemática / Métodos activos de calentamiento cutáneo para la prevención de hipotermia en el período intraoperatorio: revisión sistemática

This study analyzed the evidence available in the literature concerning the effectiveness of different active cutaneous warming systems to prevent intraoperative hypothermia. This is a systematic review with primary studies found in the following databases: CINAHL, EMBASE, Cochrane Register of Controlled Trials and Medline. The sample comprised 23 randomized controlled trials. There is evidence in the literature indicating that the circulating water garment system is the most effective in maintaining patient body temperature. These results can support nurses in the decision-making process concerning the implementation of effective measures to maintain normothermia, though the decision of health services concerning which system to choose should also take into account its cost-benefit status given the cost related to the acquisition of such systems.

O estudo teve como objetivo analisar as evidências disponíveis na literatura sobre a efetividade dos diferentes métodos ativos de aquecimento cutâneo, para a prevenção de hipotermia no período intraoperatório. Para tal, a revisão sistemática foi empregada como método de revisão. A busca por estudos primários foi realizada nas bases de dados CINAHL, EMBASE, Cochrane Register of Controlled Trials e MEDLINE. A amostra da revisão foi composta por 23 ensaios clínicos randomizados controlados. Na literatura, há evidências que indicam que o sistema de circulação de água aquecida é o método mais efetivo à manutenção da temperatura corporal. Os resultados evidenciados podem subsidiar a tomada de decisão do enfermeiro na implementação de medidas efetivas para a manutenção da temperatura corporal. Recomenda-se, entretanto, que a escolha do sistema em cada serviço de saúde seja também baseada na análise custo/benefício, devido aos custos relativos à aquisição dos sistemas investigados.

La finalidad del estudio fue analizar las evidencias disponibles en la literatura acerca de la efectividad de los diferentes métodos activos de calentamiento cutáneo para la prevención de hipotermia en el período intraoperatorio. Para esto, la revisión sistemática fue usada como método de revisión. La búsqueda de los estudios primarios fue efectuada en las bases de datos CINAHL, EMBASE, Cochrane Register of Controlled Trials y Medline. La muestra de la revisión abarcó 23 ensayos clínicos aleatorios controlados. La literatura ofrece evidencias que indican que el sistema de circulación de agua calentada es el método más efectivo en la manutención de la temperatura corporal. Los resultados evidenciados pueden subsidiar la toma de decisión del enfermero en la implementación de medidas efectivas para la manutención de la temperatura corporal. Sin embargo, considerando los costos de adquisición de los sistemas investigados, la elección del sistema en cada servicio de salud debería ser basada en el análisis de costo-beneficio.

Agentes físicos superficiales y dolor. Análisis de su eficacia a la luz de la evidencia científica / Superficial physical modalities and pain. Analysis of their efficacy in light of the scientific evidence

Introducción: Los agentes físicos son todos los elementos físicos con que cuenta el fisioterapeuta que se emplean para intervenir en el cuerpo con fines curativos; sin embargo, el aumento de las publicaciones científicas ha llevado a un incremento en el conocimiento de la efectividad de ciertos agentes fisioterapéuticos en relación con el dolor. Materiales y métodos: Se realizó una búsqueda amplia en las bases de datos Pubmed (Medline), Physiotherapy Evidence Database (PEDro) y Centre for Reviews and Dissemination (DARE), donde la búsqueda se realizó entre el 1 de agosto y el 1 de noviembre del año 2008, con los siguientes límites: estudios publicados desde el año 2003 en adelante, escritos en idioma inglés y español, hechos en humanos; se aceptaron sólo estudios metaanálisis, revisiones sistemáticas, estudios controlados y aleatorios y guías de práctica clínica. Resultados: De los 2.477 estudios que potencialmente podrían entrar a este trabajo, al pasar por los criterios de inclusión y exclusión sólo se incluyeron para su análisis 30investigaciones.Conclusiones: Falta investigación en el estudio de los agentes físicos superficiales para el tratamiento del dolor y que son tan utilizadas actualmente; pese a esto se dispone de evidencia de buen nivel que sustenta la aplicación de ciertos agentes fisioterapéuticos en ciertas enfermedades dolorosas (AU)

