In vitro thermotherapy-based methods for plant virus eradication

Production of virus-free plants is necessary to control viral diseases, import novel cultivars from other countries, exchange breeding materials between countries or regions and preserve plant germplasm. In vitro techniques represent the most successful approaches for virus eradication. In vitro thermotherapy-based methods, including combining thermotherapy with shoot tip culture, chemotherapy, micrografting or shoot tip cryotherapy, have been successfully established for efficient eradication of various viruses from almost all of the most economically important crops. The present study reviewed recent advances in in vitro thermotherapy-based methods for virus eradication since the twenty-first century. Mechanisms as to why thermotherapy-based methods could efficiently eradicate viruses were discussed. Finally, future prospects were proposed to direct further studies.

Radiofrequency-induced Thermo-chemotherapy Effect Versus a Second Course of Bacillus Calmette-Guérin or Institutional Standard in Patients with Recurrence of Non-muscle-invasive Bladder Cancer Following Induction or Maintenance Bacillus Calmette-Guérin Therapy (HYMN): A Phase III, Open-label, Randomised Controlled Trial

BACKGROUND

There is no effective intravesical second-line therapy for non-muscle-invasive bladder cancer (NMIBC) when bacillus Calmette-Guérin (BCG) fails.

OBJECTIVE

To compare disease-free survival time (DFS) between radiofrequency-induced thermo-chemotherapy effect (RITE) and institutional standard second-line therapy (control) in NMIBC patients with recurrence following induction/maintenance BCG.

DESIGN, SETTINGS, AND PARTICIPANTS

Open-label, phase III randomised controlled trial accrued across 14 centres between May 2010 and July 2013 (HYMN [ClinicalTrials.gov: NCT01094964]).

INTERVENTION

Patients were randomly assigned (1:1) to RITE (60min, 40mg mitomycin-C, 42±2°C) or control following stratification for carcinoma in situ (CIS) status (present/absent), therapy history (failure of previous induction/maintenance BCG), and treatment centre.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS

Primary outcome measures were DFS and complete response (CR) at 3 mo for the CIS at randomisation subgroup. Analysis was based on intention-to-treat.

RESULTS AND LIMITATIONS

A total of 104 patients were randomised (48 RITE: 56 control). Median follow-up for the 31 patients without a DFS event was 36 mo. There was no significant difference in DFS between treatment arms (hazard ratio [HR] 1.33, 95% confidence interval [CI] 0.84-2.10, p=0.23) or in 3-mo CR rate in CIS patients (n=71; RITE: 30% vs control: 47%, p=0.15). There was no significant difference in DFS between treatment arms in non-CIS patients (n=33; RITE: 53% vs control: 24% at 24 mo, HR 0.50, 95% CI 0.22-1.17, p=0.11). DFS was significantly lower in RITE than in control in CIS with/without papillary patients (n=71; HR 2.06, 95% CI 1.17-3.62, p=0.01; treatment-subgroup interaction p=0.007). Disease progression was observed in four patients in each treatment arm. Adverse events and health-related quality of life between treatment arms were comparable.

CONCLUSIONS

DFS was similar between RITE and control. RITE may be a second-line therapy for non-CIS recurrence following BCG failure; however, confirmatory trials are needed. RITE patients with CIS with/without papillary had lower DFS than control. HYMN highlights the importance of the control arm when evaluating novel therapies.

PATIENT SUMMARY

This study did not show a difference in bladder cancer outcomes between microwave-heated chemotherapy and standard of care treatment. Papillary bladder lesions may benefit from microwave-heated chemotherapy treatment; however, more research is needed. Both treatments are similarly well tolerated.

Dependence of HSP27 cellular level on protein kinase CK2 discloses novel therapeutic strategies

BACKGROUND

HSP27 plays a role in various diseases, including neurodegenerative diseases, ischemia, and atherosclerosis. It is particularly important in the regulation of the development, progression and metastasis of cancer as well as cell apoptosis and drug resistance. However, the absence of an ATP binding domain, that is, instead, present in other HSPs such as HSP90 and HSP70, hampers the development of small molecules as inhibitors of HSP27.

