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Sample records for interstitial thermal therapy

  1. Staged laser interstitial thermal therapy and topectomy for complete obliteration of complex focal cortical dysplasias.

    PubMed

    Ellis, Jason A; Mejia Munne, Juan C; Wang, Shih-Hsiu; McBrian, Danielle K; Akman, Cigdem I; Feldstein, Neil A; McKhann, Guy M

    2016-09-01

    Anatomically complex focal cortical dysplasias may present significant challenges to safe and complete surgical resection via standard operative corridors. Laser interstitial thermal therapy (LITT) is an emerging minimally invasive technique that may address some of these challenges, enabling stereotactic ablation of deep and/or surgically inaccessible regions. However, complete ablation may not be feasible in all cases. To address this dilemma, we have designed a protocol utilizing staged LITT followed by topectomy to effect complete obliteration of a complex focal cortical dysplasia. The approach presented demonstrates the feasibility, safety, and clinical utility of combining laser ablation and open surgery for the definitive management of this lesion. PMID:27234607

  2. Ultrasound interstitial thermal therapy (USITT) for the treatment of uterine myomas

    NASA Astrophysics Data System (ADS)

    Nau, William H., Jr.; Diederich, Chris J.; Simko, Jeff; Juang, Titania; Jacoby, Alison; Burdette, E. C.

    2007-02-01

    Uterine myomas (fibroids) are the most common pelvic tumors occurring in women, and are the leading cause of hysterectomy. Symptoms can be severe, and traditional treatments involve either surgical removal of the uterus (hysterectomy), or the fibroids (myomectomy). Interstitial ultrasound technologies have demonstrated potential for hyperthermia and high temperature thermal therapy in the treatment of benign and malignant tumors. These ultrasound devices offer favorable energy penetration allowing large volumes of tissue to be treated in short periods of time, as well as axial and angular control of heating to conform thermal treatment to a targeted tissue, while protecting surrounding tissues from thermal damage. The goal of this project is to evaluate interstitial ultrasound for controlled thermal coagulation of fibroids. Multi-element applicators were fabricated using tubular transducers, some of which were sectored to produce 180° directional heating patterns, and integrated with water cooling. Human uterine fibroids were obtained after routine myomectomies, and instrumented with thermocouples spaced at 0.5, 1.0, 1.5, 2.0, 2.5 and 3.0 cm from the applicator. Power levels ranging from 8-15 W per element were applied for up to 15 minute heating periods. Results demonstrated that therapeutic temperatures >50° C and cytotoxic thermal doses (t 43) extended beyond 2 cm radially from the applicator (>4 cm diameter). It is anticipated that this system will make a significant contribution toward the treatment of uterine fibroids.

  3. Theoretical model of internally cooled interstitial ultrasound applicators for thermal therapy

    NASA Astrophysics Data System (ADS)

    Tyréus, Per Daniel; Diederich, Chris J.

    2002-04-01

    Interstitial ultrasound applicators for high-temperature thermal therapy are currently being developed for treating cancerous and benign disease. Internally cooled, direct-coupled (ICDC) applicators, composed of a segmented array of cylindrical ultrasound transducers, have demonstrated capabilities of producing controllable and conformal heating distributions along the applicator length and angular orientation. In this study, 2D transient acoustic and biothermal models of ICDC applicators were developed using a mixed implicit and explicit finite difference solution with variable node spacing in cylindrical coordinates for enhanced speed, stability and accuracy. The model incorporates dynamic behaviour of acoustic parameters and blood perfusion as a function of temperature and thermal dose. Acoustic intensity distributions were modelled as a composite of measured and theoretical intensity distributions. The shape and time evolution of temperature contours and thermal lesions for 90°, 200° and 360° angularly directional applicators and multi-transducer applicators were modelled for heating durations between 1 and 5 min. Model parameters were selected to match previously reported ex vivo and in vivo studies of 2.2 mm diameter ICDC devices in thigh muscle and liver (15-30 W cm-2 applied power density, 0.5-5 min treatment times, 2.8-3.6 cm diameter thermal lesions). The temperatures and lethal thermal dose (600 EM43 °C) contours calculated using the models were in excellent agreement with temperatures and thermal lesion dimensions (visible coagulation) determined experimentally. The differences between maximum radial depths of coagulation calculated using the r-z and r-θ models were small, less than ~2 mm for 10-15 mm lesions. There was a strong correlation between the calculated 50 °C contour and the radial, angular and axial lesion dimensions obtained for 3-5 min heating protocols. The models developed in this study have significant application in design studies

  4. Interstitial microwave transition from hyperthermia to ablation: historical perspectives and current trends in thermal therapy.

    PubMed

    Ryan, Thomas P; Turner, Paul F; Hamilton, Brianne

    2010-01-01

    This work reviews the transition from hyperthermia to ablation for cancer treatment with interstitial microwave (MW) antennas. Early work utilising MW energy for thermal treatment of cancer tissue began in the late 1970s using single antennas applied interstitially or the use of multiple interstitial antennas driven with the same phase and equal power at 915 or 2450 MHz. The original antenna designs utilised monopole or dipole configurations. Early work in thermal therapy in the hyperthermia field eventually led to utilisation of these antennas and methods for MW ablation of tumours. Efforts to boost the radiated MW power levels while decreasing antenna shaft temperatures led to incorporation of internally cooled antennas for ablation. To address larger tumours, MW treatment utilised arrays that were simultaneously activated by either non-synchronous or synchronous phase operation, benefiting both hyperthermia and ablation strategies. Numerical modelling was used to provide treatment planning guidance for hyperthermia treatments and is expected to provide a similar benefit for ablation therapy. Although this is primarily a review paper, some new data are included. These new data show that three antennas with 2.5 cm spacing at 45 W/channel and 10 min resulted in a volume of 89.8 cm(3) when operated synchronously, but only 53.4 cm(3) non-synchronously. Efficiency was 1.1 (synchronous) versus 0.7 (non-synchronous). MW systems, treatment planning, and image guidance continue to evolve to provide better tools and options for clinicians and patients in order to provide better approach and targeting optimisation with the goal of improved treatment for the patient. PMID:20597625

  5. 3D perfused brain phantom for interstitial ultrasound thermal therapy and imaging: design, construction and characterization

    NASA Astrophysics Data System (ADS)

    Martínez, José M.; Jarosz, Boguslaw J.

    2015-03-01

    Thermal therapy has emerged as an independent modality of treating some tumors. In many clinics the hyperthermia, one of the thermal therapy modalities, has been used adjuvant to radio- or chemotherapy to substantially improve the clinical treatment outcomes. In this work, a methodology for building a realistic brain phantom for interstitial ultrasound low dose-rate thermal therapy of the brain is proposed. A 3D brain phantom made of the tissue mimicking material (TMM) had the acoustic and thermal properties in the 20-32 °C range, which is similar to that of a brain at 37 °C. The phantom had 10-11% by mass of bovine gelatin powder dissolved in ethylene glycol. The TMM sonicated at 1 MHz, 1.6 MHz and 2.5 MHz yielded the amplitude attenuation coefficients of 62  ±  1 dB m-1, 115  ±  4 dB m-1 and 175  ±  9 dB m-1, respectively. The density and acoustic speed determination at room temperature (~24 °C) gave 1040  ±  40 kg m-3 and 1545  ±  44 m s-1, respectively. The average thermal conductivity was 0.532 W m-1 K-1. The T1 and T2 values of the TMM were 207  ±  4 and 36.2  ±  0.4 ms, respectively. We envisage the use of our phantom for treatment planning and for quality assurance in MRI based temperature determination. Our phantom preparation methodology may be readily extended to other thermal therapy technologies.

  6. Magnetic resonance-guided laser interstitial thermal therapy: report of a series of pediatric brain tumors.

    PubMed

    Tovar-Spinoza, Zulma; Choi, Hoon

    2016-06-01

    OBJECTIVE Magnetic resonance-guided laser interstitial thermal therapy (MRgLITT) is a novel, minimally invasive treatment that has multiple advantages in pediatric use and broad applicability for different types of lesions. Here, the authors report the preliminary results of the first series of pediatric brain tumors treated with MRgLITT at Golisano Children's Hospital in Syracuse, New York. METHODS Pediatric brain tumors treated with MRgLITT between February 2012 and August 2014 at Golisano Children's Hospital were evaluated retrospectively. Medical records, radiological findings, surgical data, complications, and results of tumor volumetric analyses were reviewed. The Visualase thermal laser system (Medtronic) was used in all MRgLITT procedures. RESULTS This series included 11 patients with 12 tumors (pilocytic astrocytoma, ependymoma, medulloblastoma, choroid plexus xanthogranuloma, subependymal giant cell astrocytoma, and ganglioglioma). A single laser and multiple overlapping ablations were used for all procedures. The mean laser dose was 10.23 W, and the mean total ablation time was 68.95 seconds. The mean initial target volume was 6.79 cm(3), and the mean immediate post-ablation volume was 7.86 cm(3). The mean hospital stay was 3.25 days, and the mean follow-up time was 24.5 months. Tumor volume decreased in the first 3 months after surgery (n = 11; p = 0.007) and continued to decrease by the 4- to 6-month followup (n = 11; mean volume 2.61 cm(3); p = 0.009). Two patients experienced post-ablation complications: transient right leg weakness in one patient, and transient hemiparesis, akinetic mutism, and eye movement disorder in the other. CONCLUSIONS Magnetic resonance-guided laser interstitial thermal therapy is an effective first- or second-line treatment for select pediatric brain tumors. Larger multiinstitutional clinical trials are necessary to evaluate its use for different types of lesions to further standardize practices. PMID:26849811

  7. Magnetic Resonance-Guided Focal Laser-Induced Interstitial Thermal Therapy in a Canine Prostate Model

    PubMed Central

    Stafford, R. Jason; Shetty, Anil; Elliott, Andrew M.; Klumpp, Sherry A.; McNichols, Roger J.; Gowda, Ashok; Hazle, John D.; Ward, John F.

    2014-01-01

    Purpose To evaluate a newly FDA-cleared closed-loop, magnetic resonance (MR)-guided laser-induced interstitial thermal therapy (LITT) system for targeted ablation of prostate tissue in order to assess targeting ability, lesion generation and feasibility. Materials and Methods Mongrel dogs with (n = 2) and without (n = 5) canine transmissible venereal tumors in the prostate were imaged with a 1.5-T MR imaging scanner. Real-time 3D MR imaging was used to accurately position water-cooled 980-nm laser applicators to pre-determined targets within the canine prostates. Destruction of targeted tissue was guided with MR temperature imaging in real time for precise control of thermal ablation. MR predictions of thermal damage were correlated with findings from post-treatment images and compared to histopathology. Results Template-based targeting using MR guidance allowed the laser applicator to be placed within a mean of 1.1 mm (SD = 0.7 mm) of the target location. The mean width and length of the ablation zone by MR were 13.7 mm (SD = 1.3 mm) and 19.0 mm (SD = 4.2 mm) using single and compound exposures. The thermal damage predicted by MR correlated with the thermal damage determined by post-treatment imaging with a slope near unity and excellent correlation (R2 = 0.94). Conclusions This LITT system provided rapid and localized heating of tissue with minimal collateral thermal spread or injury. Combined with real-time monitoring and template-based planning, MR-guided LITT is an attractive modality for prostate cancer focal therapy. PMID:20727549

  8. A theoretical comparison of energy sources--microwave, ultrasound and laser--for interstitial thermal therapy.

    PubMed

    Skinner, M G; Iizuka, M N; Kolios, M C; Sherar, M D

    1998-12-01

    A number of heating sources are available for minimally invasive thermal therapy of tumours. The purpose of this work was to compare, theoretically, the heating characteristics of interstitial microwave, laser and ultrasound sources in three tissue sites: breast, brain and liver. Using a numerical method, the heating patterns, temperature profiles and expected volumes of thermal damage were calculated during standard treatment times with the condition that tissue temperatures were not permitted to rise above 100 degrees C (to ensure tissue vaporization did not occur). Ideal spherical and cylindrical applicators (200 microm and 800 microm radii respectively) were modelled for each energy source to demonstrate the relative importance of geometry and energy attenuation in determining heating and thermal damage profiles. The theoretical model included the effects of the collapse of perfusion due to heating. Heating patterns were less dependent on the energy source when small spherical applicators were modelled than for larger cylindrical applicators due to the very rapid geometrical decrease in energy with distance for the spherical applicators. For larger cylindrical applicators, the energy source was of greater importance. In this case, the energy source with the lowest attenuation coefficient was predicted to produce the largest volume of thermally coagulated tissue, in each tissue site. PMID:9869030

  9. NT-30COMPLICATIONS OF LASER INTERSTITIAL THERMAL THERAPY IN PATIENTS WITH BRAIN TUMORS

    PubMed Central

    Schulder, Michael; Black, Karen; Mehta, Ashesh; Gamble, Alexander

    2014-01-01

    OBJECTIVE: Laser interstitial thermal therapy (LITT) has been described as a treatment for patients with brain tumors refractory to other treatments, with little emphasis on the risks of the procedure. This report focuses on complications of LITT in patients with tumors of the central nervous system. METHODS: Laser probes were inserted in the operating room using low-field intraoperative MRI (iMRI) guidance (5 patients), frameless stereotaxy (FS) in 2, and frame-based placement in 3. LITT itself was done in a 1.5 Tesla diagnostic MRI. Diagnoses included metastatic tumors in 7 patients, glioma in 2, and pituitary tumor in 1. One patient had a filum terminale ependymoma (with laser placement in the diagnostic MRI). RESULTS: In 1 patient in whom FS was used for image guidance, diagnostic MRI showed the laser fiber to be misplaced. Three complications resulted from the LITT itself. One patient with a glioblastoma of the vermis and fourth ventricle had bilateral palsies of cranial nerves 6 and 7 after treatment. A patient with a recurrent metastatic tumor after stereotactic radiosurgery had worsened left hemiparesis. These two patients were treated with steroids, with partial improvement of their deficits. The patient with the filum terminale ependymoma developed a paraparesis the day after treatment; MRI showed expansion of the intraspinal mass with resolution of enhancement, consistent with tumor ablation. She required a laminectomy and removal of the mass, with a combination of tumor and necrosis on histological examination. CONCLUSIONS: Complications of LITT can result from laser misplacement and from the laser treatment itself. Use of a stereotactic frame can limit the risk of inaccurate placement. Avoiding complications of the LITT itself can be done by undertreating the margin of a target in close proximity to critical structures. Intraspinal LITT should be used with great caution.

  10. Feasibility of using interstitial ultrasound for intradiscal thermal therapy: a study in human cadaver lumbar discs

    NASA Astrophysics Data System (ADS)

    Nau, William H.; Diederich, Chris J.; Shu, Richard

    2005-06-01

    Application of heat in the spine using resistive wire heating devices is currently being used clinically for minimally invasive treatment of discogenic low back pain. In this study, interstitial ultrasound was evaluated for the potential to heat intradiscal tissue more precisely by directing energy towards the posterior annular wall while avoiding vertebral bodies. Two single-element directional applicator design configurations were tested: a 1.5 mm OD direct-coupled (DC) applicator which can be implanted directly within the disc, and a catheter-cooled (CC) applicator which is inserted in a 2.4 mm OD catheter with integrated water cooling and implanted within the disc. The transducers were sectored to produce 90° spatial heating patterns for directional control. Both applicator configurations were evaluated in four human cadaver lumbar disc motion segments. Two heating protocols were employed in this study in which the temperature measured 5 mm away from the applicator was controlled to either T = 52 °C, or T > 70 °C for the treatment period. These temperatures (thermal doses) are representative of those required for thermal necrosis of in-growing nociceptor nerve fibres and disc cellularity alone, or with coagulation and restructuring of annular collagen in the high-temperature case. Steady-state temperature maps, and thermal doses (t43) were used to assess the thermal treatments. Results from these studies demonstrated the capability of controlling temperature distributions within selected regions of the disc and annular wall using interstitial ultrasound, with minimal vertebral end-plate heating. While directional heating was demonstrated with both applicator designs, the CC configuration had greater directional heating capabilities and offered better temperature control than the DC configuration, particularly during the high-temperature protocol. Further, ultrasound energy was capable of penetrating within the highly attenuating disc tissue to produce more

  11. Combination of transurethral and interstitial ultrasound applicators for high-temperature prostate thermal therapy.

    PubMed

    Diederich, C J; Nau, W H; Burdette, E C; Bustany, I S; Deardorff, D L; Stauffer, P R

    2000-01-01

    The purpose of this study was to determine the feasibility of using a transurethral ultrasound applicator in combination with implantable ultrasound applicators for inducing thermal coagulation and necrosis of localized cancer lesions or benign disease within the prostate gland. The potential to treat target zones in the anterior and lateral portions of the prostate with the angularly directive transurethral applicator, while simultaneously treating regions of extracapsular extension and zones in the posterior prostate with the directive implantable applicators in combination with a rectal cooling bolus, is evaluated. Biothermal computer simulations, acoustic characterizations, and in vivo thermal dosimetry experiments with canine prostates were used to evaluate the performance of each applicator type and combinations thereof. Simulations have demonstrated that transurethral applicators with 180-270 degrees acoustic active zones can direct therapeutic heating patterns to the anterior and lateral prostate, implantable needles can isolate heating to the posterior gland while avoiding rectal tissue, and that the combination of applicators can be used to produce conformal heating to the whole gland. Single implantable applicators (1.8 mm OD x 10 mm long, approximately 180 degrees active sector, approximately 7 MHz, direct-coupled type) produced directional thermal lesions within in vivo prostate, with temperatures >50 degrees C extending more than 10 mm radially after 10-15 min. Combination of interstitial applicators (1-2) and a transurethral applicator (3-2.5 mm OD x 6 mm long, approximately 180 degrees active sector, 6.8 MHz, 6 mm OD delivery catheter) produced conforming temperature distributions (48-85 degrees C) and zones of acute thermal damage within 15 min. The preliminary results of this investigation demonstrate that implantable directional ultrasound applicators, in combination with a transurethral ultrasound applicator, have the potential to provide

  12. Magnetic Resonance Imaging-Guided Focused Laser Interstitial Thermal Therapy for Intracranial Lesions: Single-Institution Series

    PubMed Central

    Hawasli, Ammar H.; Bagade, Swapnil; Shimony, Joshua S.; Miller-Thomas, Michelle

    2013-01-01

    BACKGROUND: Surgical treatments for deep-seated intracranial lesions have been limited by morbidities associated with resection. Real-time magnetic resonance imaging–guided focused laser interstitial thermal therapy (LITT) offers a minimally invasive surgical treatment option for such lesions. OBJECTIVE: To review treatments and results of patients treated with LITT for intracranial lesions at Washington University School of Medicine. METHODS: In a review of 17 prospectively recruited LITT patients (34-78 years of age; mean, 59 years), we report demographics, treatment details, postoperative imaging characteristics, and peri- and postoperative clinical courses. RESULTS: Targets included 11 gliomas, 5 brain metastases, and 1 epilepsy focus. Lesions were lobar (n = 8), thalamic/basal ganglia (n = 5), insular (n = 3), and corpus callosum (n = 1). Mean target volume was 11.6 cm3, and LITT produced 93% target ablation. Patients with superficial lesions had shorter intensive care unit stays. Ten patients experienced no perioperative morbidities. Morbidities included transient aphasia, hemiparesis, hyponatremia, deep venous thrombosis, and fatal meningitis. Postoperative magnetic resonance imaging showed blood products within the lesion surrounded by new thin uniform rim of contrast enhancement and diffusion restriction. In conjunction with other therapies, LITT targets often showed stable or reduced local disease. Epilepsy focus LITT produced seizure freedom at 8 months. Preliminary overall median progression-free survival and survival from LITT in tumor patients were 7.6 and 10.9 months, respectively. However, this small cohort has not been followed for a sufficient length of time, necessitating future outcomes studies. CONCLUSION: Early peri- and postoperative clinical data demonstrate that LITT is a safe and viable ablative treatment option for intracranial lesions, and may be considered for select patients. ABBREVIATION: LITT, laser interstitial thermal therapy

  13. Development of a 3D patient-specific planning platform for interstitial and transurethral ultrasound thermal therapy

    NASA Astrophysics Data System (ADS)

    Prakash, Punit; Diederich, Chris J.

    2010-03-01

    Interstitial and transurethral catheter-based ultrasound devices are under development for treatment of prostate cancer and BPH, uterine fibroids, liver tumors and other soft tissue disease. Accurate 3D thermal modeling is essential for designing site-specific applicators, exploring treatment delivery strategies, and integration of patient-specific treatment planning of thermal ablations. We are developing a comprehensive 3D modeling and treatment planning platform for ultrasound ablation of tissue using catheter-based applicators. We explored the applicability of assessing thermal effects in tissue using critical temperature, thermal dose and Arrhenius thermal damage thresholds and performed a comparative analysis of dynamic tissue properties critical to accurate modeling. We used the model to assess the feasibility of automatic feedback control with MR thermometry, and demonstrated the utility of the modeling platform for 3D patient-specific treatment planning. We have identified critical temperature, thermal dose and thermal damage thresholds for assessing treatment endpoint. Dynamic changes in tissue attenuation/absorption and perfusion must be included for accurate prediction of temperature profiles and extents of the ablation zone. Lastly, we demonstrated use of the modeling platform for patient-specific treatment planning.

  14. Quantitative evaluation of treatment related changes on multi-parametric MRI after laser interstitial thermal therapy of prostate cancer

    NASA Astrophysics Data System (ADS)

    Viswanath, Satish; Toth, Robert; Rusu, Mirabela; Sperling, Dan; Lepor, Herbert; Futterer, Jurgen; Madabhushi, Anant

    2013-03-01

    Laser interstitial thermal therapy (LITT) has recently shown great promise as a treatment strategy for localized, focal, low-grade, organ-confined prostate cancer (CaP). Additionally, LITT is compatible with multi-parametric magnetic resonance imaging (MP-MRI) which in turn enables (1) high resolution, accurate localization of ablation zones on in vivo MP-MRI prior to LITT, and (2) real-time monitoring of temperature changes in vivo via MR thermometry during LITT. In spite of rapidly increasing interest in the use of LITT for treating low grade, focal CaP, very little is known about treatment-related changes following LITT. There is thus a clear need for studying post-LITT changes via MP-MRI and consequently to attempt to (1) quantitatively identify MP-MRI markers predictive of favorable treatment response and longer term patient outcome, and (2) identify which MP-MRI markers are most sensitive to post-LITT changes in the prostate. In this work, we present the first attempt at examining focal treatment-related changes on a per-voxel basis (high resolution) via quantitative evaluation of MR parameters pre- and post-LITT. A retrospective cohort of MP-MRI data comprising both pre- and post- LITT T2-weighted (T2w) and diffusion-weighted (DWI) acquisitions was considered, where DWI MRI yielded an Apparent Diffusion Co-efficient (ADC) map. A spatially constrained affine registration scheme was implemented to first bring T2w and ADC images into alignment within each of the pre- and post-LITT acquisitions, following which the pre- and post-LITT acquisitions were aligned. Pre- and post-LITT MR parameters (T2w intensity, ADC value) were then standardized to a uniform scale (to correct for intensity drift) and then quantified via the raw intensity values as well as via texture features derived from T2w MRI. In order to quantify imaging changes as a result of LITT, absolute differences were calculated between the normalized pre- and post-LITT MRI parameters. Quantitatively

  15. Theoretical and experimental design of site-specific applicators and heating protocols for interstitial ultrasound thermal therapy

    NASA Astrophysics Data System (ADS)

    Tyreus, Per Daniel; Nau, William H.; Wu, Alex; Diederich, Chris J.

    2003-06-01

    Theoretical and experimental approaches were used to develop and evaluate site-specific designs of internally cooled direct coupled (ICDC) and catheter-cooled (CC) ultrasound applicators for thermal coagulation of disease in the prostate, liver, brain, and uterus. The diameter of an interstitial applicator can influence its clinical practicality and effectiveness as well as application site. One purpose of this study was to determine whether the use of larger ultrasound transducers and the inherent increase in applicator size could be justified by potentially producing larger lesion diameters. A second purpose was to explore how the response of tissue acoustic attenuation to heating effects lesion size and preferred applicator configuration. Four applicator configurations and sizes were studied using ex vivo tissue experiments in liver and beef and using acoustic and biothermal simulations. Transmission attenuation measurements showed a 6 to 8 fold increase in baseline tissue attenution inside interstitial ultrasound lesions. Formation of these high attenuation zones in lesions reduced potential lesion size. Larger applicators produced lesions with radial penetration depths superior to their smaller counterparts at power levels in the 20-40W /cm range. The higher cooling rates along the outer surface of the larger diameter applicators due to their greater surface area was a dominant factor in increasing lesion size. The higher cooling rates pushed the maximum temperature farther from the applicator surface and reduced the formation of high acoustic attenuation tissue zones. Acoustic and biothermal simulations matched the experimental data well and were applied to model these applicators within sites of clinical interest such as prostate, uterine fibroid, brain, and normal liver. Lesions of 3.9 to 4.7cm diameter were predicted for moderately perfused tissues such as prostate and fibroid and 2.8 to 3.2cm for highly perfused tissues such as normal liver. Feedback

  16. Renaissance of laser interstitial thermal ablation.

    PubMed

    Missios, Symeon; Bekelis, Kimon; Barnett, Gene H

    2015-03-01

    Laser interstitial thermal therapy (LITT) is a minimally invasive technique for treating intracranial tumors, originally introduced in 1983. Its use in neurosurgical procedures was historically limited by early technical difficulties related to the monitoring and control of the extent of thermal damage. The development of magnetic resonance thermography and its application to LITT have allowed for real-time thermal imaging and feedback control during laser energy delivery, allowing for precise and accurate provision of tissue hyperthermia. Improvements in laser probe design, surgical stereotactic targeting hardware, and computer monitoring software have accelerated acceptance and clinical utilization of LITT as a neurosurgical treatment alternative. Current commercially available LITT systems have been used for the treatment of neurosurgical soft-tissue lesions, including difficult to access brain tumors, malignant gliomas, and radiosurgery-resistant metastases, as well as for the ablation of such lesions as epileptogenic foci and radiation necrosis. In this review, the authors aim to critically analyze the literature to describe the advent of LITT as a neurosurgical, laser excision tool, including its development, use, indications, and efficacy as it relates to neurosurgical applications. PMID:25727222

  17. MR guided thermal therapy of pancreatic tumors with endoluminal, intraluminal and interstitial catheter-based ultrasound devices: preliminary theoretical and experimental investigations

    NASA Astrophysics Data System (ADS)

    Prakash, Punit; Salgaonkar, Vasant A.; Scott, Serena J.; Jones, Peter; Hensley, Daniel; Holbrook, Andrew; Plata, Juan; Sommer, Graham; Diederich, Chris J.

    2013-02-01

    Image-guided thermal interventions have been proposed for potential palliative and curative treatments of pancreatic tumors. Catheter-based ultrasound devices offer the potential for temporal and 3D spatial control of the energy deposition profile. The objective of this study was to apply theoretical and experimental techniques to investigate the feasibility of endogastric, intraluminal and transgastric catheter-based ultrasound for MR guided thermal therapy of pancreatic tumors. The transgastric approach involves insertion of a catheter-based ultrasound applicator (array of 1.5 mm OD x 10 mm transducers, 360° or sectored 180°, ~7 MHz frequency, 13-14G cooling catheter) directly into the pancreas, either endoscopically or via image-guided percutaneous placement. An intraluminal applicator, of a more flexible but similar construct, was considered for endoscopic insertion directly into the pancreatic or biliary duct. An endoluminal approach was devised based on an ultrasound transducer assembly (tubular, planar, curvilinear) enclosed in a cooling balloon which is endoscopically positioned within the stomach or duodenum, adjacent to pancreatic targets from within the GI tract. A 3D acoustic bio-thermal model was implemented to calculate acoustic energy distributions and used a FEM solver to determine the transient temperature and thermal dose profiles in tissue during heating. These models were used to determine transducer parameters and delivery strategies and to study the feasibility of ablating 1-3 cm diameter tumors located 2-10 mm deep in the pancreas, while thermally sparing the stomach wall. Heterogeneous acoustic and thermal properties were incorporated, including approximations for tumor desmoplasia and dynamic changes during heating. A series of anatomic models based on imaging scans of representative patients were used to investigate the three approaches. Proof of concept (POC) endogastric and transgastric applicators were fabricated and experimentally

  18. Irradiation system for interstitial photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Pacheco, L.; Stolik, S.; De la Rosa, J.

    2013-11-01

    Interstitial Photodynamic Therapy (IPDT) is a promising form of treatment of deep-seated and bulky malignant tumors, based on the lethal cell response to the photochemical reactions when drug is light activated in presence of oxygen. In order to accomplish an effective internal illumination, laser sources are preferably used because of two important reasons: the monochromatic light can be confined to the narrow absorption band of the drug and the laser beam is easily focused into optical fibers. In this work the development of a diode-laser-light-source is presented. The system is tuned by temperature to get a better match in the 5-ALA absorption band. This system also comprises a trifurcated fiber system to accomplish interstitial illumination.

  19. Karyomegalic interstitial nephropathy following ifosfamide therapy

    PubMed Central

    Jayasurya, R.; Srinivas, B. H.; Ponraj, M.; Haridasan, S.; Parameswaran, S.; Priyamvada, P. S.

    2016-01-01

    Ifosfamide (IFO), an alkylating agent used for the management of solid organ tumors, can cause reversible Fanconi's syndrome and acute kidney injury. Karyomegalic interstitial nephropathy (KIN) is a rare form of chronic tubulointerstitial nephritis, initially described as a familial nephropathy in adults. So far, four cases of KIN have been reported in pediatric and adolescent population following treatment with IFO. We report a 22-year-old man who developed renal dysfunction following IFO therapy for relapsed Hodgkin's lymphoma. Renal biopsy revealed chronic tubulointerstitial nephritis with atypical tubular epithelial cells showing nuclear enlargement and hyperchromasia, consistent with a diagnosis of KIN. The renal function improved following a short course of corticosteroids. PMID:27512305

  20. MR-guided interstitial thermal therapy for the treatment of brain tumors with a multi-element ultrasound probe

    NASA Astrophysics Data System (ADS)

    Canney, Michael; Carpentier, Alexandre; Beccaria, Kevin; Souchon, Rémi; Chavrier, Françoise; Lafon, Cyril; Chapelon, Jean-Yves

    2012-10-01

    In this work, a new therapeutic ultrasound device is presented that is designed for performing minimally invasive thermal ablation of brain tumors under guidance with magnetic resonance imaging (MRI). The device consists of an array of ultrasound transducers, oriented on multiple faces of a flexible sheath with an integrated cooling system that can be directly inserted into the brain through a small burr hole in the skull. Heating can be monitored using real-time MRI and conformed to the tumor volume by varying the power to the individual elements on the probe. In this work, preliminary testing of the device was performed and included acoustic characterization, numerical simulations, and experiments in a clinical MRI system. Numerical simulations of the acoustic field and temperature rise during heating were compared with results of in vitro testing using bovine brain samples. The results demonstrate that the device has good MRI compatibility and is capable of generating output surface intensities of greater than 20 W/cm2, which is sufficient to ablate tissue at depths of more than 10 mm from the probe in less than four minutes of heating.

  1. Tissue temperature monitoring during interstitial photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Svensson, Jenny; Johansson, Ann; Svanberg, Katarina; Andersson-Engels, Stefan

    2005-04-01

    During δ-aminolevulinic acid (ALA) based Interstitial Photodynamic Therapy (IPDT) a high light fluence rate is present close to the source fibers. This might induce an unintentional tissue temperature increase of importance for the treatment outcome. In a previous study, we have observed, that the absorption in the tissue increases during the treatment. A system to measure the local tissue temperature at the source fibers during IPDT on tissue phantoms is presented. The temperature was measured by acquiring the fluorescence from small Cr3+-doped crystals attached to the tip of the illumination fiber used in an IPDT-system. The fluorescence of the Alexandrite crystal used is temperature dependent. A ratio of the intensity of the fluorescence was formed between two different wavelength bands in the red region. The system was calibrated by immersing the fibers in an Intralipid solution placed in a temperature controlled oven. Measurements were then performed by placing the fibers interstitially in a pork chop as a tissue phantom. Measurements were also performed superficially on skin on a volunteer. A treatment was conducted for 10 minutes, and the fluorescence was measured each minute during the illumination. The fluorescence yielded the temperature at the fiber tip through the calibration curve. The measurements indicate a temperature increase of a few degrees during the simulated treatment.

  2. Interstitial therapy of perineal and gynecological malignancies

    SciTech Connect

    Martinez, A.; Herstein, P.; Portnuff, J.

    1983-03-01

    Thirty-five patients, 38 to 88 years of age, were treated with 125-Iodine or 192-Iridium interstitial implants at Stanford University Medical Center between July 1974, and December, 1978. There were 25 primary epithelial malignancies, eight extensions from intrapelvic organs and two metastatic tumors (hypernephroma and Hodgkin's disease). The involved sites were: urethra (6 patients); vulva (9 patients); vagina (8 patients); anus (7 patients); cervix (5 patients). Implantation was usually performed to treat evident or microscopic disease in conjunction with external beam pelvic treatment with or without local excision. Computerized implant preplanning was used.125-Iodine seeds were inserted either directly or within absorbable suture Polyglactin 910; 192-Iridium in nylon carriers was placed by suture or transperineal template. Two patients were lost to follow-up leaving 33 patients, 27 of whom are alive and free of local disease from 37 to 76 months. The overall local control rate was 88%, or 29/33 patients. All four local recurrences appeared before 24 months. Minor complications included: 10 patients with transient mucositis, four with superficial ulcers, and one patient with infection at the implanted site. Two major complications occurred: a necrotic rectal ulcer requiring a colostomy and a contracted, painful bladder necessitating a urinary diversion. It is concluded that in selected cases interstitial irradiation provides good local control of perineal and gynecological malignancies with low morbidity in this elderly and quite often fragile group of patients.

