Time-temperature relationships for heat-induced killing of mammalian cells

Thermally reversible hydrogels printing of customizable bio-channels with curvature

Replicating intricate bio-channels, akin to expansive vascular networks, offers numerous advantages including self-repair, replacing damaged bio-channels, testing drugs, and biomedical devices. But, crafting multi-sized, editable bio-channels with specific curvatures, particularly using natural polymer-based bio-inks, poses a significant challenge. To address this, this study introduces a temperature-driven indirect printing method, exemplified by the diploic vein. Here, K-carrageenan (kca)-silk fiber (SF)-hyaluronic acid (HA)/hFOB 1.19 (SV40 transfection of human osteoblasts) and kca-collagen-HA/HUVECs (human umbilical vein endothelial cells) are employed to fabricate vascular-like walls and lumens, utilizing their thermoreversible properties to create multi-stage bifurcated lumens. Precise spatial curvature was generated by heating the vascular network wrapped in poly(N-isopropyl acrylamide) (PNIPAAm)-poly(ethylene glycol) diacrylate (PEGDA). Since temperature is specific to the thermal material carrying the cells, the rheological properties of bioinks, modeling temperature parameters, and their impact on printing size was explored. Additionally, mechanical properties and curvature response were characterized to determine the necessary process parameters for achieving the desired size. Ultimately, in vitro bioprinting experiments involving HUVECs and hFOB 1.19 demonstrate cell viability, adhesion, proliferation, and migration within the intraluminal hydrogel scaffold. This approach allows for customizing bio-channel content and controlling curvature programming, providing new prospects for in vitro biochannel production, with potential benefits for pathology research.

A new thermal dose model based on Vogel-Tammann-Fulcher behaviour in thermal damage processes

Thermal dose models are metrics that quantify the thermal effect on tissues based on the temperature and the time of exposure. These models are used to predict and control the outcome of hyperthermia (up to 45^°C) treatments, and of thermal coagulation treatments at higher temperatures (>45^°C). The validity and accuracy of the commonly used models (CEM43) are questionable when heating above the hyperthermia temperature range occurs, leading to an over-estimation of the accumulation of thermal damage. A new CEM43 dose model based on an Arrhenius-type, Vogel-Tammann-Fulcher, equation using published data, is introduced in this work. The new dose values for the same damage threshold that was produced at different in-vivo skin experiments were in the same order of magnitude, while the current dose values varied by two orders of magnitude. In addition, the dose values obtained using the new model for the same damage threshold in 6 lesions in ex-vivo liver experiments were more consistent than the current model dose values. The contribution of this work is to provide new modeling approaches to inform more robust thermal dosimetry for improved thermal therapy modeling, monitoring, and control.

Novel millimeter-wave-based method for in situ cell isolation and other applications

As an alternative to laser-based methods, we developed a novel in situ cell isolation method and instrument based on local water absorption of millimeter wave (MMW) radiation that occurs in cellular material and nearby culture medium while the cultureware materials (plastic and glass) are transparent to MMW frequencies. Unwanted cells within cell population are targeted with MMWs in order to kill them by overheating. The instrument rapidly (within 2-3 seconds) heats a cell culture area of about 500 µm in diameter to 50 °C using a low-power W-band (94 GHz) MMW source. Heated cells in the area detach from the substrate and can be removed by a media change leaving a bare spot. Hence we named the instrument "CellEraser". Quick, local and non-contact heating with sharp boundaries of the heated area allows elimination of the unwanted cells without affecting the neighboring cells. The instrument is implemented as a compact microscope attachment and the selective hyperthermic treatment can be done manually or in an automated mode. Mammalian cells heated even momentarily above 50 °C will not survive. This "temperature of no return" does not compromise cellular membranes nor does it denature proteins. Using the CellEraser instrument we found that the key event that determines the fate of a cell at elevated temperatures is whether or not the selectivity of its nucleus is compromised. If a cell nucleus becomes "leaky" allowing normally excluded (cytoplasmic) proteins in and normally nuclear-localized proteins out, that cell is destined to die. Quick heating by MMWs to higher temperatures (70 °C) denatures cellular proteins but the cells are not able to detach from the substrate - instead they undergo a phenomenon we called "thermofixation": such cells look similar to cells fixed with common chemical fixatives. They remain flat and are not washable from the substrate. Interestingly, their membranes become permeable to DNA dyes and even to antibodies. Thermofixation allows the use of western blot antibodies for immunofluorescence imaging.

A comprehensive model for heat-induced radio-sensitisation

Combined radiotherapy (RT) and hyperthermia (HT) treatments may improve treatment outcome by heat induced radio-sensitisation. We propose an empirical cell survival model (AlphaR model) to describe this multimodality therapy. The model is motivated by the observation that heat induced radio-sensitisation may be explained by a reduction in the DNA damage repair capacity of heated cells. We assume that this repair is only possible up to a threshold level above which survival will decrease exponentially with dose. Experimental cell survival data from two cell lines (HCT116, Cal27) were considered along with that taken from the literature (baby hamster kidney [BHK] and Chinese hamster ovary cells [CHO]) for HT and combined RT-HT. The AlphaR model was used to study the dependence of clonogenic survival on treatment temperature, and thermal dose R2 ≥ 0.95 for all fits). For HT survival curves (0-80 CEM43 at 43.5-57 °C), the number of free fit AlphaR model parameters could be reduced to two. Both parameters increased exponentially with temperature. We derived the relative biological effectiveness (RBE) or HT treatments at different temperatures, to provide an alternative description of thermal dose, based on our AlphaR model. For combined RT-HT, our analysis is restricted to the linear quadratic arm of the model. We show that, for the range used (20-80 CEM43, 0-12 Gy), thermal dose is a valid indicator of heat induced radio-sensitisation, and that the model parameters can be described as a function thereof. Overall, the proposed model provides a flexible framework for describing cell survival curves, and may contribute to better quantification of heat induced radio-sensitisation, and thermal dose in general.

Physical mechanism and modeling of heat generation and transfer in magnetic fluid hyperthermia through Néelian and Brownian relaxation: a review

Current clinically accepted technologies for cancer treatment still have limitations which lead to the exploration of new therapeutic methods. Since the past few decades, the hyperthermia treatment has attracted the attention of investigators owing to its strong biological rationales in applying hyperthermia as a cancer treatment modality. Advancement of nanotechnology offers a potential new heating method for hyperthermia by using nanoparticles which is termed as magnetic fluid hyperthermia (MFH). In MFH, superparamagnetic nanoparticles dissipate heat through Néelian and Brownian relaxation in the presence of an alternating magnetic field. The heating power of these particles is dependent on particle properties and treatment settings. A number of pre-clinical and clinical trials were performed to test the feasibility of this novel treatment modality. There are still issues yet to be solved for the successful transition of this technology from bench to bedside. These issues include the planning, execution, monitoring and optimization of treatment. The modeling and simulation play crucial roles in solving some of these issues. Thus, this review paper provides a basic understanding of the fundamental and rationales of hyperthermia and recent development in the modeling and simulation applied to depict the heat generation and transfer phenomena in the MFH.

Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy for mesial temporal lobe epilepsy

BACKGROUND

Open surgery effectively treats mesial temporal lobe epilepsy, but carries the risk of neurocognitive deficits, which may be reduced with minimally invasive alternatives.

OBJECTIVE

To describe technical and clinical outcomes of stereotactic laser amygdalohippocampotomy with real-time magnetic resonance thermal imaging guidance.

METHODS

With patients under general anesthesia and using standard stereotactic methods, 13 adult patients with intractable mesial temporal lobe epilepsy (with and without mesial temporal sclerosis [MTS]) prospectively underwent insertion of a saline-cooled fiberoptic laser applicator in amygdalohippocampal structures from an occipital trajectory. Computer-controlled laser ablation was performed during continuous magnetic resonance thermal imaging followed by confirmatory contrast-enhanced anatomic imaging and volumetric reconstruction. Clinical outcomes were determined from seizure diaries.

RESULTS

A mean 60% volume of the amygdalohippocampal complex was ablated in 13 patients (9 with MTS) undergoing 15 procedures. Median hospitalization was 1 day. With follow-up ranging from 5 to 26 months (median, 14 months), 77% (10/13) of patients achieved meaningful seizure reduction, of whom 54% (7/13) were free of disabling seizures. Of patients with preoperative MTS, 67% (6/9) achieved seizure freedom. All recurrences were observed before 6 months. Variances in ablation volume and length did not account for individual clinical outcomes. Although no complications of laser therapy itself were observed, 1 significant complication, a visual field defect, resulted from deviated insertion of a stereotactic aligning rod, which was corrected before ablation.

CONCLUSION

Real-time magnetic resonance-guided stereotactic laser amygdalohippocampotomy is a technically novel, safe, and effective alternative to open surgery. Further evaluation with larger cohorts over time is warranted.

Evaluation of thermal injury to liver, pancreas and kidney during irreversible electroporation in an in vivo experimental model

BACKGROUND

Irreversible electroporation (IRE) is a new technique for tumour cell ablation that is reported to involve non-thermal-based energy using high voltage at short microsecond pulse lengths. In vivo assessment of the thermal energy generated during IRE has not been performed. Thermal injury can be predicted using a critical temperature model. The aim of this study was to assess the potential for thermal injury during IRE in an in vivo porcine model.

METHODS

In vivo continuous temperature assessments of 86 different IRE procedures were performed on porcine liver, pancreas, kidney and retroperitoneal tissue. Tissue temperature was measured continuously throughout IRE by means of two thermocouples placed at set distances (0·5 cm or less, and 1 cm) from the IRE probes within the treatment field. Thermal injury was defined as a tissue temperature of 54°C lasting at least 10 s. Tissue type, pulse length, probe exposure length, number of probes and retreatment were evaluated for associations with thermal injury. In addition, IRE ablation was performed with metal clips or metal stents within the ablation field to determine their effect on thermal injury.

RESULTS

An increase in tissue temperature above the animals' baseline temperature (median 36·0°C) was generated during IRE in all tissues studied, with the greatest increase found at the thermocouple placed within 0·5 cm in all instances. On univariable and multivariable analysis, ablation in kidney tissue (maximum temperature 62·8°C), ablation with a pulse length setting of 100 µs (maximum 54·7°C), probe exposure of at least 3·0 cm (maximum 52·0°C) and ablation with metal within the ablation field (maximum 65·3°C) were all associated with a significant risk of thermal injury.

CONCLUSION

IRE can generate thermal energy, and even thermal injury, based on tissue type, probe exposure lengths, pulse lengths and proximity to metal. Awareness of probe placement regarding proximity to critical structures as well as probe exposure length and pulse length are necessary to ensure safety and prevent thermal injury. A probe exposure of 2·5 cm or less for liver IRE, and 1·5 cm or less for pancreas, with maximum pulse length of 90 µs will result in safe and non-thermal energy delivery with spacing of 1·5-2·3 cm between probe pairs.

Comparison of Models of Post-Hyperthermia Cell Survival

Several existing mathematical models of the survival of mammalian cells in culture following heating are compared. These models describe the fraction of cells that survive in a normal culture environment following a relatively brief period of heating between approximately 43 °C and 60 °C. The models have been developed either from rate process or mechanistic arguments. Little quantitative comparison between such models has been made using the same sets of data. The models are compared using the Akaike Information Criterion (AICc) after the model parameters have been estimated for two sets of existing data: human prostate cancer cells and Chinese hamster ovary cells. Most of the models capture the cell survival response. Scaled sensitivity coefficients show that some of the models have parameters that are difficult to estimate reliably. Relatively small variations in the AICc suggest that more measurements are needed before ranking the models.

Collagen unfolding accelerates water influx, determining hydration in the interstitial matrix

In the interstitial matrix, collagen unfolding at physiologic temperatures is thought to facilitate interactions with enzymes and scaffold molecules during inflammation, tissue remodeling, and wound healing. We tested the hypothesis that it also plays a role in modulating flows and matrix hydration potential. After progressively unfolding dermal collagen in situ, we measured the hydration parameters by osmotic stress techniques and modeled them as linear functions of unfolded collagen, quantified by differential scanning calorimetry after timed heat treatment. Consistent with the hypothetical model, the thermodynamic and flow parameters obtained experimentally were related linearly to the unfolded collagen fraction. The increases in relative humidity and intensity of T(2) maps were also consistent with interfacial energy contributions to the hydration potential and the hydrophobic character of the newly formed protein/water interfaces. As a plausible explanation, we propose that increased tension at interfaces formed during collagen unfolding generate local gradients in the matrix that accelerate water transfer in the dermis. This mechanism adds a convective component to interstitial transfer of biological fluids that, unlike diffusion, can speed the dispersion of water and large solutes within the matrix.

Controllable in vivo hyperthermia effect induced by pulsed high intensity focused ultrasound with low duty cycles

High intensity focused ultrasound (HIFU)-induced hyperthermia is a promising tool for cancer therapy. Three-dimensional nonlinear acoustic-bioheat transfer-blood flow-coupling model simulations and in vivo thermocouple measurements were performed to study hyperthermia effects in rabbit auricular vein exposed to pulsed HIFU (pHIFU) at varied duty cycles (DCs). pHIFU-induced temperature elevations are shown to increase with increasing DC. A critical DC of 6.9% is estimated for temperature at distal vessel wall exceeding 44 °C, although different tissue depths and inclusions could affect the DC threshold. The results demonstrate clinic potentials of achieving controllable hyperthermia by adjusting pHIFU DCs, while minimizing perivascular thermal injury.