METHODS

Knockout cell lines generated by Crispr/Cas9 gene editing tool, specific kinase inhibitors and siRNA transfections were exploited to demonstrate that the expression of HSP27 is dependent on the integrity/activity of protein kinase CK2 holoenzyme. The interaction between these proteins has been confirmed by co-immunoprecipitation, confocal immunofluorescence microscopy, and by density gradient separation of protein complexes. Finally, using a proliferation assay this study demonstrates the potential efficacy of a combinatory therapy of heath shock and CK2 inhibitors in cancer treatment.

RESULTS

Our data demonstrate that CK2 is able to regulate HSP27 turnover by affecting the expression of its ubiquitin ligase SMURF2 (Smad ubiquitination regulatory factor 2). Moreover, for the first time we show an increased sensitivity of CK2-inhibited tumour cells to hyperthermia treatment.

CONCLUSION

Being HSP27 involved in several pathological conditions, including protein conformational diseases (i.e Cystic Fibrosis) and cancer, the need of drugs to modulate its activity is growing and CK2-targeting could represent a new strategy to reduce cellular HSP27 level.

GENERAL SIGNIFICANCE

This study identifies CK2 as a molecular target to control HSP27 cellular expression.

Effects of supplemental heat therapy in multimodal treated chronic low back pain patients on strength and flexibility

BACKGROUND

The beneficial effects of thermotherapy on analgesia and relaxation are widely known for various diseases. To date, however, thermotherapy in chronic low back pain is not explicitly recommended in international guidelines. The effects of thermotherapy on biomechanical parameters within a multimodal back pain treatment concept are also unknown.

METHODS

Within a multimodal treatment concept, 176 patients with chronic low back pain were treated either with or without supplemental heat wrap therapy. The range of movement and strength parameters of the trunk in flexion, extension, lateral flexion and rotation were measured before and after 12 weeks of treatment.

FINDINGS

The range of movement as well as strength parameters of the trunk improved on average within the multimodal treatment. Patients receiving additional thermotherapy supplemental to basic multimodal treatment showed a further improvement of strength parameters regarding extension (P = 0.09, 1 - β = 0.41), rotation to the right (P = 0.09, 1 - β = 0.41) and rotation to the left (P = 0.08, 1 - β = 0.42) in comparison to those conducting only the multimodal treatment. No group differences were detected in flexibility.

INTERPRETATION

The implementation of thermotherapy for several hours a day (heat wrap therapy) in daily clinical practice additional to an individualized, evidence-based multimodal treatment concept can be recommended to enhance strength parameters. The potential causes of improved strength parameters as well as the meaning for the patients in activity of daily living are discussed.

Ultrasound thermal monitoring with an external ultrasound source for customized bipolar RF ablation shapes

PURPOSE

Thermotherapy is a clinical procedure which delivers thermal energy to a target, and it has been applied for various medical treatments. Temperature monitoring during thermotherapy is important to achieve precise and reproducible results. Medical ultrasound can be used for thermal monitoring and is an attractive medical imaging modality due to its advantages including non-ionizing radiation, cost-effectiveness and portability. We propose an ultrasound thermal monitoring method using a speed-of-sound tomographic approach coupled with a biophysical heat diffusion model.

METHODS

We implement an ultrasound thermometry approach using an external ultrasound source. We reconstruct the speed-of-sound images using time-of-flight information from the external ultrasound source and convert the speed-of-sound information into temperature by using the a priori knowledge brought by a biophysical heat diffusion model.

RESULTS

Customized treatment shapes can be created using switching channels of radio frequency bipolar needle electrodes. Simulations of various ablation lesion shapes in the temperature range of 21-59 [Formula: see text]C are performed to study the feasibility of the proposed method. We also evaluated our method with ex vivo porcine liver experiments, in which we generated temperature images between 22 and 45 [Formula: see text]C.

CONCLUSION

In this paper, we present a proof of concept showing the feasibility of our ultrasound thermal monitoring method. The proposed method could be applied to various thermotherapy procedures by only adding an ultrasound source.

Role of posterior-anterior vertebral mobilization versus thermotherapy in non specific lower back pain

Background & Objective:

Low back pain (LBP) is the foremost cause to hamper an individual’s functional activities in Pakistan. Its impact on the quality of life and work routine makes it a major reason for therapeutic consultations. About 90% of the cases with LBP are non-specific. Various options are available for the treatment of LBP. Posterior-anterior vertebral mobilization, a manual therapy technique; and thermotherapy are used in clinical practice, however evidence to gauge their relative efficacy is yet to be synthesised. This study aimed to compare the effectiveness of posterior-anterior vertebral mobilization versus thermotherapy in the management of non-specific low back pain along with general stretching exercises.