  3. Optical dosimetry for interstitial photodynamic therapy

    SciTech Connect

    Arnfield, M.R.; Tulip, J.; Chetner, M.; McPhee, M.S. )

    1989-07-01

    An approach to photodynamic treatment of tumors is the interstitial implantation of fiber optic light sources. Dosimetry is critical in identifying regions of low light intensity in the tumor which may prevent tumor cure. We describe a numerical technique for calculating light distributions within tumors, from multiple fiber optic sources. The method was tested using four translucent plastic needles, which were placed in a 0.94 X 0.94 cm grid pattern within excised Dunning R3327-AT rat prostate tumors. A cylindrical diffusing fiber tip, illuminated by 630 nm dye laser light was placed within one needle and a miniature light detector was placed within another. The average penetration depth in the tumor region between the two needles was calculated from the optical power measured by the detector, using a modified diffusion theory. Repeating the procedure for each pair of needles revealed significant variations in penetration depth within individual tumors. Average values of penetration depth, absorption coefficient, scattering coefficient, and mean scattering cosine were 0.282 cm, 0.469 cm-1, 250 cm-1 and 0.964, respectively. Calculated light distributions from four cylindrical sources in tumors gave reasonable agreement with direct light measurements using fiber optic probes.

  4. Optothermal profile of an ablation catheter with integrated microcoil for MR-thermometry during Nd:YAG laser interstitial thermal therapies of the liver—An in-vitro experimental and theoretical study

    PubMed Central

    Kardoulaki, Evdokia M.; Syms, Richard R. A.; Young, Ian R.; Choonee, Kaushal; Rea, Marc; Gedroyc, Wladyslaw M. W.

    2015-01-01

    Purpose: Flexible microcoils integrated with ablation catheters can improve the temperature accuracy during local MR-thermometry in Nd:YAG laser interstitial thermal therapies. Here, the authors are concerned with obtaining a preliminary confirmation of the clinical utility of the modified catheter. They investigate whether the thin-film substrate and copper tracks of the printed coil inductor affect the symmetry of the thermal profile, and hence of the lesion produced. Methods: Transmission spectroscopy in the near infrared was performed to test for the attenuation at 1064 nm through the 25 μm thick Kapton substrate of the microcoil. The radial transmission profile of an infrared high-power, light emitting diode with >80% normalized power at 1064 nm was measured through a cross section of the modified applicator to assess the impact of the copper inductor on the optical profile. The measurements were performed in air, as well as with the applicator surrounded by two types of scattering media; crystals of NaCl and a layer of liver-mimicking gel phantom. A numerical model based on Huygens–Fresnel principle and finite element simulations, using a commercially available package (COMSOL Multiphysics), were employed to compare with the optical measurements. The impact of the modified optical profile on the thermal symmetry was assessed by examining the high resolution microcoil derived thermal maps from a Nd:YAG laser ablation performed on a liver-mimicking gel phantom. Results: Less than 30% attenuation through the Kapton film was verified. Shadowing behind the copper tracks was observed in air and the measured radial irradiation correlated well with the diffraction pattern calculated numerically using the Huygens–Fresnel principle. Both optical experiments and simulations, demonstrate that shadowing is mitigated by the scattering properties of a turbid medium. The microcoil derived thermal maps at the end of a Nd:YAG laser ablation performed on a gel phantom in a

  5. Complementary and Alternative Therapies as Treatment Approaches for Interstitial Cystitis

    PubMed Central

    Whitmore, Kristene E

    2002-01-01

    The management of interstitial cystitis (IC) is predominantly the reduction of the symptoms of frequency, urgency, and pain. Multimodal treatment approaches for IC are helpful in customizing therapy for individual patients. Complementary and alternative therapies are a quintessential addition to the therapeutic armamentarium and frequently include dietary modification, nutraceuticals, bladder training, neuromodulation, stress reduction, and sex therapy. Dietary modification involves elimination of bladder irritants, fluid regulation, and a bowel regimen. Nutraceuticals studied for the treatment of IC include calcium glycerophosphate, L-arginine, mucopolysaccharides, bioflavinoids, and Chinese herbs. Bladder training is effective after pain reduction. The neuromodulation of high-tone pelvic-floor muscle dysfunction is achieved with physical therapy and acupuncture. Stress reduction and sex therapy are best administered by a qualified stress manager and sex therapist. Multimodal, nonconventional management may add efficacy to the treatment of IC. PMID:16986031

  6. Near-infrared fiber delivery systems for interstitial photothermal therapy

    NASA Astrophysics Data System (ADS)

    Slatkine, Michael; Mead, Douglass S.; Konwitz, Eli; Rosenberg, Zvi

    1995-05-01

    Interstitial photothermal coagulation has long been recognized as a potential important, minimally invasive modality for treating a variety of pathologic conditions. We present two different technologies for interstitial photothermal coagulation of tissue with infrared lasers: An optical fiber with a radially symmetric diffusing tip for deep coagulation, and a flat bare fiber for the coagulation of thin and long lesions by longitudinally moving the fiber while lasing in concert. Urology and Gynecology Fibers: The fibers are 600 microns diameter with 20 - 40 mm frosted distal tips protected by a smooth transparent cover. When used with a Neodymium:YAG (Nd:YAG) laser, the active fiber surface diffuses optical radiation in a radial pattern, delivering up to 40 W power, and thus providing consistent and uniform interstitial photothermal therapy. Coagulation depth ranges from 4 to 15 mm. Animal studies in the United States and clinical studies in Europe have demonstrated the feasibility of using these fibers to treat benign prostatic hyperplasia and endometrial coagulation. Rhinology Fiber: The fiber is an 800 micron diameter flat fiber operated at 8 W power level while being interstitially pushed and pulled along its axis. A long and thin coagulated zone is produced. The fiber is routinely used for the shrinking of hypertrophic turbinates without surrounding and bone mucusal damage in ambulatory environments.

  7. [Interstitial granulomatous dermatitis without arthritis: successful therapy with hydroxychloroquine].

    PubMed

    Gerbing, Eva Kristina; Metze, Dieter; Luger, Thomas A; Ständer, Sonja

    2003-02-01

    Interstitial granulomatous dermatitis is a rare entity characterized by cutaneous linear strands (the "rope sign") and rheumatoid arthritis. In the past years, 12 other cases have been described with variable cutaneous symptoms. All showed similar histological features, resembling those of granuloma annulare or 'palisaded neutrophilic and granulomatous dermatitis', suggesting a wide spectrum for a single entity. A 60-year-old patient presented with erythematous patches with an indurated, violaceous border resembling the "rope sign" on both flanks. The histological investigation revealed dense diffuse interstitial inflammatory infiltrates composed of eosinophils, neutrophils, lymphocytes, macrophages and multinucleated giant cells in the superficial and deep dermis. In the deep dermis, prominent eosinophilic degenerated collagen fibres with surrounding macrophages ('floating sign') occurred. In contrast to most previously described patients, our patient did not have arthralgias. The skin findings cleared following therapy with hydroxychloroquine. PMID:16285183

  8. Interaction of interstitial photodynamic therapy and interstitial hyperthermia in a rat rhabdomyosarcoma--a pilot study.

    PubMed

    Levendag, P C; Marijnissen, H P; de Ru, V J; Versteeg, J A; van Rhoon, G C; Star, W M

    1988-01-01

    Photodynamic therapy (PDT) involves the activation of photosensitizing drugs by light of appropriate wavelength. The photosensitive agent Hematoporphyrin Derivative (HPD) appears to be preferentially retained in malignant tumors; irradiation of HPD-containing tissue by light of appropriate wavelength (625 nm) and dose leads to (tumor) tissue destruction. The aim of this study is to achieve maximum tumor control probability with minimum normal tissue photosensitivity. In previous work from our laboratory it has been demonstrated that PDT has its fundamental effects on the tumor and normal tissue microcirculation. As it is well established that hyperthermia (HT) has its major effects in less well vascularized areas of the tumor, the combined modality of HT and PDT might prove to be advantageous. Moreover, suppression of sublethal damage repair by HT has been observed. To overcome the problem of poor light penetration into tissues and the high rate of recurrences following PDT with external irradiation, the combined effects of interstitial PDT with interstitial hyperthermia in a new line of animal experiments were studied in our laboratory. An experimental murine tumor (Rhabdomyosarcoma, type R-1) was transplanted in WAG/Rij rats and, after reaching an average diameter of 2 cm, the active component of HPD, that is Photofrin II, was injected intravenously in different dose schedules (5 mg/kg, 10 mg/kg). After 24 or 48 hrs the tumors were implanted with four flexible catheters, through which either light or heat could be applied. Light was obtained from an Argon-Dye laser system tuned to a wavelength of 625 nm at a dose rate of 75-100 mW per fiber to a dose level of 900 Joule from four linear light applicators. Heat (44 degrees C/30') was delivered by four 27 MHz radiofrequency antennas. Dose response relationships for PDT alone, HT alone and PDT combined with HT were established with cure as endpoint. This study showed that these two modalities, in the proper sequence

  9. Near "real" time magnetic resonance images as a monitoring system for interstitial laser therapy: experimental protocols

    NASA Astrophysics Data System (ADS)

    Castro, Dan J.; Farahani, Keyvan; Soudant, Jacques; Zwarun, Andrew A.; Lufkin, Robert B.

    1992-06-01

    The failure rate of cancer treatment remains unacceptably high, still being a leading cause of mortality in adults and children despite major advances over the past 50 years in the fields of surgery, radiation therapy and, more recently, chemo and immunotherapy. Surgical access to some deep tumors of the head and neck and other areas often require extensive dissections with residual functional and cosmetic deformities. Repeated treatment is not possible after maximum dose radiotherapy and chemotherapy is still limited by its systemic toxicity. An attractive solution to these problems would be the development of a new adjunctive method combining the best features of interstitial laser therapy for selective tumor destruction via minimally invasive techniques for access and 3-D magnetic resonance imaging (MRI) as a monitoring system for laser-tissue interactions. Interstitial laser therapy (ILT) via fiberoptics allow laser energy to be delivered directly into deeper tissues. However, this concept will become clinically useful only when noninvasive, accurate, and reproducible monitoring methods are developed to measure energy delivery to tissues. MRI has numerous advantages in evaluating the irreversible effects of laser treatment in tissues, since laser energy includes changes not only in the thermal motions of hydrogen protons within the tissue, but also in the distribution and mobility of water and lipids. These techniques should greatly improve the use of ILT in combination with MRI to allow treatment of deeper, more difficult to reach tumors of head and neck and other anatomical areas with a single needle stick.

  10. Effect of interstitial low level laser therapy on tibial defect

    NASA Astrophysics Data System (ADS)

    Lee, Sangyeob; Ha, Myungjin; Hwang, Donghyun; Yu, Sungkon; Jang, Seulki; Park, Jihoon; Radfar, Edalat; Kim, Hansung; Jung, Byungjo

    2016-03-01

    Tibial defect is very common musculoskeletal disorder which makes patient painful and uncomfortable. Many studies about bone regeneration tried to figure out fast bone healing on early phase. It is already known that low level laser therapy (LLLT) is very convenient and good for beginning of bone disorder. However, light scattering and absorption obstruct musculoskeletal therapy which need optimal photon energy delivery. This study has used an interstitial laser probe (ILP) to overcome the limitations of light penetration depth and scattering. Animals (mouse, C57BL/6) were divided into three groups: laser treated test group 1 (660 nm; power 10 mW; total energy 5 J) and test group 2 (660 nm; power 20 mW; total energy 10 J); and untreated control group. All animals were taken surgical operation to make tibial defect on right crest of tibia. The test groups were treated every 48 hours with ILP. Bone volume and X-ray attenuation coefficient were measured on 0, 14th and 28th day with u-CT after treatment and were used to evaluate effect of LLLT. Results show that bone volume of test groups has been improved more than control group. X-ray attenuation coefficients of each groups have slightly different. The results suggest that LLLT combined with ILP may affect on early phase of bone regeneration and may be used in various musculoskeletal disease in deep tissue layer.

  11. A robotic multi-channel platform for interstitial photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Sharikova, Anna V.; Finlay, Jarod C.; Dimofte, Andreea; Zhu, Timothy C.

    2013-03-01

    A custom-made robotic multichannel platform for interstitial photodynamic therapy (PDT) and diffuse optical tomography (DOT) was developed and tested in a phantom experiment. The system, which was compatible with the operating room (OR) environment, had 16 channels for independent positioning of light sources and/or isotropic detectors in separate catheters. Each channel's motor had an optical encoder for position feedback, with resolution of 0.05 mm, and a maximum speed of 5 cm/s. Automatic calibration of detector positions was implemented using an optical diode beam that defined the starting position of each motor, and by means of feedback algorithms controlling individual channels. As a result, the accuracy of zero position of 0.1 mm for all channels was achieved. We have also employed scanning procedures where detectors automatically covered the appropriate range around source positions. Thus, total scan time for a typical optical properties (OP) measurement throughout the phantom was about 1.5 minutes with point sources. The OP were determined based on the measured light fluence rates. These enhancements allow a tremendous improvement of treatment quality for a bulk tumor compared to the systems employed in previous clinical trials.

  12. Analysis of iodine-125 interstitial therapy in the treatment of localized carcinoma of the prostate

    SciTech Connect

    Gomella, L.G.; Steinberg, S.M.; Ellison, M.F.; Reeves, W.W.; Flanigan, R.C.; McRoberts, J.W. )

    1991-04-01

    Definitive treatment of localized carcinoma of the prostate has included radical surgery, external beam radiation therapy, and interstitial radiation therapy. The interstitial agent most commonly used is Iodine-125. Forty-eight patients were treated with interstitial radiation therapy using Iodine-125 implants with a median follow-up of 55 months. Forty-three percent of the evaluable patients had progressive disease with approximately 50% progressing at 5 years by Kaplan-Meier analysis. Overall actuarial survival in the group was 80% at 5 years. This and several other studies suggest that control of prostate cancer with Iodine-125 seeds may be suboptimal as compared with other treatment modalities, especially the radical retropubic prostatectomy. Analysis of treatment parameters is presented along with a discussion of the current status and future prospects for treatment of localized carcinoma of the prostate with interstitial radiation therapy.

  13. Minimally invasive ultrasound thermal therapy with MR thermal monitoring and guidance

    NASA Astrophysics Data System (ADS)

    Diederich, Chris J.; Stafford, R. Jason; Price, Roger E.; Nau, William H.; Tyreus, Per Daniel; Rivera, Belinda; Schomer, Donald; Olsson, Lars; Hazle, John D.

    2001-06-01

    In this study both transurethral and interstitial ultrasound thermal therapy were applied to thermally coagulate targeted portions of the canine prostate or brain and implanted TVT tumors while using MRI-based thermal mapping techniques to monitor the therapy. MRI was also used for target definition, positioning of the applicator, and evaluation of target viability post-therapy. The complex phase-difference mapping technique using an iGE-EPI sequence with lipid suppression was used for determining temperature elevations within the in vivo prostate or brain and surrounding structures. Calculated temperature distributions, thermal dose exposures, T2-wieghted & T1-contrast enhanced images, gross inspection, and histology of sectioned prostates and brains were in good agreement with each other in defining destroyed tissue zones. Interstitial and transurethral ultrasound applicators produce directed zones of thermal coagulation within targeted tissue and implanted tumor, which can be accurately monitored and evaluated by MRI.

  14. An Ultrasound Based System for Navigation and Therapy Control of Thermal Tumour Therapies

    NASA Astrophysics Data System (ADS)

    Lemor, R. M.; Tretbar, S. H.; Hewener, H. J.; Guenther, C.; Schwarzenbarth, K.; Ritz, J.-P.; Lehmann, K.

    Interstitial thermal therapies such as laser induced interstitial thermal therapy (LITT) and radio frequency induced interstitial thermal therapy (RFITT) are widely used in treatment of focal lesions of tumors and metastasis. For improving the results and the safety of these therapies it is necessary to optimize the precise heat applicator placement and to control the energy deposition into the tissue. In this paper we present a dedicated system for navigation and therapy control of thermal ablation therapies for liver applications based on ultrasound technology. The navigation scenario offers the possibility to use single or multiple applicators and allows on line three-dimensional puncturing guidance inside and outside the imaging plane of the transducer. Using attenuation changes as an ultrasound parameter for defining the thermal ablation zone the therapy process can be controlled and monitored. Differential attenuation data are derived by using a coded excitation scheme for acquiring multi band attenuation images, which are reconstructed into 3d volume data. The volume data sets are then coregistered with and compared to pretreatment data. A strong increase in attenuation change correlates with tissue coagulation

  15. Interstitial thermal ablation with a fast rotating dual-mode transducer.

    PubMed

    Bouchoux, Guillaume; Owen, Neil; Chavrier, Francoise; Berriet, Rémi; Fleury, Gérard; Chapelon, Jean-Yves; Lafon, Cyril

    2010-05-01

    Interstitial ultrasound applicators can be a minimally invasive alternative for treating targets that are unresectable or are inaccessible by extracorporeal methods. Dual-mode transducers for ultrasound imaging and therapy were developed to address the constraints of a miniaturized applicator and real-time treatment monitoring. We propose an original treatment strategy that combines ultrasound imaging and therapy using a dual-mode transducer rotating at 8 revolutions per second. Real-time B-mode imaging was interrupted to emit high-intensity ultrasound over a selected therapy aperture. A full 360 degrees image was taken every 8th rotation to image the therapy aperture. Numerical simulations were performed to study the effect of rotation on tissue heating, and to study the effect of the treatment sequence on transducer temperature. With the time-averaged transducer surface intensity held at 12 W/cm(2) to maintain transducer temperature below 66 degrees C, higher field intensities and deeper lesions were produced by narrower therapy apertures. A prototype system was built and tested using in vitro samples of porcine liver. Lesions up to 8 mm were produced using a time-averaged transducer surface intensity of 12 W/cm(2) applied for a period of 240 s over a therapy aperture of 40 degrees. Apparent strain imaging of the therapy aperture improved the contrast between treated and spared tissues, which could not be differentiated on B-mode images. With appropriate limits on the transducer output, real-time imaging and deep thermal ablation are feasible and sustainable using a rotating dual-mode transducer. PMID:20442018

  16. MRI-guided laser thermal therapy in the prostate: preliminary results

    NASA Astrophysics Data System (ADS)

    McNichols, Roger J.; Gowda, Ashok; Stafford, R. J.; Price, Roger E.; Hazle, John D.

    2004-07-01

    Minimally invasive thermal therapies for the treatment of prostate cancer offer potential to reduce cost, treatment time, and patient trauma. A drawback to such therapies is that it is often difficult or impossible to know the exact volume of which is being destroyed. In this work, we report on the use of magnetic resonance (MR) thermal imaging to provide real-time feedback control over laser interstitial thermal therapy (LITT) in an in vivo canine prostate model.

  17. Idiopathic granulomatous interstitial nephritis responsive to mycophenolate mofetil therapy.

    PubMed

    Leeaphorn, Napat; Stokes, Michael B; Ungprasert, Patompong; Lecates, William

    2014-04-01

    Granulomatous interstitial nephritis (GIN) is a rare histologic disease. Various causes have been reported in the literature, including drugs, sarcoidosis, and infections. Other incidents have no discernible cause and are identified as idiopathic. We report a 68-year-old white man who presented with acute kidney injury and was given a diagnosis of idiopathic GIN. Mycophenolate mofetil treatment was elected because of steroid toxicity. He responded well to mycophenolate mofetil and has been in remission for more than 3 years. To our knowledge, this is the first report of successful treatment with mycophenolate mofetil of an adult patient with idiopathic GIN. PMID:24315767

  18. Bevacizumab‐induced chronic interstitial pneumonia during maintenance therapy in non‐small cell lung cancer

    PubMed Central

    Sekimoto, Yasuhito; Shukuya, Takehiko; Koyama, Ryo; Nagaoka, Tetsutaro; Takahashi, Kazuhisa

    2016-01-01

    Abstract Bevacizumab is a monoclonal antibody targeting the vascular endothelial growth factor receptor and a key drug for advanced non‐small cell lung cancer. There are few reports describing bevacizumab‐induced chronic interstitial pneumonia. A 62‐year‐old man with advanced non‐small cell lung cancer was admitted to our hospital with dyspnea. He previously received four courses of carboplatin plus paclitaxel with bevacizumab combination therapy and thereafter received four courses of maintenance bevacizumab monotherapy. A chest‐computed tomography scan on admission revealed diffuse ground glass opacity. He had not received any other drugs and did not have pneumonia. Thus, he was diagnosed with bevacizumab‐induced chronic interstitial pneumonia and was treated with a high dose of corticosteroids. After steroid treatment, his dyspnea and radiological findings improved. This case report is the first description of bevacizumab‐induced chronic interstitial pneumonia during maintenance therapy in a patient with non‐small cell lung cancer. PMID:27081491

  19. Primary carcinoma of the distal male urethra: a case treated with lymphadenectomy and interstitial radiation therapy

    SciTech Connect

    Ticho, B.H.; Perez-Tamayo, C.; Konnak, J.W.

    1988-06-01

    We report a case of primary squamous cell carcinoma of the distal male urethra with a single inguinal node metastasis. Treatment consisted of unilateral pelvic and inguinal lymphadenectomy, and a combined course of external beam and interstitial radiation therapy to the distal urethra and penis by the Henschke modification of the Paris technique.

  20. Assessment of thermal effects of interstitial laser phototherapy on mammary tumors using proton resonance frequency method

    NASA Astrophysics Data System (ADS)

    Le, Kelvin; Li, Xiaosong; Figueroa, Daniel; Towner, Rheal A.; Garteiser, Philippe; Saunders, Debra; Smith, Nataliya; Liu, Hong; Hode, Tomas; Nordquist, Robert E.; Chen, Wei R.

    2011-12-01

    Laser immunotherapy (LIT) uses a synergistic approach to treat cancer systemically through local laser irradiation and immunological stimulation. Currently, LIT utilizes dye-assisted noninvasive laser irradiation to achieve selective photothermal interaction. However, LIT faces difficulties treating deeper tumors or tumors with heavily pigmented overlying skin. To circumvent these barriers, we use interstitial laser irradiation to induce the desired photothermal effects. The purpose of this study is to analyze the thermal effects of interstitial irradiation using proton resonance frequency (PRF). An 805-nm near-infrared laser with an interstitial cylindrical diffuser was used to treat rat mammary tumors. Different power settings (1.0, 1.25, and 1.5 W) were applied with an irradiation duration of 10 min. The temperature distributions of the treated tumors were measured by a 7 T magnetic resonance imager using PRF. We found that temperature distributions in tissue depended on both laser power and time settings, and that variance in tissue composition has a major influence in temperature elevation. The temperature elevations measured during interstitial laser irradiation by PRF and thermocouple were consistent, with some variations due to tissue composition and the positioning of the thermocouple's needle probes. Our results indicated that, for a tissue irradiation of 10 min, the elevation of rat tumor temperature ranged from 8 to 11°C for 1 W and 8 to 15°C for 1.5 W. This is the first time a 7 T magnetic resonance imager has been used to monitor interstitial laser irradiation via PRF. Our work provides a basic understanding of the photothermal interaction needed to control the thermal damage inside a tumor using interstitial laser treatment. Our work may lead to an optimal protocol for future cancer treatment using interstitial phototherapy in conjunction with immunotherapy.

  1. MRI-controlled interstitial ultrasound brain therapy: An initial in-vivo study

    NASA Astrophysics Data System (ADS)

    N'Djin, W. Apoutou; Burtnyk, Mathieu; Lipsman, Nir; Bronskill, Michael; Schwartz, Michael; Kucharczyk, Walter; Chopra, Rajiv

    2012-11-01

    The recent emergence at the clinical level of minimally-invasive focal therapy such as laser-induced thermal therapy (LITT) has demonstrated promise in the management of brain metastasis [1], although control over the spatial pattern of heating is limited. Delivery of HIFU from minimally-invasive applicators enables high spatial control of the heat deposition in biological tissues, large treatment volumes and high treatment rate in well chosen conditions [2,3]. In this study, the feasibility of MRI-guided interstitial ultrasound therapy in brain was studies in-vivo in a porcine model. A prototype system originally developed for transurethral ultrasound therapy [4,5,6] was used in this study. Two burr holes of 12 mm in diameter were created in the animal's skull to allow the insertion of the therapeutic ultrasound applicator (probe) into the brain at two locations (right and left frontal lobe). A 4-element linear ultrasound transducer (f = 8 MHz) was mounted at the tip of a 25-cm linear probe (6 mm in diameter). The target boundary was traced to cover in 2D a surface compatible with the treatment of a 2 cm brain tumor. Acoustic power of each element and rotation rate of the device were adjusted in real-time based on MR-thermometry feedback control to optimize heat deposition at the target boundary [2,4,5]. Two MRT-controlled ultrasound brain treatments per animal have been performed using a maximal surface acoustic power of 10W.cm-2. In all cases, it was possible to increase accurately the temperature of the brain tissues in the targeted region over the 55°C threshold necessary for the creation of irreversible thermal lesion. Tissue changes were visible on T1w contrast-enhanced images immediately after treatment. These changes were also evident on T2w FSE images taken 2 hours after the 1st treatment and correlated well with the temperature image. On average, the targeted volume was 4.7 ± 2.3 cm3 and the 55°C treated volume was 6.7 ± 4.4 cm3. The volumetric

  2. Monitoring changes in tissue optical properties following interstitial photothermal therapy of ex vivo human prostate tissue

    NASA Astrophysics Data System (ADS)

    Weersink, Robert A.; He, Jie; Veilleux, Israel; Trachtenberg, John; Wilson, Brian C.

    2013-03-01

    We are developing a method of monitoring treatment progression of interstitial photothermal therapy of focal prostate cancer using transrectal diffuse optical tomography (TRDOT) combined with transrectal 3D ultrasound (3D-TRUS). Measurements of prostate tissue optical properties were made on ex vivo human prostate samples prior to and post coagulation. Interstitial photothermal treatments were delivered to the ex vivo samples and monitored using an interstitial probe near the treatment fiber. After treatment, bulk optical properties were measured on native and coagulated zones of tissue. Changes in optical properties across the boundary between native and coagulated tissues were spatially mapped using a small diffuse reflectance probe. The optical property estimates and spatial information obtained using each method was compared.

  3. Interstitial hyperthermia using 27 MHz wire antennas and interstitial photodynamic therapy in a rat rhabdomyosarcoma: phantom and animal studies.

    PubMed

    Levendag, P C; Visser, A G; van Mierlo, I J; de Ru, V J; Marijnissen, J P; Star, W M; van den Berg, A P; van Rhoon, G C; Hermens, A F; van Putten, W L

    1988-02-01

    This paper deals with the interaction of interstitial hyperthermia (HT) and interstitial photodynamic therapy (PDT). Its main focus, however, is on a newly developed heating system; phantom studies as well as temperature-response data obtained from the in vivo experiments are presented. Heat was delivered by thin, flexible wire antennas operating at a frequency of 27 MHz. Measurements in muscle-equivalent phantom with infrared thermography were performed. Uniform heating over the inserted length of the antenna was obtained and impedance matching appears possible by simple variable air coils, thereby minimizing the reflected power to less than 20%. Light was obtained from an Argon-Dye laser system tuned to a wavelength of 625 nm at a dose rate of 75-100 mW per fiber to a total incident dose of 900 J from four linear light applicators. An experimental murine tumor (Rhabdomyosarcoma, type R-1) was transplanted in WAG/Rij rats and, after reaching an average diameter of 2 cm, the active component of haematoporphyrin derivative (HPD), Photofrin II, was injected intravenously. The tumors were subsequently implanted with four flexible catheters, through which either light or heat could be applied. Dose-response relationships for PDT alone, HT alone and PDT followed by HT were established with cure as endpoint. The animal experiments showed that with the use of low-frequency wires a good localized heat distribution in the tumors can be obtained. Moreover, this study showed that PDT and HT, in the proper sequence and only when optimal temperatures are reached, result in an augmented cytotoxicity on the tumor cells in vivo; i.e. a cure rate of 41% was obtained. PMID:3353520

  4. Interstitial laser photocoagulation therapy for liver tumors: clinical results

    NASA Astrophysics Data System (ADS)

    Amin, Zahir; Donald, J. J.; Masters, A.; Kant, R.; Lees, William R.; Bown, Stephen G.

    1993-07-01

    Interstitial laser photocoagulation is a new technique of tumor ablation using low power (2 W) laser light over a long time (500 s) via thin (0.2 mm) optical fibers. We have treated 26 patients with 70 liver metastases measuring 1 to 15 cm (median 2.5 cm). There were 1 to 8 treatment sessions per patient (median 3). Each tumor was treated via 1 to 4 optical fibers. The median energy used was 16000 J (range 3000 to 34000 J). Treatment effects were monitored in real-time with ultrasound, and the extent of tumor necrosis evaluated 1 to 3 days later using dynamic enhanced CT which showed laser-induced necrosis as well-defined new areas of non-enhancement. Greater than 50% necrosis of tumor volume was achieved in 86% (60 out of 70) of the tumors treated, and 100% necrosis in 53% (37 out of 70). Metastases under 4 cm were treated more effectively and required fewer treatment sessions than those over 4 cm. In eleven patients there was evidence of disease progression (follow-up 14 months or longer) and in 15 patients there has been overall tumor reduction (follow-up less than 1 year, median 4 months). Conclusion: With further development, ILP may offer a practical and minimally invasive alternative to major surgery for eradicating small, deep seated tumors, and debulking larger ones.

  5. Interstitial laser coagulation therapy for benign prostatic hyperplasia

    NASA Astrophysics Data System (ADS)

    McNicholas, Thomas A.; Alsudani, Mohammed

    1996-05-01

    Alternatives to the side-firing laser method include controlled destruction of prostatic adenoma by an atraumatic saline cooled laser fiber introduced endoscopically into the prostate under visual and transrectal ultrasound (TRUS) control. Laser light produces intense heating and interstitial laser coagulation (ILC) occurs with characteristic TRUS changes which are used to control the volume of tissue destruction. The prostatic urethral lining is preserved which may reduce laser side effects). Thirty-six men with symptomatic BPH were treated by ILC between April 1994 and September 1995. All were discharged home on the first post-operative day and reviewed periodically to 12 months post-treatment with measurement of IPSS, flow rate (FR), residual volume, complications, potency and TRUS. Seventeen men (47%) voided immediately, 15 (42%) performed intermittent self-catheterization (ISC) for 3.5 days (2 - 5). Four men (11%) required catheterization for 1/52. Thirty-five men tolerated the treatment well, requiring only mild oral analgesia. One man developed dysuria and required early transurethral resection revealing a large volume of coagulative necrosis. Improvement in symptoms and flow rate developed from 1 - 30 days later. There were no significant complications. Hyperechoic and cystic zones developed at the ILC site which persisted to 12 months. This clinical study indicates the feasibility and safety of intense heating by ILC with visible and ultrasound control to coagulate the adenoma while preserving the urethra. Changes are easily seen on TRUS, symptomatic improvement is good and there have been minimal urethral symptoms or complications.

  6. Image guidance, treatment planning and evaluation of cancer interstitial focal therapy using liposomal radionuclides

    NASA Astrophysics Data System (ADS)

    Ware, Steve William

    Focally ablative therapy of cancer has gained significant interest recently. Improvements in diagnostic techniques have created possibilities for treatment which were once clinically unfeasible. Imaging must be capable of allowing accurate diagnosis, staging and planning upon initiation of therapy. Recent improvements in MRI and molecular imaging techniques have made it possible to accurately localize lesions and in so doing, improve the accuracy of proposed focal treatments. Using multimodality imaging it is now possible to target, plan and evaluate interstitial focal treatment using liposome encapsulated beta emitting radionuclides in a variety of cancer types. Since most absorbed dose is deposited early and heterogeneously in beta-radionuclide therapy, investigation of the resultant molecular and cellular events during this time is important for evaluating treatment efficacy. Additionally, investigating a multifocal entity such as prostate cancer is helpful for determining whether MRI is capable of discriminating the proper lesion for therapy. Correlation of MRI findings with histopathology can further improve the accuracy of interstitial focal radionuclide therapy by providing non-invasive surrogates for tissue compartment sizes. In the application of such therapies, compartmental sizes are known to heavily influence the distribution of injected agents. This has clear dosimetric implications with the potential to significantly alter the efficacy of treatment. The hypothesis of this project was that multimodality imaging with magnetic resonance imaging (MRI), autoradiography (AR), and single photon emission computed tomography (SPECT) could be used to target, plan, and evaluate interstitial focal therapy with non-sealed source, liposome-encapsulated 186Re beta emitting radionuclides. The specific aims of this project were to 1) Identify suitable targets for interstitial focal therapy. This was done by retrospectively analyzing MRI data to characterize the tumor

  7. 3-D modeling of the thermal coagulation necrosis induced by an interstitial ultrasonic transducer.

    PubMed

    Garnier, Carole; Lafon, Cyril; Dillenseger, Jean-Louis

    2008-02-01

    This letter describes a temperature-varying attenuation approach for preoperative planning of high intensity ultrasound interstitial targeted therapy. Such approach is mainly aimed at the treatment of primary liver cancer for which a precise lesion control must be achieved. It is shown through simulation that the shape and size of the resulting necrotic volume is significantly different from the one obtained when this tissue property is considered constant in time. PMID:18270029

  8. Effect of Stem Cell Therapy on Amiodarone Induced Fibrosing Interstitial Lung Disease in Albino Rat

    PubMed Central

    Zaglool, Somaya Saad; Zickri, Maha Baligh; Abd El Aziz, Dalia Hussein; Mabrouk, Doaa; Metwally, Hala Gabr

    2011-01-01

    Background and Objectives: The fibrosing forms of interstitial lung disease (ILD) are associated with significant morbidity and mortality. ILD may be idiopathic, secondary to occupational, infection, complicate rheumatic diseases or drug induced. Efficacy of antifibrotic agents is as far as, limited and uncertain. No effective treatment was confirmed for pulmonary fibrosis except lung transplantation. The present study aimed at investigating the possible effect of human cord blood mesenchymal stem cell (MSC) therapy on fibrosing ILD. This was accomplished by using amiodarone as a model of induced lung damage in albino rat. Methods and Results: Seventeen adult male albino rats were divided into 3 groups. Rats of amiodarone group were given 30 mg/kg of amiodarone orally 6 days/ week for 6 weeks. Rats of stem cell therapy group were injected with stem cells in the tail vein following confirmation of lung damage and left for 4 weeks before sacrifice. Obstructed bronchioles, thickened interalveolar septa and thickened wall of pulmonary vessels were found and proved morphometrically. Reduced type I pneumocytes and increased area% of collagen fibers were recorded. All findings regressed on stem cell therapy. Conclusions: Cord blood MSC therapy proved definite amelioration of fibrosing interstitial lung disease provided therapy starts early in the development of the pathogenesis. PMID:24298346

  9. Thermal effects in tissues induced by interstitial irradiation of near infrared laser with a cylindrical diffuser

    NASA Astrophysics Data System (ADS)

    Le, Kelvin; Johsi, Chet; Figueroa, Daniel; Goddard, Jessica; Li, Xiaosong; Towner, Rheal A.; Saunders, Debra; Smith, Nataliya; Liu, Hong; Hode, Tomas; Nordquist, Robert E.; Chen, Wei R.