Targeted magnetic hyperthermia

Many nanotechnologies, which enable unique approaches to treat cancer, have been developed based upon non-toxic organic and inorganic materials to improve current cancer treatments. The use of inorganic materials to form magnetic nanoparticles for hyperthermia therapy is of great interest for localized treatment of cancers without effecting adjacent healthy tissue. Extensive clinical trials have begun using magnetic hyperthermia in animal models. The purpose of this article is to address different factors that affect targeting, heating and biodistribution to safely control the therapeutic efficacy of targeted magnetic hyperthermia. This method involves accumulation of magnetic nanoparticles at a tumor site and then manipulating the magnetic properties of the nanoparticles to heat the targeted tissues.

Considerations for Thermal Injury Analysis for RF Ablation Devices

Background:

The estimation of lesion size is an integral part of treatment planning for the clinical applications of radiofrequency ablation. However, to date, studies have not directly evaluated the impact of different computational estimation techniques for predicting lesion size. In this study, we focus on three common methods used for predicting tissue injury: (1) iso-temperature contours, (2) Cumulative equivalent minutes, (3) Arrhenius based thermal injury.

Methods:

We created a geometric model of a multi-tyne ablation electrode and simulated thermal and tissue injury profiles that result from three calculation methods after 15 minutes exposure to a constant RF voltage source. A hybrid finite element technique was used to calculate temperature and tissue injury. Time-temperature curves were used in the assessment of iso-temperature thresholds and the method of cumulative equivalent minutes. An Arrhenius-based formulation was used to calculate sequential and recursive thermal injury to tissues.

Results:

The data demonstrate that while iso-temperature and cumulative equivalent minute contours are similar in shape, these two methodologies grossly over-estimate the amount of tissue injury when compared to recursive thermal injury calculations, which have previously been shown to correlate closely with in vitro pathologic lesion volume measurement. In addition, Arrhenius calculations that do not use a recursive algorithm result in a significant underestimation of lesion volume. The data also demonstrate that lesion width and depth are inadequate means of characterizing treatment volume for multi-tine ablation devices.

Conclusions:

Recursive thermal injury remains the most physiologically relevant means of computationally estimating lesion size for hepatic tumor applications. Iso-thermal and cumulative equivalent minute approaches may produce significant errors in the estimation of lesion size.

Considerations for thermal injury analysis for RF ablation devices

BACKGROUND

The estimation of lesion size is an integral part of treatment planning for the clinical applications of radiofrequency ablation. However, to date, studies have not directly evaluated the impact of different computational estimation techniques for predicting lesion size. In this study, we focus on three common methods used for predicting tissue injury: (1) iso-temperature contours, (2) Cumulative equivalent minutes, (3) Arrhenius based thermal injury.

METHODS

We created a geometric model of a multi-tyne ablation electrode and simulated thermal and tissue injury profiles that result from three calculation methods after 15 minutes exposure to a constant RF voltage source. A hybrid finite element technique was used to calculate temperature and tissue injury. Time-temperature curves were used in the assessment of iso-temperature thresholds and the method of cumulative equivalent minutes. An Arrhenius-based formulation was used to calculate sequential and recursive thermal injury to tissues.

RESULTS

The data demonstrate that while iso-temperature and cumulative equivalent minute contours are similar in shape, these two methodologies grossly over-estimate the amount of tissue injury when compared to recursive thermal injury calculations, which have previously been shown to correlate closely with in vitro pathologic lesion volume measurement. In addition, Arrhenius calculations that do not use a recursive algorithm result in a significant underestimation of lesion volume. The data also demonstrate that lesion width and depth are inadequate means of characterizing treatment volume for multi-tine ablation devices.

CONCLUSIONS

Recursive thermal injury remains the most physiologically relevant means of computationally estimating lesion size for hepatic tumor applications. Iso-thermal and cumulative equivalent minute approaches may produce significant errors in the estimation of lesion size.

Cellular responses to hyperthermia (40-46 degrees C): cell killing and molecular events

The goal of this review is to provide a brief introduction to the effects of hyperthermia on cellular structures and physiology. The review focuses on the effects of hyperthermia thought to contribute to the enhancement of cancer therapy namely the mechanisms of cell killing and the sensitization of cells to ionizing radiation or chemotherapeutic agents. Specifically the review addresses four topics: hyperthermia induced cell killing, mathematical models of cell killing, mechanisms of thermal effects in the hyperthermia temperature range and effects on proteins that contribute to resistance to other stresses, i.e., DNA damage. Hyperthermia has significant effects on proteins including unfolding, exposing hydrophobic groups, and aggregation with proteins not directly altered by hyperthermia. Protein aggregation has effects throughout the cell but has a significant impact within the nucleus. Changes in the associations of nuclear proteins particularly those involved in DNA replication cause the stalling of DNA replication forks and lead to the induction of DNA damage such as double strand breaks. It has long been recognized that heat has effects on plasma membrane protein distribution alters the permeability of plasma membranes resulting in a calcium spike and disrupts the mitochondrial membrane potential resulting in the change in the redox status of cells. These effects contribute to the protein unfolding effects of hyperthermia and contribute to effects observed in the nucleus. Thus heat effects on multiple cellular targets can be integrated through global effects on protein folding to affect specific end points such as cell killing and sensitization to additional stresses.

Physiologically relevant increase in temperature causes an increase in intestinal epithelial tight junction permeability

The effects of physiologically relevant increase in temperature (37-41 degrees C) on intestinal epithelial tight junction (TJ) barrier have not been previously studied. Additionally, the role of heat-shock proteins (HSPs) in the regulation of intestinal TJ barrier during heat stress remains unknown. Because heat-induced disturbance of intestinal TJ barrier could lead to endotoxemia and bacterial translocation during physiological thermal stress, the purpose of this study was to investigate the effects of modest, physiologically relevant increases in temperature (37-41 degrees C) on intestinal epithelial TJ barrier and to examine the protective role of HSPs on intestinal TJ barrier. Filter-grown Caco-2 intestinal epithelial cells were used as an in vitro intestinal epithelial model system to assess the effects of heat exposure on intestinal TJ barrier. Exposure of filter-grown Caco-2 monolayers to modest increases in temperatures (37-41 degrees C) resulted in a significant time- and temperature-dependent increases in Caco-2 TJ permeability. Exposure to modest heat (39 or 41 degrees C) resulted in rapid and sustained increases in HSP expression; and inhibition of HSP expression produced a marked increase in heat-induced increase in Caco-2 TJ permeability (P < 0.001). Heat exposure (41 degrees C) resulted in a compensatory increase in Caco-2 occludin protein expression and an increase in junctional localization. Inhibition of HSP expression prevented the compensatory upregulation of occludin protein expression and produced a marked disruption in junctional localization of occludin protein during heat stress. In conclusion, our findings demonstrate for the first time that a modest, physiologically relevant increase in temperature causes an increase in intestinal epithelial TJ permeability. Our data also show that HSPs play an important protective role in preventing the heat-induced disruption of intestinal TJ barrier and suggest that HSP mediated upregulation of occludin expression may be an important mechanism involved in the maintenance of intestinal epithelial TJ barrier function during heat stress.

