Electrochemotherapy for the treatment of squamous cell carcinoma in cats: a preliminary report.

Squamous cell carcinomas (SCC) of the skin are commonly described in cats. Reported treatments include surgery, radiation therapy and photodynamic therapy. This preliminary study reports on the management of these lesions combining the local administration of bleomycin (plus hyaluronidase for a more uniform distribution) with permeabilizing biphasic electric pulses. Nine cats with SCC graded T(2)-T(4) were treated over a 5 year period, and each cat received two sessions of electrochemotherapy (ECT) 1 week apart. The side effects of this treatment were minimal and limited to mild erythema of the nose. Seven of the cats (77.7%) had a complete response lasting up to 3 years. ECT seems to be a safe and effective option for the treatment of feline sun-induced squamous cell carcinomas and warrants further investigation.

Adjuvant electrochemotherapy for incompletely excised anal sac carcinoma in a dog.

Canine anal sac gland carcinoma (ASGC) is a frequently described neoplasm that is highly aggressive and can frequently lead to metastatic spread. In this paper, we describe the successful treatment of an incompletely excised ASGC by using cisplatin selectively driven within the tumor cells by trains of biphasic pulses. The dog received two courses of electrochemotherapy 14 days apart. Neither systemic nor local toxicities were detected during the whole course of therapy. The dog is still in complete remission after 18 months. Electrochemotherapy is a safe and efficacious adjuvant therapy for ASGC and warrants further investigation in order to standardize its protocols.

Successful rescue of an apocrine gland carcinoma metastatic to the cervical lymph nodes by mitoxantrone coupled with trains of permeabilizing electrical pulses (electrochemotherapy).

Canine apocrine gland carcinoma is a locally aggressive neoplasm that can occasionally lead to metastatic spread, thus mimicking the behavior of their human counterpart. In this paper we describe the successful treatment of a cervical metastatic spread of this neoplasia by using mitoxantrone selectively driven within the tumor cells by trains of biphasic pulses. The dog experienced tumor reduction from the first cycle of electrochemotherapy (ECT) and complete remission by the time of its fourth session. Neither systemic or local toxicities were detected during the whole course of therapy. The dog is in complete remission after six months from his last treatment. Electrochemotherapy is a safe and efficacious therapy for metastatic carcinoma and warrants further investigation.

Electrochemotherapy-induced radiation recall in a cat.

Electrochemotherapy is gaining popularity for the treatment of malignancies of companion animals due to its efficacy and low cost. In this paper, we describe the successful treatment of a recurring fibrosarcoma in a cat by using cisplatin selectively driven within the tumor cells by trains of biphasic pulses. The cat's tumor did not recur over the following five months, however the cat did experience severe erythema at the site of previous irradiation, followed by moist desquamation and ulcer that required debridement and prolonged therapy with steroids and antihistaminic drugs. The symptoms and the response to symptomatic therapy were strongly suggestive of radiation recall. Electrochemotherapy (ECT) should be used with caution in previously irradiated areas. Further studies are warranted in this field due to its potential as a rescue for relapsing tumors.

Digital lock-in techniques for adaptive power-line interference extraction.

This paper presents a simple digital approach for adaptive power-line (PL) or other periodic interference extraction. By means of two digital square (or sine) wave mixers, the real and imaginary parts of the interference are found, and the interference waveform is synthesized and finally subtracted. The described technique can be implemented in an open-loop architecture where the interference is synthesized as a complex sinusoid or in a closed-loop architecture for automatic phase and gain control. The same approach can be used for removal of the fundamental frequency of the PL interference as well as its higher harmonics. It is suitable for real-time operation with popular low-cost microcontrollers.

Bootstrapped two-electrode biosignal amplifier.

Portable biomedical instrumentation has become an important part of diagnostic and treatment instrumentation. Low-voltage and low-power tendencies prevail. A two-electrode biopotential amplifier, designed for low-supply voltage (2.7-5.5 V), is presented. This biomedical amplifier design has high differential and sufficiently low common mode input impedances achieved by means of positive feedback, implemented with an original interface stage. The presented circuit makes use of passive components of popular values and tolerances. The amplifier is intended for use in various two-electrode applications, such as Holter monitors, external defibrillators, ECG monitors and other heart beat sensing biomedical devices.

Ganglioneuroblastoma in a cat: a rare neoplasm treated with electrochemotherapy.

An 8-year-old male castrated cat was referred for sudden onset of lameness. Physical examination revealed a 1x2x1cm mass originating from a footpad of the right hind leg. A diagnosis of ganglioneuroblastoma was suggested by the tumour appearance following histopathological staining with haematoxylin and eosin and haematoxylin/van Gieson. Immunohistochemical staining for glial fibrillary acidic protein (GFAP), vimentin, neuron-specific enolase (NSE), neurofilament and S100 further confirmed the diagnosis. The staging process did not indicate metastatic spread. The cat was treated with three sessions of electrochemotherapy (ECT) 1 week apart, following local injection of bleomycin. The tumour had completely regressed within 1 week of the third ECT application and remained in remission for 402 days at which time a small recurrence was noted. The animal was given a further session of ECT using intra-lesional cisplatin and again went into remission. It remained tumour free at 450 days. Electrochemotherapy is considered a safe and effective treatment for localised neoplasms of cats and dogs and warrants further investigation.

Adjuvant electrochemotherapy for the treatment of incompletely excised spontaneous canine sarcomas.