Methods:

A randomised controlled trial with two-group pretest-posttest design was conducted at IPM&R, Dow University of Health Sciences (DUHS). A total of 60 Non-specific low back pain (NSLBP) patients with ages from 18 to 35 years were inducted through non-probability and purposive sampling technique. Baseline screening was done using an assessment form (Appendix-I). Subjects were allocated into two groups through systematic random sampling. Group-A (experimental group) received posterior-anterior vertebral mobilization with general stretching exercises while group B (control group) received thermotherapy with general stretching exercises. Pain and functional disability were assessed using NPRS and RMDQ respectively. Pre & post treatment scores were documented. A maximum drop-out rate of 20% was assumed. Recorded data were entered into SPSS V-19. Frequency and percentages were calculated for categorical variables. Intragroup and intergroup analyses were done using Wilcoxon signed ranked test and Mann-Whitney Test respectively. A P-value of 0.05 was considered statistically significant.

Results:

Pre and post treatment analysis revealed that P-values for both pain and disability were less than 0.05, suggesting significant difference in NPRS and RMDQ scores. Whereas, median scores for both pain and disability were decreased by 75% in experimental group and 50% in control group. For inter group analysis p-values for both pain and disability were found to be less than 0.05.

Conclusion:

Both physiotherapeutic interventions, the PAVMs and thermotherapy, have significant effects on NSLBP in terms of relieving pain and improving functional disability. However PAVMs appeared to be more effective than thermotherapy.

Effect of Capacitive and Resistive electric transfer on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise

[Purpose] This study aimed to clarify the effects of Capacitive and Resistive electric transfer (CRet) on changes in muscle flexibility and lumbopelvic alignment after fatiguing exercise. [Subjects and Methods] Twenty-two healthy males were assigned into either the CRet (n=11) or control (n=11) group. Fatiguing exercise and CRet intervention were applied at the quadriceps muscle of the participants' dominant legs. The Ely test, pelvic tilt, lumbar lordosis, and superficial temperature were measured before and after exercise and for 30 minutes after intervention. Statistical analysis was performed using one-way analysis of variance, with Tukey's post-hoc multiple comparison test to clarify within-group changes and Student's t-test to clarify between-group differences. [Results] The Ely test and pelvic tilt were significantly different in both groups after exercise, but there was no difference in the CRet group after intervention. Superficial temperature significantly increased in the CRet group for 30 minutes after intervention, in contrast to after the exercise and intervention in the control group. There was no significant between-group difference at any timepoint, except in superficial temperature. [Conclusion] CRet could effectively improve muscle flexibility and lumbopelvic alignment after fatiguing exercise.

Elimination of viruses through thermotherapy and meristem culture in apple cultivar 'Oregon Spur-II'

In the present study, an attempt was made to eliminate apple chlorotic leaf spot virus, apple mosaic virus, apple stem grooving virus and apple stem pitting virus from apple cultivar 'Oregon Spur-II'. Thermotherapy was carried out at 37-40 °C for 4 weeks followed by culturing of meristems of different sizes. During establishment of explants, highest survival percentage (62.35%) and proliferation (30.68%) was recorded during summer season. However, size of meristems and position of buds from where meristems were excised also influenced their survival. The meristems of size 0.6-0.7 mm were found to be the most appropriate for maximum establishment. Meristems excised from buds positioned on distil portions of actively growing shoots showed better results. MS medium supplemented with BA (1.0 mg/l), IBA (0.05 mg/l) and GA₃ (0.1 mg/l) resulted in 56.62% establishment of explants, while maximum number of meristems proliferated with low BA (0.5 mg/l), IBA (0.08 mg/l) and same GA₃ concentration. Two to fourfold multiplication was observed. Virus indexing of shoots raised from different sizes of meristems was carried out and found that 0.3-0.6 mm size was able to eliminate ACLSV, ApMV, ASGV and ASPV. However, some of 0.5-0.6 mm sized shoots were found infected with ACLSV. Larger meristems could not completely eliminate the viruses under study.