Therapeutic efficacy as predicted by quantitative assessment of murine RIF-1 tumour pH and phosphorous metabolite response during hyperthermia: an in vivo 31P NMR study

Described herein are the initial findings from an 'in-magnet' 31P NMR compatible hyperthermia system capable of concurrently heating and monitoring the metabolic response of murine tumours; the murine radiation induced fibrosarcoma (RIF-1) was employed for these studies. At thermal doses sufficient to raise tumour temperature to 41.5 and 43 degrees C for a period of 30 min, a marked and rapid decrease in nucleoside triphosphate concentration and in pH was observed during the heating period, while inorganic phosphate concentration increased significantly but more gradually. These 31P NMR determined metabolic indices remained depressed/elevated throughout a 1.5 h post-hyperthermia monitoring period. Importantly, these metabolic indices correlated significantly with specific growth delay. This suggests a possible role for NMR spectroscopy in early assessment, and perhaps control, of therapeutic response to hyperthermia.

THERMAL DOSE REQUIREMENT FOR TISSUE EFFECT: EXPERIMENTAL AND CLINICAL FINDINGS

In this review we have summarized the basic principles that govern the relationships between thermal exposure (Temperature and time of exposure) and thermal damage, with an emphasis on normal tissue effects. We have also attempted to identify specific thermal dose information (for safety and injury) for a variety of tissues in a variety of species. We address the use, accuracy and difficulty of conversion of an individual time and temperature (thermal doses) to a standardized value (eg equivalent minutes at 43 degrees C) for comparison of thermal treatments. Although, the conversion algorithm appears to work well within a range of moderately elevated temperatures (2-15 deg C) above normal physiologic baseline (37-39 deg C) there is concern that conversion accuracy does not hold up for temperatures which are minimally or significantly above baseline. An extensive review of the literature suggests a comprehensive assessment of the "thermal does-to-tissue effect" has not previously been assembled for most individual tissues and never been viewed in a semi-comprehensive (tissues and species) manner. Finally, we have addressed the relationship of thermal does-to-effect vs. baseline temperature. This issues is important since much of the thermal dose-to-effect information has been accrued in animal models with baseline temperatures 1-2 deg higher than that of humans.

Head insulation and heat loss in naked and clothed newborns using a thermal mannequin

In newborns, large amounts of heat are lost from the head, due to its high skin surface area. Insulating the head (for example, with a hat or bonnet) can be a simple and effective method of reducing dry heat loss. In the present study, we evaluated the safety aspects of insulating the head of low-birth-weight naked or clothed newborns by using a heated mannequin that simulates a low-birth-weight newborn. Experimental conditions (comprising a nude and three clothed setups) were performed in a closed incubator at three different air temperatures (29 degrees C, 32 degrees C, and 34 degrees C) and with and without the head being covered with a bonnet in each case, i.e., 24 experimental conditions in all. The study shows that added clothing elements and insulating the head decreases the total heat loss of the mannequin as a whole. As regards the dry heat exchange from the head, wearing a bonnet decreases the local heat loss by an average of 18.9% in all clothed and thermal conditions. This phenomenon could be at the origin of brain overheating in heavily dressed newborns, when unrestricted heat loss is limited to the face only. Our results suggest that--apart from accidental hypothermia-in order to achieve thermal equilibrium of the body, it is preferable to leave the head unprotected and to increase the level of clothing insulation over the rest of the body.

Mathematical description of synergistic interaction of hyperthermia and ionizing radiation

A simple mathematical model of simultaneous combined action of ionizing radiation and hyperthermia has been proposed. The model suggests that the synergistic interaction of ionizing radiation and hyperthermia is expected to result from the additional lethal damage arising from the interaction of sublesions induced by both agents. These sublesions are considered nonlethal after each agent taken alone. The model was applied to the quantitative analysis of the simultaneous action of hyperthermia and ionizing radiation. It predicts the dependence of synergistic interaction of the ratio of lethal events produced by every agent used, as well as the maximal value of the synergistic effect, conditions at which the maximal interactive effect can be achieved, and the dependence of synergistic effect on dose rate. The predictions of the model have been tested with four experimental data sets reported in the literature. The theory appears to be appropriate and the conclusions valid.

Corrosion analysis of NiCu and PdCo thermal seed alloys used as interstitial hyperthermia implants

Ferromagnetic materials with low Curie temperatures are being investigated for use as interstitial implants for fractionated hyperthermia treatment of prostatic disease. Previous investigations of the system have utilized alloys, such as NiCu, with inadequate corrosion resistance, requiring the use of catheters for removal of the implants following treatment or inert surface coatings which may interfere with thermal characteristics of the implants. We are evaluating a palladium-cobalt (PdCo) binary alloy which is very similar to high palladium alloys used in dentistry. Electrochemical corrosion tests and immersion tests at 37 degrees C for both NiCu and PdCo alloy samples in mammalian Ringer's solution were performed. Long-term corrosion rates are 5.8 x 10(-5) microm per year (NiCu) and 7.7 x 10(-8) microm per year (PdCo) from average immersion test results, indicating higher corrosion resistance of PdCo (P < 0.02); immersion corrosion rates were much lower than initial corrosion rates found electrochemically. Both alloys had significantly lower corrosion rates than standard surgical implant rates of 0.04 microm per year (P < 0.001 for both alloys). Scanning electron microscopy illustrates changes in the NiCu alloy surface due to pitting corrosion; no difference is observed for PdCo. The data indicate that the PdCo alloy may be suitable as a long-term implant for use in fractionated hyperthermia.