Introduction: Physical agents are all of the physical elements that physiotherapists use to intervene in the body with curative intent. However, the increase in scientific publications has allowed greater knowledge to be gained on the effectiveness of certain therapeutic agents in relation to pain. Material and methods: We performed a broad, systematic search of Pubmed (Medline),the Physiotherapy Evidence Database (PEDro) and the Centre for Reviews and Dissemination(D.A.R.E) between August 1 and November 1, 2008 with the following criteria: studies published since 2003, written in English or Spanish, and performed in humans. Only metaanalyses, systematic reviews, randomized controlled trials and clinical practice guidelines were accepted. Results: Of the 2477 studies that could potentially have been included, only 30 met the inclusion and exclusion criteria. Conclusions: Further investigation is needed into commonly used physical agents. Nevertheless, there is a good level of evidence to support the use of certain therapeutic agents in some painful conditions (AU)

Linear versus non-linear noninvasive temperature prediction in a homogeneous medium subjected to physiotherapeutic ultrasound / Comparação entre predição linear e não linear não-invasiva de temperatura num meio homogêneo sujeito a ultra-som de terapia

The lack of accurate time-spatial temperature estimators/predictors conditions the safe application of thermal therapies, such as hyperthermia. In this paper, a comparison between a linear and a non-linear class of models for non-invasive temperature prediction in a homogeneous medium, subjected to ultrasound at physiotherapeutic levels is presented. The linear models used were autoregressive with exogenous inputs (ARX) and the non-linear models were radial basis functions neural networks (RBFNN). In order to create and validate the models, an experiment was build to extract in vitro ultrasound RF-lines, as well as its correspondent temperature values. Then, features were extracted from the measured RF-lines and the models were trained and validated. For both the models, the best-fitted structures were selected using the multi-objective genetic algorithm (MOGA), given the enormous number of possible structures. The best RBFNN model presented a maximum absolute predictive error in the validation set five times less than the value presented by the best ARX model. In this work, the best RBFNN reached a maximum absolute error of 0.42 ºC, which is bellow the value pointed as a borderline between an appropriate and an undesired temperature estimator, which is 0.5 ºC. The average error was one order of magnitude less in the RBFNN case, and a less biased estimation was met. In addition, the best RBFNN needed less environmental information(inputs), given the capacity to non-linearly relate the information. The results obtained are encouraging, considering that coherent results should be obtained in a time-spatial modelling schema using RBFNN models.

A falta de estimadores de temperatura espaço-temporais que sejam precisos impede a aplicação segura das terapias térmicas, como por exemplo a hipertermia. Neste artigo é apresentada uma comparação entre uma classe de modelos lineares e uma classe de modelos não lineares, na predição não invasiva de temperatura num meio homogêneo, quando o mesmo é aquecido por ultra-som em níveis usados em fisioterapia. Os modelos lineares considerados foram do tipo auto-regressivo com entradas exógenas (ARX); a nível não-linear foram considerados redes neuronais RBF (RBFNN). Para treinar e validar os modelos foram recolhidas os ecos provenientes do meio, bem como os correspondentes valores de temperatura. Após a colheita de informação, foram extraídas características dos ecos medidos e posteriormente os modelos foram treinados e validados. Para ambas as classes de modelos, as melhores estruturas foram seleccionadas usando um algoritmo genético multi-objectivo (MOGA), devido ao número elevado de estruturas possíveis. O melhor modelo RBFNN apresentou um erro máximo absoluto cinco vezes inferior ao erro máximo absoluto apresentado pelo melhor modelo ARX. Neste trabalho, o melhor modelo RBFNN apresentou um erro máximo absolutode 0,42 ºC, valor este que é inferior ao limite (0,5 ºC) apresentado como sendo a fronteira entre um estimador desejado e um estimador indesejado. O erro médio cometido pelo melhor modelo neuronal é uma ordem de grandeza inferior ao erro médio apresentado pelo melhor modelo linear, obtendo-se deste modo uma estimação menos enviesada no caso das redes neuronais, com menos informação do ambiente (menos entradas) devido ao processamento não-linear dos dados de entrada. Os resultados obtidos são encorajadores, apontando no sentido de se obter bons resultados numa estimação espaço-temporal.