    2011-03-01

    Laser immunotherapy (LIT), using non-invasive laser irradiation, has resulted in promising outcomes in the treatment of late-stage cancer patients. However, the tissue absorption of laser light limits the clinical applications of LIT in patients with dark skin, or with deep tumors. The present study is designed to investigate the thermal effects of interstitial irradiation using an 805-nm laser with a cylindrical diffuser, in order to overcome the limitations of the non-invasive mode of treatment. Cow liver and rat tumors were irradiated using interstitial fiber. The temperature increase was monitored by thermocouples that were inserted into the tissue at different sites around the cylinder fiber. Three-dimensional temperature distribution in target tissues during and after interstitial laser irradiation was also determined by Proton Resonance Frequency. The preliminary results showed that the output power of laser and the optical parameters of the target tissue determined the light distribution in the tissue. The temperature distributions varied in the tissue according to the locations relative to the active tip of the cylindrical diffuser. The temperature increase is strongly related to the laser power and irradiation time. Our results using thermocouples and optical sensors indicated that the PRF method is reliable and accurate for temperature determination. Although the inhomogeneous biological tissues could result in temperature fluctuation, the temperature trend still can be reliable enough for the guidance of interstitial irradiation. While this study provides temperature profiles in tumor tissue during interstitial irradiation, the biological effects of the irradiation remain unclear. Future studies will be needed, particularly in combination with the application of immunostimulant for inducing tumor-specific immune responses in the treatment of metastatic tumors.

  10. Thermal analysis of laser interstitial thermotherapy in ex vivo fibro-fatty tissue using exponential functions

    NASA Astrophysics Data System (ADS)

    Salas, Nelson, Jr.; Manns, Fabrice; Milne, Peter J.; Denham, David B.; Minhaj, Ahmed M.; Parel, Jean-Marie; Robinson, David S.

    2004-05-01

    A therapeutic procedure to treat small, surface breast tumours up to 10 mm in radius plus a 5 mm margin of healthy, surrounding tissue using laser interstitial thermotherapy (LITT) is currently being investigated. The purpose of this study is to analyse and model the thermal and coagulative response of ex vivo fibro-fatty tissue, a model for breast tissue, during experimental laser interstitial thermotherapy at 980 nm. Laser radiation at 980 nm was delivered interstitially through a diffusing tip optical fibre inserted into a fibro-fatty tissue model to produce controlled heating at powers ranging from 3.2 to 8.0 W. Tissue temperature was measured with thermocouples placed at 15 positions around the fibre. The induced coagulation zone was measured on gross anatomical sections. Thermal analysis indicates that a finite sum of exponential functions is an approximate solution to the heat conduction equation that more accurately predicts the time-temperature dependence in tissue prior to carbonization (T < 100 °C) during LITT than the traditional model using a single exponential function. Analysis of the ellipsoid coagulation volume induced in tissue indicates that the 980 nm wavelength does not penetrate deep enough in fibro-fatty tissue to produce a desired 30 mm diameter (14.1 × 103 mm3) coagulation volume without unwanted tissue liquefaction and carbonization.

  11. Endoscopic and interstitial Nd:YAG laser therapy to control duodenal and periampullary carcinoma

    NASA Astrophysics Data System (ADS)

    Barr, Hugh; Fowler, Aiden L.

    1996-12-01

    Duodenal and periampullary cancer present with jaundice, bleeding and obstruction. Many patients are unsuitable for radical surgery. Endoscopic palliation of jaundice can be achieved using endoscopic sphincterotomy or stent insertion. However, the problems of bleeding and obstruction can be difficult to manage. Ten patients were treated using superficial Nd:YAG laser ablation and lower power interstitial laser therapy. After initial outpatient endoscopic therapy, treatment was repeated at 4 monthly intervals to prevent recurrent symptoms. Bleeding was controlled in all patients and only one patient developed obstructive symptoms between treatment sessions. This responded to further endoscopic laser therapy. The median survival was 21 months. Laser treated patients were compared with a historical series of 22 patients treated with endoscopic sphincterotomy or stent insertion. The complication rate was less in patients treated with the laser.

  12. Noninfectious interstitial lung disease during infliximab therapy: Case report and literature review

    PubMed Central

    Caccaro, Roberta; Savarino, Edoardo; D’Incà, Renata; Sturniolo, Giacomo Carlo

    2013-01-01

    Pulmonary abnormalities are not frequently encountered in patients with inflammatory bowel diseases. However, lung toxicity can be induced by conventional medications used to maintain remission, and similar evidence is also emerging for biologics. We present the case of a young woman affected by colonic Crohn’s disease who was treated with oral mesalamine and became steroid-dependent and refractory to azathioprine and adalimumab. She was referred to our clinic with a severe relapse and was treated with infliximab, an anti-tumor necrosis factor α (TNF-α) antibody, to induce remission. After an initial benefit, with decreases in bowel movements, rectal bleeding and C-reactive protein levels, she experienced shortness of breath after the 5th infusion. Noninfectious interstitial lung disease was diagnosed. Both mesalamine and infliximab were discontinued, and steroids were introduced with slow but progressive improvement of symptoms, radiology and functional tests. This represents a rare case of interstitial lung disease associated with infliximab therapy and the effect of drug withdrawal on these lung alterations. Given the increasing use of anti-TNF-α therapies and the increasing reports of pulmonary abnormalities in patients with inflammatory bowel diseases, this case underlines the importance of a careful evaluation of respiratory symptoms in patients undergoing infliximab therapy. PMID:23983443

  13. Review of intravesical therapies for bladder pain syndrome/interstitial cystitis

    PubMed Central

    Rosamilia, Anna

    2015-01-01

    Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic pain condition characterised by urinary frequency, urgency and pain or discomfort which the patient attributes to the bladder. It is a complex condition to manage and treat and requires a multi-disciplinary and multi-modal approach. As well as lifestyle and behavioural modifications, physical therapy and oral medications, intravesical treatments can be used in the treatment algorithm for BPS/IC. A number of intravesical agents are reviewed in this paper along with the available evidence for their use. PMID:26816864

  14. Early CT findings after interstitial radiation therapy for primary malignant brain tumors

    SciTech Connect

    Tolly, T.L.; Bruckman, J.E.; Czarnecki, D.J.; Frazin, L.J.; Lewis, H.J.; Richards, M.J.; Adamkiewicz, J.J. Jr.

    1988-11-01

    The CT findings after interstitial radiation therapy for brain tumors have not been extensively described. We evaluated retrospectively the CT scans of 13 patients who were treated with brachytherapy for malignant glioma. We found no typical CT appearance that differentiates recurrent tumor from radiation effect. After undergoing brachytherapy, eight of the 13 patients scanned demonstrated enhancement of brain tissue beyond the margins of the original enhancing tumor mass. In most cases, the pattern of enhancement diminished and extended more peripherally from the central necrotic area with time. We also report a new CT finding of focal calcification developing at the site of the radioactive implant.

  15. Interstitial pneumonitis associated with pegylated interferon alpha-2b therapy for chronic hepatitis C: case report.

    PubMed

    Carrillo-Esper, Raúl; González-Avila, Daniela; Uribe-Ríos, Marittza; Méndez-Sánchez, Nahum

    2008-01-01

    Since 2004, pegylated interferon (P-IFN) in combination with ribavirin has become the optimal choice of therapy for chronic hepatitis C virus (HCV) infection. IFN a-2b suppresses HCV replication and restores elevated serum aminotransferase levels, leading to improvements in the histological changes in the livers of patients with chronic hepatitis C. Unfortunately, P-IFN has several adverse effects, including pneumonitis. This complication has been reported in the treatment of malignant diseases and CHC. We report a patient with interstitial pneumonitis thought to be caused by an IFN-based treatment in an unusual scenario of a patient with HCV-related Child-Pugh stage A cirrhosis, who experienced dyspnea, fever, and cough after 12 months of treatment with P-IFN a-2b. Her lung injury and pulmonary symptoms did not disappear despite discontinuation of IFN and the administration of corticosteroid. We concluded that the patient developed a fatal interstitial pneumonitis associated with P-INF a-2b therapy. PMID:18376374

  16. ICDC interstitial ultrasound applicators for high-temperature thermal therapy

    NASA Astrophysics Data System (ADS)

    Tyreus, Per Daniel; Diederich, Chris J.; Nau, William H.

    2001-06-01

    Theoretical and experimental approaches were used to evaluate Internally-Cooled Direct-Coupled (ICDC) ultrasound applicators for treating disease in the prostate and liver. 2-D and 3-D transient biothermal models, which account for dynamic tissue changes, were used to calculate temperature distributions and zones of coagulation. Experimental evaluations and verification of these models were performed using in vitro tissue and in vivo porcine and canine models. Devices of 2.2 mm outer diameter were evaluated under varied applied power schemes and cooling levels. Both duty cycle power application and PI-controlled power application were found to improve applicator performance by increasing radial depths of lesions with lower maximum temperature. ICDC applicators were found to be able to create 3-5 cm diameter lesions in liver and muscle under 15 minute treatment times using the optimal designs and power application schemes found in this study. From these initial feasibility studies it has been demonstrated that ICDC devices have potential for treating cancerous tumors in prostate, liver and possibly breast.

  17. Association of Acute Interstitial Nephritis With Programmed Cell Death 1 Inhibitor Therapy in Lung Cancer Patients.

    PubMed

    Shirali, Anushree C; Perazella, Mark A; Gettinger, Scott

    2016-08-01

    Immune checkpoint inhibitors that target the programmed death 1 (PD-1) signaling pathway have recently been approved for use in advanced pretreated non-small cell lung cancer and melanoma. Clinical trial data suggest that these drugs may have adverse effects on the kidney, but these effects have not been well described. We present 6 cases of acute kidney injury in patients with lung cancer who received anti-PD-1 antibodies, with each case displaying evidence of acute interstitial nephritis (AIN) on kidney biopsy. All patients were also treated with other drugs (proton pump inhibitors and nonsteroidal anti-inflammatory drugs) linked to AIN, but in most cases, use of these drugs long preceded PD-1 inhibitor therapy. The association of AIN with these drugs in our patients raises the possibility that PD-1 inhibitor therapy may release suppression of T-cell immunity that normally permits renal tolerance of drugs known to be associated with AIN. PMID:27113507

  18. Targeted Prostate Thermal Therapy with Catheter-Based Ultrasound Devices and MR Thermal Monitoring

    NASA Astrophysics Data System (ADS)

    Diederich, Chris; Ross, Anthony; Kinsey, Adam; Nau, Will H.; Rieke, Viola; Butts Pauly, Kim; Sommer, Graham

    2006-05-01

    Catheter-based ultrasound devices have significant advantages for thermal therapy procedures, including potential for precise spatial and dynamic control of heating patterns to conform to targeted volumes. Interstitial and transurethral ultrasound applicators, with associated treatment strategies, were developed for thermal ablation of prostate combined with MR thermal monitoring. Four types of multielement transurethral applicators were devised, each with different levels of selectivity and intended therapeutic goals: sectored tubular transducer devices with fixed directional heating patterns; planar and lightly focused curvilinear devices with narrow heating patterns; and multi-sectored tubular devices capable of dynamic angular control without applicator movement. These devices are integrated with a 4 mm delivery catheter, incorporate an inflatable cooling balloon (10 mm OD) for positioning within the prostate and capable of rotation via an MR-compatible motor. Similarly, interstitial devices (2.4 mm OD) have been developed for percutaneous implantation with fixed directional heating patterns (e.g., 180 deg.). In vivo experiments in canine prostate (n=15) under MR temperature imaging were used to evaluate the heating technology and develop treatment strategies. MR thermal imaging in a 0.5 T interventional MRI was used to monitor temperature contours and thermal dose in multiple slices through the target volume. Sectored transurethral devices produce directional coagulation zones, extending 15-20 mm radial distance to the outer prostate capsule. The curvilinear applicator produces distinct 2-3 mm wide lesions, and with sequential rotation and modulated dwell time can precisely conform thermal ablation to selected areas or the entire prostate gland. Multi-sectored transurethral applicators can dynamically control the angular heating profile and target large regions of the gland in short treatment times without applicator manipulation. Interstitial implants with

  19. Online dosimetry for temoporfin-mediated interstitial photodynamic therapy using the canine prostate as model

    NASA Astrophysics Data System (ADS)

    Swartling, Johannes; Höglund, Odd V.; Hansson, Kerstin; Södersten, Fredrik; Axelsson, Johan; Lagerstedt, Anne-Sofie

    2016-02-01

    Online light dosimetry with real-time feedback was applied for temoporfin-mediated interstitial photodynamic therapy (PDT) of dog prostate. The aim was to investigate the performance of online dosimetry by studying the correlation between light dose plans and the tissue response, i.e., extent of induced tissue necrosis and damage to surrounding organs at risk. Light-dose planning software provided dose plans, including light source positions and light doses, based on ultrasound images. A laser instrument provided therapeutic light and dosimetric measurements. The procedure was designed to closely emulate the procedure for whole-prostate PDT in humans with prostate cancer. Nine healthy dogs were subjected to the procedure according to a light-dose escalation plan. About 0.15 mg/kg temoporfin was administered 72 h before the procedure. The results of the procedure were assessed by magnetic resonance imaging, and gross pathology and histopathology of excised tissue. Light dose planning and online dosimetry clearly resulted in more focused effect and less damage to surrounding tissue than interstitial PDT without dosimetry. A light energy dose-response relationship was established where the threshold dose to induce prostate gland necrosis was estimated from 20 to 30 J/cm2.

  20. Online dosimetry for temoporfin-mediated interstitial photodynamic therapy using the canine prostate as model.

    PubMed

    Swartling, Johannes; Höglund, Odd V; Hansson, Kerstin; Södersten, Fredrik; Axelsson, Johan; Lagerstedt, Anne-Sofie

    2016-02-01

    Online light dosimetry with real-time feedback was applied for temoporfin-mediated interstitial photodynamic therapy (PDT) of dog prostate. The aim was to investigate the performance of online dosimetry by studying the correlation between light dose plans and the tissue response, i.e., extent of induced tissue necrosis and damage to surrounding organs at risk. Light-dose planning software provided dose plans, including light source positions and light doses, based on ultrasound images. A laser instrument provided therapeutic light and dosimetric measurements. The procedure was designed to closely emulate the procedure for whole-prostate PDT in humans with prostate cancer. Nine healthy dogs were subjected to the procedure according to a light-dose escalation plan. About 0.15 mg/kg temoporfin was administered 72 h before the procedure. The results of the procedure were assessed by magnetic resonance imaging, and gross pathology and histopathology of excised tissue. Light dose planning and online dosimetry clearly resulted in more focused effect and less damage to surrounding tissue than interstitial PDT without dosimetry. A light energy dose-response relationship was established where the threshold dose to induce prostate gland necrosis was estimated from 20 to 30  J/cm2. PMID:26886806

  1. Exercise pathophysiology and the role of oxygen therapy in idiopathic interstitial pneumonia.

    PubMed

    Troy, Lauren K; Young, Iven H; Lau, Edmund M T; Corte, Tamera J

    2016-08-01

    Exercise limitation is a common feature in idiopathic interstitial pneumonia (IIP). There are multiple contributing pathophysiological mechanisms, including ventilatory mechanical limitation, impaired gas exchange, pulmonary vascular insufficiency and peripheral muscle dysfunction. Progressive exertional dyspnoea and functional incapacity impact significantly on quality of life. Exercise-induced desaturation is frequently observed and is predictive of poorer outcomes. Tests to assess the cardiorespiratory system under stress (e.g. cardiopulmonary exercise testing and the 6-min walk test) can provide important physiologic and prognostic information as adjuncts to resting measurements of lung function. Despite many advances in understanding disease mechanisms, therapies to improve exercise capacity, symptom burden and quality of life are lacking. Exercise training and supplemental oxygen are two potential interventions that require closer evaluation in patients with IIP. PMID:26416262

  2. Complementary and alternative medical therapies for interstitial cystitis: an update from the United States

    PubMed Central

    Atchley, Megan Danielle; Shah, Nima M.

    2015-01-01

    The diagnosis and treatment of interstitial cystitis/bladder pain syndrome (IC/BPS) has shifted from organ-specific to a multifactorial, multidisciplinary and individualized approach. Patients with refractory and debilitating symptoms may respond to complementary and alternative medical treatments (CAM). Through CAM therapies, practitioners assist the patient to be at the center of their care, empowering them to be emotionally and physically involved. Multi-disciplinary care, including urology, gynecology, gastroenterology, neurology, psychology, physiotherapy and pain medicine, is also identified to be the crux of adequate management of patients with chronic pelvic pain because of its variable etiology. The purpose of this review is to emphasize these changes and discuss management strategies. PMID:26816868

  3. Interstitial photodynamic therapy for cancers of cavum oris, skin, and cervix

    NASA Astrophysics Data System (ADS)

    Zeng, Chaoying; Yang, Dong; Wang, Kaihua; Cao, Qingqing

    1993-03-01

    Interstitial photodynamic therapy, in which the straight cut optical fiber was directly inserted into tumors and the insertion points were rationally arranged on an entire lesion area, was performed on 31 oral cancers, 6 skin cancers, and 4 cervix cancers in 41 patients. A highly satisfactory rate of complete response (90%) was obtained via only one treatment. And no severe complication occurred in any of the treatments. The follow-up record for 33 cases with a CR curative effect shows 12 cases have survived free of tumor more than 4 years and only 5 cases relapsed within a year. In this paper, the factors affecting therapeutic effectiveness and the selection of indication are discussed.

  4. Monte Carlo fluence simulation for prospective evaluation of interstitial photodynamic therapy treatment plans

    NASA Astrophysics Data System (ADS)

    Cassidy, Jeffrey; Betz, Vaughn; Lilge, Lothar

    2015-03-01

    Photodynamic therapy (PDT) delivers a localized cytotoxic dose that is a function of tissue oxygen availability, photosensitive drug concentration, and light fluence. Providing safe and effective PDT requires an understanding of all three elements and the physiological response to the radicals generated. Interstitial PDT (IPDT) for solid tumours poses particular challenges due to complex organ geometries and the associated limitations for diffusion theory based fluence rate prediction, in addition to restricted access for light delivery and dose monitoring. As a first step towards enabling a complete prospective IPDT treatment-planning platform, we demonstrate use of our previously developed FullMonte tetrahedral Monte Carlo simulation engine for modeling of the interstitial fluence field due to intravesicular insertion of brief light sources. The goal is to enable a complete treatment planning and monitoring work flow analogous to that used in ionizing radiation therapy, including plan evaluation through dose-volume histograms and algorithmic treatment plan optimization. FullMonte is to our knowledge the fastest open-source tetrahedral MC light propagation software. Using custom hardware acceleration, we achieve 4x faster computing with 67x better power efficiency for limited-size meshes compared to the software. Ongoing work will improve the performance advantage to 16x with unlimited mesh size, enabling algorithmic plan optimization in reasonable time. Using FullMonte, we demonstrate significant new plan-evaluation capabilities including fluence field visualization, generation of organ dose-volume histograms, and rendering of isofluence surfaces for a representative bladder cancer mesh from a real patient. We also discuss the advantages of MC simulations for dose-volume histogram generation and the need for online personalized fluence-rate monitoring.

  5. Interstitial radiation therapy in the treatment of childhood soft-tissue sarcomas

    SciTech Connect

    Curran, W.J. Jr.; Littman, P.; Raney, R.B.

    1988-01-01

    Between 1971 and 1985, 12 children and adolescents aged 0.7 to 19 years (median 4.7 years) with localized residual soft-tissue sarcomas (STS) underwent interstitial radiation therapy (IRT) at our institution. Eight received IRT as a component of initial therapy, and four were treated for recurrent or persistent disease. Tumor sites were head and neck (6), pelvis (4), extremity (1), and retroperitoneum (1). The radionuclides employed were Iridium-192 (9), Iodine-125 (2), and Californium-252 (1). The median prescribed dose in the Iridium-192 group was 3960 cGy (1955-7300). Seven of eight children receiving IRT during initial therapy have maintained local control, and six remain without evidence of disease for a median follow-up time of 5.8 years (2.0-16.0). One of the four patients treated for recurrent disease is free of disease after salvage surgery, and the other three are dead of disease. Multidisciplinary evaluation of the nine patients with more than 2 years of follow-up revealed functional and cosmetic effects of IRT to be minimal. IRT can be an effective method of delivering high dose irradiation in childhood sarcomas while reducing the deleterious effects in adjacent normal tissues.

  6. System for interstitial photodynamic therapy with online dosimetry: first clinical experiences of prostate cancer

    NASA Astrophysics Data System (ADS)

    Swartling, Johannes; Axelsson, Johan; Ahlgren, Göran; Kälkner, Karl Mikael; Nilsson, Sten; Svanberg, Sune; Svanberg, Katarina; Andersson-Engels, Stefan

    2010-09-01

    The first results from a clinical study for Temoporfin-mediated photodynamic therapy (PDT) of low-grade (T1c) primary prostate cancer using online dosimetry are presented. Dosimetric feedback in real time was applied, for the first time to our knowledge, in interstitial photodynamic therapy. The dosimetry software IDOSE provided dose plans, including optical fiber positions and light doses based on 3-D tissue models generated from ultrasound images. Tissue optical property measurements were obtained using the same fibers used for light delivery. Measurements were taken before, during, and after the treatment session. On the basis of these real-time measured optical properties, the light-dose plan was recalculated. The aim of the treatment was to ablate the entire prostate while minimizing exposure to surrounding organs. The results indicate that online dosimetry based on real-time tissue optical property measurements enabled the light dose to be adapted and optimized. However, histopathological analysis of tissue biopsies taken six months post-PDT treatment showed there were still residual viable cancer cells present in the prostate tissue sections. The authors propose that the incomplete treatment of the prostate tissue could be due to a too low light threshold dose, which was set to 5 J/cm2.

  7. Catheter-Based Ultrasound for 3D Control of Thermal Therapy

    NASA Astrophysics Data System (ADS)

    Diederich, Chris; Chen, Xin; Wootton, Jeffery; Juang, Titania; Nau, Will H.; Kinsey, Adam; Hsu, I.-Chow; Rieke, Viola; Pauly, Kim Butts; Sommer, Graham; Bouley, Donna

    2009-04-01

    Catheter-based ultrasound applicators have been investigated for delivering hyperthermia and thermal ablation for the treatment of cancer and benign diseases. Technology includes an intrauterine applicator integrated with an HDR ring applicator, interstitial applicators for hyperthermia delivery during brachytherapy, interstitial applicators for tumor ablation, and transurethral devices for conformal prostate ablation. Arrays of multiple sectored tubular transducers have been fabricated for interstitial and intrauterine hyperthermia applicators. High-power interstitial versions have been evaluated for percutaneous implantation with directional or dynamic angular control of thermal ablation. Transurethral applicators include curvilinear transducers with rotational sweeping of narrow heating patterns, and multi-sectored tubular devices capable of dynamic angular control without applicator movement. Performance was evaluated in phantom, excised tissue, in vivo experiments in canine prostate under MR temperature monitoring, clinical hyperthermia, and 3D-biothermal simulations with patient anatomy. Interstitial and intrauterine devices can tailor hyperthermia to large treatment volumes, with multisectored control useful to limit exposure to rectum and bladder. Curvilinear transurethral devices with sequential rotation produce target conforming coagulation zones that can cover either the whole gland or defined focal regions. Multi-sectored transurethral applicators can dynamically control the angular heating profile and target large regions of the prostate without applicator manipulation. High-power interstitial implants with directional devices can be used to effectively ablate defined target regions while avoiding sensitive tissues. MR temperature monitoring can effectively define the extent of thermal damage and provided a means for real-time control of the applicators. In summary, these catheter-based ultrasound devices allow for dynamic control of heating profiles

  8. Interstitial photodynamic therapy and glioblastoma: light fractionation study on a preclinical model: preliminary results

    NASA Astrophysics Data System (ADS)

    Leroy, Henri-Arthur; Vermandel, Maximilien; Tétard, Marie-Charlotte; Lejeune, Jean-Paul; Mordon, Serge; Reyns, Nicolas

    2015-03-01

    Background Glioblastoma is a high-grade cerebral tumor with local recurrence and poor outcome. Photodynamic therapy (PDT) is a local treatment based on the light activation of a photosensitizer (PS) in the presence of oxygen to form cytotoxic species. Fractionation of light delivery may enhance treatment efficiency by restoring tissue oxygenation. Objectives To evaluate the efficiency of light fractionation using MRI imaging, including diffusion and perfusion, compared to histological data. Materials and Methods Thirty-nine "Nude" rats were grafted with human U87 cells into the right putamen. After PS precursor intake (5-ALA), an optic fiber was introduced into the tumor. The rats were randomized in three groups: without illumination, with monofractionated illumination and the third one with multifractionated light. Treatment effects were assessed with early MRI including diffusion and perfusion sequences. The animals were eventually sacrificed to perform brain histology. Results On MRI, we observed elevated diffusion values in the center of the tumor among treated animals, especially in multifractionated group. Perfusion decreased around the treatment site, all the more in the multifractionated group. Histology confirmed our MRI findings, with a more extensive necrosis and associated with a rarified angiogenic network in the treatment area, after multifractionated PDT. However, we observed more surrounding edema and neovascularization in the peripheral ring after multifractionated PDT. Conclusion Fractionated interstitial PDT induced specific tumoral lesions. The multifractionated scheme was more efficient, inducing increased tumoral necrosis, but it also caused significant peripheral edema and neovascularization. Diffusion and perfusion MRI imaging were able to predict the histological lesions.

  9. Interstitial photodynamic therapy for primary prostate cancer incorporating real-time treatment dosimetry

    NASA Astrophysics Data System (ADS)

    Johansson, Ann; Axelsson, Johan; Swartling, Johannes; Johansson, Thomas; Pålsson, Sara; Stensson, Johan; Einarsdóttír, Margret; Svanberg, Katarina; Bendsoe, Niels; Kälkner, Karl Mikael; Nilsson, Sten; Svanberg, Sune; Andersson-Engels, Stefan

    2007-02-01

    Photodynamic therapy (PDT) for the treatment of prostate cancer has been demonstrated to be a safe treatment option capable of inducing tissue necrosis and decrease in prostate specific antigen (PSA). Research groups report on large variations in treatment response, possibly due to biological variations in tissue composition and short-term response to the therapeutic irradiation. Within our group, an instrument for interstitial PDT on prostate tissue that incorporates realtime treatment feedback is being developed. The treatment protocol consists of two parts. The first part incorporates the pre-treatment plan with ultrasound investigations, providing the geometry for the prostate gland and surrounding risk organs, an iterative random-search algorithm to determine near-optimal fiber positions within the reconstructed geometry and a Block-Cimmino optimization algorithm for predicting individual fiber irradiation times. During the second part, the therapeutic light delivery is combined with measurements of the light transmission signals between the optical fibers, thus monitoring the tissue effective attenuation coefficient by means of spatially resolved spectroscopy. These data are then used as input for repeated runs of the Block-Cimmino optimization algorithm. Thus, the irradiation times for individual fibers are updated throughout the treatment in order to compensate for the influence of changes in tissue composition on the light distribution at the therapeutic wavelength.

  10. Photobleaching-based method to individualize irradiation time during interstitial 5-aminolevulinic acid photodynamic therapy.

    PubMed

    Hennig, Georg; Stepp, Herbert; Johansson, Ann

    2011-09-01

    Interstitial photodynamic therapy (iPDT) is being investigated for the treatment of high-grade human brain malignancies. In recent clinical studies, fluorescence monitoring during iPDT of glioblastoma multiforme has revealed patient-specific accumulation of photosensitizer (aminolevulinic acid (ALA) induced protoporphyrin IX, PpIX) and its photobleaching kinetics. As photosensitizer degradation, also referred to as photobleaching, and tissue damage are caused by the same underlying processes, the photobleaching kinetics might provide a tool for real-time treatment supervision. Here, we show with computer simulations that varying optical properties have a strong influence on the irradiation time required to fully bleach the photosensitizer. We propose a method to potentially determine the time point during iPDT, when the photosensitizer within the target volume has been largely photobleached. Simulations show that it is possible to determine this time point by continuously monitoring the ratio of the fluorescence intensities at two time points during irradiation. We show that this method works for a large range of optical properties, different photobleaching rates and varying inter-fibre distances. In conclusion, the relative fluorescence method offers the potential to individualize irradiation times to consume the photosensitizer within the target tissue during iPDT. PMID:21864802

  11. Treatment planning and dose analysis for interstitial photodynamic therapy of prostate cancer

    NASA Astrophysics Data System (ADS)

    Davidson, Sean R. H.; Weersink, Robert A.; Haider, Masoom A.; Gertner, Mark R.; Bogaards, Arjen; Giewercer, David; Scherz, Avigdor; Sherar, Michael D.; Elhilali, Mostafa; Chin, Joseph L.; Trachtenberg, John; Wilson, Brian C.

    2009-04-01

    With the development of new photosensitizers that are activated by light at longer wavelengths, interstitial photodynamic therapy (PDT) is emerging as a feasible alternative for the treatment of larger volumes of tissue. Described here is the application of PDT treatment planning software developed by our group to ensure complete coverage of larger, geometrically complex target volumes such as the prostate. In a phase II clinical trial of TOOKAD vascular targeted photodynamic therapy (VTP) for prostate cancer in patients who failed prior radiotherapy, the software was used to generate patient-specific treatment prescriptions for the number of treatment fibres, their lengths, their positions and the energy each delivered. The core of the software is a finite element solution to the light diffusion equation. Validation against in vivo light measurements indicated that the software could predict the location of an iso-fluence contour to within approximately ±2 mm. The same software was used to reconstruct the treatments that were actually delivered, thereby providing an analysis of the threshold light dose required for TOOKAD-VTP of the post-irradiated prostate. The threshold light dose for VTP-induced prostate damage, as measured one week post-treatment using contrast-enhanced MRI, was found to be highly heterogeneous, both within and between patients. The minimum light dose received by 90% of the prostate, D90, was determined from each patient's dose-volume histogram and compared to six-month sextant biopsy results. No patient with a D90 less than 23 J cm-2 had complete biopsy response, while 8/13 (62%) of patients with a D90 greater than 23 J cm-2 had negative biopsies at six months. The doses received by the urethra and the rectal wall were also investigated.

  12. Experimental evidence for thermal generation of interstitials in a metallic crystal near the melting temperature.

    PubMed

    Safonova, E V; Mitrofanov, Yu P; Konchakov, R A; Yu Vinogradov, A; Kobelev, N P; Khonik, V A

    2016-06-01

    The only intrinsic point defects of simple crystalline metals known from solid state physics are vacancies and interstitials. It is widely believed that while vacancies play a major role in crystal properties and their concentration reaches relatively big values near the melting temperature T m, interstitials essentially do not occur in thermodynamic equilibrium and their influence on properties is minor. Here, taking aluminum single crystals as an example, we present compelling experimental evidence for rapid thermoactivated growth of interstitial concentration upon approaching T m. Using high precision measurements of the shear modulus we found a diaelastic effect of up to [Formula: see text] near T m. It is argued that this effect is mostly due to the generation of dumbbell (split) interstitials. The interstitial concentration c i rapidly increases upon approaching T m and becomes only 2-3 times smaller than that of vacancies just below T m. The reason for this c i -increase is conditioned by a decrease of the Gibbs free energy with temperature, which in turn originates from the high formation entropy of dumbbell interstitials and a decrease of their formation enthalpy at high c i . Special molecular dynamic simulation confirmed all basic aspects of the proposed interpretation. The results obtained (i) demonstrate the significance of interstitial concentration near T m that could lead to the revaluation of vacancy concentration at high temperatures, (ii) suggest that dumbbell interstitials play a major role in the melting mechanism of monatomic metallic crystals and (iii) support a new avenue for in-depth understanding of glassy metals. PMID:27143564

  13. Experimental evidence for thermal generation of interstitials in a metallic crystal near the melting temperature

    NASA Astrophysics Data System (ADS)

    Safonova, E. V.; Mitrofanov, Yu P.; Konchakov, R. A.; Vinogradov, A. Yu; Kobelev, N. P.; Khonik, V. A.

    2016-06-01

    The only intrinsic point defects of simple crystalline metals known from solid state physics are vacancies and interstitials. It is widely believed that while vacancies play a major role in crystal properties and their concentration reaches relatively big values near the melting temperature T m, interstitials essentially do not occur in thermodynamic equilibrium and their influence on properties is minor. Here, taking aluminum single crystals as an example, we present compelling experimental evidence for rapid thermoactivated growth of interstitial concentration upon approaching T m. Using high precision measurements of the shear modulus we found a diaelastic effect of up to -1.5% near T m. It is argued that this effect is mostly due to the generation of dumbbell (split) interstitials. The interstitial concentration c i rapidly increases upon approaching T m and becomes only 2–3 times smaller than that of vacancies just below T m. The reason for this c i -increase is conditioned by a decrease of the Gibbs free energy with temperature, which in turn originates from the high formation entropy of dumbbell interstitials and a decrease of their formation enthalpy at high c i . Special molecular dynamic simulation confirmed all basic aspects of the proposed interpretation. The results obtained (i) demonstrate the significance of interstitial concentration near T m that could lead to the revaluation of vacancy concentration at high temperatures, (ii) suggest that dumbbell interstitials play a major role in the melting mechanism of monatomic metallic crystals and (iii) support a new avenue for in-depth understanding of glassy metals.

  14. Recovery of optical properties from interstitial spectroscopy for photodynamic therapy treatment planning

    NASA Astrophysics Data System (ADS)

    Baran, Timothy M.; Fenn, Michael C.; Foster, Thomas H.

    2014-03-01

    Knowledge of optical properties is required to determine light dose in photodynamic therapy. We have designed an interstitial optical probe, consisting of six helically arranged side-firing fibers enclosed in a 1.1 mm diameter encapsulant, that can be used to determine these values. White light is delivered by one fiber and detected by the others. Based on a Monte Carlo (MC) model of the probe, the absorption (μa) and reduced scattering (μs') coefficients of the sample are determined. Recovery was verified in tissue-simulating phantoms containing MnTPPS or intact human erythrocytes as absorbers and Intralipid as scatterer. Mean errors in recovery of μa and μs' were 9% and 19%, respectively. In phantoms containing erythrocytes, hemoglobin oxygen saturation was recovered with mean error of 12%. Using the MC model, we mapped the volumes sampled by particular spectroscopy fibers. For μa = 0.1 cm-1 and μs' = 20cm-1, 49% of photon packets detected at the fiber adjacent to the source sampled a radius further than 5 mm from the probe, while 24% of photon packets sampled further than 7.5 mm. When μs' was reduced to 10 cm-1, 54% of photon packets traversed a radius greater than 5 mm from the probe and 29% sampled further than 7.5 mm. Changing the value of μa to 0.2 cm-1 did not have an effect on the sampled volume. We also provide a new probe design that aims to improve upon the accuracy of the current probe by incorporating a wider range of source-detector separations.