Comprehensive economic evaluation of thermotherapy for the treatment of cutaneous leishmaniasis in Colombia

Background

Cutaneous leishmaniasis causes a high disease burden in Colombia, and available treatments present systemic toxicity, low patient compliance, contraindications, and high costs. The purpose of this study was to estimate the cost-effectiveness of thermotherapy versus Glucantime in patients with cutaneous leishmaniasis in Colombia.

Methods

Cost-effectiveness study from an institutional perspective in 8133 incident cases. Data on therapeutic efficacy and safety were included, calculating standard costs; the outcomes were disability adjusted life years (DALYs) and the number of patients cured. The information sources were the Colombian Public Health Surveillance System, disease burden studies, and one meta-analysis of controlled clinical trials. Incremental cost-effectiveness was determined, and uncertainty was evaluated with tornado diagrams and Monte Carlo simulations.

Results

Thermotherapy would generate costs of US$ 501,621; the handling of adverse effects, US$ 29,224; and therapeutic failures, US$ 300,053. For Glucantime, these costs would be US$ 2,731,276, US$ 58,254, and US$ 406,298, respectively. With thermotherapy, the cost would be US$ 2062 per DALY averted and US$ 69 per patient cured; with Glucantime, the cost would be US$ 4241 per DALY averted and US$ 85 per patient cured. In Monte Carlo simulations, thermotherapy was the dominant strategy for DALYs averted in 67.9% of cases and highly cost-effective for patients cured in 72%.

Conclusion

In Colombia, thermotherapy can be included as a cost-effective strategy for the management of cutaneous leishmaniasis. Its incorporation into clinical practice guidelines could represent savings of approximately US$ 10,488 per DALY averted and costs of US$ 116 per additional patient cured, compared to the use of Glucantime. These findings show the relevance of the incorporation of this treatment in our country and others with similar parasitological, clinical, and epidemiological patterns.

Advantages of cooled fiber for monitoring laser tissue ablation through temporal and spectral analysis of RF ultrasound signal: A case study

The promising minimally invasive laser thermal therapy technique may be improved if thermal lesions induced into the tissue can be carefully monitored in extension and morphology during the treatment. According to results obtained in several recent experimentations, solutions that avoid tissue carbonization during the treatment have been proposed, in order to allow deeper and longer lasting light penetration in treated tissue and to reduce failures of the applicator tip and fiber optic, dangerous for patients. In the work the advantages in using a cooled fiber are shown, in order not only to induce efficient lesions but also in performing an accurate monitoring by ultrasound. Indeed, one important limit of the ultrasound control is caused by the gas bubbles generation, which represent an acoustic barrier that invalidate the ultrasonic image representation of the treated tissue. Ultrasonic radiofrequency signals were acquired from the same bovine liver ex vivo sample by using both bare and cooled fiber and processed to produce B-mode and spectral parametric images by implementing TUV (Thermotherapy Ultrasonic View) algorithm. Radiofrequency signals, B-mode and TUV images were analysed and compared in order to evaluate the different tissue heating processes during ablation and the different lesion extensions induced into the tissue after the treatment. Cooled fiber avoided carbonization and strongly reduced gas bubbles generation inducing a larger lesion and allowing a more effective ultrasound monitoring. Moreover by correlating optical images of the lesions and the corresponding Integral TUV images, by using Dice and Jaccard coefficients, it was proven that TUV algorithm is able to characterize the tissue portions differently modified by ablation exhibiting better performances in the case of cooled fiber and revealing to be a potential tool capable to improve the laser delivery settings control.

Recirculating chemohyperthermia as a treatment for non-muscle invasive bladder cancer: Current and future perspectives

About 75% of all bladder cancer diagnosed are non-muscle invasive bladder cancer (NMIBC), recurring over 50% of them after transurethral resection of the bladder tumor. In order to prevent recurrences, adjuvant intravesical chemotherapy with mitomycin C and immunotherapy with bacillus Calmette-Guérin (BCG) is traditionally used. Unfortunately, many patients relapse after receiving these treatments and a significant proportion of them require surgery. After a one-to-three years BCG maintenance, the risk for progression at 5 years was 19.3% for T1G3 tumors. Many new treatment approaches are being investigated to increase the effectiveness of adjuvant intravesical therapy. One of the developing treatments for intermediate and high-risk NMIBC is the combination of intravesical chemotherapy and hyperthermia, called chemohyperthermia. This article provides a review of the mechanism of action, current status and indications, results and future perspectives.