Electrochemotherapy (ECT) is a new therapeutical technique that combines the administration of trains of biphasic pulses with the local application of poorly permeant anticancer molecules, thus obtaining increased chemotherapy uptake. The purpose of this study was to prospectively assess the adjuvant potentialities of ECT for the treatment of different incompletely excised canine sarcomas. Twenty-two privately owned dogs with incomplete surgical excision of high grade sarcomas were treated with bleomycin injected within the tumor bed (1.5 IU/mg) followed by the sequential application of trains of biphasic pulses (8 pulses, 1300 V/cm, 50+50 micros duration, 1 Hz frequency). The overall response rate was 95% (21 out of 22 patients) with a mean time to recurrence of 730 days. At the time of writing 11 dogs were still in remission, three dogs had died of unrelated causes, one had local recurrence and the owner declined further treatment, one had limb amputation following recurrence, four had both local recurrence and distant metastases that led to euthanasia, and two were retreated following tumor recurrence and are disease free at 850 and 1947 days. The only observed toxicity was wound dehiscence in three patients. Electrochemotherapy is well tolerated and has effectiveness against incompletely excised sarcomas in companion animals. Further investigations are warranted to improve the currently available protocols.

Local control and distant metastasis after electrochemotherapy of a canine anal melanoma.

Canine anal melanoma is an aggressive neoplasm that rapidly leads to constipation in dogs, thus mimicking the behavior of their human counterpart. In this paper, the successful local palliation of this neoplasm is described using cisplatin selectively driven within the tumor cells by trains of biphasic pulses. The dog experienced tumor reduction with restoration of normal defecation for three months, then experienced massive dissemination to the sublumbar lymph nodes that led to intestinal obstruction and euthanasia. Electrochemotherapy (ECT) is a safe palliative therapy for such neoplasm and warrants further investigations in dogs as well humans.

Transthoracic impedance study with large self-adhesive electrodes in two conventional positions for defibrillation.

External defibrillation requires the application of high voltage electrical impulses via large external electrodes, placed on selected locations on the thorax surface. The position of the electrodes is one of the major determinants of the transthoracic impedance (TTI) which influences the intracardiac current flow during electric shock and defibrillation success. The variety of factors which influence TTI measurements raised our interest to investigate the range of TTI values and the temporal TTI variance during long-term application of defibrillation self-adhesive electrodes in two conventional positions on the patient's chest--position 1 (sub-clavicular/sub-axillar position) and position 2 (antero-posterior position). The prospective study included 86 randomly selected volunteers (39 male and 49 female, 67 patients with normal skin, 13 patients with dry skin and 6 patients with greasy skin, 16 patients with chest pilosity and 70 patients without chest pilosity). The TTI was measured according to the interelectrode voltage drop obtained by passage of a low-amplitude high-frequency current (32 kHz) between the two self-adhesive electrodes (active area about 92 cm2). For each patient, the TTI values were measured within 10 s, 1 min and 5 min after sticking the electrodes to the skin surface, independently for the two tested electrode positions. We found that the expected TTI range is between 58 Omega and 152 Omega for position 1 and between 55 Omega and 149 Omega for position 2. Although the two TTI ranges are comparable, we measured significantly higher TTI mean of about (107.2 +/- 22.3) Omega for position 1 compared to (96.6 +/- 19.2) Omega for position 2 (p = 0.001). This fact suggested that the antero-posterior position of the electrodes is favourable for defibrillation. Within the investigated time interval of 5 min, we observed a significant TTI reduction with about 6.9% (7.4 Omega/107.2 Omega) for position 1 and about 5.3% (5.1 Omega/96.6 Omega) for position 2. We suppose that the long-term application of self-adhesive electrodes would lead to improvement of the physical conditions for conduction of the defibrillation current and to diminution of energy loss in the electrode-skin contact impedance. We found that gender is important when position 1 is used because women have significantly higher TTI (111 +/- 20.3) Omega compared to the TTI of men (102.6 +/- 24) Omega (p = 0.0442). Although we found some specifics of the electrode-skin contact layer, we can conclude that because of the insignificant differences in TTI, the operator of the defibrillator paddles does not need to take into consideration the skin type and pilosity of the patients. Analysis of the correlations between TTI and the individual patient characteristics (chest size, weight, height, age) showed that these patient characteristics are unreliable factors for prediction of the TTI values and optimal defibrillation pulse parameters and energy.

Biphasic pulses enhance bleomycin efficacy in a spontaneous canine genital tumor model of chemoresistance: Sticker sarcoma.

Sticker's sarcoma (also known as transmissible venereal tumor) is a horizontally transmitted neoplasm of the dog, that is passed with coitus. It is a locally aggressive tumor with a low tendency to metastatic spread. The most common locations are the genitals, the nose, the perianal area. Standard treatment consists with chemotherapy with vincristine, however other therapies such as, cryotherapy, immunotherapy or, in selected cases, radiation therapy, have been reported. In this article we describe the outcome of a small cohort of canine patients, with chemotherapy resistant transmissible venereal tumor (TVT), treated with bleomycin selectively driven by trains of biphasic pulses (electrochemotherapy). Three canine patients, with refractory TVT, entered the study and received two sessions of ECT under sedation. The pets had local injection of bleomycin at the concentration of 1.5 mg/ml and five minutes after the chemotherapy, trains of 8 biphasic electric pulses lasting 50 + 50 mus each, with 1 ms interpulse intervals, were delivered by means of modified caliper or, for difficult districts, through paired needle electrode. All the patients responded to the treatment and are still in remission at different times. Electrochemotherapy appears as a safe and efficacious modality for the treatment of TVT and warrants further investigations.