Survival time and prevention of side effects of intraperitoneal hyperthermic perfusion with mitomycin C combined with surgery for patients with advanced gastric cancer

In an attempt to prevent postoperative intraperitoneal recurrence in patients with advanced gastric cancer and consequently to improve survival time, we treated patients with intraperitoneal hyperthermic perfusion (IPHP) using mitomycin C (MMC) combined with surgery. There were 60 patients with advanced gastric cancer who were treated with IPHP (long-term study) group, and the survival of this group was compared with the outcome in 52 patients with advanced gastric cancer treated with surgery alone (control group). To avoid or diminish side effects derived from scald injury of the peritoneal surface due to IPHP, 50 mg/kg of cimetidine was given intravenously just before administration of IPHP. For prophylaxis of anastomotic leakage, duodenostomy using a Foley catheter was performed. The 60 patients who were treated with IPHP lived longer than the 52 patients in the control group (p = 0.000610). The 3 year survival rate was 45 percent for the former compared with 16 percent for the latter. The intravenous administration of cimetidine just prior to IPHP protected the peritoneoserosal surface from scald injury, even though the heated perfusate exposure was at 44.3-46.3 degrees C for 2 hours. Because the intraabdominal pressure within the duodenum and jejunum was decompressed postoperatively through catheter duodenostomy and the peritoneoserosal surface was protected from scald injury caused by IPHP, anastomotic leakage in the study group was nil. Therefore, IPHP treatment plus aggressive surgery combined with pre-IPHP cimetidine administration are indicated for patients with advanced gastric cancer. The side effects of IPHP and postoperative morbidity can thus be reduced and a favorable outcome obtained.

Thermal stress induces epithelial permeability

The mechanisms by which heat injury results in multiorgan system failure are unknown, but the presence of endotoxemia and intestinal hemorrhage suggests that changes in gut epithelial permeability may be crucial to this process. To determine whether alterations in epithelial permeability occur at physiologically relevant temperatures, heat-induced changes on epithelial barrier integrity were studied using a high-resistance clone of Madin-Darby canine kidney epithelial cells. Transepithelial electrical conductance increased when monolayers were heated above 38.3 degrees C. Early changes in conductance were completely reversible with cooling. Increased conductance was due to increased paracellular permeability because heat also induced increased mannitol permeability across the monolayers. A conditioning heat stress (42 degrees C for 90 min) altered heat-induced permeability. When cell monolayers were exposed to this conditioning stress 48 h before measurement of conductance with increasing temperatures, the conductance increase did not occur until they were heated to 39.4 degrees C compared with 38.8 degrees C in naive control cells. This conditioning treatment also conferred thermotolerance as measured by cell survival after a lethal 45.0 degrees C heat stress. There was no difference in the temperature at which conductance increased between preheated and control cells 96 h after a preconditioning heat stress. The conditioning heat stress resulted in accumulation of heat-shock protein (HSP) 70 in cells at 48 h, but HSP 70 returned to control levels at 96 h. These studies demonstrate that small temperature elevations increase epithelial permeability and that prior heat stress which induces HSP 70 shifts the threshold temperature required to disrupt the epithelium.

A model for cell killing by continuous heating

Based on an analysis of cellular survival curves following single heating, a model is proposed to explain the action of heat on cell survival. The basic idea of this model is that cellular inactivation by heat is a three-step process. In the first step, heating produces sublethal damage. Secondly, the produced damage is repaired in a certain time period after the cell has received it. The time period to be required for repairing the sublethal damage changes with the thermal conditions that the cell has undergone. In the third step, the lethal event is induced when the cell undergoes cumulative sublethal damage to the extent that it cannot be repaired. The incidence of sublethal damage is calculated using the Arrhenius equation, where one inactivation energy is postulated. Based on the assumption that sublethal damage occurs at random, a mathematical model has been worked out that quantitatively describes cell killing by single heating. This mathematical model has been applied to the surviving fractions of Chinese hamster ovary cells reported by Sapareto, and it correlates to the whole surviving data at a temperature range of from 41.5 to 46 degrees C by the substitution of the appropriate values for the parameters of the model.

The relationship between hsp 70 localization and heat resistance

Using indirect immunofluorescence we have investigated the kinetics of nuclear accumulation and removal of hsp 70 in HA-1 Chinese hamster fibroblasts exposed to elevated temperatures. The kinetics of accumulation of hsp 70 in the nuclei were found to be time/temperature dependent at all temperatures tested (42-45 degrees C). At a given temperature, the fraction of cells manifesting nuclear localization of hsp 70 increased with exposure time. For a given duration of heating, the fraction of cells manifesting nuclear localization of hsp 70 increased with the temperature. The kinetics of the nuclear accumulation of hsp 70 were similar for normal HA-1 cells, their heat-resistant variants, and transiently thermotolerant cells (triggered by prior exposure to a brief heat shock or to sodium arsenite). Upon return to 37 degrees C after heat shock, the kinetics of removal of the hsp 70 associated with the nucleus was dependent on the severity of the initial heat challenge. However, for a given heat dose, the decay of nuclear localization of hsp 70 was more rapid in thermotolerant and heat-resistant cells than in their normal counterparts. These results suggest that the increased levels of hsp 70 associated with the transient or permanently heat-resistant state may play a direct role in restoring and/or repairing heat-induced nuclear and nucleolar alterations associated with heat-induced cell killing. Furthermore, they also suggest that the heat-resistant state may involve ameliorated repair of heat-induced cellular alterations.

Winner of the Lund Science Award 1992. Thermosensitization induced by step-down heating. A review on heat-induced sensitization to hyperthermia alone or hyperthermia combined with radiation

A few minute's exposure to a high temperature (sensitizing treatment, ST) may substantially increase the cytotoxic and the radiosensitizing effect of a subsequent heating at a lower temperature (test treatment, TT). This phenomenon, which is known as step-down heating (SDH) or thermosensitization, has been observed both in cultured cells in vitro and in tumours and normal tissues in vivo. The effect of SDH increases with a lowering of TT temperature, but it is rapidly lost at temperatures very close to 37 degrees C. SDH-induced thermosensitization decays within a few hours, when an interval is inserted between ST and TT. In vitro results suggest an exponential decay of the SDH effect with half times ranging from 1.5- to 3.1 h. The effect of SDH increases with increasing ST time or temperature. For single heating, the Arrhenius plot is biphasic with activation energies of 500-800 and 1200-1700 kJ/mol above and below a break point temperature in the region 42.5-43.0 degrees C, respectively. For SDH, the Arrhenius plot gradually becomes monophasic with increasing severity of ST and it approaches asymptotically to an activation energy of about 400 kJ/mol. The reduction of the activation energy depends on cell survival after the priming ST and not on the specific ST heating time or temperature. SDH strongly enhances hyperthermic radiosensitization with a 5-6-fold reduction of the radiation dose required to achieve tumour control. The thermosensitizing and the radiosensitizing effects of SDH have several features in common. Both effects become more prominent when the TT temperature is decreased and when the ST heating time or temperature increases. In addition, the decay kinetics for both effects are comparable. For heat alone, the effect of SDH in tumour and normal tissue seems to be quantitatively similar. However, the therapeutic ratio may be increased by combining SDH with radiation. Biologically, the critical subcellular targets involved in the SDH effect have not been revealed. However, the ability of SDH to inhibit the clearance of heat-induced aggregation of proteins in the nucleus is interesting. Blockage of the nuclear function by proteins is a central theory in the present molecular biological models for both cell kill by heat and heat radiosensitization. Clinically, SDH may be an advantage since even a short exposure to high temperature increases the effect of an otherwise inadequate heat treatment. The disadvantages are that SDH complicates thermal dose calculations, and may cause unacceptable damage to normal tissue.