Modelagem computacional da biotransferência de calor no tratamento por hipertermia em tumores de duodeno através do método dos volumes finitos em malhas não estruturadas / Computational modeling of the bioheat transfer during the hypertermic treatment of duodenum tumors using an unstructured mesh finite volume method

Tumores de duodeno não-operáveis podem ser irradiados com fontes de laser por via endoscópica. Sua função é causar uma elevação de temperatura local a fim de destruir as células cancerígenas, sem, no entanto, causar dano térmico à região sadia circunvizinha. A exatidão do cálculo das temperaturas está ligada à utilização de métodos numéricos adequados. O presente trabalho apresenta a análise térmica de um procedimento terapêutico, onde um tumor de duodeno de 2 cm de diâmetro é aquecido por uma sonda de laser Nd:YAG, através da utilização do método dos volumes finitos (MVF) para solucionar a equação da biotransferência de calor em malhas bidimensionais triangulares não-estruturadas. É feita uma descrição detalhada do modelo físico-matemático pertinente e da função dano térmico. São apresentadas as propriedades termofísicas dos tecidos envolvidos, bem como a escolha dafonte de laser mais adequada à utilização no procedimento a ser simulado. Em seguida é descrita brevemente a formulação do método dos volumes finitos com estrutura de dados por arestas e apresentados os resultados obtidos da análise térmica dos tecidos.

Tumors that cannot be surgically removed could be irradiated using laser sources through endoscopic procedures. The idea is to increase the local temperature to kill the cancer cells without a thermal damage on the healthy tissues in the neighborhood. The accuracy of the estimated temperatures is directly related to the proper choice ofthe adopted numerical methods. In this work a computational tool using the finite volume method was developed, in order to obtain the approximate equations of the bioheat transfer equation using bidimensional unstructured triangular meshes. The analyzed problem consists of a duodenum tumor with 2 cm of diameter that is heated using a Nd:YAG laser probe. The following items will be described: the appropriate physical-mathematical model; the damage function; the thermo-physical properties of the tissues involved; as well as the choice of the best laser source to be used in the procedure to be simulated. Next, the edge based finite volume formulation is described and the results obtained from the tissue thermal analysis are presented.

The Induction of Hyperthermia in Rabbit Liver by means of Duplex Stainless Steel Thermoseeds

OBJECTIVE: To determine the heating characteristics of needle-shaped duplex stainless steel thermoseeds, and to evaluate their effectiveness in the induction of hyperthermia in rabbit liver. MATERIALS AND METHODS: Thermoseeds of the two different shapes, L-shaped for single doses of hyperthermia and I-shaped for in-vitro study and repeated hyperthermic induction, were prepared. For the in-vitro study, an I-shaped thermoseed 0.23 mm in diameter and 25 mm long was placed inside a plastic tube filled with water. Heat was applied for 30 minutes within an induction magnetic field, and during this time changes in temperature were recorded using three thermocouples. For the in-vivo study, fifteen New Zealand white rabbits were divided into five equal groups. An I-shaped or L-shaped thermoseed was inserted in each rabbit's liver, and then placed within the center of the magnetic induction coil during a 30-minute period of hyperthermia. The rabbits in the first group were sacrificed immediately after hyperthermia was induced once, while those in the other groups were sacrificed at 1, 3, and 7 days, respectively, also after one induction. The remaining three rabbits were sacrificed 4 days after three consecutive daily treatment sessions. The resected segments of liver were subsequently evaluated histopathologically for the extent of coagulation necrosis caused by heating of the thermoseed. RESULTS: The in-vitro study demonstrated that the temperature in the thermoseed, which was 25.9 degree C before heating and 54.8 degree C after heating, rose rapidly at first but progressively less rapidly as time elapsed. Light microscopic examination of the rabbits' livers revealed coagulation necrosis and infiltration by inflammatory cells around the insertion site of the thermoseed. The maximum diameter of coagulation necrosis was 2.81+/-1.68 mm, and this occurred in the rabbits that were sacrificed 7 days after heat induction. CONCLUSION: Needle-shaped duplex stainless steel thermoseeds show temperature-dependent-type heating characteristics, and in rabbit liver, induced coagulation necrosis of surrounding tissues after heat is applied for 30 minutes. These thermoseeds may thus be useful for the induction of interstitial hyperthermia.