Laser interstitial thermotherapy application for breast surgery: Current situation and new trends

While breast specialists debate on therapeutic de-escalation in breast cancer, the treatment of benign lesions is also discussed in relation to new percutaneous ablation techniques. The purpose of these innovations is to minimize potential morbidity. Laser Interstitial ThermoTherapy (LITT) is an option for the ablation of targeted nodules. This review evaluated the scientific publications investigating the LITT approach in malignant and benign breast disease. Three preclinical studies and eight clinical studies (2 studies including fibroadenomas and 6 studies including breast cancers) were reviewed. Although the feasibility and safety of LITT have been confirmed in a phase I trial, heterogeneous inclusion criteria and methods seem to be the main reason for LITT not being yet an extensively used treatment option. In conclusion, further development is necessary before this technique can be used in daily practice.

The protective effects of resveratrol, H2S and thermotherapy on the cell apoptosis induced by CdTe quantum dots

Quantum dots (QDs) could be used in the field of biology and medicine as excellent nano-scale fluorescent probes due to their unique optical properties, but the adverse effects of QDs are always the obstruction for its usage in living organisms. In this study, we observed that CdTe QDs exposure decreased the cell viability while increased the apoptosis rates in the L929 cells. Apart from QD-induced oxidative stress indicated by excessive ROS generation, three signal transductions, including Akt, p38 and JNK, played important roles on the regulation of cell apoptosis by CdTe QDs exposure as well. In order to reduce the toxicity of CdTe QDs, we explored the protective effects of three treatments, i.e. resveratrol, H₂S and thermotherapy at 43°C, against the cell apoptosis elicited by CdTe QDs. The results showed that resveratrol, H₂S and thermotherapy at 43°C were capable of attenuating cell apoptosis and intercellular ROS production through inhibiting signal pathways of Akt, p38 and JNK, respectively. As there is only limited number of exogenous treatments reported to diminish the toxicity of QDs, our findings will provide a novel insight for researchers who try to reduce or even eliminate the adverse health effects of QDs.

In Vivo Magnetic Resonance Imaging and Microwave Thermotherapy of Cancer Using Novel Chitosan Microcapsules

Herein, we develop a novel integrated strategy for the preparation of theranostic chitosan microcapsules by encapsulating ion liquids (ILs) and Fe3O4 nanoparticles. The as-prepared chitosan/Fe3O4@IL microcapsules exhibit not only significant heating efficacy in vitro under microwave (MW) irradiation but also obvious enhancement of T2-weighted magnetic resonance (MR) imaging, besides the excellent biocompatibility in physiological environments. The chitosan/Fe3O4@IL microcapsules show ideal temperature rise and therapeutic efficiency when applied to microwave thermal therapy in vivo. Complete tumor elimination is realizing after MW irradiation at an ultralow power density (1.8 W/cm(2)), while neither the MW group nor the chitosan microcapsule group has significant influence on the tumor development. The applicability of the chitosan/Fe3O4@IL microcapsules as an efficient contrast agent for MR imaging is proved in vivo. Moreover, the result of in vivo systematic toxicity shows that chitosan/Fe3O4@IL microcapsules have no acute fatal toxicity. Our study presents an interesting type of multifunctional platform developed by chitosan microcapsule promising for imaging-guided MW thermotherapy.

Efficacy of the device combining high-frequency transcutaneous electrical nerve stimulation and thermotherapy for relieving primary dysmenorrhea: a randomized, single-blind, placebo-controlled trial

OBJECTIVE

To investigate the efficacy and safety of the combined therapy with high-frequency transcutaneous electrical nerve stimulation (hf-TENS) and thermotherapy in relieving primary dysmenorrheal pain.

STUDY DESIGN

In this randomized, single-blind, placebo-controlled study, 115 women with moderate or severe primary dysmenorrhea were assigned to the study or control group at a ratio of 1:1. Subjects in the study group used an integrated hf-TENS/thermotherapy device, whereas control subjects used a sham device. A visual analog scale was used to measure pain intensity. Variables related to pain relief, including reduction rate of dysmenorrheal score, were compared between the groups.

RESULTS

The dysmenorrheal score was significantly reduced in the study group compared to the control group following the use of the devices. The duration of pain relief was significantly increased in the study group compared to the control group. There were no differences between the groups in the brief pain inventory scores, numbers of ibuprofen tablets taken orally, and World Health Organization quality of life-BREF scores. No adverse events were observed related to the use of the study device.