Effect of chronic thermotolerance on thermosensitization in Chinese hamster ovary cells studied at various temperatures

The effect of chronic thermotolerance on the thermal responses of Chinese hamster ovary (CHO) cells to single and step-down heating was studied. Thermotolerance was induced by pre-heating exponentially growing cells at 39 degrees C for 9 h, followed by test treatments for variable times at temperatures ranging from 39 to 43 degrees C. In the temperature range studied, the heat sensitivity of thermotolerant CHO cells was characterized by an Arrhenius activation energy of Ea = 1175 +/- 40 kJ/mol. This value agreed well with Ea = 1180 +/- 45 kJ/mol measured after single heating, indicating that the induction of chronic thermotolerance did not affect the activation energy for cell killing by heat. Thermosensitization was studied after a priming treatment at 43 degrees C for 50 min followed by step-down heating at temperatures ranging from 39 to 43 degrees C. The temperature dependence of the thermal response after step-down heating was characterized by an activation energy of Ea = 490 +/- 17 kJ/mol. When the cells were pre-treated for 1-16 h at 39 degrees C prior to step-down heating (43 degrees C, 50 min, followed by graded exposure to 39-43 degrees C), the activation energy was gradually enhanced and approached Ea = 825 +/- 42 kJ/mol for 39 degrees C, 16 h. This change in Ea reflects the effect of thermotolerance on the priming treatment at 43 degrees C for 50 min, whereas the effect on the final test treatment resulted in a parallel shift of the Arrhenius curve without changing the slope, indicating that the effect of thermotolerance on the priming and the test treatment is expressed in the Arrhenius diagram in different ways.

Tumor-targeted delivery of 8-hydroxyquinoline

RIF-1 mouse tumors express high levels of beta-glucuronidase activity relative to most normal tissues. The high activity can be exploited for targeting specific drugs preferentially to tumor tissues. In this study we examined the kinetics of 8-hydroxyquinoline (8-OHQ) accumulation in tumor and in several normal tissues resulting from the in vivo deconjugation of 8-hydroxyquinolyl-glucuronide (8-OHQ-GlcA). Tumors were acidified with D-glucose and NaHCO3 prior to the administration of 8-OHQ-GlcA; subsequently the deconjugated aglycone, 8-OHQ, accumulated preferentially in tumors and reached peak levels between 30 and 60 min after the 8-OHQ-GlcA injection. Mild hyperthermia of 30 min at 43 degrees C to the tumors further increased their peak 8-OHQ levels by a factor of 2-3. Some normal tissues, mostly kidney, liver, and colon, also accumulated 8-OHQ, but the aglycone appeared early in the normal tissues (near 30 min post-injection) and was significantly reduced by 60 min when 8-OHQ remained high in the tumor. Administration of 8-OHQ-GlcA alone, without prior tumor acidification, failed to produce measurable accumulations of 8-OHQ in tumors and in normal tissues. Tissue clearance of 8-OHQ is mediated primarily by the enzymatic reconjugation of 8-OHQ via UDP-glucuronosyltransferase (UDPGT). UDPGT activity was high in liver, kidney, and bowel, but low in the RIF tumor, spleen, muscle, and brain. Hyperthermia had only a modest effects on UDPGT activity: a heat dose of 30 min at 45 degrees C reduced activity less than 60%. Thus, preferential accumulation and prolonged retention of 8-OHQ in RIF tumors may be caused by a combination of factors: a) high tumor beta-glucuronidase activity, b) selective tumor acidification during hyperglycemia, c) low tumor UDPGT activity, and d) other factors, such as tumor blood flow.

Sensitization to hyperthermia induced in a normal tissue by step-down heating

The effect of step-down heating was investigated in the skin of the CDF1 mouse foot. Step-down heating was induced with a 44.7 degrees C/10 min pretreatment followed by a test treatment at a lower temperature for variable time. Step-up heating, that is, a test treatment followed by a 44.7 degrees C/10 min treatment, and single heating were used as controls. The normal tissue reaction was scored at five levels of damage (from slight redness and oedema to loss of a toe or greater reaction), and the heating time to induce each level in 50% of the animals, RD50, was used as the endpoint. The effect of step-down heating was quantified by the step-down ratio, calculated as the ratio of test heating times to obtain the endpoint. A significant reduction of the RD50 was seen at all score levels when the 44.7 degrees C/10 min was given in a step-down heating schedule, and the effect increased with decreasing test treatment temperature. In contrast, the heat sensitivity was only marginally influenced by step-up heating. An analysis of the time-temperature relationship demonstrated a log-linear relationship between temperature and RD50 for single heating in the range 42.2-44.7 degrees C and for step-down heating in the range 41.7-44.7 degrees C. The curve for step-down heating showed a lesser slope indicating a decrease of the activation energy. The kinetics of the SDH effect were investigated by inserting an interval between a primary 44.7 degrees C/10 min treatment and a test treatment performed at 42.2 degrees C. The effect of step-down heating was maximal with no interval between the priming treatment and the test treatment. As the interval was increased to 1.5 hr the step-down sensitization disappeared, and with even longer intervals thermotolerance developed. From a clinical point of view, the present data indicate that step-down heating may increase the extent of both reversible and irreversible heat damage in the normal tissue.

The response of human and rodent cells to hyperthermia

Inherent cellular radiosensitivity in vitro has been shown to be a good predictor of human tumor response in vivo. In contrast, the importance of the intrinsic thermosensitivity of normal and neoplastic human cells as a factor in the responsiveness of human tumors to adjuvant hyperthermia has never been analyzed systematically. A comparison of thermal sensitivity and thermo-radiosensitization in four rodent and eight human-derived cell lines was made in vitro. Arrhenius plots indicated that the rodent cells were more sensitive to heat killing than the human, and the break-point was 0.5 degrees C higher for the human than rodent cells. The relationship between thermal sensitivity and the interaction of heat with X rays at low doses was documented by thermal enhancement ratios (TER's). Cells received either a 1 hr exposure to 43 degrees C or a 20 minute treatment at 45 degrees C before exposure to 300 kVp X rays. Thermal enhancement ratios ranged from 1.0 to 2.7 for human cells heated at 43 degrees C and from 2.1 to 5.3 for heat exposures at 45 degrees C. Thermal enhancement ratios for rodent cells were generally 2 to 3 times higher than for human cells, because of the fact that the greater thermosensitivity of rodent cells results in a greater enhancement of radiation damage. Intrinsic thermosensitivity of human cells has relevance to the concept of thermal dose; intrinsic thermo-radiosensitization of a range of different tumor cells is useful in documenting the interactive effects of radiation combined with heat.