  15. Thermal modelling using discrete vasculature for thermal therapy: a review

    PubMed Central

    Kok, H.P.; Gellermann, J.; van den Berg, C.A.T.; Stauffer, P.R.; Hand, J.W.; Crezee, J.

    2013-01-01

    Reliable temperature information during clinical hyperthermia and thermal ablation is essential for adequate treatment control, but conventional temperature measurements do not provide 3D temperature information. Treatment planning is a very useful tool to improve treatment quality and substantial progress has been made over the last decade. Thermal modelling is a very important and challenging aspect of hyperthermia treatment planning. Various thermal models have been developed for this purpose, with varying complexity. Since blood perfusion is such an important factor in thermal redistribution of energy in in vivo tissue, thermal simulations are most accurately performed by modelling discrete vasculature. This review describes the progress in thermal modelling with discrete vasculature for the purpose of hyperthermia treatment planning and thermal ablation. There has been significant progress in thermal modelling with discrete vasculature. Recent developments have made real-time simulations possible, which can provide feedback during treatment for improved therapy. Future clinical application of thermal modelling with discrete vasculature in hyperthermia treatment planning is expected to further improve treatment quality. PMID:23738700

  16. Comparison of flat cleaved and cylindrical diffusing fibers as treatment sources for interstitial photodynamic therapy

    SciTech Connect

    Baran, Timothy M. Foster, Thomas H.

    2014-02-15

    Purpose: For interstitial photodynamic therapy (iPDT) of bulky tumors, careful treatment planning is required in order to ensure that a therapeutic dose is delivered to the tumor, while minimizing damage to surrounding normal tissue. In clinical contexts, iPDT has typically been performed with either flat cleaved or cylindrical diffusing optical fibers as light sources. Here, the authors directly compare these two source geometries in terms of the number of fibers and duration of treatment required to deliver a prescribed light dose to a tumor volume. Methods: Treatment planning software for iPDT was developed based on graphics processing unit enhanced Monte Carlo simulations. This software was used to optimize the number of fibers, total energy delivered by each fiber, and the position of individual fibers in order to deliver a target light dose (D{sub 90}) to 90% of the tumor volume. Treatment plans were developed using both flat cleaved and cylindrical diffusing fibers, based on tissue volumes derived from CT data from a head and neck cancer patient. Plans were created for four cases: fixed energy per fiber, fixed number of fibers, and in cases where both or neither of these factors were fixed. Results: When the number of source fibers was fixed at eight, treatment plans based on flat cleaved fibers required each to deliver 7180–8080 J in order to deposit 90 J/cm{sup 2} in 90% of the tumor volume. For diffusers, each fiber was required to deliver 2270–2350 J (333–1178 J/cm) in order to achieve this same result. For the case of fibers delivering a fixed 900 J, 13 diffusers or 19 flat cleaved fibers at a spacing of 1 cm were required to deliver the desired dose. With energy per fiber fixed at 2400 J and the number of fibers fixed at eight, diffuser fibers delivered the desired dose to 93% of the tumor volume, while flat cleaved fibers delivered this dose to 79%. With both energy and number of fibers allowed to vary, six diffusers delivering 3485–3600 J

  17. In what type of interstitial cystitis/bladder pain syndrome is DMSO intravesical instillation therapy effective?

    PubMed Central

    2015-01-01

    Background Dimethylsulfoxide (DMSO) is the most-used agent for intravesical instillation. We conducted this retrospective clinical study to determine in what type of the interstitial cystitis (IC)/bladder pain syndrome (BPS) DMSO was effective. Methods We combined DMSO with hydrodistension in 2003 and from 2004 we performed hydrodistension alone. Hydrodistension had been performed in 7 cases of IC/BPS with Hunner’s lesions (H group) and 7 cases of IC/BPS without Hunner’s lesions (non-H group), and they served as the control group (C group; n=14). There was also a DMSO group (D group; n=14) that consisted of an H group of 7 cases and an non-H group of 7 cases in which the hydrodistension had been immediately followed by intravesical instillation of 50% DMSO 50 mL. Before, and 2, 6, 12, 18, and 24 months (M) after the intervention, the patients were asked to complete a 4-day frequency-volume chart (FVC) and the O’Leary-Sant IC symptom index (ICSI) questionnaire and IC problem index (ICPI) questionnaire, and to rate their pain on a visual analogue scale (VAS). Results All parameters were improved after hydrodistension in both the C group and the D group. However, comparison of the C group and D group according to whether Hunner lesions were present showed that there were no significant differences in any of the postoperative parameters between the non-H groups in the C group and D group, but in the H groups, average and maximum voided volume were significantly higher and the ICSI, ICPI, and VAS scores were lower in the D group. Moreover, the significant differences increased with the duration of the postoperative period. Conclusions DMSO intravesical instillation therapy was useful in both maintaining and improving the effectiveness of hydrodistension in IC/BPS with Hunner lesions. However, DMSO did not have any particular efficacy in the treatment of IC/BPS in the absence of Hunner lesions. PMID:26816859

  18. Magnetic resonance-guided interstitial therapy for vaginal recurrence of endometrial cancer

    SciTech Connect

    Viswanathan, Akila N. . E-mail: aviswanathan@partners.org; Cormack, Robert; Holloway, Caroline L.; Tanaka, Cynthia; O'Farrell, Desmond C.; Devlin, Phillip M.; Tempany, Clare

    2006-09-01

    Purpose: To evaluate the feasibility and to describe the acute toxicity of a real-time intraoperative magnetic resonance (MR)-image guided interstitial approach to treating vaginal recurrence of endometrial cancer. Methods and Materials: From February 2004 to April 2005, 10 patients with recurrent endometrial cancer underwent MR-guided interstitial brachytherapy. Parameters evaluated included needle placement, dose-volume histograms (DVH), and complications. Results: Magnetic resonance-image guidance resulted in accurate needle placement. Tumor DVH values included median volume, 47 cc; V100, 89%; V150, 61%; V200, 38%; D90, 71 Gy; and D100, 60 Gy. DVH of organs at risk resulted in a median D2cc of external beam and brachytherapy dose (% of brachytherapy prescription): bladder, 75Gy{sub 3} (88%); rectum, 70Gy{sub 3} (87%); and sigmoid, 56Gy{sub 3} (41%). All patients experienced either a Grade 1 or 2 acute toxicity related to the radiation; only 1 patient had Grade 3 toxicity. No toxicities were attributable to the use of MR guidance. Conclusions: Real-time MR guidance during the insertion of interstitial needles reduces the likelihood of an inadvertent insertion of the needles into the bladder and the rectum. Three-dimensional dosimetry allows estimation of the dose to organs at risk. Toxicities are limited.

  19. Interstitial pressure gradients in tissue-isolated and subcutaneous tumors: implications for therapy.

    PubMed

    Boucher, Y; Baxter, L T; Jain, R K

    1990-08-01

    High interstitial fluid pressure (IFP) in solid tumors is associated with reduced blood flow as well as inadequate delivery of therapeutic agents such as monoclonal antibodies. In the present study, IFP was measured as a function of radial position within two rat tissue-isolated tumors (mammary adenocarcinoma R3230AC, 0.4-1.9 g, n = 9, and Walker 256 carcinoma, 0.5-5.0 g, n = 6) and a s.c. tumor (mammary adenocarcinoma R3230AC, 0.6-20.0 g, n = 7). Micropipettes (tip diameters 2 to 4 microns) connected to a servo-null pressure-monitoring system were introduced to depths of 2.5 to 3.5 mm from the tumor surface and IFP was measured while the micropipettes were retrieved to the surface. The majority (86%) of the pressure profiles demonstrated a large gradient in the periphery leading to a plateau of almost uniform pressure in the deeper layers of the tumors. Within isolated tumors, pressures reached plateau values at a distance of 0.2 to 1.1 mm from the surface. In s.c. tumors the sharp increase began in skin and levelled off at the skin-tumor interface. These results demonstrate for the first time that the IFP is elevated throughout the tumor and drops precipitously to normal values in the tumor's periphery or in the immediately surrounding tissue. These results confirm the predictions of our recently published mathematical model of interstitial fluid transport in tumors (Jain and Baxter, Cancer Res., 48: 7022-7032, 1988), offer novel insight into the etiology of interstitial hypertension, and suggest possible strategies for improved delivery of therapeutic agents. PMID:2369726

  20. Examination of light distribution from sol-gel based applicators for interstitial laser therapy

    NASA Astrophysics Data System (ADS)

    Hołowacz, I.; Ulatowska-Jarża, A.; Podbielska, H.; Garbaczewska, I.

    2006-02-01

    We describe here the construction of sol-gel based applicators for interstitial thermotheraphy. The silica sol-gel coatings were prepared from silicate precursor TEOS (tetraethylorthosilicate) mixed with ethyl alcohol in acid catalyzed hydrolysis. The matrices were produced with various ratios R=5, 10, 20, 32, 50, whereas R denotes the number of solvent molds (here ethanol) to the number of TEOS moles. The spatial light intensity distribution was examined in order to find out the influence of R factor on the light distribution shape. It was shows that the most homogeneous patterns are observed for sol-gel coatings with R factors equal 10 and 20.

  1. Treatment plan evaluation for interstitial photodynamic therapy in a mouse model by Monte Carlo simulation with FullMonte

    NASA Astrophysics Data System (ADS)

    Cassidy, Jeffrey; Betz, Vaughn; Lilge, Lothar

    2015-02-01

    Monte Carlo (MC) simulation is recognized as the “gold standard” for biophotonic simulation, capturing all relevant physics and material properties at the perceived cost of high computing demands. Tetrahedral-mesh-based MC simulations particularly are attractive due to the ability to refine the mesh at will to conform to complicated geometries or user-defined resolution requirements. Since no approximations of material or light-source properties are required, MC methods are applicable to the broadest set of biophotonic simulation problems. MC methods also have other implementation features including inherent parallelism, and permit a continuously-variable quality-runtime tradeoff. We demonstrate here a complete MC-based prospective fluence dose evaluation system for interstitial PDT to generate dose-volume histograms on a tetrahedral mesh geometry description. To our knowledge, this is the first such system for general interstitial photodynamic therapy employing MC methods and is therefore applicable to a very broad cross-section of anatomy and material properties. We demonstrate that evaluation of dose-volume histograms is an effective variance-reduction scheme in its own right which greatly reduces the number of packets required and hence runtime required to achieve acceptable result confidence. We conclude that MC methods are feasible for general PDT treatment evaluation and planning, and considerably less costly than widely believed.

  2. Intracavitary ultrasound phased arrays for thermal therapies

    NASA Astrophysics Data System (ADS)

    Hutchinson, Erin

    Currently, the success of hyperthermia and thermal surgery treatments is limited by the technology used in the design and fabrication of clinical heating devices and the completeness of the thermometry systems used for guidance. For both hyperthermia and thermal surgery, electrically focused ultrasound generated by phased arrays provides a means of controlling localized energy deposition in body tissues. Intracavitary applicators can be used to bring the energy source close to a target volume, such as the prostate, thereby minimizing normal tissue damage. The work performed in this study was aimed at improving noninvasive prostate thermal therapies and utilized three research approaches: (1) Acoustic, thermal and optimization simulations, (2) Design and fabrication of multiple phased arrays, (3) Ex vivo and in vivo experimental testing of the heating capabilities of the phased arrays. As part of this study, a novel aperiodic phased array design was developed which resulted in a 30- 45% reduction in grating lobe levels when compared to conventional phased arrays. Measured acoustic fields generated by the constructed aperiodic arrays agreed closely with the fields predicted by the theoretical simulations and covered anatomically appropriate ranges. The power capabilities of these arrays were demonstrated to be sufficient for the purposes of hyperthermia and thermal surgery. The advantage of using phased arrays in place of fixed focus transducers was shown by demonstrating the ability of electronic scanning to increase the size of the necrosed tissue volume while providing a more uniform thermal dose, which can ultimately reduce patient treatment times. A theoretical study on the feasibility of MRI (magnetic resonance imaging) thermometry for noninvasive temperature feedback control was investigated as a means to improve transient and steady state temperature distributions achieved in hyperthermia treatments. MRI guided ex vivo and in vivo experiments demonstrated

  3. [Rituximab therapy in the treatment of anti-neutrophil cytoplasmic antibody (ANCA) -positive interstitial pneumonia: case report].

    PubMed

    Miyaoka, Tokiko; Itabashi, Mitsuyo; Kumon, Saeko; Akiyama, Kenichi; Iwabuchi, Yuko; Kataoka, Hiroshi; Moriyama, Takahito; Takei, Takashi; Nitta, Kosaku

    2016-01-01

    We report a patient treated with rituximab for interstitial pneumonia (IP) associated with microscopic polyangiitis (MPA) and who was undergoing hemodialysis. A 59-year-old woman who had been treated with tacrolimus for 1 year for rheumatic arthritis was referred to the Department of Nephrology for fatigue, fever, weight loss, and rapidly developing renal dysfunction. On the first admission, severe renal dysfunction, proteinuria, hematuria, and an elevated titer of MPO-ANCA were observed, and the woman was diagnosed with rapidly progressive glomerulonephritis because of MPA. At that point, IP was found to be present but not active. Although steroid semipulse therapy following an initial prednisolone (PSL) administration of 40 mg/day, IVCY, and plasma exchange were administered, renal dysfunction did not recover, and the patient required maintenance hemodialysis. Upon discharge, a high titer of MPO-ANCA was continuously observed. Nine months after the initiation of hemodialysis, respiratory discomfort and desaturation developed. Interstitial shadow and ground glass opacity were seen on a CT scan, and the patient was diagnosed with exacerbation of interstitial pneumonia caused by MPA recurrence. At the second admission, acute findings identified by imaging techniques had improved. However, the high titer of MPO-ANCA continued in spite of the steroid semi-pulse therapy following PSL administration, and rituximab corresponding to 200 mg/weekly for 1 month was also administered. The dose of rituximab was decreased subsequently because the patient was judged to be compromised by the hemodialysis. At the same time, internal administration of sulfamethoxazole/trimethoprim was initiated. After the rituximab treatment, MPO-ANCA antibodies gradually decreased, and the respiratory condition improved. Five months after the rituximab treatment, respiratory dysfunction recurred. Based on the CT findings and a high level of β-D-glycan, the patient was diagnosed with ARDS due to

  4. High-flow nasal cannula oxygen therapy for acute exacerbation of interstitial pneumonia: A case series.

    PubMed

    Horio, Yukihiro; Takihara, Takahisa; Niimi, Kyoko; Komatsu, Masamichi; Sato, Masako; Tanaka, Jun; Takiguchi, Hiroto; Tomomatsu, Hiromi; Tomomatsu, Katsuyoshi; Hayama, Naoki; Oguma, Tsuyoshi; Aoki, Takuya; Urano, Tetsuya; Takagi, Atsushi; Asano, Koichiro

    2016-03-01

    We report 3 cases (all men, age: 69-81 years) of acute exacerbation of interstitial pneumonia (AEIP) that were successfully treated with a high-flow nasal cannula (HFNC), which delivers heated, humidified gas at a fraction of inspired oxygen (FIO2) up to 1.0 (100%). Oxygenation was insufficient under non-rebreathing face masks; however, the introduction of HFNC with an FIO2 of 0.7-1.0 (flow rate: 40L/min) improved oxygenation and was well-tolerated until the partial pressure of oxygen in blood/FIO2 ratio increased (between 21 and 26 days). Thus, HFNC might be an effective and well-tolerated therapeutic addition to the management of AEIP. PMID:26879483

  5. Quantitative evaluation of multi-parametric MR imaging marker changes post-laser interstitial ablation therapy (LITT) for epilepsy

    NASA Astrophysics Data System (ADS)

    Tiwari, Pallavi; Danish, Shabbar; Wong, Stephen; Madabhushi, Anant

    2013-03-01

    Laser-induced interstitial thermal therapy (LITT) has recently emerged as a new, less invasive alternative to craniotomy for treating epilepsy; which allows for focussed delivery of laser energy monitored in real time by MRI, for precise removal of the epileptogenic foci. Despite being minimally invasive, the effects of laser ablation on the epileptogenic foci (reflected by changes in MR imaging markers post-LITT) are currently unknown. In this work, we present a quantitative framework for evaluating LITT-related changes by quantifying per-voxel changes in MR imaging markers which may be more reflective of local treatment related changes (TRC) that occur post-LITT, as compared to the standard volumetric analysis which involves monitoring a more global volume change across pre-, and post-LITT MRI. Our framework focuses on three objectives: (a) development of temporal MRI signatures that characterize TRC corresponding to patients with seizure freedom by comparing differences in MR imaging markers and monitoring them over time, (b) identification of the optimal time point when early LITT induced effects (such as edema and mass effect) subside by monitoring TRC at subsequent time-points post-LITT, and (c) identification of contributions of individual MRI protocols towards characterizing LITT-TRC for epilepsy by identifying MR markers that change most dramatically over time and employ individual contributions to create a more optimal weighted MP-MRI temporal profile that can better characterize TRC compared to any individual imaging marker. A cohort of patients were monitored at different time points post-LITT via MP-MRI involving T1-w, T2-w, T2-GRE, T2-FLAIR, and apparent diffusion coefficient (ADC) protocols. Post affine registration of individual MRI protocols to a reference MRI protocol pre-LITT, differences in individual MR markers are computed on a per-voxel basis, at different time-points with respect to baseline (pre-LITT) MRI as well as across subsequent time

  6. Interstitial Nephritis

    MedlinePlus

    ... rye-tus) is a kidney disorder. The kidneys filter waste and extra fluid from the body. Interstitial nephritis reduces the kidneys’ ability to filter properly. Interstitial nephritis is a serious condition, but ...

  7. Development of transrectal diffuse optical tomography combined with 3D-transrectal ultrasound imaging to monitor the photocoagulation front during interstitial photothermal therapy of primary focal prostate cancer

    NASA Astrophysics Data System (ADS)

    He, Jie; Weersink, Robert; Veilleux, Israel; Mayo, Kenwrick; Zhang, Anqi; Piao, Daqing; Alam, Adeel; Trachtenberg, John; Wilson, Brian C.

    2013-03-01

    Interstitial near-infrared laser thermal therapy (LITT) is currently undergoing clinical trials as an alternative to watchful waiting or radical surgery in patients with low-risk focal prostate cancer. Currently, we use magnetic resonance image (MRI)-based thermography to monitor treatment delivery and determine indirectly the completeness of the target tissue destruction while avoiding damage to adjacent normal tissues, particularly the rectal wall. However, incomplete tumor destruction has occurred in a significant fraction of patients due to premature termination of treatment, since the photocoagulation zone is not directly observed. Hence, we are developing transrectal diffuse optical tomography (TRDOT), in combination with transrectal 3D ultrasound (3D-TRUS), to address his limitation. This is based on the large changes in optical scattering expected upon tissue coagulation. Here, we present forward simulations of a growing coagulated lesion with optical scattering contrast, using an established finite element analysis software platform (NIRFAST). The simulations were validated in tissue-simulating phantoms, with measurements acquired by a state-of-the-art continuous wave (CW) TRDOT system and a recently assembled bench-top CW-DOT system, with specific source-detector configurations. Two image reconstruction schemes were investigated and evaluated, specifically for the accurate delineation of the posterior boundary of the coagulation zone as the critical parameter for treatment guidance in this clinical application.

  8. Surface morphology and electrical transport of rapid thermal annealed chromium-doped indium zinc oxides: The influence of zinc interstitials and out-diffusion

    SciTech Connect

    Hsu, C. Y.

    2013-12-09

    We investigate the complex impedance (CI) spectra of chromium-doped indium zinc oxide (CIZO) films with different rapid thermal annealing (RTA) temperatures. The CI spectra drawn from the impedance contributions of Zn-O and In-O bondings in CIZO films were analyzed by two sets of parallel resistance and capacitance components in series. The result demonstrates that zinc interstitials controls electron concentration and transition of electrical transport from semiconducting to metallic. At higher RTA temperature, high-density zinc interstitial promotes Zn atom diffusion from the surface, modifying surface morphology.

  9. Surface morphology and electrical transport of rapid thermal annealed chromium-doped indium zinc oxides: The influence of zinc interstitials and out-diffusion

    NASA Astrophysics Data System (ADS)

    Hsu, C. Y.

    2013-12-01

    We investigate the complex impedance (CI) spectra of chromium-doped indium zinc oxide (CIZO) films with different rapid thermal annealing (RTA) temperatures. The CI spectra drawn from the impedance contributions of Zn-O and In-O bondings in CIZO films were analyzed by two sets of parallel resistance and capacitance components in series. The result demonstrates that zinc interstitials controls electron concentration and transition of electrical transport from semiconducting to metallic. At higher RTA temperature, high-density zinc interstitial promotes Zn atom diffusion from the surface, modifying surface morphology.

  10. 192Ir pharyngoepiglottic fold interstitial implants. The key to successful treatment of base tongue carcinoma by radiation therapy.

    PubMed

    Goffinet, D R; Fee, W E; Wells, J; Austin-Seymour, M; Clarke, D; Mariscal, J M; Goode, R L

    1985-03-01

    Twenty-eight patients with squamous carcinomas of the base tongue were seen and evaluated in a conjoint Head and Neck Tumor Board at Stanford between 1976 and 1982. Fourteen patients were treated by combined external beam and interstitial irradiation, 11 of whom had Stage III and IV carcinomas (American Joint Committee). An initial dose of 5000 to 5500 rad was first delivered by external beam irradiation in 5 to 5.5 weeks, followed approximately 3 weeks later by an iridium 192 (192Ir) interstitial implant boost by the trocar and loop technique. The key to successful treatment of these neoplasms was found to be the use of a lateral percutaneous cervical technique, which placed horizontal loops through the oropharyngeal wall above and below the hyoid bone; the superior loop included the pharyngoepiglottic fold and the tonsilloglossal groove. Standard multiple loop implants (submentally inserted) of the base tongue from the vallecula anteriorly to the circumvallate papillae were also used routinely. This approach has been successful, since 10 of the 14 patients (71%) remain without evidence of disease (mean follow-up, 32 months). There have been only two local recurrences, both on the pharyngoepiglottic fold in patients who did not receive the now standard pharyngoepiglottic fold/lateral pharyngeal wall implants. No patients have relapsed after 18 months. The other 14 patients were treated prospectively during the same period by combining initial resection, radical neck dissection, and postoperative irradiation. In this group, there were more locoregional failures compared to the group treated with radiation therapy alone (5 tongue recurrences and 7 neck relapses); in addition, more severe complications were noted in these 14 patients who received surgery and postoperative irradiation. The authors believe that combined external beam and interstitial irradiation is effective treatment for base tongue carcinomas, especially when the high-dose distribution includes the

  11. A systematic review and meta-analysis on the efficacy of intravesical therapy for bladder pain syndrome/interstitial cystitis.

    PubMed

    Barua, Jayanta M; Arance, Ignacio; Angulo, Javier C; Riedl, Claus R

    2016-08-01

    Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease characterised by persistent irritating micturition symptoms and pain. The objective was to compare the clinical efficacy of currently available products for intravesical therapy of BPS/IC and to assess their pharmacoeconomic impact. A Pubmed/Medline database search was performed for articles on intravesical therapy for BPS/IC. A total of 345 publications were identified, from which 326 were excluded. Statistical evaluation was performed with effect size (ES) assessment of symptom reduction and response rates. The final set of 19 articles on intravesical BPS/IC therapy included 5 prospective controlled trials (CTs), the remaining were classified as uncontrolled clinical studies. The total number of patients included was 801, 228 of whom had been evaluated in a CT. For CTs, the largest ES for symptom reduction as well as response rate was observed for high molecular weight hyaluronic acid (HMW-HA), with similar findings in two uncontrolled studies with HMW-HA. The number needed to treat to achieve a response to intravesical therapy was 2.67 for intravesical pentosan polysulphate and 1.31 for HMW-HA which were superior to all other instillates. HMW-HA was significantly superior in cost effectiveness and cost efficacy to all other instillation regimes. The present meta-analysis combined medical and pharmacoeconomic aspects and demonstrated an advantage of HMW-HA over other instillation agents; however, direct comparisons between the different products have not been performed to date in properly designed controlled studies. PMID:26590137

  12. Interstitial photodynamic therapy of canine prostate with meso-tetra-(m-hydroxyphenyl) chlorin and 5-aminolevulinic acid: a preliminary study

    NASA Astrophysics Data System (ADS)

    Chang, Shi-Chung; Buonaccorsi, Giovanni A.; MacRobert, Alexander J.; Bown, Stephen G.

    1996-01-01

    Photodynamic therapy (PDT) is proved to have potential for managing various malignancies. We investigated tissue biodistribution and photodynamic effects on a canine model in vivo using second generation photosensitizers, meso-tetra(m-hydroxyphenyl)chlorin (mTHPC) and 5-aminolaevulinic acid (ALA) to evaluate the feasibility and possible future application of PDT on the prostate. Using fluorescence microscopy, the optimal sensitization time of the prostate was between 24 - 72 hours with mTHPC and, 3 hours with ALA. After optimum time of sensitization, prostates of mature beagle were treated with laser at various sites by placing fiber interstitially under the guidance of transrectal ultrasound. The light dose for each treatment site was 100 J (100 mW for 1,000 seconds at the wavelength of 650 and 630 nm, respectively). With mTHPC, single laser fiber was able to induce organ confined PDT lesion as large as 20 by 18 by 18 mm in size. However, the PDT lesion with ALA was negligible 3 days after treatment. Physical distress manifested as urinary retention, poor appetite and body weigh loss, was more prominent with increasing number of treatment sites as a result of extensive prostatic swelling and urethral damages. However, these problems usually alleviated spontaneously 7 to 10 days after PDT. The characteristic histological changes were hemorrhagic necrosis and glandular destruction with preservation of interlobular collagen fibers. Urethral damage seen at the early stage healed by regeneration of urothelium in 4 weeks. We conclude that interstitial PDT with mTHPC is technically possible to produce extensive glandular necrosis in the normal prostate which heals safely and does not change the prostatic architecture. ALA, although it seems promising for bladder tumors, is much less effective than mTHPC on the prostate. With mTHPC, it might have the potential for treating prostate cancers localized in the periphery of the gland.

  13. Interstitial radiation therapy for early-stage nasal vestibule cancer: A continuing quest for optimal tumor control and cosmesis

    SciTech Connect

    Levendag, Peter C. . E-mail: p.levendag@erasmusmc.nl; Nijdam, Wideke M.; Moolenburgh, Sanne E. van; Tan, Lisa; Noever, Inge R.T.T.; Rooy, Peter van; Mureau, Marc; Jansen, Peter P.; Munte, Kai; Hofer, Stefan O.P.

    2006-09-01

    Introduction: This article reports on the effectiveness, cosmetic outcome, and costs of interstitial high-dose-rate (HDR) brachytherapy for early-stage cancer of the nasal vestibule (NV) proper and/or columella high-dose-rate (HDR). Methods and Materials: Tumor control, survival, cosmetic outcome, functional results, and costs were established in 64 T1/T2N0 nasal vestibule cancers treated from 1991-2005 by fractionated interstitial radiation therapy (IRT) only. Total dose is 44 Gy: 2 fractions of 3 Gy per day, 6-hour interval, first and last fraction 4 Gy. Cosmesis is noted in the chart by the medical doctor during follow-up, by the patient (visual analog scale), and by a panel. Finally, full hospital costs are computed. Results: A local relapse-free survival rate of 92% at 5 years was obtained. Four local failures were observed; all four patients were salvaged. The neck was not treated electively; no neck recurrence in follow-up was seen. Excellent cosmetic and functional results were observed. With 10 days admission for full treatment, hospital costs amounted to Euro 5772 ($7044). Conclusion: Excellent tumor control, cosmesis, and function of nasal airway passage can be achieved when HDR-IRT for T1/T2N0 NV cancers is used. For the more advanced cancers (Wang classification: T3 tumor stage), we elect to treat by local excision followed by a reconstructive procedure. The costs, admission to hospital inclusive, for treatment by HDR-IRT amounts to Euro 5772 ($7044 US). This contrasts substantially with the full hospital costs when NV cancers are treated by plastic reconstructive surgery, being on average threefold as expensive.

  14. Direct identification of interstitial Mn in heavily p-type doped GaAs and evidence of its high thermal stability

    SciTech Connect

    Pereira, L. M. C.; Wahl, U.; Correia, J. G.; Decoster, S.; Vantomme, A.; Silva, M. R. da; Araujo, J. P.

    2011-05-16

    We report on the lattice location of Mn in heavily p-type doped GaAs by means of {beta}{sup -} emission channeling from the decay of {sup 56}Mn. The majority of the Mn atoms substitute for Ga and up to 31% occupy the tetrahedral interstitial site with As nearest neighbors. Contrary to the general belief, we find that interstitial Mn is immobile up to 400 deg. C, with an activation energy for diffusion of 1.7-2.3 eV. Such high thermal stability of interstitial Mn has significant implications on the strategies and prospects for achieving room temperature ferromagnetism in Ga{sub 1-x}Mn{sub x}As.

  15. Phase I trial of motexafin-lutetium-mediated interstitial photodynamic therapy in patients with locally recurrent prostate cancer

    NASA Astrophysics Data System (ADS)

    Stripp, Diana C. H.; Mick, Rosemarie; Zhu, Timothy C.; Whittington, Richard; Smith, Debbie; Dimofte, Andreea; Finlay, Jarod C.; Miles, Jeremy; Busch, Theresa M.; Shin, Daniel; Kachur, Alex; Tochner, Zelig A.; Malkowicz, S. Bruce; Glatstein, Eli; Hahn, Stephen M.

    2004-06-01

    Therapeutic options for patients with locally recurrent prostate cancer after treatment with radiation therapy are limited. An ongoing Phase I trial of interstitial photodynamic therapy (PDT) with the photosensitizer motexafin lutetium (MLu) was initiated in year 2000 for men with locally recurrent prostate cancer. The primary objective of this trial is to determine the maximally tolerated dose of motexafin lutetium-mediated PDT. Twelve men with biopsy-proven recurrent prostate cancer and no evidence of distant metastatic disease have been enrolled. Pre-treatment evaluation included an MRI of the prostate, bone scan, laboratory studies, cystoscopy, and transrectal ultrasound. Treatment plans were generated based upon the ultrasound findings. PDT dose was escalated by increasing the motexafin lutetium dose, increasing the 732 nm light dose, and decreasing the drug-light interval. Motexafin lutetium doses ranged from 0.5 to 2 mg/kg administered IV 3, 6, or 24 hours prior to 732 nm light delivery. The light dose measured in real time with in situ spherical detectors was 25-100 J/cm2 for all patients. Light was delivered through optical fibers inserted through a transperineal brachytherapy template in the operating room and optical property measurements were made before and after light therapy. Prostate biopsies were obtained before and after light delivery for spectrofluorometric measurements of photosensitizer uptake. Twelve patients have completed protocol treatment on eight dose levels without dose-limiting toxicity. Grade I PDT-related genitourinary symptoms were observed. One patient had Grade II urinary urgency that was urinary catheter-related. No rectal or other GI PDT-related toxicities were observed. Measurements of motexafin lutetium in prostate tissue demonstrated the presence of photosensitizer at all dose levels. Conclusions: Motexafin lutetium-mediated PDT designed to treat comprehensively the entired prostate gland has been well-tolerated at the doses

  16. Protection of fiber function by para-axial fluid flow in interstitial laser therapy of malignant tumors.

    PubMed

    Dowlatshahi, K; Bangert, J D; Haklin, M F; Rhodes, C K; Weinstein, R S; Economou, S G

    1990-01-01

    In the past, interstitial laser therapy frequently has failed because of the damage to the bare fiber tip due to intense heat generated at the point of contact. Using a rat mammary tumor model, we describe a method of placing a 600 micron fiber inside a gauge 19 needle cannula after its insertion into the tumor. With this device continuous wave Nd:YAG laser is delivered to the target tumor while 0.9% saline flows para-axially into the tumor. Significant coagulation necrosis was induced with 500 joules at 5 watts, 100 seconds and 1 cc per minute of saline while the needle-fiber is pulled out of the tumor by 10 mm. The mean transmission loss after 500 joules was 2% in ten experiments. The tumor edema due to 1.5 ml of saline was transient. We conclude that successful hyperthermic coagulation necrosis by Nd:YAG laser can be achieved with minimal transmission loss by employing the above technique. PMID:2392016

  17. Numerical study and optimization of interstitial antennas for microwave ablation therapy

    NASA Astrophysics Data System (ADS)

    Komarov, Vyacheslav V.

    2014-10-01

    Electromagnetic and thermal characteristics of coaxial monopole antennas of 2.45 GHz and 24.125 GHz for microwave ablation of malignant tumors are investigated. Microwave heating processes in an interaction domain (biological tissue) are described by the coupled electromagnetic and heat transfer problem, which was solved numerically in the present study. Proposed applicators provide reducing of reflected power and localized distribution of temperature in the near-field zone. Different mathematical models are used to optimize the antennas sizes and simulate heating patterns.

  18. Severe acute interstitial nephritis after combination immune-checkpoint inhibitor therapy for metastatic melanoma.

    PubMed

    Murakami, Naoka; Borges, Thiago J; Yamashita, Michifumi; Riella, Leonardo V

    2016-06-01

    Immune-checkpoint inhibitors are emerging as revolutionary drugs for certain malignancies. However, blocking the co-inhibitory signals may lead to immune-related adverse events, mainly in the spectrum of autoimmune diseases including colitis, endocrinopathies and nephritis. Here, we report a case of a 75-year-old man with metastatic malignant melanoma treated with a combination of nivolumab (anti-PD1-antibody) and ipilimumab (anti-CTLA-4 antibody) who developed systemic rash along with severe acute tubulointerstitial nephritis after two doses of combination therapy. Kidney biopsy and peripheral blood immune profile revealed highly proliferative and cytotoxic T cell features. Herein, we discuss the pathophysiology and management of immune checkpoint blockade-related adverse events. PMID:27274826

  19. Tissue temperature measurements during interstitial laser therapy using Cr3+-doped crystals at the fiber tip

    NASA Astrophysics Data System (ADS)

    Svensson, Jenny; Ralsgard, Anna; Johansson, Thomas; Andersson-Engels, Stefan

    2003-10-01

    In this project a technique to optically measure the temperature is evaluated. The measurement is to be performed through optical fibres during photodynamic laser treatments or laser thermo therapy of malignant tumours. For this technique Cr3+-doped crystals were used. The lifetime of the ions" fluorescence were measured, since the fluorescence is strongly temperature dependent. A piece of a crystal was attached to the tip of an optical fibre. The crystal was excited at 635 nm, which is the wavelength most frequently used for photodynamic treatment. An accuracy in the temperature measurement of +/- 0.3 °C was obtained for Cr:LiSAF in the region 20 - 70 °C. This is well within the requirements for this application. Alexandrite and Cr:YAG were also evaluated in this study, also yielding a very good accuracy. A laser treatment was simulated using pork chop as tissue phantom and the temperature was measured.