CONCLUSIONS

The combination of hf-TENS and thermotherapy was effective in relieving acute pain in women with moderate or severe primary dysmenorrhea.

Comparison of the effects of hamstring stretching using proprioceptive neuromuscular facilitation with prior application of cryotherapy or ultrasound therapy

[Purpose] Stretching using proprioceptive neuromuscular facilitation involve physiological reflex mechanisms through submaximal contraction of agonists which activate Golgi organ, promoting the relaxation reflex. The aim of this study was to evaluate the effects of proprioceptive neuromuscular facilitation alone and with prior application of cryotherapy and thermotherapy on hamstring stretching. [Subjects and Methods] The sample comprised of 32 young subjects with hamstring retraction of the right limb. The subjects were randomly allocated to four groups: the control, flexibility PNF, flexibility PNF associated with cryotherapy, flexibility PNF in association with ultrasound therapy. [Results] After 12 stretching sessions, experimental groups showed significant improvements compared to the control group. Moreover, we did not find any significant differences among the experimental groups indicating PNF stretching alone elicits similar results to PNF stretching with prior administration of cryotherapy or thermotherapy. [Conclusion] PNF without other therapy may be a more practical and less expensive choice for clinical care.

Indocyanine Green-Enhanced Thermotherapy for Retinoblastoma

PURPOSE

To report the outcome of pediatric patients with retinoblastoma refractory to traditional local therapy who were treated with indocyanine green (ICG)-enhanced thermotherapy.

MATERIALS AND METHODS

This is a retrospective review of a case series of 3 patients with bilateral retinoblastoma who were treated with ICG-enhanced thermotherapy after showing no response to conventional chemothermotherapy or transpupillary thermotherapy (TTT) alone noted on two consecutive examinations under anesthesia.

RESULTS

The 3 patients had had one eye enucleated previously due to advanced disease, and the remaining eye was diagnosed with a large tumor, which showed either a marginal or no response to systemic chemotherapy and TTT. Addition of ICG enhancement during the subsequent TTT session shrunk the tumor to a measurable size that could then be followed by TTT alone as a means of treatment. One patient had tumor recurrence, at which time additional TTT without ICG was successfully applied after the tumor size had decreased; ICG enhancement was then added whenever TTT alone provided no response.

CONCLUSIONS

ICG enhancement with TTT led to a measurable tumor regression in lesions that had previously not been responsive to traditional chemothermotherapy or isolated TTT.

MESSAGE

These tumors had shown a minimal to no response to previous TTT treatment. However, adding ICG resulted in a measurable regression even though the same TTT treatment parameters were applied.

Influence of deep hyperthermia combined with systemic chemotherapy on overall survival of recurrent gastric cancer patients: Predictors of response to treatment

AIM: To investigate the effect of tumor deep hyperthermia combined with systemic chemotherapy on overall survival (OS) of recurrent gastric cancer patients, and to explore the predictors of response to the treatment.

METHODS: Ninety-nine patients with recurrent gastric cancer were divided into either a thermo-chemotherapy group (n = 42) or a control group (n = 57). The thermo-chemotherapy group was treated by deep tumor hyperthermia and chemotherapy, and the control group received systemic chemotherapy alone. The OS was compared for the two groups, and the predictors of response to individualized treatment was analyzed.

RESULTS: The median OS was significantly longer in the thermo-chemotherapy group than in the control group (18 mo vs 12.8 mo. (P = 0.003). In the thermo-chemotherapy group, the OS of patients with albumin (ALB) ≥ 35 g/L (19 mo) was better than that of patients with ALB < 35g/L (10 mo) ((P = 0.027); and the OS of patients with a neutrophil/lymphocyte ratio (NLR) < 4.558 (33 mo) was superior than that of patients with an NLR ≥ 4.558 (10 mo) ((P = 0.007).

CONCLUSION: For recurrent gastric cancer patients, thermotherapy combined with chemotherapy may be a more effective treatment option. Patients with normal serum ALB and an NLR < 4.558 may have a better prognosis. For patients with ALB < 35 g/L and an NLR ≥ 4.558, deep tumor hyperthermia combined with systemic chemotherapy is not recommended.