Synergistic effect of irradiation and hyperthermia on established cell lines derived from maxillary carcinoma. Report I

Cultured tumor cells of an established cell line derived from cancer of the head and neck (maxillary and lingual cancer) were irradiated with X-rays (5 or 10 Gy). This treatment inhibited cell proliferation in a dose-dependent way. Cell cycle analysis showed that the ratio of cells in the S phase to the population of viable cells was higher than that in a non-irradiated control group. Thus, the S phase was prolonged by exposure to X-rays. Cell proliferation was also inhibited by 1 h of heat treatment at 43 degrees C. However, movement through the cell cycle was slowed down overall and no cell aggregation in any phase of the cell cycle was found. Proliferation of not only radioresistant but also radiosensitive cells was inhibited by this treatment. Hyperthermia at 43 degrees C for 1 h did not affect cell proliferation, nor did it influence the pattern of cell cycle distribution. However, it caused a decrease in intracellular polyamine amount. The combination of irradiation and hyperthermia caused a stronger inhibition than either treatment alone. The synergistic effect of the two treatments probably arose from the S-phase cells being heat-labile although radioresistant.

Synergistic effects of irradiation and hyperthermia on established cell lines derived from maxillary carcinoma. Report II

We studied in vitro the capability of radiation, hyperthermia, and their combination to inhibit growth of cell strains isolated from maxillary carcinoma and their radiation tolerant strains. Synergic effects of the combination were studied by investigating effects of hyperthermia and radiation on cell cycles with BrdU pulse labelling to establish optimal conditions for the combination. Growth of cell strains from maxillary carcinoma was remarkably inhibited by thermal treatment because of retarded cellular cycles. Cells at the S-phase were so sensitive to heat that their intake of BrdU was debilitated. Radiation increased the proportion of cells at the S-phase that poorly synthesized DNA. When combining radiation with hyperthermia, the heat killed cells at the S-phase, which was prolonged by radiation, and survivors showed retarded cellular cycles; that is, synergism was found.

Combined effect of cadmium (CdCl2) and high temperature on HeLa S3 cells

The combined effect of cadmium (CdCl2) and high temperature on the subsequent growth, the synthesis of nucleic acids and protein, and the cell cycle in HeLa S3 cells was investigated. The subsequent growth rate was depressed by cadmium at 37.1 degrees C. This suppression effect was enhanced at 40.4 degrees C compared with the effect at 37.1 degrees C. The synthesis of DNA, RNA and protein was inhibited at higher temperatures in cultivation without cadmium, and depressed at each temperature in a concentration-dependent manner by the addition of cadmium. The DNA, RNA and protein-IC50 values at 40.4 degrees C decreased compared with the values at 37.1 degrees C. The DNA and RNA-IC50 values were significantly decreased (p less than 0.01, p less than 0.005, respectively) depending on the temperature. After treating the cells with cadmium at 40.4 degrees C, the DNA/BrdUrd distribution showed that the rate of dead cells increased and the rate of the G1/G0 phase decreased. These results indicate that the inhibitory effect of cadmium on the subsequent growth of HeLa S3 cells is enhanced at high temperature and this enhancement is related to the increased inhibitory effect of cadmium on DNA and RNA synthesis at high temperature.

Step-down heating of CHO cells at 37.5-39 degrees C

The thermosensitizing effect of step-down heating was studied using Chinese hamster ovary (CHO) cells. Exponentially growing cells were given priming heat treatments at 43 degrees C for 45 or 90 min, immediately followed by a second exposure to a temperature ranging from 37.5 to 39 degrees C. The measured rates of cell killing, 1/D0, increased exponentially with temperature; the slopes correspond to Arrhenius activation energies of Ea = 1200 +/- 150 kJ mol-1 and Ea = 1275 +/- 125 kJ mol-1 for cells preheated at 43 degrees C for 45 or 90 min, respectively. For the temperature range 39-43 degrees C an activation energy of Ea = 561 +/- 24 kJ mol-1 was obtained for step-down heated cells (43 degrees C, 45 min followed by T = 39-43 degrees C). These results indicate that there is a 'second inflection point' at 39 degrees C on the Arrhenius curve for step-down heating of CHO cells. Data evaluation using a mathematical model published previously (H. Jung, Radiation Research, 106, 56-72, 1986) showed that the rate constant c for the conversion of nonlethal lesions into lethal events increased with an activation energy of Ea = 1520 +/- 140 kJ mol-1 in the temperature range from 37.5-39 degrees C. For 39-45 degrees C the activation energy for c was Ea = 360 +/- 26 kJ mol-1, indicating that the temperature dependence of c shows a break at 39 degrees C similar to that observed on the 1/D0 Arrhenius plot.

Analysis of pre-rRNAs in heat-shocked HeLa cells allows identification of the upstream termination site of human polymerase I transcription

Human rRNA precursor from normal or stressed HeLa cells were studied by S1 nuclease mapping of unlabeled RNA and by antisense RNase mapping of RNA from cells that had been labeled in vivo with [32P]PO4. Heating cells to 43 degrees C decreased the amount of newly synthesized rRNA to less than 5% of the control level and led to greater than 95% inhibition of transcription termination at a region 355 to 362 nucleotides downstream of the 3' end of 28S rRNA, with readthrough continuing into the next transcription unit. Heating of cells to 42 degrees C led to 60% inhibition of termination at this site; 50% of transcripts that extended into the nontranscribed spacer ended in a region 200 to 210 nucleotides upstream of the polymerase I (Pol I) initiation site. This is presumed to be the human upstream transcription termination site because of the absence of RNAs with a 5' end corresponding to this region, the location relative to the Pol I initiation site (which is similar to the location of upstream terminators in other species), and the fact that it is 15 to 25 nucleotides upstream of the sequence GGGTTGACC, which has an 8-of-9 base identity with the sequence 3' of the downstream termination site. Surprisingly, treatment of cells with sodium arsenite, which also leads to the induction of a stress response, did not inhibit termination. Pol I initiation was decreased to the same extent as termination, which lends support to the hypothesis that termination and initiation are coupled. Although termination was almost completely inhibited at 43 degrees C, the majority of the recently synthesized rRNAs were processed to have the correct 3' end of 28S. This finding suggests that 3'-end formation can involve an endonucleolytic cut and is not solely dependent on exonucleolytic trimming of correctly terminated rRNAs.