  20. Severe acute interstitial nephritis after combination immune-checkpoint inhibitor therapy for metastatic melanoma

    PubMed Central

    Murakami, Naoka; Borges, Thiago J.; Yamashita, Michifumi; Riella, Leonardo V.

    2016-01-01

    Immune-checkpoint inhibitors are emerging as revolutionary drugs for certain malignancies. However, blocking the co-inhibitory signals may lead to immune-related adverse events, mainly in the spectrum of autoimmune diseases including colitis, endocrinopathies and nephritis. Here, we report a case of a 75-year-old man with metastatic malignant melanoma treated with a combination of nivolumab (anti-PD1-antibody) and ipilimumab (anti-CTLA-4 antibody) who developed systemic rash along with severe acute tubulointerstitial nephritis after two doses of combination therapy. Kidney biopsy and peripheral blood immune profile revealed highly proliferative and cytotoxic T cell features. Herein, we discuss the pathophysiology and management of immune checkpoint blockade-related adverse events. PMID:27274826

  1. Prostate biopsy after definitive treatment by interstitial iodine 125 implant or external beam radiation therapy

    SciTech Connect

    Schellhammer, P.F.; el-Mahdi, A.M.; Higgins, E.M.; Schultheiss, T.E.; Ladaga, L.E.; Babb, T.J.

    1987-05-01

    The response to definitive radiation therapy of localized carcinoma of the prostate by iodine 125 implantation or external beam radiotherapy was monitored by examining specimens from biopsies performed after treatment. We analyzed 126 biopsy specimens obtained 18 months or more after treatment: 71 were obtained from 109 patients treated by iodine 125 and 55 from 197 patients treated by external beam radiotherapy. Thereafter, the disease status of these patients was examined at minimum 3-year intervals. No significant statistical difference was found between the negative specimen rates of the 2 treatment modalities: 46 of 71 (65 per cent) after iodine 125 implantation and 39 of 55 (71 per cent) after external beam radiotherapy were negative. To analyze the predictive value of biopsy results 103 patients whose prostatic examination results were normal at biopsy or who showed regression of tumor size and tumor induration after radiation were evaluated. The biopsy results from all patients were combined for analysis. Of 77 patients with negative biopsy specimens 16 (21 per cent) have had recurrent disease, compared to 17 of 26 (65 per cent) with positive biopsy specimens (p equals 0.00005). Of the 77 patients with negative biopsy specimens 7 (9 per cent) had local disease recurrence, compared to 12 of 26 (46 per cent) with a positive biopsy specimen (p equals 0.0001). The value of a positive specimen to predict failure remained significant with patients stratified by pre-treatment clinical stage and grade of the disease. Our results show that patients with positive specimens from the prostate who had been judged clinically by rectal examination to have responded to radiation therapy had a significantly increased incidence of local and distant failure compared to patients who had negative biopsy specimens.

  2. Novel microwave applicators for thermal therapy, ablation, and hemostasis

    NASA Astrophysics Data System (ADS)

    Ryan, Thomas P.; Clegg, Peter

    2009-02-01

    Microwave applicators are becoming more prevalent in cancer ablation therapy due to factors of penetration, high power, and shortened treatment time. These applicators create the largest zones of necrosis of available energy sources. Progress has been made both with interstitial applicators for surgical, laparoscopic, or radiological approaches, as well as surface applicators that provide hemostasis or precoagulation prior to resection. Most commonly, the applicators operate at 915 MHz or 2450 MHz, and are well matched to tissue. Surgical applicators are as large as 5.6 mm and have the capability to operate at 100-200 W. With smaller applicators, internal cooling may be required to avoid heating sensitive skin surfaces if used percutaneously or laparoscopically. With the interstitial applicators, animal studies have shown a strong relationship between power and ablation volume, including reaching a steady-state plateau in performance based more on power level and less on time. As shown in-vivo, MW surface applicators are very efficient in surface coagulation for hemostasis or precoagulation and in the treatment of surface breaking lesions. These applicators are also capable of deep penetration as applied from the surface. Characteristic treatment times for interstitial applicators are four minutes and for surface applicators, one minute or less is sufficient. Examples will be shown of multi-organ results with surface coagulation using high-power microwaves. Finally, future trends will be discussed that include treatment planning, multiple applicators, and navigation.

  3. Interstitial bipolar rf-thermotherapy (RFITT): therapy planning by computer simulation and MRI monitoring--a new concept for minimally invasive procedures

    NASA Astrophysics Data System (ADS)

    Desinger, Kai; Stein, Thomas; Mueller, Gerhard J.; Mack, Martin G.; Vogl, Thomas J.

    1998-04-01

    In addition to the laser, microwave or other energy sources, interstitial thermotherapy with radio-frequency current (RFITT) in bipolar technique has already been shown in vitro to be a safe and an economical alternative energy source with a comparable operating performance. The therapeutical application efficiency of these bipolar RF-needle applicators was evaluated using 3 different types of probes: standard, flushed and high performance cooled RF-probes (3 mm). These can be used to create large coagulation volumes in tissue such as for the palliative treatment of liver metastases or the therapy of the benign prostate hyperplasia. It was shown that the achievable lesion size resulting from the cooled RF-probes could be increased by a factor of three compared to a standard bipolar probe. With these bipolar power RF-applicators, coagulation dimensions of 5 cm length and 4 cm diameter with a power input of 40 watt could be achieved within 20 minutes. No carbonization and electrode tissue adherence was observed. Investigations in vitro with adapted RFITT-probes, using paramagnetic materials such as titanium alloys and high performance plastic, have shown that monitoring under MRI (Siemens Magnetom, 1.5 Tesla) allows visualization of the development of the spatial temperature distribution in tissue using an intermittent diagnostic and therapeutical application. This is no loss in performance compared to continuous applications. A ratio of 1:4 (15 s Thermal Flash MRI, 60 s RF-energy) has shown to be feasible. A computer simulation of the temperature and damage distribution during a bipolar RFITT application has been developed. The simulation works on-line with a RF-generator and measures the output power continuously. The electric power density (heat generating term) and the damage distribution is displayed graphically in real time.

  4. Tissue-mimicking gel phantoms for thermal therapy studies.

    PubMed

    Dabbagh, Ali; Abdullah, Basri Johan Jeet; Ramasindarum, Chanthiriga; Abu Kasim, Noor Hayaty

    2014-10-01

    Tissue-mimicking phantoms that are currently available for routine biomedical applications may not be suitable for high-temperature experiments or calibration of thermal modalities. Therefore, design and fabrication of customized thermal phantoms with tailored properties are necessary for thermal therapy studies. A multitude of thermal phantoms have been developed in liquid, solid, and gel forms to simulate biological tissues in thermal therapy experiments. This article is an attempt to outline the various materials and techniques used to prepare thermal phantoms in the gel state. The relevant thermal, electrical, acoustic, and optical properties of these phantoms are presented in detail and the benefits and shortcomings of each type are discussed. This review could assist the researchers in the selection of appropriate phantom recipes for their in vitro study of thermal modalities and highlight the limitations of current phantom recipes that remain to be addressed in further studies. PMID:24626566

  5. Catheter-based ultrasound technology for image-guided thermal therapy: Current technology and applications

    PubMed Central

    Salgaonkar, Vasant A.; Diederich, Chris J.

    2015-01-01

    Catheter-based ultrasound (CBUS) is being applied to deliver minimally invasive thermal therapy to solid cancer tumors, benign tissue growth, vascular disease, and tissue remodeling. Compared to other energy modalities used in catheter-based surgical interventions, unique features of ultrasound result in conformable and precise energy delivery with high selectivity, fast treatment times, and larger treatment volumes. Here, a concise review of CBUS technology being currently utilized in animal and clinical studies or being developed for future applications is presented. CBUS devices have been categorized into interstitial, endoluminal and endovascular/cardiac applications. Basic applicator designs, site specific evaluations and possible treatment applications have been discussed in brief. Particular emphasis has been given on ablation studies that incorporate image-guidance for applicator placement, therapy monitoring, feedback control, and post-procedure assessment. Examples of devices included here span the entire spectrum of development cycle from preliminary simulation based design studies to implementation in clinical investigations. The use of CBUS under image guidance has the potential for significantly improving precision and applicability of thermal therapy delivery. PMID:25799287

  6. Prostate thermal therapy with catheter-based ultrasound devices and MR thermal monitoring

    NASA Astrophysics Data System (ADS)

    Diederich, Chris J.; Nau, Will H.; Kinsey, Adam; Ross, Tony; Wootton, Jeff; Juang, Titania; Butts-Pauly, Kim; Ricke, Viola; Liu, Erin H.; Chen, Jing; Bouley, Donna M.; Van den Bosch, Maurice; Sommer, Graham

    2007-02-01

    Four types of transurethral applicators were devised for thermal ablation of prostate combined with MR thermal monitoring: sectored tubular transducer devices with directional heating patterns; planar and curvilinear devices with narrow heating patterns; and multi-sectored tubular devices capable of dynamic angular control without applicator movement. These devices are integrated with a 4 mm delivery catheter, incorporate an inflatable cooling balloon (10 mm OD) for positioning within the prostate and capable of rotation via an MR-compatible motor. Interstitial devices (2.4 mm OD) have been developed for percutaneous implantation with directional or dynamic angular control. In vivo experiments in canine prostate under MR temperature imaging were used to evaluate the heating technology and develop treatment control strategies. MR thermal imaging in a 0.5 T interventional MRI was used to monitor temperature and thermal dose in multiple slices through the target volume. Sectored tubular, planar, and curvilinear transurethral devices produce directional coagulation zones, extending 15-20 mm radial distance to the outer prostate capsule. Sequential rotation and modulated dwell time can conform thermal ablation to selected regions. Multi-sectored transurethral applicators can dynamically control the angular heating profile and target large regions of the gland in short treatment times without applicator manipulation. Interstitial implants with directional devices can be used to effectively ablate the posterior peripheral zone of the gland while protecting the rectum. The MR derived 52 °C and lethal thermal dose contours (t 43=240 min) allowed for real-time control of the applicators and effectively defined the extent of thermal damage. Catheter-based ultrasound devices, combined with MR thermal monitoring, can produce relatively fast and precise thermal ablation of prostate, with potential for treatment of cancer or BPH.

  7. Interstitial keratitis

    MedlinePlus

    ... cornea. This condition is often caused by infections. Syphilis is the most common cause of interstitial keratitis, ... Tuberculosis In the United States, most cases of syphilis are recognized and treated before this eye condition ...

  8. Scleroderma renal crisis during intravenous cyclophosphamide pulse therapy for complicated interstitial lung disease was successfully treated with angiotensin converting enzyme inhibitor and plasma exchange

    PubMed Central

    Nagamura, Norihiro; Kin, Seikon

    2016-01-01

    ABSTRACT Systemic sclerosis (SSc) is a multiorgan disorder involving the skin, heart, lungs, kidneys, and intestines. Progressive interstitial lung disease (ILD) is a serious complication in SSc patients, and cyclophosphamide (CYC) is the only recommended therapy for this condition;1) however, its clinical effectiveness is not sufficient. Scleroderma renal crisis (SRC) is a rare complication, characterized by acute renal failure and progressive hypertension. Angiotensin-converting-enzyme inhibitor (ACE-i) is a widely accepted therapy for SRC. We report an SSc patient with SRC and progressive ILD who underwent treatment with CYC and successful treatment with ACE-i and plasma exchange (PE). SRC and ILD are significant contributors to morbidity and mortality among SSc patients, and the therapy for these disorders is of great interest to rheumatologists. This study presents the possibility of favorable effects of PE for SSc-associated ILD and SRC. PMID:27578917

  9. Scleroderma renal crisis during intravenous cyclophosphamide pulse therapy for complicated interstitial lung disease was successfully treated with angiotensin converting enzyme inhibitor and plasma exchange.

    PubMed

    Nagamura, Norihiro; Kin, Seikon

    2016-08-01

    Systemic sclerosis (SSc) is a multiorgan disorder involving the skin, heart, lungs, kidneys, and intestines. Progressive interstitial lung disease (ILD) is a serious complication in SSc patients, and cyclophosphamide (CYC) is the only recommended therapy for this condition;(1)) however, its clinical effectiveness is not sufficient. Scleroderma renal crisis (SRC) is a rare complication, characterized by acute renal failure and progressive hypertension. Angiotensin-converting-enzyme inhibitor (ACE-i) is a widely accepted therapy for SRC. We report an SSc patient with SRC and progressive ILD who underwent treatment with CYC and successful treatment with ACE-i and plasma exchange (PE). SRC and ILD are significant contributors to morbidity and mortality among SSc patients, and the therapy for these disorders is of great interest to rheumatologists. This study presents the possibility of favorable effects of PE for SSc-associated ILD and SRC. PMID:27578917

  10. Identification of Reduced-Order Thermal Therapy Models Using Thermal MR Images: Theory and Validation

    PubMed Central

    2013-01-01

    In this paper, we develop and validate a method to identify computationally efficient site- and patient-specific models of ultrasound thermal therapies from MR thermal images. The models of the specific absorption rate of the transduced energy and the temperature response of the therapy target are identified in the reduced basis of proper orthogonal decomposition of thermal images, acquired in response to a mild thermal test excitation. The method permits dynamic reidentification of the treatment models during the therapy by recursively utilizing newly acquired images. Such adaptation is particularly important during high-temperature therapies, which are known to substantially and rapidly change tissue properties and blood perfusion. The developed theory was validated for the case of focused ultrasound heating of a tissue phantom. The experimental and computational results indicate that the developed approach produces accurate low-dimensional treatment models despite temporal and spatial noises in MR images and slow image acquisition rate. PMID:22531754

  11. Hematoporphyrin derivatives high-power interstitial irradiation of argon laser photodynamic therapy for superficial transitional cell bladder tumor

    NASA Astrophysics Data System (ADS)

    Li, Xi-hua; Guo, You-chi; Hua, Lian-sheng; Li, Zhi-bing; Shao, Guo-xing; Xin, Jian-guo

    1993-03-01

    Hematoporphyrin derivatives (HPD) argon laser phototherapy has been carried out since 1986 for 37 cases of superficial transitional cell bladder tumor. A modified high power interstitial (contact) irradiation of argon ion laser was employed to destroy the visible tumor and a cylindrical optical fiber was used for whole bladder mucosal irradiation to lessen recurrence. Follow up cystoscopic examination 1 - 3 years after treatment revealed complete remission of the growth in all the patients. Recurrence was found by cystoscopy in 9 cases (24.4%). The procedure was claimed to be a simple, safe, and effective new means for the management of superficial transitional cell tumors of the bladder. Satisfactory results have been achieved.

  12. Boron thermal/epithermal neutron capture therapy

    SciTech Connect

    Fairchild, R.G.

    1982-01-01

    The development of various particle beams for radiotherapy represents an attempt to improve dose distribution, and to provide high LET radiations which are less sensitive to ambient physical and radiobiological factors such as oxygen tension, cell cycle, and dose rate. In general, a compromise is necessary as effective RBE is reduced in order to spread the dose distribution over the anticipated tumor volume. The approach of delivering stable non-toxic isotopes to tumor, and then activating these atoms subsequently via an external radiation beam has mator advantages; problems associated with high uptake of these isotopes in competing cell pools are obviated, and the general tumor volume can be included in the treatment field of the activating beam. As long as the normal tissues supporting tumor show a low uptake of the isotope to be activated, and as long as the range of the reaction products is short, dose will be restricted to tumor, with a consequent high therapeutic ratio. Neutron Capture Therapy (NCT) is generally carried out by activating boron-10 with low energy neutrons. The range of the high LET, low OER particles from the /sup 10/B(n, ..cap alpha..)/sup 7/Li reaction is approx. 10..mu.., or one cell diameter, a situation that is optimal for cell killing. Significant advantages may be gained by using the NCT procedure in conjunction with improved tissue penetration provided with epithermal or filtered beams, and new compounds showing physiological binding to tumor.

  13. Drug associated acute interstitial nephritis: clinical and pathological features and the response to high dose steroid therapy.

    PubMed

    Pusey, C D; Saltissi, D; Bloodworth, L; Rainford, D J; Christie, J L

    1983-01-01

    Nine episodes of drug associated acute interstitial nephritis, in seven patients, were treated between 1972 and 1980. The drugs implicated were cotrimoxazole (three times), ampicillin, Magnapen (ampicillin and flucloxacillin), penicillin, gentamicin, paracetamol and bendrofluazide. The time from exposure to the onset of symptoms ranged from one to 30 days. Presentation was with acute renal failure, which was non-oliguric in five cases, accompanied by rash (four), fever (four), and loin pain (two). Renal biopsy was carried out in all cases, and showed a characteristic interstitial infiltrate comprising substantial numbers of lymphocytes and plasma cells, with a variable number of neutrophils, eosinophils and histiocytes. Immunofluorescence was negative in all four cases studied in the acute phase, and showed scattered deposits of IgG, IgM, IgA and C3 on the tubular basement membrane in one patient during recovery. Significant proteinuria and an abnormal urine deposit were present in all cases, and seven of nine had radiological evidence of enlarged kidneys. Seven episodes were treated with high doses of methyl prednisolone and in all there was a response with a diuresis or spontaneous fall in serum creatinine within 72 hrs, and recovery of virtually normal renal function. Of two cases who did not initially receive steroids, one improved more slowly and one developed chronic renal impairment. PMID:6604293

  14. Interstitial radiation therapy for carcinoma of the penis using iridium 192 wires: the Henri Mondor experience (1970-1979)

    SciTech Connect

    Mazeron, J.J.; Langlois, D.; Lobo, P.A.; Huart, J.A.; Calitchi, E.; Lusinchi, A.; Raynal, M.; Le Bourgeois, J.P.; Abbou, C.C.; Pierquin, B.

    1984-10-01

    From 1970 to 1979, a group of 50 patients was treated for squamous cell carcinoma of the penis by interstitial irradiation using an afterloading technique and iridium 192 wires. The group included 9 patients with T1 tumors, 27 with T2 tumors, and 14 with T3 tumors. Forty-five patients presented with no metastatic inguinal nodes (NO), 3 patients with N1 nodes, and 2 patients had N3 nodes. After treatment, 11 patients (1 T1, 6 T2 and 4 T3) developed local recurrences. Three patients developed post-therapeutic necrosis which necessitated partial amputation in 2 cases. Eight patients developed post-therapeutic urethral stenosis, which required surgical treatment in three of the cases. Twenty-one percent of the patients died of their disease. The authors advocate interstitial irradiation using iridium 192 wires for the treatment of non-infiltrating or moderately infiltrating squamous cell carcinoma of the penis in which the largest dimension does no exceed 4 cm. When regular follow-up can be assurred, it is reasonable to forgo prophylactic treatment of the inguinal nodes in patients presenting without groin metastasis.

  15. Nanoparticle Albumin-bound Paclitaxel+Carboplatin Therapy for Small Cell Lung Cancer Combined with Squamous Cell Carcinoma and Interstitial Lung Disease.

    PubMed

    Azuma, Yuichiro; Tamiya, Motohiro; Shiroyama, Takayuki; Osa, Akio; Takeoka, Sawa; Morishita, Naoko; Suzuki, Hidekazu; Okamoto, Norio; Hirashima, Tomonori; Kawase, Ichiro

    2015-01-01

    It has recently been shown that nanoparticle albumin-bound paclitaxel (nab-PAC)+carboplatin (CBDCA) provides a favorable overall response rate in non-small cell lung cancer. This is the first case report of nab-PAC+CBDCA therapy in small cell lung cancer (SCLC). Our patient was a 72-year-old man with stage IV SCLC combined with squamous cell carcinoma and interstitial lung disease (ILD). We administered nab-PAC+CBDCA as a second-line chemotherapy. A partial response was evident after two cycles of chemotherapy, and no serious side effects occurred. The progression-free survival was 15 weeks. Second-line chemotherapy using nab-PAC+CBDCA was effective and well tolerated in an SCLC patient with ILD. PMID:26568008

  16. Suspected ciprofloxacin-induced interstitial nephritis.

    PubMed

    Murray, K M; Wilson, M G

    1990-04-01

    Interstitial nephritis is a rare but serious adverse effect of many drugs and usually is diagnosed by clinical signs and symptoms of hematuria, proteinuria, eosinophilia, fever, azotemia, and rash. Ciprofloxacin is one drug that has been reported to cause interstitial nephritis. Renal toxicities have been reported in less than one percent of the patients receiving ciprofloxacin therapy. Limited documentation of this adverse effect exists in the literature. This article describes a patient with suspected ciprofloxacin-induced interstitial nephritis. PMID:2327115

  17. Dynamic Angular Control Of Thermal Therapy With Stationary Multi-Sectored Tubular Ultrasound Applicators Under MR Temperature Monitoring

    NASA Astrophysics Data System (ADS)

    Kinsey, Adam M.; Diederich, Chris J.; Nau, William H.; Ross, Anthony B.; Butts Pauly, Kim; Rieke, Viola; Sommer, Graham

    2006-05-01

    Multi-sectored ultrasound heating applicators with dynamic angular and longitudinal control of heating profiles are being investigated for the thermal treatment of tumors in sites such as prostate, uterus, and brain. Multi-sectored tubular ultrasound transducers with independent sector power control were incorporated into interstitial and transurethral applicators and provided dynamic angular control of a heating pattern without requiring device manipulation during treatment. Acoustic beam measurements of each applicator type demonstrated a 35-40° acoustic dead zone between each independent sector, with negligible mechanical or electrical coupling. Despite the acoustic dead zone between sectors, simulations and experiments under MR temperature (MRT) monitoring showed that the variance from the maximum lesion radius (scalloping) with all elements activated on a transducer was minimal and did not affect conformal heating of a target area. A biothermal model with a multi-point controller was used to adjust the applied power and treatment time of individual transducer segments as the tissue temperature changed in simulations of thermal lesions with both interstitial and transurethral applicators. Transurethral ultrasound applicators for benign prostatic hyperplasia (BPH) treatment with either three or four sectors conformed a thermal dose to a simulated target area in the angular and radial dimensions. The simulated treatment was controlled to a maximum temperature of 85°C, and had a maximum duration of 5 min when power was turned off as the 52°C temperature contour reach a predetermined control point for each sector in the tissue. Experiments conducted with multi-sectored applicators under MRT monitoring showed thermal ablation and hyperthermia treatments had little or no border `scalloping', conformed to a pretreatment target area, and correlated very well with the simulated thermal lesions. The radial penetration of the heat treatments in tissue with interstitial

  18. Mesenchymal stromal stem cell therapy in advanced interstitial lung disease - Anaphylaxis and short-term follow-up.

    PubMed

    Thangakunam, Balamugesh; Christopher, Devasahayam Jesudas; Mathews, Vikram; Srivastava, Alok

    2015-01-01

    There are limited treatment options for advanced interstitial lung disease (ILD). We describe a patient of ILD treated with mesenchymal stromal stem cell infusion. The index patient had end-stage ILD due to a combination of insults including treatment with radiotherapy and a tyrosine kinase inhibitor Erlotinib. He was oxygen-dependent and this was hampering his quality of life. He tolerated the first infusion stem cells without any problem. During the second infusion he developed anaphylactic shock, which was appropriately managed. At 6-months follow-up he had no improvement in oxygenation, pulmonary function or CT scan parameters. In view of anaphylaxis, further infusions of MSC were withheld. A longer follow-up may reveal long-term benefits or side effects, if any. However the occurrence of anaphylaxis is of concern suggesting that further trials should be conducted with intensive monitoring. PMID:26628765

  19. Interstitial cystitis - resources

    MedlinePlus

    Resources - interstitial cystitis ... The following organizations are good resources for information on interstitial cystitis : Interstitial Cystitis Association -- www.ichelp.org National Kidney and Urologic Diseases Information Clearinghouse -- www.kidney.niddk. ...

  20. Childhood Interstitial Lung Disease

    MedlinePlus

    ... from the NHLBI on Twitter. What Is Childhood Interstitial Lung Disease? Childhood interstitial (in-ter-STISH-al) lung disease, ... with similar symptoms—it's not a precise diagnosis. Interstitial lung disease (ILD) also occurs in adults. However, the cause ...

  1. Granulomatous interstitial nephritis

    PubMed Central

    Shah, Shivani; Carter-Monroe, Naima; Atta, Mohamed G.

    2015-01-01

    Granulomatous interstitial nephritis (GIN) is a rare entity detected in ∼0.5–0.9% of all renal biopsies. GIN has been linked to several antibiotics such as cephalosporins, vancomycin, nitrofurantoin and ciprofloxacin. It is also associated with NSAIDs and granulomatous disorders such as sarcoidosis, tuberculosis, fungal infections, and granulomatosis with polyangiitis. Renal biopsy is critical in establishing this diagnosis, and the extent of tubular atrophy and interstitial fibrosis may aid in determining prognosis. Retrospective data and clinical experience suggest that removal of the offending agent in conjunction with corticosteroid therapy often results in improvement in renal function. We describe a patient with a history of multiple spinal surgeries complicated by wound infection who presented with confusion and rash with subsequent development of acute kidney injury. Urinalysis demonstrated pyuria and eosinophiluria, and renal biopsy revealed acute interstitial nephritis with granulomas. These findings were attributed to doxycycline treatment of his wound infection. This review explores the clinical associations, presentation, diagnosis, and treatment of this uncommon cause of acute kidney injury. PMID:26413275

  2. Granulomatous interstitial nephritis.

    PubMed

    Shah, Shivani; Carter-Monroe, Naima; Atta, Mohamed G

    2015-10-01

    Granulomatous interstitial nephritis (GIN) is a rare entity detected in ∼0.5-0.9% of all renal biopsies. GIN has been linked to several antibiotics such as cephalosporins, vancomycin, nitrofurantoin and ciprofloxacin. It is also associated with NSAIDs and granulomatous disorders such as sarcoidosis, tuberculosis, fungal infections, and granulomatosis with polyangiitis. Renal biopsy is critical in establishing this diagnosis, and the extent of tubular atrophy and interstitial fibrosis may aid in determining prognosis. Retrospective data and clinical experience suggest that removal of the offending agent in conjunction with corticosteroid therapy often results in improvement in renal function. We describe a patient with a history of multiple spinal surgeries complicated by wound infection who presented with confusion and rash with subsequent development of acute kidney injury. Urinalysis demonstrated pyuria and eosinophiluria, and renal biopsy revealed acute interstitial nephritis with granulomas. These findings were attributed to doxycycline treatment of his wound infection. This review explores the clinical associations, presentation, diagnosis, and treatment of this uncommon cause of acute kidney injury. PMID:26413275

  3. Interstitial Photoacoustic Sensor for the Measurement of Tissue Temperature during Interstitial Laser Phototherapy

    PubMed Central

    Li, Zhifang; Chen, Haiyu; Zhou, Feifan; Li, Hui; Chen, Wei R.

    2015-01-01

    Photothermal therapy is an effective means to induce tumor cell death, since tumor tissue is more sensitive to temperature increases than normal tissue. Biological responses depend on tissue temperature; target tissue temperature needs to be precisely measured and controlled to achieve desired thermal effects. In this work, a unique photoacoustic (PA) sensor is proposed for temperature measurement during interstitial laser phototherapy. A continuous-wave laser light and a pulsed laser light, for photothermal irradiation and photoacoustic temperature measurement, respectively, were delivered to the target tissue through a fiber coupler. During laser irradiation, the PA amplitude was measured. The Grüneisen parameter and the bioheat equation were used to determine the temperature in strategic positions in the target tissue. Our results demonstrate that the interstitial PA amplitude is a linear function of temperature in the range of 22 to 55 °C, as confirmed by thermocouple measurement. Furthermore, by choosing appropriate laser parameters, the maximum temperature surrounding the active diffuse fiber tip in tissue can be controlled in the range of 41 to 55 °C. Thus, this sensor could potentially be used for fast, accurate, and convenient three-dimensional temperature measurement, and for real-time feedback and control of interstitial laser phototherapy in cancer treatment. PMID:25756865

  4. Interstitial photoacoustic sensor for the measurement of tissue temperature during interstitial laser phototherapy.

    PubMed

    Li, Zhifang; Chen, Haiyu; Zhou, Feifan; Li, Hui; Chen, Wei R

    2015-01-01

    Photothermal therapy is an effective means to induce tumor cell death, since tumor tissue is more sensitive to temperature increases than normal tissue. Biological responses depend on tissue temperature; target tissue temperature needs to be precisely measured and controlled to achieve desired thermal effects. In this work, a unique photoacoustic (PA) sensor is proposed for temperature measurement during interstitial laser phototherapy. A continuous-wave laser light and a pulsed laser light, for photothermal irradiation and photoacoustic temperature measurement, respectively, were delivered to the target tissue through a fiber coupler. During laser irradiation, the PA amplitude was measured. The Grüneisen parameter and the bioheat equation were used to determine the temperature in strategic positions in the target tissue. Our results demonstrate that the interstitial PA amplitude is a linear function of temperature in the range of 22 to 55 °C, as confirmed by thermocouple measurement. Furthermore, by choosing appropriate laser parameters, the maximum temperature surrounding the active diffuse fiber tip in tissue can be controlled in the range of 41 to 55 °C. Thus, this sensor could potentially be used for fast, accurate, and convenient three-dimensional temperature measurement, and for real-time feedback and control of interstitial laser phototherapy in cancer treatment. PMID:25756865

  5. Harnessing the immunomodulatory effect of thermal and non-thermal ablative therapies for cancer treatment.

    PubMed

    Bastianpillai, Christopher; Petrides, Neophytos; Shah, Taimur; Guillaumier, Stephanie; Ahmed, Hashim U; Arya, Manit

    2015-12-01

    Minimally invasive interventional therapies are evolving rapidly and their use for the treatment of solid tumours is becoming more extensive. The in situ destruction of solid tumours by such therapies is thought to release antigens that can prime an antitumour immune response. In this review, we offer an overview of the current evidence for immune response activation associated with the utilisation of the main thermal and non-thermal ablation therapies currently in use today. This is followed by an assessment of the hypothesised mechanisms behind this immune response priming and by a discussion of potential methods of harnessing this specific response, which may subsequently be applicable in the treatment of cancer patients. References were identified through searches of PubMed/MEDLINE and Cochrane databases to identify peer-reviewed original articles, meta-analyses and reviews. Papers were searched from 1850 until October 2014. Articles were also identified through searches of the authors' files. Only papers published in English were reviewed. Thermal and non-thermal therapies have the potential to stimulate antitumour immunity although the current body of evidence is based mostly on murine trials or small-scale phase 1 human trials. The evidence for this immune-modulatory response is currently the strongest in relation to cryotherapy and radiotherapy, although data is accumulating for related ablative treatments such as high-intensity focused ultrasound, radiofrequency ablation and irreversible electroporation. This effect may be greatly enhanced by combining these therapies with other immunostimulatory interventions. Evidence is emerging into the immunomodulatory effect associated with thermal and non-thermal ablative therapies used in cancer treatment in addition to the mechanism behind this effect and how it may be harnessed for therapeutic use. A potential exists for treatment approaches that combine ablation of the primary tumour with control and possible

  6. Salvage brachytherapy in combination with interstitial hyperthermia for locally recurrent prostate carcinoma following external beam radiation therapy: a prospective phase II study.

    PubMed

    Kukiełka, Andrzej M; Strnad, Vratislav; Stauffer, Paul; Dąbrowski, Tomasz; Hetnał, Marcin; Nahajowski, Damian; Walasek, Tomasz; Brandys, Piotr; Matys, Robert

    2015-06-01

    Optimal treatment for patients with only local prostate cancer recurrence after external beam radiation therapy (EBRT) failure remains unclear. Possible curative treatments are radical prostatectomy, cryosurgery, and brachytherapy. Several single institution series proved that high-dose-rate brachytherapy (HDRBT) and pulsed-dose-rate brachytherapy (PDRBT) are reasonable options for this group of patients with acceptable levels of genitourinary and gastrointestinal toxicity. A standard dose prescription and scheme have not been established yet, and the literature presents a wide range of fractionation protocols. Furthermore, hyperthermia has shown the potential to enhance the efficacy of re-irradiation. Consequently, a prospective trial is urgently needed to attain clear structured prospective data regarding the efficacy of salvage brachytherapy with adjuvant hyperthermia for locally recurrent prostate cancer. The purpose of this report is to introduce a new prospective phase II trial that would meet this need. The primary aim of this prospective phase II study combining Iridium-192 brachytherapy with interstitial hyperthermia (IHT) is to analyze toxicity of the combined treatment; a secondary aim is to define the efficacy (bNED, DFS, OS) of salvage brachytherapy. The dose prescribed to PTV will be 30 Gy in 3 fractions for HDRBT, and 60 Gy in 2 fractions for PDRBT. During IHT, the prostate will be heated to the range of 40-47°C for 60 minutes prior to brachytherapy dose delivery. The protocol plans for treatment of 77 patients. PMID:26207116

  7. A Micro-Thermal Sensor for Focal Therapy Applications

    NASA Astrophysics Data System (ADS)

    Natesan, Harishankar; Hodges, Wyatt; Choi, Jeunghwan; Lubner, Sean; Dames, Chris; Bischof, John

    2016-02-01

    There is an urgent need for sensors deployed during focal therapies to inform treatment planning and in vivo monitoring in thin tissues. Specifically, the measurement of thermal properties, cooling surface contact, tissue thickness, blood flow and phase change with mm to sub mm accuracy are needed. As a proof of principle, we demonstrate that a micro-thermal sensor based on the supported “3ω” technique can achieve this in vitro under idealized conditions in 0.5 to 2 mm thick tissues relevant to cryoablation of the pulmonary vein (PV). To begin with “3ω” sensors were microfabricated onto flat glass as an idealization of a focal probe surface. The sensor was then used to make new measurements of ‘k’ (W/m.K) of porcine PV, esophagus, and phrenic nerve, all needed for PV cryoabalation treatment planning. Further, by modifying the sensor use from traditional to dynamic mode new measurements related to tissue vs. fluid (i.e. water) contact, fluid flow conditions, tissue thickness, and phase change were made. In summary, the in vitro idealized system data presented is promising and warrants future work to integrate and test supported “3ω” sensors on in vivo deployed focal therapy probe surfaces (i.e. balloons or catheters).