Fixed cutaneous sporotrichosis treated with topical amphotericin B in an immune suppressed patient

Both fixed cutaneous and lymphocutaneous sporotrichosis are associated with significant morbidity due to chronicity. Although treatment with itraconazole, saturated solution of potassium iodide or terbinafine is recommended in most cases, the described patient with fixed cutaneous sporotrichosis could not tolerate any of these. Her lesion healed after 8weeks of topical amphotericin-B (0.1% w/w). Topical amphotericin-B appears useful treatment modality for uncomplicated cutaneous sporotrichosis when systemic treatment needs deferment, remains contraindicated, or in pediatric patients.

The effect of a physiotherapy intervention on intestinal motility

[Purpose] It is important to facilitate intestinal motility in patients with reduced bowel movement through physiotherapy. The purpose of the present study was to compare the effects of passive exercise of the lower limbs and trunk (PELT) and combination therapies (COM) with those of conventional thermotherapy (TT) on bowel sounds (BSs) in healthy adult subjects. Since autonomic activity (AA) significantly influences intestinal motility, we also investigated the relation between intestinal motility and AA by measurement of BSs. [Subjects] The subjects were 16 healthy adult males. [Methods] The subjects were randomly assigned to 3 different physiotherapies, and BSs and sympathetic nerve activity were measured before and after the physiotherapies. [Results] While BSs significantly increased following all physiotherapies, the temporal changes in BSs were different among the physiotherapies. AA measurement showed that PELT and TT significantly decreased the heart rate. While the high-frequency (HF) component was increased in all physiotherapy groups, the increases in HF did not reach statistical significance. There were no significant correlations between BSs and AA. [Conclusion] We found that all of the tested physiotherapies increased BSs, suggesting that they are clinically useful for treatment of patients with reduced intestinal motility due to limited spontaneous movement or inability to rise up from bed.

The efficacy of thermotherapy and cryotherapy on pain relief in patients with acute low back pain, a clinical trial study

INTRODUCTION

Acute low back pain is one of the most common health problems especially in industrialized countries where 75 per cent of the population develop it at least once during their life. This study examined the efficacy of thermotherapy and cryotherapy, alongside a routine pharmacologic treatment, on pain relief in patients with acute low back pain referring an orthopedic clinic in Shahrekord, Iran.

MATERIALS AND METHODS

This clinical trial study was conducted on 87 patients randomly assigned to three (thermotherapy and cryotherapy as intervention, and naproxen as control) groups of 29 each. The first (thermotherapy) group underwent treatment with hot water bag and naproxen, the second (cryotherapy) group was treated with ice and naproxen, and the naproxen group was only treated with naproxen, all for one week. All patients were examined on 0, 3(rd), 8(th), and 15(th) day after the first visit and the data gathered by McGill Pain Questionnaire. The data were analyzed by SPSS software using paired t-test, ANOVA, and chi-square.

RESULTS

In this study, mean age of the patients was 34.48 (20-50) years and 51.72 per cent were female. Thermotherapy patients reported significantly less pain compared to cryotherapy and control (p≤0.05). In thermotherapy and cryotherapy groups, mean pain in the first visit was 12.70±3.7 and 12.06±2.6, and on the 15(th) day after intervention 0.75±0.37 and 2.20±2.12, respectively.

CONCLUSION

The results indicated that the application of thermo-therapy and cryotherapy accompanied with a pharmacologic treatment could relieve pain in the patients with acute low back pain.

Effectiveness of thermotherapy using a heat and steam generating sheet for cartilage in knee osteoarthritis

[Purpose] Superficial heat treatment is one of the most widely used physical therapies for osteoarthritis (OA). We clinically evaluated the effects of local heat treatment and exercise therapy for knee OA, and evaluated the articular cartilage using magnetic resonance imaging (MRI) T2 mapping. [Subjects and Methods] Eighteen females aged 50–69 (59.5 ± 8.5 years, mean ± SD) years diagnosed with early-stage knee OA were randomly assigned using computer-generated random numbers to either a local heat treatment group (LH group, 9 subjects) or an exercise therapy group (EX group, 9 subjects). These groups were subjected to a 12-week intervention experiment. MRI T2 mapping was performed for cartilage imaging and quantitative evaluation. For clinical evaluation, the Japanese Knee Osteoarthritis Measure (JKOM) and the Timed Up and Go (TUG) test were performed. Both clinical and MRI evaluations were performed at the beginning and end of the intervention (0 week (Time 0) and 12 weeks). [Results] The total JKOM score had a significantly decreased in the LH group at 12 weeks. However, in the EX group the total JKOM scores at Time 0 and 12 weeks were not significantly different. The TUG time in the EX group was significant shorter at 12 weeks, whereas it showed no significant change in the LH group at 12 weeks, though the TUG times of 7 of the 9 patients decreased, exhibiting some improvement. The T2 value of the LH group was significantly shorter at 12 weeks. However, the T2 value in the EX group showed no significant change at 12 weeks. [Conclusion] After local heat treatment using heat- and steam moisture-generating sheets for 12 weeks, we observed improvements in clinical symptoms and walking abilities. Moreover, positive effects on cartilage metabolism were suggested.

