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.

c-Jun N-terminal kinase is required for thermotherapy-induced apoptosis in human gastric cancer cells

AIM: To investigate the role of c-Jun N-terminal kinase (JNK) in thermotherapy-induced apoptosis in human gastric cancer SGC-7901 cells.

METHODS: Human gastric cancer SGC-7901 cells were cultured in vitro. Following thermotherapy at 43 °C for 0, 0.5, 1, 2 or 3 h, the cells were cultured for a further 24 h with or without the JNK specific inhibitor, SP600125 for 2 h. Apoptosis was evaluated by immunohistochemistry [terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL)] and flow cytometry (Annexin vs propidium iodide). Cell proliferation was determined by 3-(4,5-Dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide. The production of p-JNK, Bcl-2, Bax and caspase-3 proteins was evaluated by Western blotting. The expression of JNK at mRNA level was determined by reverse transcription polymerase chain reaction.

RESULTS: The proliferation of gastric carcinoma SGC-7901 cells was significantly inhibited following thermotherapy, and was 32.7%, 30.6%, 43.8% and 52.9% at 0.5, 1, 2 and 3 h post-thermotherapy, respectively. Flow cytometry analysis revealed an increased population of SGC-790l cells in G0/G1 phase, but a reduced population in S phase following thermotherapy for 1 or 2 h, compared to untreated cells (P < 0.05). The increased number of SGC-790l cells in G0/G1 phase was consistent with induced apoptosis (flow cytometry) following thermotherapy for 0.5, 1, 2 or 3 h, compared to the untreated group (46.5% ± 0.23%, 39.9% ± 0.53%, 56.6% ± 0.35% and 50.4% ± 0.29% vs 7.3% ± 0.10%, P < 0.01), respectively. This was supported by the TUNEL assay (48.2% ± 0.4%, 40.1% ± 0.2%, 61.2% ± 0.29% and 52.0% ± 0.42% vs 12.2% ± 0.22%, P < 0.01) respectively. More importantly, the expression of p-JNK protein and JNK mRNA levels were significantly higher at 0.5 h than at 0 h post-treatment (P < 0.01), and peaked at 2 h. A similar pattern was detected for Bax and caspase-3 proteins. Bcl-2 increased at 0.5 h, peaked at 1 h, and then decreased. Furthermore, the JNK specific inhibitor, SP600125, suppressed p-JNK, Bax and caspase-3 at the protein level in SGC790l cells following thermotherapy, compared to mock-inhibitor treatment, which was in line with the decreased rate of apoptosis. The expression of Bcl-2 was consistent with thermotherapy alone.

CONCLUSION: Thermotherapy induced apoptosis in gastric cancer cells by promoting p-JNK at the mRNA and protein levels, and up-regulated the expression of Bax and caspase-3 proteins. Bcl-2 may play a protective role during thermotherapy. Activation of JNK via the Bax-caspase-3 pathway may be important in thermotherapy-induced apoptosis in gastric cancer cells.

Therapeutic efficacy of bipolar radiofrequency thermotherapy for patients with chronic prostatitis: a retrospective analysis of 26 cases

PURPOSE

Chronic prostatitis (CP) does not yet have a universally successful therapy. Alternative treatments including thermotherapy have been adopted in the multimodal management of pain and voiding dysfunction. We retrospectively analyzed the therapeutic efficacy of bipolar radiofrequency thermotherapy for patients who were unsatisfied with conventional medication for CP.

MATERIALS AND METHODS

A retrospective study between October 2009 and September 2010 of 26 patients who were under 50 years old and diagnosed with CP (National Institutes of Health [NIH]-category III) was performed. Twenty patients were diagnosed with inflammatory CP (NIH-category IIIa) and the rest with noninflammatory CP (NIH-category IIIb). We used the Tempro system at an intraprostatic temperature of 55℃ for 50 minutes with a medium heating rate. All patients also completed the NIH-Chronic Prostatitis Symptom Index (CPSI) before and after treatment.

RESULTS

In the patients diagnosed with CP, the mean serum prostate-specific antigen (PSA) level was 0.9±0.3 ng/ml, the prostate volume was 27.1±5.5 g, and the average score for all 3 domains on the NIH-CPSI significantly decreased. The total scores decreased from 19.8±7.1 to 11.1±7.0, the pain domain decreased from 8.6±3.1 to 4.8±3.1, the voiding symptom domain decreased from 5.1±1.8 to 2.9±1.8, and the effect on the quality of life decreased from 6.1±2.2 to 3.4±2.2 (p<0.05).

CONCLUSIONS

Bipolar radiofrequency thermotherapy for patients with CP intractable to conventional medication can provide significant improvement in the NIH-CPSI. Large, randomized controlled trials will also be required to confirm the efficacy of this therapy.

The effect of mechanical lymph drainage accompanied with heat on lymphedema

BACKGROUND

Thermotherapy has been indicated by some researchers as a treatment for lymphedema. A study comparing temperatures demonstrated that a temperature of 40°C significantly increased the transportation of lymph compared to other temperatures assessed. The aim of this study was to evaluate the possible benefits of mechanical lymph drainage accompanied with heat in the treatment of lymphedema of the lower limbs.

METHODS

In a cross-over randomized study, the effect of heat on lymph drainage was evaluated in the treatment of leg lymphedema. The study, performed in the Godoy Clinic in São Jose do Rio Preto, Brazil, involved seven patients (two males and five females) with leg lymphedema. The patients' ages ranged from 18 to 79 years old with a mean of 48.5 years. The subjects underwent a total of 38 assessments including 19 evaluations of mechanical lymph drainage alone and 19 combined with thermotherapy. Heat was applied using an electric blanket which was wrapped around the legs of the patients. The volume of legs was evaluated by water plethysmography before and after treatment sessions. The paired t-test was used for statistical analysis with an alpha error of p = 0.05 being considered as acceptable.