  8. Acceleration of ultrasound thermal therapy by patterned acoustic droplet vaporization

    PubMed Central

    Kripfgans, Oliver D.; Zhang, Man; Fabiilli, Mario L.; Carson, Paul L.; Padilla, Frederic; Swanson, Scott D.; Mougenot, Charles; Brian Fowlkes, J.; Mougenot, Charles

    2014-01-01

    One application of acoustic droplet vaporization (ADV), a method of converting biocompatible microdroplets into microbubbles, is to enhance locally high intensity focused ultrasound (HIFU) therapy. Two objectives are pursued here: (1) the controlled creation of a bubble trench prior to HIFU using ADV and (2) use of the trench for increasing ablation volumes, lowering acoustic powers, and decreasing therapy duration. Thermally responsive phantoms were made with perfluorocarbon emulsion. Compound lesions were formed in a laboratory setting and a clinical magnetic resonance imaging (MRI)-guided HIFU system. Linear and spiral patterned compound lesions were generated in trenches. A larger fraction of the HIFU beam is contained to increase the generation of heat. Using the laboratory system, a 90 mm linear length spiral trench was formed in 30 s with mechanical beam steering. Comparatively, the clinical HIFU system formed a 19.9 mm linear length spiral trench in approximately 1 s with electronic beam steering. Lesions were imaged optically and with MRI. A uniform thermal ablation volume of 3.25 mL was achieved in 55.4 s (4-times faster than standard clinical HIFU and 14-times larger volume versus sum of individual lesions). Single lesions showed a 400% volume increase. PMID:24437794

  9. A Micro-Thermal Sensor for Focal Therapy Applications

    PubMed Central

    Natesan, Harishankar; Hodges, Wyatt; Choi, Jeunghwan; Lubner, Sean; Dames, Chris; Bischof, John

    2016-01-01

    There is an urgent need for sensors deployed during focal therapies to inform treatment planning and in vivo monitoring in thin tissues. Specifically, the measurement of thermal properties, cooling surface contact, tissue thickness, blood flow and phase change with mm to sub mm accuracy are needed. As a proof of principle, we demonstrate that a micro-thermal sensor based on the supported “3ω” technique can achieve this in vitro under idealized conditions in 0.5 to 2 mm thick tissues relevant to cryoablation of the pulmonary vein (PV). To begin with “3ω” sensors were microfabricated onto flat glass as an idealization of a focal probe surface. The sensor was then used to make new measurements of ‘k’ (W/m.K) of porcine PV, esophagus, and phrenic nerve, all needed for PV cryoabalation treatment planning. Further, by modifying the sensor use from traditional to dynamic mode new measurements related to tissue vs. fluid (i.e. water) contact, fluid flow conditions, tissue thickness, and phase change were made. In summary, the in vitro idealized system data presented is promising and warrants future work to integrate and test supported “3ω” sensors on in vivo deployed focal therapy probe surfaces (i.e. balloons or catheters). PMID:26916460

  10. Extracorporeal shock wave therapy ameliorates cyclophosphamide-induced rat acute interstitial cystitis though inhibiting inflammation and oxidative stress-in vitro and in vivo experiment studies

    PubMed Central

    Chen, Yen-Ta; Yang, Chih-Chao; Sun, Cheuk-Kwan; Chiang, Hsin-Ju; Chen, Yi-Ling; Sung, Pei-Hsun; Zhen, Yen-Yi; Huang, Tein-Hung; Chang, Chia-Lo; Chen, Hong-Hwa; Chang, Hsueh-Wen; Yip, Hon-Kan

    2014-01-01

    Background: We investigated whether extracorporeal shock wave (ECSW) therapy can attenuate cyclophosphamide (CYP)-induced acute interstitial cystitis (AIC) in rats. Methods and Results: Eighteen male-adult Sprague-Dawley rats were equally divided into group 1 (sham control), group 2 (AIC induced by 150 mg/kg CYP by intra-peritoneal injection) and group 3 (AIC + ECSW 200 impulses at 0.11 mJ/mm2 to the urinary bladder at 3 and 24 h after CYP treatment). Smooth-muscle cells co-culture with menadione (25 µM) with and without ECSW treatment was performed. Western-blot results demonstrated that ECSW significant attenuated oxidative stress and inflammatory reactions in this in-vitro studies (all p < 0.001). 24-hour urine amount and microscopic findings of red-blood-cell count (i.e., hematuria) were higher in group 2 than in groups 1 and 3, and significantly higher in group 3 than in group 1 (all p < 0.001). The urine levels of albumin and interleukin-6 showed an identical pattern of hematuria among all three groups (all p < 0.001). The cellular and mRNA expressions of macrophage migration inhibitory factor (MIF)+, CD74+, CD68+, substance p+, and Cox-2+ cells in the bladder tissue exhibited an identical pattern of hematuria among all groups (all p < 0.0001). The integrity of epithelial layer and collagen-deposition area as stained by Sirius red displayed an opposite pattern of hematuria among the three groups (p < 0.0001). The protein expression of IL-12, iNOS, TNF-α, NF-κB, MMP-9, NOX-1, NOX-2, RANTES, and Oxyblot displayed an identical pattern of hematuria among all groups (all p < 0.01). Conclusion: ECSW therapy markedly attenuated CYP-induced AIC through inhibitions of the inflammation and oxidative stress. PMID:25628776

  11. Ultrasound Strain Imaging Towards Verification and Guidance of Prostate Thermal Therapy with Catheter-Based Ultrasound Applicators

    NASA Astrophysics Data System (ADS)

    Sridhar-Keralapura, Mallika; Chubb, Nicole; Scott, Serena; Phipps, Natalie; Burdette, Clif; Diederich, Chris

    2010-03-01

    Ultrasound based transurethral and interstitial catheters have been developed and tested in vivo to thermally ablate prostate cancers. Treatment validation and accurate control of therapy is currently done using MR thermal imaging (±1° C, update: 5-15 s). MRTI is effective for real-time monitoring and guidance, but, cost, setup time, and accessibility can be limiting. Ultrasound imaging methods could be a practicable approach to monitoring. We investigated Ultrasound Strain Imaging (USI) as a tool towards verifying and controlling prostate treatments by developing a novel methodology for tissue compression using ultrasound phantoms and ex vivo tissue models. We estimate strain using quasi real-time estimation algorithms and added automatic segmentation features. The methodology involved inserting an ultrasound applicator into ex vivo liver or porcine muscle tissue, ablating it for 10 min at 15 W to create a well defined thermal lesion. After treatment, the tissue was compressed either externally (3-5%) using the probe or by deflating/inflating the applicator's coupling balloon internally. Ultrasound RF data was recorded during the compression and USI was computed within 20 seconds and compared with photographs of corresponding excised tissue sections. USI estimated post ablation using balloon and external methods yielded significant contrast that correlated well with measurements of excised tissue sections. From these preliminary studies, USI can become an effective feasible tool for verification and guidance of ablation regions with these devices. Balloon compressions could potentially allow computation USI in clinical treatments for confirmation and boundary control.

  12. Carboxyhemoglobin formation secondary to nitric oxide therapy in the setting of interstitial lung disease and pulmonary hypertension.

    PubMed

    Ruisi, Phillip; Ruisi, Michael

    2011-01-01

    Carbon monoxide (CO) has been widely recognized as an exogenous poison, although endogenous mechanisms for its formation involve heme-oxygenase (HO) isoforms, more specifically HO-1, in the setting of oxidative stress such as acute respiratory distress syndrome, sepsis, trauma, and nitric oxide use have been studied. In patients with refractory hypoxemia, inhaled nitric oxide (iNO) therapy is used to selectively vasodilate the pulmonary vasculature and improve ventilation-perfusion match. Inhaled nitric oxide is rapidly inactivated on binding to hemoglobin in the formation of nitrosyl- and methemoglobin in the pulmonary vasculature. Hence, inhaled nitric oxide has minimal systemic dissemination. Several experimental design studies involving lab rats have demonstrated increased levels of carboxyhemoglobin and exhaled CO as a result of nitric oxide HO-1 induction. PMID:21079530

  13. Subclinical Interstitial Lung Disease

    PubMed Central

    Doyle, Tracy J.; Hunninghake, Gary M.

    2012-01-01

    The widespread use of high-resolution computed tomography in clinical and research settings has increased the detection of interstitial lung abnormalities (ILA) in asymptomatic and undiagnosed individuals. We reported that in smokers, ILA were present in about 1 of every 12 high-resolution computed tomographic scans; however, the long-term significance of these subclinical changes remains unclear. Studies in families affected with pulmonary fibrosis, smokers with chronic obstructive pulmonary disease, and patients with inflammatory lung disease have shown that asymptomatic and undiagnosed individuals with ILA have reductions in lung volume, functional limitations, increased pulmonary symptoms, histopathologic changes, and molecular profiles similar to those observed in patients with clinically significant interstitial lung disease (ILD). These findings suggest that, in select at-risk populations, ILA may represent early stages of pulmonary fibrosis or subclinical ILD. The growing interest surrounding this topic is motivated by our poor understanding of the inciting events and natural history of ILD, coupled with a lack of effective therapies. In this perspective, we outline past and current research focused on validating radiologic, physiological, and molecular methods to detect subclinical ILD. We discuss the limitations of the available cross-sectional studies and the need for future longitudinal studies to determine the prognostic and therapeutic implications of subclinical ILD in populations at risk of developing clinically significant ILD. PMID:22366047

  14. Attenuation mapping for monitoring thermal therapy using ultrasound transmission imaging.

    PubMed

    Parmar, N; Kolios, M C

    2004-01-01

    The use of an ultrasound (US) transmission imaging system to monitor attenuation changes during tissue heating was investigated. This work presents preliminary results of images obtained from an acoustic camera before, during and after heating tissue phantoms using a heated needle. Two types of tissue-mimicking phantoms were used, agar and polyacrylamide-based. Regions of interests were chosen in images obtained from the real-time imaging system, and the pixel intensity values before, during and after heating were compared. In both phantoms, a decrease in image intensities was observed during heating, indicating an increase in tissue attenuation. Additionally, an irreversible change in image intensity was observed in regions close to the heat source. The reversibility of the intensity change was shown to be a function of the distance from the heating needle to the selected region. Initial results indicate that US transmission imaging can be used to monitor thermal therapy. PMID:17271937

  15. Photoacoustic temperature measurements for monitoring of thermal therapy

    NASA Astrophysics Data System (ADS)

    Wang, Shiou-Han; Wei, Chen-Wei; Jee, Shiou-Hwa; Li, Pai-Chi

    2009-02-01

    Plasmonic photothermal therapy is a new cancer thermotherapy method based on surface plasmon resonance of nanoparticles. It is important to measure the temperature during thermotherapy for safety and efficacy. In this study, we apply a photoacoustic (PA) method for real-time, non-invasive temperature measurements. In particular, this method can be effectively combined with a photothermal therapy system that we developed in parallel. The method is based on the fact that the PA pressure amplitude is linearly related to temperature. To explore its potential, a home-made, 20 MHz PA transducer was used, in which an optical fiber was inserted in its center for emitting laser pulses while the PA signal was simultaneously detected. Continuous wave (CW) laser was used to heat the subject, including both phantoms and mice. The temperature of the region of interest was also measured by a fine-needle thermal couple. Results show that the temperature was linearly proportional to the PA signal with good correlation with the CW laser irradiation. The in vivo study also demonstrated potential of this technique.

  16. Interstitial Lung Diseases

    MedlinePlus

    Interstitial lung disease is the name for a large group of diseases that inflame or scar the lungs. The inflammation and ... is responsible for some types of interstitial lung diseases. Specific types include Black lung disease among coal ...

  17. Interstitial Pneumonitis from Treatment with Gemcitabine

    PubMed Central

    Poole, Brolin B.; Brockman, Megan M.; Byrd, Debbie C.

    2014-01-01

    Introduction: The use of gemcitabine may lead to numerous adverse effects ranging from mild to very severe, such as interstitial pneumonitis. The diagnosis of this complication is based on multiple laboratory findings, radiographic evidence, and high clinical suspicion. Presented is a case report of a patient who met these criteria and had onset consistent with drug-induced interstitial pneumonitis. Case Presentation: A 76-year-old White female was treated with gemcitabine for pancreatic cancer. Two months after the initiation of therapy, she was admitted to the hospital for worsening dyspnea and cough. High clinical suspicion, bilateral interstitial opacities on chest x-ray, worsening pulmonary status, and onset 2 months after initiation of therapy led to the diagnosis of gemcitabine-induced interstitial pneumonitis. Steroid therapy with prednisone was initiated, and the patient’s clinical symptoms and radiographic findings improved. Discussion: Gemcitabine-induced interstitial pneumonitis is well described in the literature. It is a rare but serious complication associated with gemcitabine therapy in which patients present with worsening dyspnea. Most patients only require supportive care and discontinuation of the drug for treatment, but in severe cases supplemental oxygen and steroid therapy must be used before resolution of symptoms. It is important to obtain an accurate medication history to evaluate for other potentially pulmonary toxic medications. Radiographic findings such as bilateral infiltrates should be completely resolved after therapy. Conclusion: Radiographic findings, clinical symptoms, and clinical suspicion can lead to early recognition of interstitial pneumonitis from gemcitabine. Physician awareness of this adverse effect and early recognition are keys to providing prompt treatment in resolving symptoms and decreasing mortality. PMID:25477616

  18. Nanoparticle-mediated thermal therapy: Evolving strategies for prostate cancer therapy

    PubMed Central

    Krishnan, Sunil; Diagaradjane, Parmeswaran; Cho, Sang

    2011-01-01

    Purpose Recent advances in nanotechnology have resulted in the manufacture of a plethora of nanoparticles with different sizes, shapes, core physicochemical properties and surface modifications that are being investigated for potential medical applications, particularly for the treatment of cancer. This review focuses on the therapeutic use of customized gold nanoparticles, magnetic nanoparticles and carbon nanotubes that efficiently generate heat upon electromagnetic (light and magnetic fields) stimulation after direct injection into tumors or preferential accumulation in tumors following systemic administration. This review will also focus on the evolving strategies to improve the therapeutic index of prostate cancer treatment using nanoparticle-mediated hyperthermia. Conclusions Nanoparticle-mediated thermal therapy is a new and minimally invasive tool in the armamentarium for the treatment of cancers. Unique challenges posed by this form of hyperthermia include the non-target biodistribution of nanoparticles in the reticuloendothelial system when administered systemically, the inability to visualize or quantify the global concentration and spatial distribution of these particles within tumors, the lack of standardized thermal modeling and dosimetry algorithms, and the concerns regarding their biocompatibility. Nevertheless, novel particle compositions, geometries, activation strategies, targeting techniques, payload delivery strategies, and radiation dose enhancement concepts are unique attributes of this form of hyperthermia that warrant further exploration. Capitalizing on these opportunities and overcoming these challenges offers the possibility of seamless and logical translation of this nanoparticle-mediated hyperthermia paradigm from the bench to the bedside. PMID:20858069

  19. Monitoring of thermal therapy based on shear modulus changes: II. Shear wave imaging of thermal lesions.

    PubMed

    Arnal, Bastien; Pernot, Mathieu; Tanter, Mickael

    2011-08-01

    The clinical applicability of high-intensity focused ultrasound (HIFU) for noninvasive therapy is currently hampered by the lack of robust and real-time monitoring of tissue damage during treatment. The goal of this study is to show that the estimation of local tissue elasticity from shear wave imaging (SWI) can lead to a precise mapping of the lesion. HIFU treatment and monitoring were respectively performed using a confocal setup consisting of a 2.5-MHz single element transducer focused at 34 mm on ex vivo samples and an 8-MHz ultrasound diagnostic probe. Ultrasound-based strain imaging was combined with shear wave imaging on the same device. The SWI sequences consisted of 2 successive shear waves induced at different lateral positions. Each wave was created with pushing beams of 100 μs at 3 depths. The shear wave propagation was acquired at 17,000 frames/s, from which the elasticity map was recovered. HIFU sonications were interleaved with fast imaging acquisitions, allowing a duty cycle of more than 90%. Thus, elasticity and strain mapping was achieved every 3 s, leading to real-time monitoring of the treatment. When thermal damage occurs, tissue stiffness was found to increase up to 4-fold and strain imaging showed strong shrinkages that blur the temperature information. We show that strain imaging elastograms are not easy to interpret for accurate lesion characterization, but SWI provides a quantitative mapping of the thermal lesion. Moreover, the concept of shear wave thermometry (SWT) developed in the companion paper allows mapping temperature with the same method. Combined SWT and shear wave imaging can map the lesion stiffening and temperature outside the lesion, which could be used to predict the eventual lesion growth by thermal dose calculation. Finally, SWI is shown to be robust to motion and reliable in vivo on sheep muscle. PMID:21859579

  20. Interstitial irradiation of brain tumors: a review

    SciTech Connect

    Bernstein, M.; Gutin, P.H.

    1981-12-01

    As an adjuvant to surgery, radiation therapy has consistently proven to be the most successful form of treatment for primary and secondary malignant brain tumors and possibly for inoperable benign tumors. Because the risk of radiation necrosis of normal brain limits the amount of radiation that can be given by external beam therapy at conventional dose rates, interstitial radiation of brain tumors is a logical alternative treatment approach. We discuss the radiobiological advantages of low dose rate irradiation and intratumoral placement of sources that make interstitial irradiation an attractive treatment for brain tumors and review the history of clinical brachytherapy for intracranial neoplasia.

  1. Droop: a rapidly computable descriptor of local minimum tissue temperature during conductive interstitial hyperthermia.

    PubMed

    DeFord, J A; Babbs, C F; Patel, U H

    1992-05-01

    Although the goal of local hyperthermia therapy for cancer is to elevate the temperature of a tumour to cytotoxic levels, without the presence of 'cold spots', varying blood flow has made the achievement of consistent, therapeutic temperature distributions extraordinarily difficult. The paper presents a novel approach to estimating local minimum tumour temperatures during conductive interstitial hyperthermia which facilitates identification and elimination of cold spots. Conductive interstitial hyperthermia is modelled mathematically for a parallel array of implanted, electrically heated catheters which warms the treated tissue by thermal conduction and blood perfusion. Computer simulations employing the bioheat transfer equation reveal a predictive relationship between implanted catheter temperature, catheter power, implantation geometry and local minimum tumour temperature. Formulation of this relationship in terms of a parameter named 'droop' allows estimation of local minimum intratumoural temperatures from individual catheter temperature and power. Computer simulations are also performed to determine the sensitivity of the droop-based estimator to variations in properties of the tissue and catheters. Generally, variations in geometry or thermal properties of about 10 per cent cause estimation errors of less than 1 degree C in magnitude. These results suggest that online estimates of thermal 'droop' may provide a practical route to more consistent control of intratumoural minimum temperature during conductive interstitial heat therapy. PMID:1453806

  2. Biochemical comparison between radon effects and thermal effects on humans in radon hot spring therapy.

    PubMed

    Yamaoka, Kiyonori; Mitsunobu, Fumihiro; Hanamoto, Katsumi; Shibuya, Koichi; Mori, Shuji; Tanizaki, Yoshiro; Sugita, Katsuhiko

    2004-03-01

    The radioactive and thermal effects of radon hot spring were biochemically compared under a sauna room or hot spring conditions with a similar chemical component, using the parameters that are closely involved in the clinic for radon therapy. The results showed that the radon and thermal therapy enhanced the antioxidation functions, such as the activities of superoxide dismutase (SOD) and catalase, which inhibit lipid peroxidation and total cholesterol produced in the body. Moreover the therapy enhanced concanavalin A (ConA)-induced mitogen response and increased the percentage of CD4 positive cells, which is the marker of helper T cells, and decreased the percentage of CD8 positive cells, which is the common marker of killer T cells and suppressor T cells, in the white blood cell differentiation antigen (CD8/CD4) assay. Furthermore, the therapy increased the levels of alpha atrial natriuretic polypeptide (alpha ANP), beta endorphin, adrenocorticotropic hormone (ACTH), insulin and glucose-6-phosphate dehydrogenase (G-6-PDH), and it decreased the vasopression level. The results were on the whole larger in the radon group than in the thermal group. The findings suggest that radon therapy contributes more to the prevention of life-style-related diseases related to peroxidation reactions and immune suppression than to thermal therapy. Moreover, these indicate what may be a part of the mechanism for the alleviation of hypertension, osteoarthritis (pain), and diabetes mellitus brought about more by radon therapy than by thermal therapy. PMID:15133294

  3. Interstitial Lung Diseases

    MedlinePlus

    Interstitial lung disease is the name for a large group of diseases that inflame or scar the lungs. The inflammation and scarring make it hard to ... air is responsible for some types of interstitial lung diseases. Specific types include Black lung disease among ...

  4. An overview of interstitial brachytherapy and hyperthermia

    SciTech Connect

    Brandt, B.B.; Harney, J.

    1989-11-01

    Interstitial thermoradiotherapy, an experimental cancer treatment that combines interstitial radiation implants (brachytherapy) and interstitial hyperthermia, is in the early stages of investigation. In accordance with the procedure used in a current national trial protocol, a 60-minute hyperthermia treatment is administered after catheters are placed into the tumor area while the patient is under general anesthesia. This is immediately followed by loading of radioactive Iridium-192 seeds into the catheters for a defined period of time. Once the prescribed radiation dose is delivered, the radioactive sources are removed and a second, 60-minute hyperthermia treatment is administered. Clinical trials with hyperthermia in combination with radiation have increased in recent years. Nurses caring for these patients need to become more knowledgeable about this investigational therapy. This paper provides an overview of the biologic rationale for this therapy, as well as a description of the delivery method and clinical application. Specific related nursing interventions are defined in a nursing protocol.23 references.

  5. Ultrasound therapy applicators for controlled thermal modification of tissue

    NASA Astrophysics Data System (ADS)

    Burdette, E. Clif; Lichtenstiger, Carol; Rund, Laurie; Keralapura, Mallika; Gossett, Chad; Stahlhut, Randy; Neubauer, Paul; Komadina, Bruce; Williams, Emery; Alix, Chris; Jensen, Tor; Schook, Lawrence; Diederich, Chris J.

    2011-03-01

    Heat therapy has long been used for treatments in dermatology and sports medicine. The use of laser, RF, microwave, and more recently, ultrasound treatment, for psoriasis, collagen reformation, and skin tightening has gained considerable interest over the past several years. Numerous studies and commercial devices have demonstrated the efficacy of these methods for treatment of skin disorders. Despite these promising results, current systems remain highly dependent on operator skill, and cannot effectively treat effectively because there is little or no control of the size, shape, and depth of the target zone. These limitations make it extremely difficult to obtain consistent treatment results. The purpose of this study was to determine the feasibility for using acoustic energy for controlled dose delivery sufficient to produce collagen modification for the treatment of skin tissue in the dermal and sub-dermal layers. We designed and evaluated a curvilinear focused ultrasound device for treating skin disorders such as psoriasis, stimulation of wound healing, tightening of skin through shrinkage of existing collagen and stimulation of new collagen formation, and skin cancer. Design parameters were examined using acoustic pattern simulations and thermal modeling. Acute studies were performed in 201 freshly-excised samples of young porcine underbelly skin tissue and 56 in-vivo treatment areas in 60- 80 kg pigs. These were treated with ultrasound (9-11MHz) focused in the deep dermis. Dose distribution was analyzed and gross pathology assessed. Tissue shrinkage was measured based on fiducial markers and video image registration and analyzed using NIH Image-J software. Comparisons were made between RF and focused ultrasound for five energy ranges. In each experimental series, therapeutic dose levels (60degC) were attained at 2-5mm depth. Localized collagen changes ranged from 1-3% for RF versus 8-15% for focused ultrasound. Therapeutic ultrasound applied at high

  6. Implications and considerations of thermal effects when applying irreversible electroporation tissue ablation therapy.

    PubMed

    Davalos, Rafael V; Bhonsle, Suyashree; Neal, Robert E

    2015-07-01

    Irreversible electroporation (IRE) describes a cellular response to electric field exposure, resulting in the formation of nanoscale defects that can lead to cell death. While this behavior occurs independently of thermally-induced processes, therapeutic ablation of targeted tissues with IRE uses a series of brief electric pulses, whose parameters result in secondary Joule heating of the tissue. Where contemporary clinical pulse protocols use aggressive energy regimes, additional evidence is supplementing original studies that assert care must be taken in clinical ablation protocols to ensure the cumulative thermal effects do not induce damage that will alter outcomes for therapies using the IRE non-thermal cell death process for tissue ablation. In this letter, we seek to clarify the nomenclature regarding IRE as a non-thermal ablation technique, as well as identify existing literature that uses experimental, clinical, and numerical results to discretely address and evaluate the thermal considerations relevant when applying IRE in clinical scenarios, including several approaches for reducing these effects. Existing evidence in the literature describes cell response to electric fields, suggesting cell death from IRE is a unique process, independent from traditional thermal damage. Numerical simulations, as well as preclinical and clinical findings demonstrate the ability to deliver therapeutic IRE ablation without occurrence of morbidity associated with thermal therapies. Clinical IRE therapy generates thermal effects, which may moderate the non-thermal aspects of IRE ablation. Appropriate protocol development, utilization, and pulse delivery devices may be implemented to restrain these effects and maintain IRE as the vastly predominant tissue death modality, reducing therapy-mitigating thermal damage. Clinical applications of IRE should consider thermal effects and employ protocols to ensure safe and effective therapy delivery. PMID:25809014

  7. Interstitial cystitis. Etiology, diagnosis, and treatment.

    PubMed Central

    Nickel, J. C.

    2000-01-01

    OBJECTIVE: To review current knowledge about the epidemiology, etiology, diagnosis, and treatment of interstitial cystitis, with special emphasis on management of this condition by family physicians. QUALITY OF EVIDENCE: Articles were identified through MEDLINE and review of abstracts presented at Urology and Interstitial Cystitis meetings during the last decade. Recent reviews were further searched for additional studies and trials. Data were summarized from large epidemiologic studies. Etiologic theories were extracted from current concepts and reviews of scientific studies. Diagnostic criteria described in this review are based on clinical interpretation of National Institutes of Health (NIH) research guidelines, interpretation of data from the NIH Interstitial Cystitis Cohort Study, and recent evidence on use of the potassium sensitivity test. Treatment suggestions are based on six randomized placebo-controlled clinical treatment trials and best available clinical data. MAIN MESSAGE: Interstitial cystitis affects about 0.01% to 0.5% of women. Its etiology is unknown, but might involve microbiologic, immunologic, mucosal, neurogenic, and other yet undefined agents. The diagnosis of interstitial cystitis is a diagnosis of exclusion. It is impossible to provide a purely evidence-based treatment strategy, but review of available evidence suggests that conservative supportive therapy (including diet modification); oral treatment with pentosan polysulfate, amitriptyline, or hydroxyzine; and intravesical treatments with heparinlike medications, dimethyl sulfoxide, or BCG vaccine could benefit some patients. CONCLUSION: Family physicians should have an understanding of interstitial cystitis and be able to make a diagnosis and formulate an evidence-based treatment strategy for their patients. PMID:11153410

  8. Respiratory failure due to infliximab induced interstitial lung disease.

    PubMed

    Kakavas, Sotiris; Balis, Evangelos; Lazarou, Vasiliki; Kouvela, Marousa; Tatsis, Georgios

    2013-01-01

    Although poorly understood, interstitial lung disease has been reported as a possible complication of tumor necrosis factor alpha inhibitors. We report a case of interstitial lung disease in a 64-year-old man with psoriasis 3 weeks after the initiation of infliximab treatment. The patient had received two fortnightly infusions of infliximab following a short course of methotrexate. Thoracic computed tomography showed bilateral ground glass and interstitial infiltrates, while the results of microbiology and immunologic workup were negative. Likewise, bronchoalveolar lavage detected neither typical nor atypical pathogens. Infliximab-induced interstitial lung injury was suspected and corticosteroid therapy was administered which resulted in rapid clinical and radiological improvement. This is one of the few reported cases of interstitial lung disease due to infliximab in the psoriasis population. The patient had no pre-existing lung pathology, while his previous exposure to methotrexate was minimal and was not temporally associated with the induction of interstitial lung disease. PMID:23969008

  9. [Interstitial cystitis. A challenge for the clinician].

    PubMed

    Young, Pablo; Finn, Bárbara C; González, Martín; Comercio, Laura P; Quezel, Mariano; Bruetman, Julio E

    2010-01-01

    Interstitial cystitis is characterized by over 6 months of chronic pain, pressure and discomfort felt in the lower pelvis or bladder. It is often relieved with voiding, along with daytime frequency and nocturia in the absence of an urinary tract infection. The disorder can be divided clinically into two groups -ulcerative and non-ulcerative- based on cystoscopic findings and response to treatment. Management follows an approach of applying the least invasive therapy that affords sufficient relief of symptoms. We report a case of a patient with interstitial cystitis. The diagnosis was performed by symptoms and lesion in the cystoscopy and excellent response to amitriptyline. PMID:20679058

  10. Acute and subacute idiopathic interstitial pneumonias.

    PubMed

    Taniguchi, Hiroyuki; Kondoh, Yasuhiro

    2016-07-01

    Idiopathic interstitial pneumonias (IIPs) may have an acute or subacute presentation, or acute exacerbation may occur in a previously subclinical or unrecognized chronic IIP. Acute or subacute IIPs include acute interstitial pneumonia (AIP), cryptogenic organizing pneumonia (COP), nonspecific interstitial pneumonia (NSIP), acute exacerbation of idiopathic pulmonary fibrosis (AE-IPF) and AE-NSIP. Interstitial lung diseases (ILDs) including connective tissue disease (CTD) associated ILD, hypersensitivity pneumonitis, acute eosinophilic pneumonia, drug-induced lung disease and diffuse alveolar haemorrhage need to be differentiated from acute and subacute IIPs. Despite the severe lack of randomized controlled trials for the treatment of acute and subacute IIPs, the mainstream treatment remains corticosteroid therapy. Other potential therapies reported in the literature include corticosteroids and immunosuppression, antibiotics, anticoagulants, neutrophil elastase inhibitor, autoantibody-targeted treatment, antifibrotics and hemoperfusion therapy. With regard to mechanical ventilation, patients in recent studies with acute and subacute IIPs have shown better survival than those in previous studies. Therefore, a careful value-laden decision about the indications for endotracheal intubation should be made for each patient. Noninvasive ventilation may be beneficial to reduce ventilator associated pneumonia. PMID:27123874

  11. Development of quantum dot-mediated fluorescence thermometry for thermal therapies.

    PubMed

    Han, Bumsoo; Hanson, Willard L; Bensalah, Karim; Tuncel, Altug; Stern, Joshua M; Cadeddu, Jeffrey A

    2009-06-01

    As thermal therapies are frequently employed for management of tumors in various organs, there are growing demands for reliable and accurate intraoperative monitoring techniques of the thermal lesion. However, current monitoring techniques have limited accuracy, accessibility and are not capable of monitoring the thermal lesion in real-time during the procedure. In the present study, quantum dot-mediated fluorescence thermometry was developed and its performance was characterized to demonstrate the feasibility of spatiotemporal monitoring of thermal lesions. First, the temperature dependency of two different types of CdTe/ZnS quantum dots (QDs) were characterized in a temperature range relevant to hyperthermic therapies, and a temperature-intensity relationship was established for each QD. The spatial and temporal resolutions of the system were characterized by exposing QDs to a pre-determined spatial temperature gradient, and by monitoring the spatiotemporal temperature during gold nanoshell-mediated heating. The results demonstrated that QD-mediated thermometry is capable of measuring spatiotemporally varying temperature fields relevant for hyperthermic thermal therapies. Its implication for intraoperative image-guidance of thermal therapy was also discussed. PMID:19322658

  12. Swim therapy reduces mechanical allodynia and thermal hyperalgesia induced by chronic constriction nerve injury in rats

    PubMed Central

    Shen, Jun; Fox, Lyle E.; Cheng, Jianguo

    2013-01-01

    Objective Neuropathic pain is common and often difficult to treat because it generally does not respond well to the currently available pain medications or nerve blocks. Recent studies in both humans and animals have suggested that exercise may induce a transient analgesia and reduce acute pain in normal healthy individuals. We examined whether swim therapy could alleviate neuropathic pain in rats. Design Rats were trained to swim over a two week period in warm water. After the rats were trained, neuropathic pain was induced by constricting the right sciatic nerve and regular swimming was resumed. The sensitivity of each hind paw was monitored using the Hargreaves test and von Frey test to evaluate the withdrawal response thresholds to heat and touch. Results The paw ipsilateral to the nerve ligation expressed pain-like behaviors including thermal hyperalgesia and mechanical allodynia. Regular swim therapy sessions significantly reduced the mechanical allodynia and thermal hyperalgesia. Swim therapy had little effect on the withdrawal thresholds for the contralateral paw. In addition, swim therapy alone did not alter the thermal or mechanical thresholds of normal rats. Conclusions The results suggest that regular exercise, including swim therapy, may be an effective treatment for neuropathic pain caused by nerve injuries. This study, showing that swim therapy reduces neuropathic pain behavior in rats, provides a scientific rationale for clinicians to test the efficacy of exercise in the management of neuropathic pain. It may prove to be a safe and cost-effective therapy in a variety of neuropathic pain states. PMID:23438327

  13. Irreversible electroporation: Just another form of thermal therapy?

    PubMed Central

    van Gemert, Martin J C; Wagstaff, Peter G K; de Bruin, Daniel M; van Leeuwen, Ton G; van der Wal, Allard C; Heger, Michal; van der Geld, Cees W M

    2015-01-01

    Background Irreversible electroporation (IRE) is (virtually) always called non-thermal despite many reports showing that significant Joule heating occurs. Our first aim is to validate with mathematical simulations that IRE as currently practiced has a non-negligible thermal response. Our second aim is to present a method that allows simple temperature estimation to aid IRE treatment planning. Methods We derived an approximate analytical solution of the bio-heat equation for multiple 2-needle IRE pulses in an electrically conducting medium, with and without a blood vessel, and incorporated published observations that an electric pulse increases the medium's electric conductance. Results IRE simulation in prostate-resembling tissue shows thermal lesions with 67–92°C temperatures, which match the positions of the coagulative necrotic lesions seen in an experimental study. Simulation of IRE around a blood vessel when blood flow removes the heated blood between pulses confirms clinical observations that the perivascular tissue is thermally injured without affecting vascular patency. Conclusions The demonstration that significant Joule heating surrounds current multiple-pulsed IRE practice may contribute to future in-depth discussions on this thermal issue. This is an important subject because it has long been under-exposed in literature. Its awareness pleads for preventing IRE from calling “non-thermal” in future publications, in order to provide IRE-users with the most accurate information possible. The prospect of thermal treatment planning as outlined in this paper likely aids to the important further successful dissemination of IRE in interventional medicine. Prostate 75:332–335, 2015. © 2014 The Authors. The Prostate Published by Wiley Periodicals, Inc. PMID:25327875

  14. Magnetic-resonance-guided directional transurethral ultrasound thermal therapy

    NASA Astrophysics Data System (ADS)

    Ross, Anthony; Diederich, Chris J.; Nau, William H.; Tyreus, Per Daniel; Gill, Harchi; Bouley, Donna; Butts, R. K.; Rieke, Viola; Daniel, Bruce; Sommer, Graham

    2003-06-01

    Two catheter-based transurethral ultrasound applicators designed for selective thermal coagulation of prostate tissue were evaluated. The first applicator utilized two 3.5 mm piezoelectric sectored tubes with the active transducer surface forming 90°. The second applicator's transducer assembly consisted of a linear array of 3.5 x 10 mm planar transducer elements. Both applicators operated at 8 MHz and were positioned on a 4 mm diameter catheter within an integrated expandable balloon (10 mm). Manual rotation of the transducer assembly within the balloon allowed for angular control and/or sweeping of the treatment volume. Ambient temperature degassed cooling water (~120 ml/min) was circulated inside the balloon to preserve the urethral mucosa. Acoustic efficiencies of 20-54% and acoustic beam distributions were measured. The thermal treatment characteristics of the applicator were investigated in vivo (canine prostate) under MRI guidance in an interventional open magnet (0.5 T). Magnetic resonance thermal imaging (MRTI) monitored the treatments (GRE phase mapping, multiple planes, 15 sec update intervals). Post-treatment imaging (T1 w/contrast) and TTC staining of the prostate were used to verify zones of thermal damage. Single sonications lasting 8-15 min produced coagulated zones of tissue extending to the outer boundary of the prostate while preserving 2-3 mm of urethral mucosa. Multiple sonications in sequence produced larger contiguous sectors of coagulated tissue (~ 3/4 of the gland). In summary, highly directional transurethral applicators under MRI guidance were able to produce selective and controllable thermal coagulation.