Temperature-dependent thermal properties of ex vivo liver undergoing thermal ablation

Thermotherapy uses a heat source that raises temperatures in the target tissue, and the temperature rise depends on the thermal properties of the tissue. Little is known about the temperature-dependent thermal properties of tissue, which prevents us from accurately predicting the temperature distribution of the target tissue undergoing thermotherapy. The present study reports the key thermal parameters (specific heat capacity, thermal conductivity and heat diffusivity) measured in ex vivo porcine liver while being heated from 20 ° C to 90 ° C and then naturally cooled down to 20 ° C. The study indicates that as the tissue was heated, all the thermal parameters resulted in plots with asymmetric quasi-parabolic curves with temperature, being convex downward with their minima at the turning temperature of 35-40 ° C. The largest change was observed for thermal conductivity, which decreased by 9.6% from its initial value (at 20 ° C) at the turning temperature (35 ° C) and rose by 45% at 90 ° C from its minimum (at 35 ° C). The minima were 3.567 mJ/(m(3) ∙ K) for specific heat capacity, 0.520 W/(m.K) for thermal conductivity and 0.141 mm(2)/s for thermal diffusivity. The minimum at the turning temperature was unique, and it is suggested that it be taken as a characteristic value of the thermal parameter of the tissue. On the other hand, the thermal parameters were insensitive to temperature and remained almost unchanged when the tissue cooled down, indicating that their variations with temperature were irreversible. The rate of the irreversible rise at 35 ° C was 18% in specific heat capacity, 40% in thermal conductivity and 38.3% in thermal diffusivity. The study indicates that the key thermal parameters of ex vivo porcine liver vary largely with temperature when heated, as described by asymmetric quasi-parabolic curves of the thermal parameters with temperature, and therefore, substantial influence on the temperature distribution of the tissue undergoing thermotherapy is expected.

Effect of Heated Red Bean Pillow Application for College Women with Dysmenorrhea

PURPOSE

Dysmenorrhea is a menstrual condition characterized by severe and frequent cramps and pain. Effective treatment methods for dysmenorrhea are not yet fully understood. This research compares the effects of pain killers and heated red bean pillows.

METHODS

Data were got on demographic data, menstrual cycle status, and activities of daily living (ADLs) limitations, dysmenorrhea severity and menstrual pain scores. Following a 10% drop-out rate, 44 young women satisfied the inclusion criteria. To prevent any bias, the experimental and control groups were selected from different campuses. We used two sizes of red bean pillows: 15x18 cm, weighing 400g; and 13x11.5 cm, weighing 220g. For analysis, we used IBM SPSS statistics 19.0.

RESULTS

Ninety-nine point seven percentage of total subjects reported moderate to severe dysmenorrhea and 63.6% reported as moderate to severe daily activities limitations. The mean pain score with visual analogue scale was 80.2+/-9.42 of 100 and 86.4% used pain killers to alleviate menstrual discomfort in all the subjects. In both groups, all three variables showed significant improvement and the Moos's Menstrual Distress Questionnaire (MDQ) scores changed significantly between menstrual and post-menstrual time point at within groups and not significantly different at premenstrual and menstrual time point at between groups. However, the MDQ score was significantly higher in experimental group than control group at post-menstruation time point and the degree of satisfaction was higher in the control group.

CONCLUSION

This research shows that red-bean pillows on the abdomen are effective in assisting the ADL and diminishing pain severity. With regard to its safety the study indicates it can be a convenient and safe option for female students with menstrual discomfort in schoolas a non-pharmacological self-help.