Clinical trial with surgery and intraperitoneal hyperthermic perfusion for peritoneal recurrence of gastrointestinal cancer

To treat six patients with peritoneal recurrence after radical operation for gastrointestinal cancer, an intraperitoneal hyperthermic perfusion (IPHP), combined with surgical resection of recurrent tumors, intestinal by-pass anastomosis, or both, was carried out. Immediately after complete resection of the intraperitoneal recurrent tumors, a 2- to 3-hour IPHP was performed under hypothermic general anesthesia at about 32 degrees C, using a perfusate containing 10 micrograms/ml or 20 micrograms/ml of mitomycin C (MMC) warmed at the inflow temperature of 46.6 degrees C to 46.9 degrees C. The apparatus used for IPHP was designed for intraperitoneal perfusion as a closed circuit. Although five of the six patients had a malignant peritoneal effusion at the time of admission, the effusion disappeared soon after IPHP, and no cancer cell was present in the lavage from Douglas' pouch. The other patient had a recurrent tumor at the anastomotic region after low anterior resection for rectal cancer and complete resection of the recurrent tumor, combined with IPHP, was carried out. One patient with a recurrent gastric cancer died of hepatic metastasis and cancerous pleuritis 5 months after this treatment, and the other five are in good health 12.8 +/- 5.1 months after IPHP. On the other hand, five patients with intra-abdominal recurrent gastric cancer, who received only surgical treatment within the same period of time, died 3.0 +/- 2.1 months after the surgery. Postoperatively, in the six patients with IPHP, transitory hepatic dysfunction, hypoproteinemia, and thrombocytopenia occurred. These results show that IPHP using MMC combined with surgery is a safe, reliable treatment for patients with peritoneal recurrence of gastrointestinal cancer.

Analysis of pre-rRNAs in heat-shocked HeLa cells allows identification of the upstream termination site of human polymerase I transcription

Human rRNA precursor from normal or stressed HeLa cells were studied by S1 nuclease mapping of unlabeled RNA and by antisense RNase mapping of RNA from cells that had been labeled in vivo with [32P]PO4. Heating cells to 43 degrees C decreased the amount of newly synthesized rRNA to less than 5% of the control level and led to greater than 95% inhibition of transcription termination at a region 355 to 362 nucleotides downstream of the 3' end of 28S rRNA, with readthrough continuing into the next transcription unit. Heating of cells to 42 degrees C led to 60% inhibition of termination at this site; 50% of transcripts that extended into the nontranscribed spacer ended in a region 200 to 210 nucleotides upstream of the polymerase I (Pol I) initiation site. This is presumed to be the human upstream transcription termination site because of the absence of RNAs with a 5' end corresponding to this region, the location relative to the Pol I initiation site (which is similar to the location of upstream terminators in other species), and the fact that it is 15 to 25 nucleotides upstream of the sequence GGGTTGACC, which has an 8-of-9 base identity with the sequence 3' of the downstream termination site. Surprisingly, treatment of cells with sodium arsenite, which also leads to the induction of a stress response, did not inhibit termination. Pol I initiation was decreased to the same extent as termination, which lends support to the hypothesis that termination and initiation are coupled. Although termination was almost completely inhibited at 43 degrees C, the majority of the recently synthesized rRNAs were processed to have the correct 3' end of 28S. This finding suggests that 3'-end formation can involve an endonucleolytic cut and is not solely dependent on exonucleolytic trimming of correctly terminated rRNAs.

Thermotolerance of xenografted human gastric cancer

To compare the thermotolerance in vivo of two human gastric cancers with different doubling times, the xenografted tumors were warmed twice at 43.5 +/- 0.1 degree C in a water bath for 20 minutes at a predetermined interval. In the tumors with doubling times of 5.2 and 10.9 days, a 7-day interval heat treatment resulted in a prolongation in tumor tripling times by 156 per cent and 132 per cent, respectively, compared with a single heat treatment for 40 minutes. On the contrary, two heat treatments given at intervals of 3 to 5 days had a short tumor tripling time, compared to that of the 40-minute single treatment. Thus, the thermotolerance of these human gastric cancers gradually increased to a maximum within a 3- to 4-day interval and disappeared completely after a 7-day interval. These results indicate that the times required to reach maximal thermotolerance in these human gastric cancers were longer than those previously demonstrated for human and rodent cancer cell lines in vitro. The development and decay of thermotolerance in these human gastric cancers need to be considered in the design of multiple-fractionated regimens.

Hyperthermic effects on DNA repair of UV-irradiated Dictyostelium discoideum

DNA repair of a lower eukaryote, Dictyostelium discoideum, has been investigated through the analysis of heat effects on cell mortality and DNA repair of UV-irradiated amoeboid cells. In a wild-type strain (NC4), an increase in temperature immediately after UV irradiation resulted in an increase in cell mortality, though similar heat treatment before UV irradiation had no such effect. Similar results were obtained in another wild-type strain, HPS83. In NC4, heat treatment after UV irradiation did not inhibit the nicking of DNA strands during excision repair processes, but did inhibit the rejoining of the DNA strand breaks. Removal of thymine-containing pyrimidine dimers from DNA molecules was also depressed by heat treatment after UV irradiation. In contrast, heat treatment before UV irradiation had no effect on any stage of the nicking process, the excision of the dimers or the rejoining. On the other hand, a radiation-sensitive mutant (TW8) defective in an incision step of the excision repair process did not show an increase in cell mortality in response to heat treatment administered either before or after UV irradiation. Though the optimum temperature for cell growth of the amoebae was 23 degrees C, the critical temperature for effective enhancement of cell killing was ca. 30 degrees C. Hence we assume that the excision repair of UV-damaged DNA is selectively sensitive to heat treatment.

Effect of pH on development and decay of thermotolerance in CHO cells using fractionated heating at 43 degrees C

The development and decay of thermotolerance at pH 6.7, 7.1 and 7.7 was studied after fractionated hyperthermia at 43 degrees C using exponentially growing CHO cells. The maximum of thermotolerance and the time interval to reach this maximum were found to correlate with the survival decrement after the priming heat treatment. Both parameters were only affected by pH in so far as the pH altered survival after the priming treatment. Decay of thermotolerance was exponential. For a given priming heat treatment for the time t1, the half-time of decay, tau 1/2, increased linearly with increasing cell doubling time, tau d, measured for non-heated cells growing at different pH. On the other hand, for a given cell doubling time, tau d, the half-time, tau 1/2, increased exponentially with increasing duration of the priming heat treatment, t1. For all measured data the half-time of thermotolerance decay could be described by the equation tau 1/2 = alpha. tau d.exp(k.t1), with k = 2.2 +/- 0.2 h-1 and alpha = 0.094 +/- 0.009 for all pretreatments applied and all pH conditions tested. This relationship might indicate that the decay of thermotolerance is governed by a single mechanism.