  15. [Modern Views on Children's Interstitial Lung Disease].

    PubMed

    Boĭtsova, E V; Beliashova, M A; Ovsiannikov, D Iu

    2015-01-01

    Interstitial lung diseases (ILD, diffuse lung diseases) are a heterogeneous group of diseases in which a pathological process primarily involved alveoli and perialveolar interstitium, resulting in impaired gas exchange, restrictive changes of lung ventilation function and diffuse interstitial changes detectable by X-ray. Children's interstitial lung diseases is an topical problem ofpediatricpulmonoogy. The article presents current information about classification, epidemiology, clinical presentation, diagnostics, treatment and prognosis of these rare diseases. The article describes the differences in the structure, pathogenesis, detection of various histological changes in children's ILD compared with adult patients with ILD. Authors cite an instance of registers pediatric patients with ILD. The clinical semiotics of ILD, the possible results of objective research, the frequency of symptoms, the features of medical history, the changes detected on chest X-rays, CT semiotics described in detail. Particular attention was paid to interstitial lung diseases, occurring mainly in newborns and children during the first two years of life, such as congenital deficiencies of surfactant proteins, neuroendocrine cell hyperplasia of infancy, pulmonary interstitial glycogenosis. The diagnostic program for children's ILD, therapy options are presented in this article. PMID:26234096

  16. Cancer therapy using non-thermal atmospheric pressure plasma with ultra-high electron density

    SciTech Connect

    Tanaka, Hiromasa; Mizuno, Masaaki; Toyokuni, Shinya; Maruyama, Shoichi; Kodera, Yasuhiro; Terasaki, Hiroko; Adachi, Tetsuo; Kato, Masashi; Kikkawa, Fumitaka; Hori, Masaru

    2015-12-15

    Cancer therapy using non-thermal atmospheric pressure plasma is a big challenge in plasma medicine. Reactive species generated from plasma are key factors for treating cancer cells, and thus, non-thermal atmospheric pressure plasma with high electron density has been developed and applied for cancer treatment. Various cancer cell lines have been treated with plasma, and non-thermal atmospheric plasma clearly has anti-tumor effects. Recent innovative studies suggest that plasma can both directly and indirectly affect cells and tissues, and this observation has widened the range of applications. Thus, cancer therapy using non-thermal atmospheric pressure plasma is promising. Animal experiments and understanding the mode of action are essential for clinical application in the future. A new academic field that combines plasma science, the biology of free radicals, and systems biology will be established.

  17. Cancer therapy using non-thermal atmospheric pressure plasma with ultra-high electron density

    NASA Astrophysics Data System (ADS)

    Tanaka, Hiromasa; Mizuno, Masaaki; Toyokuni, Shinya; Maruyama, Shoichi; Kodera, Yasuhiro; Terasaki, Hiroko; Adachi, Tetsuo; Kato, Masashi; Kikkawa, Fumitaka; Hori, Masaru

    2015-12-01

    Cancer therapy using non-thermal atmospheric pressure plasma is a big challenge in plasma medicine. Reactive species generated from plasma are key factors for treating cancer cells, and thus, non-thermal atmospheric pressure plasma with high electron density has been developed and applied for cancer treatment. Various cancer cell lines have been treated with plasma, and non-thermal atmospheric plasma clearly has anti-tumor effects. Recent innovative studies suggest that plasma can both directly and indirectly affect cells and tissues, and this observation has widened the range of applications. Thus, cancer therapy using non-thermal atmospheric pressure plasma is promising. Animal experiments and understanding the mode of action are essential for clinical application in the future. A new academic field that combines plasma science, the biology of free radicals, and systems biology will be established.

  18. Model-based real-time control for laser induced thermal therapy with applications to prostate cancer treatment

    NASA Astrophysics Data System (ADS)

    Feng, Yusheng; Fuentes, David; Stafford, R. Jason; Oden, J. Tinsley

    2009-02-01

    In this paper, we present a model-based predictive control system that is capable of capturing physical and biological variations of laser-tissue interaction as well as heterogeneity in real-time during laser induced thermal therapy (LITT). Using a three-dimensional predictive bioheat transfer model, which is built based on regular magnetic resonance imaging (MRI) anatomic scan and driven by imaging data produced by real-time magnetic resonance temperature imaging (MRTI), the computational system provides a regirous real-time predictive control during surgical operation process. The unique feature of the this system is its ability for predictive control based on validated model with high precision in real-time, which is made possible by implementation of efficient parallel algorithms. The major components of the current computational systems involves real-time finite element solution of the bioheat transfer induced by laser-tissue interaction, solution module of real-time calibration problem, optimal laser source control, goal-oriented error estimation applied to the bioheat transfer equation, and state-of-the-art imaging process module to characterize the heterogeneous biological domain. The system was tested in vivo in a canine animal model in which an interstitial laser probe was placed in the prostate region and the desired treatment outcome in terms of ablation temperature and damage zone were achieved. Using the guidance of the predictive model driven by real-time MRTI data while applying the optimized laser heat source has the potential to provide unprecedented control over the treatment outcome for laser ablation.

  19. Magnetic Resonance-Guided Thermal Therapy for Localized and Recurrent Prostate Cancer.

    PubMed

    Woodrum, David A; Kawashima, Akira; Gorny, Krzysztof R; Mynderse, Lance A

    2015-11-01

    The advent of focal therapies theoretically offers new treatment options for patients with localized prostate cancer. The goal of prostate cancer treatment is effective long-term cure with minimal impact on health-related quality of life. Multiparametric MR imaging of the prostate is being increasingly used for diagnosis, image-guided targeted biopsy, guidance for targeted focal and regional therapy, and monitoring the effectiveness of treatments for prostate cancer of all stages. In this article, the use of prostate MRI in the burgeoning domain of thermal ablative therapy for localized and recurrent prostate cancer is reviewed. PMID:26499278

  20. Sildenafil Induced Acute Interstitial Nephritis

    PubMed Central

    Burkhart, Ryan; Shah, Nina; Lewin, Matthew

    2015-01-01

    Acute interstitial nephritis (AIN) is characterized by inflammation of the renal interstitium and usually occurs in a temporal relationship with the medication. We present a case of an Asian male who had nephrotic range proteinuria and presented with acute kidney injury. The patient reported an acute change in physical appearance and symptomatology after the ingestion of a single dose of sildenafil. Renal biopsy was notable for minimal change disease (MCD) with acute and chronic interstitial nephritis. Renal replacement and glucocorticoid therapy were initiated. Renal recovery within six weeks permitted discontinuation of dialysis. AIN superimposed on MCD is a known association of NSAID induced nephropathy. The temporal association and the absence of any new drugs suggest that the AIN was most likely due to the sildenafil. NSAIDs are less likely to have caused the AIN given their remote use. The ease of steroid responsiveness would also suggest another cause as NSAID induced AIN is often steroid resistant. The MCD was most likely idiopathic given the lack of temporal association with a secondary cause. As the number of sildenafil prescriptions increases, more cases of AIN may be identified and physician awareness for this potential drug disease association is necessary. PMID:26491581

  1. Pulmonary interstitial emphysema.

    PubMed Central

    Greenough, A; Dixon, A K; Roberton, N R

    1984-01-01

    Forty one of 210 preterm infants ventilated for respiratory distress syndrome in a three year period had radiological evidence of pulmonary interstitial emphysema. The development of this condition was significantly associated with malpositioning of the endotracheal tube in a main bronchus and the use of high peak pressure ventilation. Pulmonary interstitial emphysema was associated with a significant increase in the number of pneumothoraces, intraventricular haemorrhages, and the need for prolonged respiratory support, but did not increase mortality. Although in 12 infants in whom fast rate ventilation was used there was a significant reduction in the number of pneumothoraces, outcome was not altered in any other way. Fast rate ventilation may be of greater benefit if initiated before the development of pulmonary interstitial emphysema. Images Fig. 1 Fig. 2 Fig. 3 Fig. 4 PMID:6508339

  2. Inherited interstitial lung disease.

    PubMed

    Garcia, Christine Kim; Raghu, Ganesh

    2004-09-01

    This article focuses on recent advances in the identification of genes and genetic polymorphisms that have been implicated in the development of human interstitial lung diseases. It focuses on the inherited mendelian diseases in which pulmonary fibrosis is part of the clinical phenotype and the genetics of familial idiopathic pulmonary fibrosis and other rare inherited interstitial lung diseases. The article also reviews the association studies that have been published to date regarding the genetics of sporadic idiopathic pulmonary fibrosis. The reader is directed to recent reviews on human genetic predisposition of sarcoidosis, environmental-related, drug-related, connective tissue related pulmonary fibrosis, and genetic predisposition of fibrosis in animal models. PMID:15331184

  3. Biothermal modeling of transurethral ultrasound applicators for MR-guided prostate thermal therapy (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Ross, Anthony B.; Diederich, Chris J.; Nau, William H.; Tyreus, Per D.; Gill, Harcharan; Bouley, Donna; Butts, R. K.; Rieke, Viola; Daniel, Bruce; Sommer, Graham

    2005-04-01

    Thermal ablation is a minimally-invasive treatment option for benign prostatic hyperplasia (BPH) and localized prostate cancer. Accurate spatial control of thermal dose delivery is paramount to improving thermal therapy efficacy and avoiding post-treatment complications. We have recently developed three types of transurethral ultrasound applicators, each with different degrees of heating selectivity. These applicators have been evaluated in vivo in coordination with magnetic resonance temperature imaging, and demonstrated to accurately ablate specific regions of the canine prostate. A finite difference biothermal model of the three types of transurethral ultrasound applicators (sectored tubular, planar, and curvilinear transducer sections) was developed and used to further study the performance and heating capabilities of each these devices. The biothermal model is based on the Pennes bioheat equation. The acoustic power deposition pattern corresponding to each applicator type was calculated using the rectangular radiator approximation to the Raleigh Sommerfield diffraction integral. In this study, temperature and thermal dose profiles were calculated for different treatment schemes and target volumes, including single shot and angular scanning procedures. This study also demonstrated the ability of the applicators to conform the cytotoxic thermal dose distribution to a predefined target area. Simulated thermal profiles corresponded well with MR temperature images from previous in vivo experiments. Biothermal simulations presented in this study reinforce the potential of improved efficacy of transurethral ultrasound thermal therapy of prostatic disease.

  4. Idiopathic interstitial pneumonias: progress in classification, diagnosis, pathogenesis and management.

    PubMed Central

    King, Talmadge E.

    2004-01-01

    The idiopathic interstitial pneumonias are a heterogeneous group of poorly understood diseases with often devastating consequences for those afflicted. Subclassification of the idiopathic interstitial pneumonia based on clinical-radiological-pathological criteria has highlighted important pathogenic, therapeutic and prognostic implications. The most critical distinction is the presence of usual interstitial pneumonia, the histopathological pattern seen in idiopathic pulmonary fibrosis. Idiopathic pulmonary fibrosis has a worse response to therapy and prognosis. New insight into the pathophysiology of usual interstitial pneumonia suggests a distinctly fibroproliferative process, and antifibrotic therapies show promise. While the clinical and radiographic diagnosis of idiopathic interstitial pneumonias can be made confidently in some cases, many patients require surgical lung biopsy to determine their underlying histopathology. A structured, clinical-radiological-pathological approach to the diagnosis of the idiopathic interstitial pneumonias, with particular attention to the identification of idiopathic pulmonary fibrosis, insures proper therapy, enhances prognostication, and allows for further investigation of therapies aimed at distinct pathophysiology. Images Fig. 2 Fig. 4 Fig. 5 Fig. 6 PMID:17060957

  5. Microdialysis based monitoring of subcutaneous interstitial and venous blood glucose in Type 1 diabetic subjects by mid-infrared spectrometry for intensive insulin therapy

    NASA Astrophysics Data System (ADS)

    Heise, H. Michael; Kondepati, Venkata Radhakrishna; Damm, Uwe; Licht, Michael; Feichtner, Franz; Mader, Julia Katharina; Ellmerer, Martin

    2008-02-01

    Implementing strict glycemic control can reduce the risk of serious complications in both diabetic and critically ill patients. For this purpose, many different blood glucose monitoring techniques and insulin infusion strategies have been tested towards the realization of an artificial pancreas under closed loop control. In contrast to competing subcutaneously implanted electrochemical biosensors, microdialysis based systems for sampling body fluids from either the interstitial adipose tissue compartment or from venous blood have been developed, which allow an ex-vivo glucose monitoring by mid-infrared spectrometry. For the first option, a commercially available, subcutaneously inserted CMA 60 microdialysis catheter has been used routinely. The vascular body interface includes a double-lumen venous catheter in combination with whole blood dilution using a heparin solution. The diluted whole blood is transported to a flow-through dialysis cell, where the harvesting of analytes across the microdialysis membrane takes place at high recovery rates. The dialysate is continuously transported to the IR-sensor. Ex-vivo measurements were conducted on type-1 diabetic subjects lasting up to 28 hours. Experiments have shown excellent agreement between the sensor readout and the reference blood glucose concentration values. The simultaneous assessment of dialysis recovery rates renders a reliable quantification of whole blood concentrations of glucose and metabolites (urea, lactate etc) after taking blood dilution into account. Our results from transmission spectrometry indicate, that the developed bed-side device enables reliable long-term glucose monitoring with reagent- and calibration-free operation.

  6. IDTT therapy in cadaveric lumbar spine: temperature and thermal dose distributions

    NASA Astrophysics Data System (ADS)

    Diederich, Chris J.; Nau, William H.; Kleinstueck, Frank; Lotz, Jeff; Bradford, David

    2001-06-01

    The purpose of this study was to perform extensive temperature mapping throughout human cadaveric disc (n=12) specimens during Intradiscal Thermal Therapy IDTT using the SpineCathTM applicator. Temperature distributions and accumulated thermal dose or thermal damage calculated from the temperature-time history are used to define probable regions of thermal necrosis (destruction of nerves) or thermal coagulation (induced structural changes). The IDTT procedure using SpineCath (5 cm resistive heating segment) and the current standard heating protocol (~17 min) produces intra-discal temperatures which are too low to generate appreciable regions of thermal coagulation and resultant changes in biomechanical properties. This finding was supported by temperature measurements which were mostly below the critical temperature of 60-65°C, except for regions within 1-2 mm of the SpineCath applicator. Furthermore, the analysis of the thermal dose profiles indicate that sufficient thermal doses (240-640 EM43°C) capable of generating complete thermal damage to the nociceptive nerves fibers infiltrating the disc are limited to within ~6 mm of the nucleus and IDTT probe heating segment.

  7. Interstitial Cystitis / Painful Bladder Syndrome

    MedlinePlus

    ... by the National Institutes of Health. Articles and Book Chapters Keay SK, Warren JW. Is interstitial cystitis ... Incontinence. Paris: Health Publication Ltd.; 2009: 1459–1518. Books and Booklets Moldwin RM. Interstitial Cystitis Survival Guide: ...

  8. Interstitial cystitis/painful bladder syndrome.

    PubMed

    Panzera, Alis Kolter

    2007-02-01

    Interstitial cystitis (IC) is a chronic, painful bladder syndrome primarily found in women. Although the direct cause(s) of IC are unknown, several theories exist. Common symptoms include urinary urgency, frequency, and pain. Treatment options include behavioral therapies, use of pharmacologic agents, and surgery. Patients benefit from prompt diagnosis and initiation of treatments. Important clinical features of IC in women including the pathology, common symptoms, and recommended evaluation and management strategies are reviewed. PMID:17390922

  9. Karyomegalic Interstitial Nephritis

    PubMed Central

    Isnard, Pierre; Rabant, Marion; Labaye, Jacques; Antignac, Corinne; Knebelmann, Bertrand; Zaidan, Mohamad

    2016-01-01

    Abstract Karyomegalic interstitial nephritis is a rare cause of hereditary chronic interstitial nephritis, described for the first time over 40 years ago. A 36-year-old woman, of Turkish origin, presented with chronic kidney disease and high blood pressure. She had a history of recurrent upper respiratory tract infections but no familial history of nephropathy. Physical examination was unremarkable. Laboratory tests showed serum creatinine at 2.3 mg/dL with an estimated glomerular filtration rate of 26 mL/min/1.73m2, and gamma-glutamyl transpeptidase and alkaline phosphatase at 3 and 1.5 times the upper normal limit. Urinalysis showed 0.8 g/day of nonselective proteinuria, microscopic hematuria, and aseptic leukocyturia. Immunological tests and tests for human immunodeficiency and hepatitis B and C viruses were negative. Complement level and serum proteins electrophoresis were normal. Analysis of the renal biopsy showed severe interstitial fibrosis and tubular atrophy. Numerous tubular cells had nuclear enlargement with irregular outlines, hyperchromatic aspect, and prominent nucleoli. These findings were highly suggestive of karyomegalic interstitial nephritis, which was further confirmed by exome sequencing of FAN1 gene showing an identified homozygous frameshift mutation due to a one-base-pair deletion in exon 12 (c.2616delA). The present case illustrates a rare but severe cause of hereditary interstitial nephritis, sometimes accompanied by subtle extrarenal manifestations. Identification of mutations in FAN1 gene underscores recent insights linking inadequate DNA repair and susceptibility to chronic kidney disease. PMID:27196444

  10. Key Role of the Cation Interstitial Structure in the Radiation Resistance of Pyrochlores

    SciTech Connect

    Chartier, Alain; Catillon, Gilles; Crocombette, Jean-Paul

    2009-04-17

    The annealing of the B cation interstitial is shown to drive the thermokinetic of the response to irradiations of A{sub 2}B{sub 2}O{sub 7} pyrochlores. Molecular dynamics simulations evidenced that the annealing of interstitials created by irradiations depends upon the nature of B. As the coordination number of B decreases, the dumbbell interstitial is stabilized at the expense of the isolated interstitial. Unlike the isolated interstitials, the recombination of the dumbbells is thermally activated and hindered at low temperatures. The occurrence of dumbbells drives the structure towards the amorphous state.

  11. Mild systemic thermal therapy ameliorates renal dysfunction in a rodent model of chronic kidney disease.

    PubMed

    Iwashita, Yoshihiro; Kuwabara, Takashige; Hayata, Manabu; Kakizoe, Yutaka; Izumi, Yuichiro; Iiyama, Junichi; Kitamura, Kenichiro; Mukoyama, Masashi

    2016-06-01

    Thermal therapy has become a nonpharmacological therapy in clinical settings, especially for cardiovascular diseases. However, the practical role of thermal therapy on chronic kidney disease remains elusive. We performed the present study to investigate whether a modified thermal protocol, repeated mild thermal stimulation (MTS), could affect renal damages in chronic kidney disease using a mouse renal ablation model. Mice were subjected to MTS or room temperature (RT) treatment once daily for 4 wk after subtotal nephrectomy (Nx) or sham operation (Sh). We revealed that MTS alleviated renal impairment as indicated by serum creatinine and albuminuria in Nx groups. In addition, the Nx + MTS group showed attenuated tubular histological changes and reduced urinary neutrophil gelatinase-associated lipocalin excretion approximately by half compared with the Nx + RT group. Increased apoptotic signaling, such as TUNEL-positive cell count and cleavage of caspase 3, as well as enhanced oxidative stress were significantly reduced in the Nx + MTS group compared with the Nx + RT group. These changes were accompanied with the restoration of kidney Mn-SOD levels by MTS. Heat shock protein 27, a key molecular chaperone, was phosphorylated by MTS only in Nx kidneys rather than in Sh kidneys. MTS also tended to increase the phosphorylation of p38 MAPK and Akt in Nx kidneys, possibly associated with the activation of heat shock protein 27. Taken together, these results suggest that modified MTS can protect against renal injury in a rodent model of chronic kidney disease. PMID:27029428

  12. Two-dimensional acoustic attenuation mapping of high-temperature interstitial ultrasound lesions

    NASA Astrophysics Data System (ADS)

    Tyréus, Per Daniel; Diederich, Chris

    2004-02-01

    Acoustic attenuation change in biological tissues with temperature and time is a critical parameter for interstitial ultrasound thermal therapy treatment planning and applicator design. Earlier studies have not fully explored the effects on attenuation of temperatures (75-95 °C) and times (5-15 min) common in interstitial ultrasound treatments. A scanning transmission ultrasound attenuation measurement system was devised and used to measure attenuation changes due to these types of thermal exposures. To validate the approach and to loosely define expected values, attenuation changes in degassed ex vivo bovine liver, bovine brain and chicken muscle were measured after 10 min exposures in a water bath to temperatures up to 90 °C. Maximum attenuation increases of approximately seven, four and two times the values at 37 °C were measured for the three tissue models at 5 MHz. By using the system to scan over lesions produced using interstitial ultrasound applicators, 2D contour maps of attenuation were produced. Attenuation profiles measured through the centrelines of lesions showed that attenuation was highest close to the applicator and decreased with radial distance, as expected with decreasing thermal exposure. Attenuation values measured in profiles through lesions were also shown to decrease with reduced power to the applicator. Attenuation increases in 2D maps of interstitial ultrasound lesions in ex vivo chicken breast, bovine liver and bovine brain were correlated with visible tissue coagulation. While regions of visible coagulation corresponded well to contours of attenuation increase in liver and chicken, no lesion was visible under the same experimental conditions in brain, due primarily to the heterogeneity of the tissue. Acoustic and biothermal simulations were employed to show that attenuation models taking into account these attenuation changes at higher temperatures and longer times were better able to fit experimental data than previous models. These

  13. The use of magnetic nanoparticles in thermal therapy monitoring and screening: Localization and imaging (invited)

    NASA Astrophysics Data System (ADS)

    Weaver, John B.

    2012-04-01

    Magnetic nanoparticles have many diagnostic and therapeutic applications. A method termed magnetic spectroscopy of nanoparticle Brownian motion (MSB) was developed to interrogate in vivo the microscopic environment surrounding magnetic nanoparticles. We can monitor several effects that are important in thermal therapy and screening including temperature measurement and the bound state distribution. Here we report on simulations of nanoparticle localization. Measuring the spatial distribution of nanoparticles would allow us to identify ovarian cancer much earlier when it is still curable or monitor thermal therapies more accurately. We demonstrate that with well-designed equipment superior signal to noise ratio (SNR) can be achieved using only two harmonics rather than using all the harmonics containing signal. Alternatively, smaller magnetic field amplitudes can be used to achieve the same SNR. The SNR is improved using fewer harmonics because the noise is limited.

  14. Interstitial lung diseases in children

    PubMed Central

    2010-01-01

    Interstitial lung disease (ILD) in infants and children comprises a large spectrum of rare respiratory disorders that are mostly chronic and associated with high morbidity and mortality. These disorders are characterized by inflammatory and fibrotic changes that affect alveolar walls. Typical features of ILD include dyspnea, diffuse infiltrates on chest radiographs, and abnormal pulmonary function tests with restrictive ventilatory defect and/or impaired gas exchange. Many pathological situations can impair gas exchange and, therefore, may contribute to progressive lung damage and ILD. Consequently, diagnosis approach needs to be structured with a clinical evaluation requiring a careful history paying attention to exposures and systemic diseases. Several classifications for ILD have been proposed but none is entirely satisfactory especially in children. The present article reviews current concepts of pathophysiological mechanisms, etiology and diagnostic approaches, as well as therapeutic strategies. The following diagnostic grouping is used to discuss the various causes of pediatric ILD: 1) exposure-related ILD; 2) systemic disease-associated ILD; 3) alveolar structure disorder-associated ILD; and 4) ILD specific to infancy. Therapeutic options include mainly anti-inflammatory, immunosuppressive, and/or anti-fibrotic drugs. The outcome is highly variable with a mortality rate around 15%. An overall favorable response to corticosteroid therapy is observed in around 50% of cases, often associated with sequelae such as limited exercise tolerance or the need for long-term oxygen therapy. PMID:20727133

  15. Changes in relative light fluence measured during laser heating: implications for optical monitoring and modelling of interstitial laser photocoagulation

    NASA Astrophysics Data System (ADS)

    Chin, L. C. L.; Whelan, W. M.; Sherar, M. D.; Vitkin, I. A.

    2001-09-01

    Dynamic changes in internal light fluence were measured during interstitial laser heating of tissue phantoms and ex vivo bovine liver. In albumen phantoms, the results demonstrate an unexpected rise in optical power transmitted ≈1 cm away from the source during laser exposure at low power (0.5-1 W), and a decrease at higher powers (1.5-2.5 W) due to coagulation and possibly charring. Similar trends were observed in liver tissue, with a rise in interstitial fluence observed during 0.5 W exposure and a drop in interstitial fluence seen at higher powers (1-1.5 W) due to tissue coagulation. At 1.5 W irradiation an additional, later decrease was also seen which was most likely due to tissue charring. Independent spectrophotometric studies in Naphthol Green dye indicate the rise in fluence observed in the heated albumen phantoms may have been primarily due to light exposure causing photobleaching of the absorbing chromophore, and not due to heat effects. Experiments in liver tissue demonstrated that the observed rise in fluence is dependent on the starting temperature of the tissue. Correlating changes in light fluence with key clinical endpoints/events such as the onset of tissue coagulation or charring may be useful for on-line monitoring and control of laser thermal therapy via interstitial fluence sensors.

  16. Objective assessment of biomagnetic devices and alternative clinical therapies using infrared thermal imaging

    NASA Astrophysics Data System (ADS)

    Rockley, Graham J.

    2001-03-01

    The overwhelming introduction of magnetic devices and other alternative therapies into the health care market prompts the need for objective evaluation of these techniques through the use of infrared thermal imaging. Many of these therapies are reported to promote the stimulation of blood flow or the relief of pain conditions. Infrared imaging is an efficient tool to assess such changes in the physiological state. Therefore, a thermal imager can help document and substantiate whether these therapies are in fact providing an effective change to the local circulation. Thermal images may also indicate whether the change is temporary or sustained. As a specific case example, preliminary findings will be presented concerning the use of magnets and the effect they have on peripheral circulation. This will include a discussion of the recommended protocols for this type of infrared testing. This test model can be applied to the evaluation of other devices and therapeutic procedures which are reputed to affect circulation such as electro acupuncture, orthopedic footwear and topical ointments designed to relieve pain or inflammation.

  17. Ulcerative colitis and steroid-responsive, diffuse interstitial lung disease

    SciTech Connect

    Balestra, D.J.; Balestra, S.T.; Wasson, J.H.

    1988-07-01

    The authors describe a patient with ulcerative colitis and extracolonic manifestations in whom diffuse interstitial pulmonary disease developed that was responsive to glucocorticoid therapy one year after total proctocolectomy. The patient presented in December 1983 with a subacute course marked by cough and progressive exertional dyspnea, abnormal chest examination results, and a chest roentgenogram that revealed diffuse interstitital and alveolar infiltrates. A transbronchial biopsy specimen revealed a polymorphic interstitial infiltrate, mild interstitial fibrosis without apparent intraluminal fibrosis, and no vasculitis, granulomas, or significant eosinophilic infiltration. Within one week of the initiation of daily high-dose steroid therapy, the patient's symptoms dramatically improved; chest roentgenogram and forced vital capacity (60%) improved at a slower rate. All three measures deteriorated when alternate-day prednisone therapy was started but once again improved until the patient was totally asymptomatic, chest roentgenograms were normal, and forced vital capacity was 80% of the predicted value 2 1/2 years later.

  18. Magnetic resonance thermometry for monitoring photothermal effects of interstitial laser irradiation

    NASA Astrophysics Data System (ADS)

    Goddard, Jessica; Jose, Jessnie; Figueroa, Daniel; Le, Kelvin; Liu, Hong; Nordquist, Robert E.; Hode, Tomas; Chen, Wei R.

    2012-03-01

    Selective photothermal interaction using dye-assisted non-invasive laser irradiation has limitations when treating deeper tumors or when the overlying skin is heavily pigmented. We developed an interstitial laser irradiation method to induce the desired photothermal effects. An 805-nm near-infrared laser with a cylindrical diffuser was used to treat rat mammary tumors by placing the active tip of the fiber inside the target tumors. Three different power settings (1.0 to 1.5 watts) were applied to treat animal tumors with an irradiation duration of 10 minutes. The temperature distributions of the treated tumors were measured by a 7.1-Tesla magnetic resonance imager using proton resonance frequency (PRF) method. Three-dimensional temperature profiles were reconstructed and assessed using PRF. This is the first time a 7.1-Tesla magnetic resonance imager has been used to monitor interstitial laser irradiation via PRF. This study provides a basic understanding of the photothermal interaction needed to control the thermal damage inside tumor using interstitial laser irradiation. It also shows that PRF can be used effectively in monitoring photothermal interaction. Our long-term goal is to develop a PRF-guided laser therapy for cancer treatment.

  19. Sublethal and potentially lethal damage repair on thermal neutron capture therapy

    SciTech Connect

    Utsumi, H.; Ichihashi, M.; Kobayashi, T.; Elkind, M.M. )

    1989-07-01

    Tonicity shock or caffeine postirradiation treatment makes evident fast-type potentially lethal damage (PLD). Caffeine expresses fast-type PLD more efficiently than tonicity shock in X-irradiated B-16 mouse melanoma cells, compared with V79 Chinese hamster cells. The survival curves of thermal neutrons for either V79 or B-16 cells exhibit no shoulder. Neither V79 nor B-16 cells show the sublethal damage (SLD) repair of thermal neutrons. Caffeine-sensitive fast-type PLD repairs exist in X-irradiated B-16 cells, as well as V79 cells. The fast-type PLD repair of B-16 cells exposed to thermal neutrons alone is rather less than that of X-irradiated cells. Furthermore, an extremely low level of fast-type PLD repair of B-16 cells with 10B1-paraboronophenylalanine (BPA) preincubation (20 hours) followed by thermal neutron irradiation indicated that 10B(n,alpha)7Li reaction effectively eradicates actively growing melanoma cells. The plateau-phase B-16 cells are well able to repair the slow-type PLD of X-rays. However, cells can not repair the slow-type PLD induced by thermal neutron irradiation with or without 10B1-BPA preincubation. These results suggest that thermal neutron capture therapy can effectively kill radioresistant melanoma cells in both proliferating and quiescent phases.

  20. Comparison of laser- and RF-based interstitial coagulation systems for the treatment of liver tumors (Invited Paper)

    NASA Astrophysics Data System (ADS)

    de Jager, Arjan A.; van Trier, Bart N.; Veenendaal, Liesbeth M.; van Hillegersberg, Richard; Verdaasdonk, Rudolf M.

    2005-04-01

    Hepatocellular carcinoma (HCC) is one of the most common cancers in the world. Surgical treatments, including hepatic resection and liver transplantation are considered as the most effective treatment of HCC. However, less than 20% of HCC patients can be treated surgically because of: multi-focal diseases, proximity of tumor to key vascular or biliary structures and inadequate functional hepatic reserve related coexistent cirrhosis. In this unfortunate groups of patients various palliative treatments modalities are being performed to extend the time of survival and quality of life. These techniques include trans-catheter arterial chemoembolization (TACE), percutaneous ethanol injection (PEI) and Interstitial Thermal Therapy: laser-induced interstitial thermotherapy (LITT) and radio-frequency ablation (RFA).

  1. Systemic anti-tumour effects of local thermally sensitive liposome therapy

    PubMed Central

    Viglianti, Benjamin L.; Dewhirst, Mark W.; Boruta, R.J.; Park, Ji-Young; Landon, Chelsea; Fontanella, Andrew N.; Guo, Jing; Manzoor, Ashley; Hofmann, Christina L.; Palmer, Gregory M.