RESULTS

No statistically significant differences were evidenced between mechanical lymph drainage alone and lymph drainage combined with thermotherapy.

CONCLUSIONS

There was no obvious synergic effect in the immediate post-treatment period when heat was combined with mechanical lymph drainage in the treatment of lymphedema.

Thermostability of biological systems: fundamentals, challenges, and quantification

This review examines the fundamentals and challenges in engineering/understanding the thermostability of biological systems over a wide temperature range (from the cryogenic to hyperthermic regimen). Applications of the bio-thermostability engineering to either destroy unwanted or stabilize useful biologicals for the treatment of diseases in modern medicine are first introduced. Studies on the biological responses to cryogenic and hyperthermic temperatures for the various applications are reviewed to understand the mechanism of thermal (both cryo and hyperthermic) injury and its quantification at the molecular, cellular and tissue/organ levels. Methods for quantifying the thermophysical processes of the various applications are then summarized accounting for the effect of blood perfusion, metabolism, water transport across cell plasma membrane, and phase transition (both equilibrium and non-equilibrium such as ice formation and glass transition) of water. The review concludes with a summary of the status quo and future perspectives in engineering the thermostability of biological systems.

Synergistic killing effect of radiotherapy and thermotherapy on hepatoma cells in vitro

AIM: To investigate whether radiotherapy (RT) and thermotherapy (TT) have a synergistic killing effect on hepatoma cells (HepG2) in vitro.

METHODS: Human HepG2 cells were divided into four groups: control group, TT group, RT group, and RT plus TT group. Cell apoptosis was determined by flow cytometry (FCM) assay. The ultrastructural alterations of HepG2 cells were observed under a transmission electron microscope. The expression of P53 protein was detected by immunohistochemistry.

RESULTS: Compared with the control group, the apoptosis rate significantly increased (19.98% ± 1.76%, 20.83% ± 1.84% and 32.16% ± 2.03% vs 16.47% ± 1.24%, all P < 0.05 or 0.01), cell ultrastructural alterations were more significant, and the expression of P53 protein was significantly up-regulated (34.98% ± 1.16%, 35.21% ± 1.23%, 45.50% ± 1.55% vs 32.00% ± 1.05%, all P < 0.05 or 0.01) in the TT group, RT group, and RT plus TT group, which were most prominent in the RT plus TT group.

CONCLUSION: RT and TT exert a synergistic killing effect on hepatoma cells possibly by up-regulating P53 expression and inducing apoptosis.

Treating delayed endoscopic sphincterotomy-induced bleeding: Epinephrine injection with or without thermotherapy

AIM: To compare the hemostatic efficacy between epinephrine injection alone and epinephrine injection combined with thermotherapy for delayed post-endoscopic sphincterotomy (ES) bleeding.

METHODS: Cases with delayed post-ES bleeding undergoing epinephrine injection alone (epinephrine injection group, n = 26) or epinephrine combined with thermotherapy (combination therapy group, n = 33) in our institution between 1999 and 2007 were retrospectively investigated. The main outcome measurements were: initial endoscopic hemostasis, re-bleeding, complications, requirement of angiographic embolization or surgery, requirement for blood transfusion, and mortality.

RESULTS: The initial hemostatic efficacy was 96.2% for epinephrine injection alone and 100% for combination therapy (P = 0.44). There were four patients with re-bleeding in each group (16.0% vs 12.1%, P = 0.72). There was only one complication of pancreatitis from the combination therapy group. Three patients (11.5%) in the epinephrine injection group and one patient (3%) in the combination therapy group required angiographic embolization or surgery (P = 0.31). The total number of blood transfusions was not significantly different between the two groups (3.5 ± 4.6 U vs 3.5 ± 4.5 U, P = 0.94). There was no bleeding-related death in either group.

CONCLUSION: Epinephrine injection alone is as effective as epinephrine injection combined with thermotherapy for the management of delayed post-ES bleeding.

Targeting therapy with docetaxel thermosensitive nano-micelles of human gastric cancer xenografts in nude mice

AIM: To study the curative effects of docetaxel thermosensitive nano-micelles on human gastric cancer xenografts in nude mice.

METHODS: Human gastric cancer cell line BGC-823 was implanted into 48 nude mice. Different drugs were injected through the caudal vein in eight groups after establishment of the experimental model. Permanent temperature of the tumor was taken in the thermotherapy group. Tumor growth was monitored once every other day. Dynamic viewing and determining the rate of tumor regression in terms of tumor weight and volume were used to evaluate therapeutic efficacy. The side effect was evaluated through surveying all the condition and the relative variation in mouse body weight.

RESULTS: Tumor growth speed in the docetaxel thermosensitive nano-micelle thermotherapy group was significantly slower than that in the other groups. Tumor volume and weight regression in the docetaxel thermosensitive nano-micelle thermotherapy group were 81.5% and 85.4%, respectively, which were markedly higher than those of the docetaxel thermosensitive nano-micelle group (32.2% and 37.5%) and the docetaxel injection group (49.2% and 58.0%) (both P < 0.05). The drug side effects and toxicity of docetaxel thermosensitive nano-micelle thermotherapy were significantly less than those in the other groups.

CONCLUSION: Docetaxel thermosensitive nano-micelles show good inhibition of tumor growth, which indicates a favorable potential in clinical application.