    2015-01-01

    Purpose There were two primary objectives of this study: (1) to determine whether treatment of a tumour site with systemically administered thermally sensitive liposomes and local hyperthermia (HT) for triggered release would have dual anti-tumour effect on the primary heated tumour as well as an unheated secondary tumour in a distant site, and (2) to determine the ability of non-invasive optical spectroscopy to predict treatment outcome. The optical end points studied included drug levels, metabolic markers flavin adenine dinucleotide (FAD), nicotinamide adenine dinucleotide phosphate (NAD(P)H), and physiological markers (total haemoglobin (Hb) and Hb oxygen saturation) before and after treatment. Materials and methods Mice were inoculated with SKOV3 human ovarian carcinoma in both hind legs. One tumour was selected for local hyperthermia and subsequent systemic treatment. There were four treatment groups: control, DOXIL® (non-thermally sensitive liposomes containing doxorubicin), and two different thermally sensitive liposome formulations containing doxorubicin. Optical spectroscopy was performed prior to therapy, immediately after treatment, and 6, 12, and 24 h post therapy. Results Tumour growth delay was seen with DOXIL and the thermally sensitive liposomes in the tumours that were heated, similar to previous studies. Tumour growth delay was also seen in the opposing tumour in the thermally sensitive liposome-treated groups. Optical spectroscopy demonstrated correlation between growth delay, doxorubicin (DOX) levels, and changes of NAD(P)H from baseline levels. Hb and Hb saturation were not correlated with growth delay. Discussion The study demonstrated that thermally sensitive liposomes affect the primary heated tumour as well as systemic efficacy. Non-invasive optical spectroscopy methods were shown to be useful in predicting efficacy at early time points post-treatment. PMID:25164143

  2. Interstitial duplication 19p

    SciTech Connect

    Stratton, R.F.; DuPont, B.R.; Moore, C.M.

    1995-07-17

    We report on a 9-month-old girl with an interstitial duplication of 19p, developmental delay, and multiple anomalies including bifrontal prominence, obtuse frontonasal angle, short columella, additional midline philtral pillar, midline ridge on the tongue, vertical midline ridge at the mental symphysis, and a complex congenital heart defect including severe branch pulmonary artery stenosis, secundum atrial septal defect (ASD), and several ventricular septal defects (VSDs). Use of fluorescent in situ hybridization (FISH) with chromosome 19- specific probes showed a direct duplication of bands 19p13.13 and 19p13.2. 6 refs., 1 fig.

  3. Lymphocytic Interstitial Pneumonia.

    PubMed

    Panchabhai, Tanmay S; Farver, Carol; Highland, Kristin B

    2016-09-01

    Lymphocytic interstitial pneumonia (LIP) is a rare lung disease on the spectrum of benign pulmonary lymphoproliferative disorders. LIP is frequently associated with connective tissue diseases or infections. Idiopathic LIP is rare; every attempt must be made to diagnose underlying conditions when LIP is diagnosed. Computed tomography of the chest in patients with LIP may reveal ground-glass opacities, centrilobular and subpleural nodules, and randomly distributed thin-walled cysts. Demonstrating polyclonality with immunohistochemistry is the key to differentiating LIP from lymphoma. The 5-year mortality remains between 33% and 50% and is likely to vary based on the underlying disease process. PMID:27514593

  4. Feedlot Acute Interstitial Pneumonia.

    PubMed

    Woolums, Amelia R

    2015-11-01

    Acute interstitial pneumonia (AIP) of feedlot cattle is a sporadically occurring respiratory condition that is often fatal. Affected cattle have a sudden onset of labored breathing. There is no confirmed effective treatment of feedlot AIP; however, administration of antibiotics effective against common bacterial respiratory pathogens and nonsteroidal anti-inflammatory drugs, especially aspirin, has been recommended. Protective strategies are not well defined, but efforts to limit dust exposure and heat stress; to ensure consistent formulation, mixing, and delivery of feed; and to identify and treat infectious respiratory disease in a timely manner may decrease rates of feedlot AIP. PMID:26253266

  5. Interstitial Collagen Catabolism*

    PubMed Central

    Fields, Gregg B.

    2013-01-01

    Interstitial collagen mechanical and biological properties are altered by proteases that catalyze the hydrolysis of the collagen triple-helical structure. Collagenolysis is critical in development and homeostasis but also contributes to numerous pathologies. Mammalian collagenolytic enzymes include matrix metalloproteinases, cathepsin K, and neutrophil elastase, and a variety of invertebrates and pathogens possess collagenolytic enzymes. Components of the mechanism of action for the collagenolytic enzyme MMP-1 have been defined experimentally, and insights into other collagenolytic mechanisms have been provided. Ancillary biomolecules may modulate the action of collagenolytic enzymes. PMID:23430258

  6. Reduced boron diffusion under interstitial injection in fluorine implanted silicon

    SciTech Connect

    Kham, M. N.; Matko, I.; Chenevier, B.; Ashburn, P.

    2007-12-01

    Point defect injection studies are performed to investigate how fluorine implantation influences the diffusion of boron marker layers in both the vacancy-rich and interstitial-rich regions of the fluorine damage profile. A 185 keV, 2.3x10{sup 15} cm{sup -2} F{sup +} implant is made into silicon samples containing multiple boron marker layers and rapid thermal annealing is performed at 1000 deg. C for times of 15-120 s. The boron and fluorine profiles are characterized by secondary ion mass spectroscopy and the defect structures by transmission electron microscopy (TEM). Fluorine implanted samples surprisingly show less boron diffusion under interstitial injection than those under inert anneal. This effect is particularly noticeable for boron marker layers located in the interstitial-rich region of the fluorine damage profile and for short anneal times (15 s). TEM images show a band of dislocation loops around the range of the fluorine implant and the density of dislocation loops is lower under interstitial injection than under inert anneal. It is proposed that interstitial injection accelerates the evolution of interstitial defects into dislocation loops, thereby giving transient enhanced boron diffusion over a shorter period of time. The effect of the fluorine implant on boron diffusion is found to be the opposite for boron marker layers in the interstitial-rich and vacancy-rich regions of the fluorine damage profile. For marker layers in the interstitial-rich region of the fluorine damage profile, the boron diffusion coefficient decreases with anneal time, as is typically seen for transient enhanced diffusion. The boron diffusion under interstitial injection is enhanced by the fluorine implant at short anneal times but suppressed at longer anneal times. It is proposed that this behavior is due to trapping of interstitials at the dislocation loops introduced by the fluorine implant. For boron marker layers in the vacancy-rich region of the fluorine damage profile

  7. Image-guided thermal therapy with a dual-contrast magnetic nanoparticle formulation: A feasibility study

    PubMed Central

    Attaluri, Anilchandra; Seshadri, Madhav; Mirpour, Sahar; Wabler, Michele; Marinho, Thomas; Furqan, Muhammad; Zhou, Haoming; De Paoli, Silvia; Gruettner, Cordula; Gilson, Wesley; DeWeese, Theodore; Garcia, Monica; Ivkov, Robert; Liapi, Eleni

    2016-01-01

    Purpose/objective The aim of this study was to develop and investigate the properties of a magnetic iron oxide nanoparticle–ethiodised oil formulation for image-guided thermal therapy of liver cancer. Materials and methods The formulation comprises bionised nano-ferrite (BNF) nanoparticles suspended in ethiodised oil, emulsified with polysorbate 20 (BNF-lip). Nanoparticle size was measured via photon correlation spectroscopy and transmission electron microscopy. In vivo thermal therapy capability was tested in two groups of male Foxn1nu mice bearing subcutaneous HepG2 xenograft tumours. Group I (n =12) was used to screen conditions for group II (n =48). In group II, mice received one of BNF-lip (n =18), BNF alone (n =16), or PBS (n =14), followed by alternating magnetic field (AMF) hyperthermia, with either varied duration (15 or 20 min) or amplitude (0, 16, 20, or 24 kA/m). Image-guided fluoroscopic intra-arterial injection of BNF-lip was tested in New Zealand white rabbits (n =10), bearing liver VX2 tumours. The animals were subsequently imaged with CT and 3 T MRI, up to 7 days post-injection. The tumours were histopathologically evaluated for distribution of BNF-lip. Results The BNF showed larger aggregate diameters when suspended in BNF-lip, compared to clear solution. The BNF-lip formulation produced maximum tumour temperatures with AMF >20 kA/m and showed positive X-ray visibility and substantial shortening of T1 and T2 relaxation time, with sustained intratumoural retention up to 7 days post-injection. On pathology, intratumoural BNF-lip distribution correlated well with CT imaging of intratumoural BNF-lip distribution. Conclusion The BNF-lip formulation has favourable thermal and dual imaging capabilities for image-guided thermal therapy of liver cancer, suggesting further exploration for clinical applications. PMID:27151045

  8. Interstitial pneumonitis after acetylene welding: a case report.

    PubMed

    Brvar, Miran

    2014-01-01

    Acetylene is a colorless gas commonly used for welding. It acts mainly as a simple asphyxiant. In this paper, however, we present a patient who developed a severe interstitial pneumonitis after acetylene exposure during aluminum welding. A 44-year old man was welding with acetylene, argon and aluminum electrode sticks in a non-ventilated aluminum tank for 2 h. Four hours after welding dyspnea appeared and 22 h later he was admitted at the Emergency Department due to severe respiratory insufficiency with pO2 = 6.7 kPa. Chest X-ray showed diffuse interstitial infiltration. Pulmonary function and gas diffusion tests revealed a severe restriction (55% of predictive volume) and impaired diffusion capacity (47% of predicted capacity). Toxic interstitial pneumonitis was diagnosed and high-dose systemic corticosteroid methylprednisolone and inhalatory corticosteroid fluticasone therapy was started. Computed Tomography (CT) of the lungs showed a diffuse patchy ground-glass opacity with no signs of small airway disease associated with interstitial pneumonitis. Corticosteroid therapy was continued for the next 8 weeks gradually reducing the doses. The patient's follow-up did not show any deterioration of respiratory function. In conclusion, acetylene welding might result in severe toxic interstitial pneumonitis that improves after an early systemic and inhalatory corticosteroid therapy. PMID:24658888

  9. Enhancing laser thermal-therapy using ultrasound-microbubbles and gold nanorods: In vitro investigation

    NASA Astrophysics Data System (ADS)

    Tarapacki, Christine; Kumaradas, Carl; Karshafian, Raffi

    2012-11-01

    Gold nanorods (GNR) in laser-induced thermal therapy can significantly increase light absorption, leading to a local temperature increase and causing irreversible cell damage. One of the key challenges in using GNR as a thermal therapy agent is to deliver a concentration of GNR to generate sufficient heat and cause cell death. In this study, ultrasound and microbubble induced sonoporation is used to enhance intracellular uptake of GNR and improve the therapeutic outcome of laserinduced thermal therapy. Acute myeloid leukemia (AML) cells in suspension (0.6 mL) were treated with ultrasound and microbubbles (USMB) at 1 MHz frequency, 16 microseconds pulse duration, 1 kHz pulse repetition frequency, 1 minute insonation time, varying acoustic pressures (0, 1.26 and 1.73 MPa) and 10 μL Definity microbubble agent with and without GNR (12 nm × 48 nm) at varying concentration (1.0×1010 to 2.5×1011 GNR/mL). The GNR were manufactured through wet chemical synthesis process and measured using Transmission Electron Microscopy (TEM) and Atomic Absorption Spectroscopy (AAS) for size and concentration respectively. Following ultrasound and microbubble treatment, cells were centrifuged to remove excess gold nanorods and treated in suspension with an 810 nm laser (Diomed 60 NIR) at 4 W for 5 minutes. A thermal camera (FLIR Thermovision A40) was positioned to monitor the sample temperature throughout laser treatment and cell viability was assessed using flow cytometry with propidium iodide. Cell viability of 18±2% was achieved with GNR+USMB (1.26 MPa) compared to 72±3% with GNR alone (12 hour incubation) and 99±0.2% with USMB (1.26 MPa) alone. With increasing GNR concentration during ultrasound and microbubble treatment, laser induced sample temperature increased and consequently cell viability decreased. Cell viability decreased from 92±1% at 1.0×1011 GNR/mL to 29±5% at 1.5×1011 GNR/mL concentration with corresponding maximum temperatures of 50°C and 54°C, respectively

  10. [From Biological Effects of Local Cutaneous Thermal Stimulation to Moxibustion Therapy].

    PubMed

    Huang, Kai-yu; Liang, Shuang; Hu, Guang-yong; Zou, Yang-yang; Lu, Lu; Zhang, Jian-bin

    2015-12-01

    Moxibustion is one of the major external therapies of traditional Chinese medicine (TCM) and exerts a definite favorable effect in the treatment of patients with different problems. In the present paper, the authors reviewed 38 papers about somatic thermal intervention therapy published in recent 15 years and analyzed its biological functions from local, distal, and whole body effects. The local effects include 1) improving cutaneous inflammatory illnesses as verruca, herpes simplex, Leishmania infection, cutaneous necrosis, wound disunion, and promoting percutaneous absorption of some medicines, swelling pain; 2) reliving sports fatigue and muscular injury, eliminating inflammation and pain reactions, probably by lowering local reactive oxygen species, superoxide dismutase,catalase, glutathione, etc. levels, and strengthening the flexibility of the knee-joint, and anterior and posterior cruciate ligaments; 3) increasing blood perfusion of the regional arteriola, micrangium to eliminate accumulated subcutaneous blood cells, inflammatory mediators and other metabolic products. The distal effects contain 1) increase of the distal cutaneous blood flow and suppression of the arterial stenosis; and 2) improvement of the visceral functions including the heart (ischemia), liver, gastrointestinal blood flow and smooth muscles, uterus smooth muscular tension, etc. The whole body effects include raising immunoability against cancer, and reducing tumor blood flow to damage the blood vessels in the tumor tissue, etc. In addition, the effects of thermal stimulation are affected by the temperature, stimulating duration and the stimulated positions. These research results may help us to comprehensively understand the effects and mechanisms of moxibustion therapy in the treatment of different clinical disorders. PMID:26887216

  11. Model-based planning and real-time predictive control for laser-induced thermal therapy

    PubMed Central

    Feng, Yusheng; Fuentes, David

    2014-01-01

    In this article, the major idea and mathematical aspects of model-based planning and real-time predictive control for laser-induced thermal therapy (LITT) are presented. In particular, a computational framework and its major components developed by authors in recent years are reviewed. The framework provides the backbone for not only treatment planning but also real-time surgical monitoring and control with a focus on MR thermometry enabled predictive control and applications to image-guided LITT, or MRgLITT. Although this computational framework is designed for LITT in treating prostate cancer, it is further applicable to other thermal therapies in focal lesions induced by radio-frequency (RF), microwave and high-intensity-focused ultrasound (HIFU). Moreover, the model-based dynamic closed-loop predictive control algorithms in the framework, facilitated by the coupling of mathematical modelling and computer simulation with real-time imaging feedback, has great potential to enable a novel methodology in thermal medicine. Such technology could dramatically increase treatment efficacy and reduce morbidity. PMID:22098360

  12. The Feasibility of Conformal Thermal Therapy with Transurethral Ultrasound Heating Applicators and MR Temperature Feedback

    SciTech Connect

    Choy, Vanessa; Tang, Kee; Chopra, Rajiv; Wachsmuth, Jeff; Bronskill, Michael

    2006-05-08

    Transurethral thermal therapy offers a minimally invasive alternative for the treatment of prostate diseases including benign prostate hyperplasia (BPH) and prostate cancer. Accurate heating of a targeted region of the gland can be achieved through the use of a rotating directional heating source incorporating planar ultrasound transducers, and the implementation of active temperature feedback along the beam direction during heating provided by magnetic resonance (MR) thermometry. The performance of this control method with practical spatial, temporal, and temperature resolution (such as angular alignment, spatial resolution, update rate for temperature feedback (imaging time), and the presence of noise) for thermal feedback using a clinical 1.5 T MR scanner was investigated in simulations. As expected, the control algorithm was most sensitive to the presence of noise, with noticeable degradation in its performance above {+-}2 deg. C of temperature uncertainty. With respect to temporal resolution, acceptable performance was achieved at update rates of 5s or faster. The control algorithm was relatively insensitive to reduced spatial resolution due to the broad nature of the heating pattern produced by the heating applicator, this provides an opportunity to improve signal-to-noise ratio (SNR). The overall simulation results confirm that existing clinical 1.5T MR imagers are capable of providing adequate temperature feedback for transurethral thermal therapy without special pulse sequences or enhanced imaging hardware.

  13. Computed Tomography–Guided Interstitial High-Dose-Rate Brachytherapy in Combination With Regional Positive Lymph Node Intensity-Modulated Radiation Therapy in Locally Advanced Peripheral Non–Small Cell Lung Cancer: A Phase 1 Clinical Trial

    SciTech Connect

    Xiang, Li; Zhang, Jian-wen; Lin, Sheng; Luo, Hui-Qun; Wen, Qing-Lian; He, Li-Jia; Shang, Chang-Ling; Ren, Pei-Rong; Yang, Hong-Ru; Pang, Hao-Wen; Yang, Bo; He, Huai-Lin; Chen, Yue; Wu, Jing-Bo

    2015-08-01

    Purpose: To assess the technical safety, adverse events, and efficacy of computed tomography (CT)-guided interstitial high-dose-rate (HDR) brachytherapy in combination with regional positive lymph node intensity modulated radiation therapy in patients with locally advanced peripheral non–small cell lung cancer (NSCLC). Methods and Materials: Twenty-six patients with histologically confirmed NSCLC were enrolled in a prospective, officially approved phase 1 trial. Primary tumors were treated with HDR brachytherapy. A single 30-Gy dose was delivered to the 90% isodose line of the gross lung tumor volume. A total dose of at least 70 Gy was administered to the 95% isodose line of the planning target volume of malignant lymph nodes using 6-MV X-rays. The patients received concurrent or sequential chemotherapy. We assessed treatment efficacy, adverse events, and radiation toxicity. Results: The median follow-up time was 28 months (range, 7-44 months). There were 3 cases of mild pneumothorax but no cases of hemothorax, dyspnea, or pyothorax after the procedure. Grade 3 or 4 acute hematologic toxicity was observed in 5 patients. During follow-up, mild fibrosis around the puncture point was observed on the CT scans of 2 patients, but both patients were asymptomatic. The overall response rates (complete and partial) for the primary mass and positive lymph nodes were 100% and 92.3%, respectively. The 1-year and 2-year overall survival (OS) rates were 90.9% and 67%, respectively, with a median OS of 22.5 months. Conclusion: Our findings suggest that HDR brachytherapy is safe and feasible for peripheral locally advanced NSCLC, justifying a phase 2 clinical trial.

  14. Interstitial fibrosis and growth factors.

    PubMed Central

    Lasky, J A; Brody, A R

    2000-01-01

    Interstitial pulmonary fibrosis (IPF) is scarring of the lung caused by a variety of inhaled agents including mineral particles, organic dusts, and oxidant gases. The disease afflicts millions of individuals worldwide, and there are no effective therapeutic approaches. A major reason for this lack of useful treatments is that few of the molecular mechanisms of disease have been defined sufficiently to design appropriate targets for therapy. Our laboratory has focused on the molecular mechanisms through which three selected peptide growth factors could play a role in the development of IPF. Hundreds of growth factors and cytokines could be involved in the complex disease process. We are studying platelet-derived growth factor because it is the most potent mesenchymal cell mitogen yet described, transforming growth factor beta because it is a powerful inducer of extracellular matrix (scar tissue) components by mesenchymal cells, and tumor necrosis factor alpha because it is a pleiotropic cytokine that we and others have shown is essential for the development of IPF in animal models. This review describes some of the evidence from studies in humans, in animal models, and in vitro, that supports the growth factor hypothesis. The use of modern molecular and transgenic technologies could elucidate those targets that will allow effective therapeutic approaches. Images Figure 1 Figure 2 PMID:10931794

  15. MRI-guided Transurethral Thermal Therapy for Prostate Disease: In-vivo Demonstration in a Canine Model

    NASA Astrophysics Data System (ADS)

    Chopra, Rajiv; Baker, Nicole; Boyes, Aaron; Choy, Vanessa; Tang, Kee; Teahan, Seamus; Klotz, Laurence; Sugar, Linda; Haider, Masoom A.; Bronskill, Michael

    2006-05-01

    A system for MRI-guided prostate thermal therapy has been developed, and its capability to target thermal damage to specific regions of the prostate gland has been investigated in a canine model. Accurate positioning of heating applicators within the prostate gland was achieved, and quantitative, stable temperature maps were obtained during minutes of treatment using a custom-built four-channel phased array coil. MRI-guided transurethral ultrasound thermal therapy is feasible in a clinical MR imager, and quantitative thermometry can be performed during treatment to monitor and potentially to adjust the spatial heating pattern.

  16. Development of a quantum dot mediated thermometry for minimally invasive thermal therapy

    NASA Astrophysics Data System (ADS)

    Hanson, Willard L.

    Thermally-related, minimally invasive therapies are designed to treat tumors while minimizing damage to the surrounding tissues. Adjacent tissues become susceptible to thermal injury to ensure the cancer is completely destroyed. Destroying tumor cells, while minimizing collateral damage to the surrounding tissue, requires the capacity to control and monitor tissue temperatures both spatially and temporally. Current devices measure the tumor's tissue temperature at a specific location leaving the majority unmonitored. A point-wise application can not substantiate complete tumor destruction. This type of surgery would be more effective if volumetric tissue temperature measurement were available. On this premise, the feasibility of a quantum dot (QD) assembly to measure the tissue temperature volumetrically was tested in the experiments described in this dissertation. QDs are fluorescence semiconductor nanoparticles having various superior optical properties. This new QD-mediated thermometry is capable of monitoring the thermal features of tissues non-invasively by measuring the aggregate fluorescence intensity of the QDs accumulated at the target tissues prior to and during the surgical procedure. Thus, such a modality would allow evaluation of tissue destruction by measuring the fluorescence intensity of the QD as a function of temperature. The present study also quantified the photoluminescence intensity and attenuation of the QD as a function of depth and wavelength using a tissue phantom. A prototype system was developed to measure the illumination through a tissue phantom as a proof of concept of the feasibility of a noninvasive thermal therapy. This prototype includes experimental hardware, software and working methods to perform image acquisition, and data reduction strategic to quantify the intensity and transport characteristics of the QD. The significance of this work is that real-time volumetric temperature information will prove a more robust tool for use

  17. Thermal analysis of the surrounding anatomy during 3-D MRI-guided transurethral ultrasound prostate therapy

    NASA Astrophysics Data System (ADS)

    Burtnyk, Mathieu; Chopra, Rajiv; Bronskill, Michael

    2010-03-01

    Previous numerical simulations have shown that MRI-guided transurethral ultrasound therapy can generate highly accurate volumes of thermal coagulation conforming to 3-D human prostate geometries. The goal of this work is to simulate, quantify and evaluate the thermal impact of these treatments on the rectum, pelvic bone, neurovascular bundles (NVB) and urinary sphincters. This study used twenty 3-D anatomical models of prostate cancer patients and detailed bio-acoustic simulations incorporating an active feedback algorithm which controlled a rotating, planar ultrasound transducer (17-4×3 mm elements, 4.7/9.7 MHz, 10 Wac/cm2). Heating of the adjacent surrounding anatomy was evaluated using thermal tolerances reported in the literature. Heating of the rectum poses the most important safety concern and is influenced largely by the water temperature flowing through an endorectal cooling device; temperatures of 7-37° C are required to limit potential damage to less than 10 mm3 on the outer 1 mm layer of rectum. Significant heating of the pelvic bone was predicted in 30% of the patient models with an ultrasound frequency of 4.7 MHz; setting the frequency to 9.7 MHz when the bone is less than 10 mm away from the prostate reduced heating in all cases below the threshold for irreversible damage. Heating of the NVB was significant in 75% of the patient models in the absence of treatment planning; this proportion was reduced to 5% by using treatment margins of up to 4 mm. To avoid damaging the urinary sphincters, margins from the transducer of 2-4 mm should be used, depending on the transurethral cooling temperature. Simulations show that MRI-guided transurethral therapy can treat the entire prostate accurately. Strategies have been developed which, along with careful treatment planning, can be used to avoid causing thermal injury to the rectum, pelvic bone, NVB and urinary sphincters.

  18. Focused ultrasound thermal therapy system with ultrasound image guidance and temperature measurement feedback.

    PubMed

    Lin, Kao-Han; Young, Sun-Yi; Hsu, Ming-Chuan; Chan, Hsu; Chen, Yung-Yaw; Lin, Win-Li

    2008-01-01

    In this study, we developed a focused ultrasound (FUS) thermal therapy system with ultrasound image guidance and thermocouple temperature measurement feedback. Hydraulic position devices and computer-controlled servo motors were used to move the FUS transducer to the desired location with the measurement of actual movement by linear scale. The entire system integrated automatic position devices, FUS transducer, power amplifier, ultrasound image system, and thermocouple temperature measurement into a graphical user interface. For the treatment procedure, a thermocouple was implanted into a targeted treatment region in a tissue-mimicking phantom under ultrasound image guidance, and then the acoustic interference pattern formed by image ultrasound beam and low-power FUS beam was employed as image guidance to move the FUS transducer to have its focal zone coincident with the thermocouple tip. The thermocouple temperature rise was used to determine the sonication duration for a suitable thermal lesion as a high power was turned on and ultrasound image was used to capture the thermal lesion formation. For a multiple lesion formation, the FUS transducer was moved under the acoustic interference guidance to a new location and then it sonicated with the same power level and duration. This system was evaluated and the results showed that it could perform two-dimensional motion control to do a two-dimensional thermal therapy with a small localization error 0.5 mm. Through the user interface, the FUS transducer could be moved to heat the target region with the guidance of ultrasound image and acoustic interference pattern. The preliminary phantom experimental results demonstrated that the system could achieve the desired treatment plan satisfactorily. PMID:19163216

  19. Combined Cisplatinum and Laser Thermal Therapy for Palliation of Recurrent Head and Neck Tumors

    PubMed Central

    Paiva, Marcos B.; Saxton, Romaine E.; Blackwell, Keith E.; Buechler, Peter; Cohen, Alen; Liu, Carson D.; Calcaterra, Thomas C.; Ward, Paul H.

    2000-01-01

    In recent years endoscopically controlled laser-induced thermal therapy (LITT) has been increasingly accepted as a minimally invasive method for palliation of advanced or recurrent head and neck or gastrointestinal cancer. Previous studies have shown that adjuvant chemotherapy can potentiate endoscopic laser thermal ablation of obstructing tumors leading to improved palliation in advanced cancer patients. Eight patients with recurrent head and neck tumors volunteered to enroll as part of an ongoing phase II LITT clinical trial, and also elected to be treated with systemic chemotherapy (cisplatin, 80 mg/m2) followed 24 h later by palliative laser thermal ablation. Laser treatments were repeated in patients with residual disease or recurrence for a total of 27 LITT sessions. Four of the 8 patients treated with laser thermal chemotherapy remained alive after a median follow-up of 12 months. Of the 12 tumor sites treated, complete responses were located in the oral cavity (3), oropharynx (1), hypopharynx (1), maxillary sinus (1), and median survival for these patients was 9.5 months. This initial experience with cisplatinum-based laser chemotherapy indicates both safety and therapeutic potential for palliation of advanced head and neck cancer but this must be confirmed by longer follow-up in a larger cohort of patients. PMID:18493516

  20. Renal Medullary Interstitial Cells

    NASA Astrophysics Data System (ADS)

    Rao, Reena; Hao, Chuan-Ming; Breyer, Matthew D.

    2007-04-01

    Renal medullary interstitial cells (RMICs) are specialized fibroblast-like cells that reside in the renal medulla among the vasa recta, the thin limbs of Henle's loop, and medullary collecting ducts. These cells are characterized by abundant lipid droplets in the cytoplasm. The lipid droplets are composed of triglycerides, cholesterol esters and free long-chain fatty acids, including arachidonic acid. RMICs are also a major site of cyclooxygenase2 (COX-2) expression, and thus a major site of COX-2 derived prostanoid biosynthesis. RMICs are also a potential target of hormones such as angiotensin II and endothelin. The RMIC COX-2 expression and the abundance of lipid droplets change with salt and water intake. These properties of RMICs are consistent with an important role of these cells in modulating physiologic and pathologic processes of the kidney.

  1. Interstitial devices for treating deep seated tumors

    NASA Astrophysics Data System (ADS)

    Lafon, Cyril; Cathignol, Dominique; Prat, Frédéric; Melodelima, David; Salomir, Rares; Theillère, Yves; Chapelon, Jean-Yves

    2006-05-01

    Techniques using intracavitary or interstitial applicators have been proposed because extracorporeal HIFU techniques are not always suitable for deep-seated tumors. Bones or gaseous pockets may indeed be located in the intervening tissue. The objective is to bring the ultrasound source as close as possible to the target through natural routes in order to minimize the effects of attenuation and phase aberration along the ultrasound pathway. Under these circumstances, it becomes possible to use higher frequency, thus increasing the ultrasonic absorption coefficient and resulting in more efficient heating of the treatment region. In contrast to extra-corporeal applicators, the design of interstitial probes imposes additional constraints relative to size and ergonomy. The goal of this paper is to present the range of miniature interstitial applicators we developed at INSERM for various applications. The sources are rotating plane water-cooled transducers that operate at a frequency between 3 and 10 MHz depending on the desired therapeutic depth. The choice of a plane transducer rather than divergent sources permits to extend the therapeutic depth and to enhance the angular selectivity of the treatment Rotating single element flat transducer can also be replaced by cylindrical arrays for rotating electronically a reconstructed plane wave. When extended zone of coagulation are required, original therapeutic modalities combining cavitation and thermal effects are used. These methods consist in favoring in depth heating by increasing the acoustic attenuation away from the transducer with the presence of bubbles. When associated to modern imaging modalities, these minimally invasive therapeutic devices offer very promising options for cancer treatment. For examples, two versions of an image-guided esophageal applicator are designed: one uses a retractable ultrasound mini probe for the positioning of the applicator, while the other is MRI compatible and offers on line

  2. Iodine 125 interstitial irradiation for localized prostate cancer.

    PubMed Central

    Kumar, P. P.; Good, R. R.; Bartone, F. F.

    1990-01-01

    We present the technique, complications, and 5-year results of transperineal percutaneous template permanent interstitial iodine 125 endocurietherapy of localized prostate cancer in 85 treated patients. The 5-year outcome appears similar to that of external beam radiation therapy or radical surgery, but the iatrogenic mortality, morbidity, treatment time, and hospitalization are significantly reduced. Images Figure 1 Figure 2 Figure 3 PMID:2319613

  3. Iodine 125 interstitial irradiation for localized prostate cancer

    SciTech Connect

    Kumar, P.P.; Good, R.R.; Bartone, F.F. )

    1990-03-01

    We present the technique, complications, and 5-year results of transperineal percutaneous template permanent interstitial iodine 125 endocurietherapy of localized prostate cancer in 85 treated patients. The 5-year outcome appears similar to that of external beam radiation therapy or radical surgery, but the iatrogenic mortality, morbidity, treatment time, and hospitalization are significantly reduced.

  4. Localized interstitial granuloma annulare induced by subcutaneous injections for desensitization.

    PubMed

    Spring, Philipp; Vernez, Maxime; Maniu, Christa-Maria; Hohl, Daniel

    2013-06-01

    We describe a patient with interstitial granuloma annulare associated with subcutaneous injection therapy (SIT) for desensitization to a type I allergy. Asymptomatic, erythematous, violaceous annular patches were located at the injection sites on both her arms. Medical history revealed perennial rhinoconjonctivitis treated with SIT (Phostal Stallergen® cat 100% and D. pteronyssinus/D.farinae 50%:50%). PMID:24011321

  5. [A Case of Disseminated Cutaneous Mycobacterium chelonae Infection Successfully Improved with Thermal Therapy].

    PubMed

    Yoshimoto, Akira; Nakamura-Uchiyama, Fukumi; Sato, Masatoshi; Fukumori, Tatsuya; Yamada, Yutaka; Hishiya, Naokuni; Shiraishi, Naotaka; Ogawa, Taku; Uno, Kenji; Kasahara, Kei; Maeda, Koichi; Konishi, Mitsuru; Yoshikawa, Masahide; Mikasa, Keiichi

    2015-05-01

    A 54-year-old female with dermatomyositis treated with cyclosporine and methylprednisolone presented with multiple subcutaneous nodules on her upper and lower extremities on December 2011. The number of lesions gradually increased. She had a history of surgical intervention such as debridement, skin graft of right lower leg due to trauma and subsequent bacterial infection on August 2011. Culture from a skin lesion on June 2012 confirmed Mycobacterium chelonae, which was susceptible to clarithromycin (CAM). We started treatment with CAM, imipenem/cilastatin (IPM/CS) and tobramycin (TOB) for 2 weeks. Then CAM monotherapy was continued, however CAM was discontinued because of liver dysfunction. In September 2012 new nodular lesions were observed on the left arm and right leg. We administrated azithromycin, IPM/CS and TOB. Subcutaneous nodules were partially improved, but new lesions appeared on her right leg. A culture of skin lesion yielded M. chelonae, which was highly resistant to CAM and IPM/CS. Based on the sensitivity test, moxifloxacin was used. However, there was no significant improvement in her skin lesions, so we started thermal therapy on day 57 after admission. She showed an excellent response to thermal therapy, and there has been no recurrence. PMID:26552135

  6. Real-time Microwave Imaging of Differential Temperature for Thermal Therapy Monitoring

    PubMed Central

    Haynes, Mark; Stang, John; Moghaddam, Mahta

    2014-01-01

    A microwave imaging system for real-time 3D imaging of differential temperature has been developed for the monitoring and feedback of thermal therapy systems. Design parameters are constrained by features of a prototype focused microwave thermal therapy system for the breast, operating at 915 MHz. Real-time imaging is accomplished with a precomputed linear inverse scattering solution combined with continuous Vector Network Analyzer (VNA) measurements of a 36-antenna, HFSS modeled, cylindrical cavity. Volumetric images of differential change of dielectric constant due to temperature are formed with a refresh rate as fast as 1 frame per second and 1°C resolution. Procedures for data segmentation and post-processed S-parameter error-correction are developed. Antenna pair VNA calibration is accelerated by using the cavity as the unknown thru standard. The device is tested on water targets and a simple breast phantom. Differentially heated targets are successfully imaged in cluttered environments. The rate of change of scattering contrast magnitude correlates 1:1 with target temperature. PMID:24845289

  7. Monitoring and guidance of minimally-invasive thermal therapy using diagnostic ultrasound.

    PubMed

    Ebbini, Emad S; Bischof, John C

    2009-01-01

    We present specialized ultrasound imaging modes for monitoring and guidance of noninvasive and minimally-invasive thermal therapy. One mode is based on two-dimensional imaging of temperature change using diagnostic ultrasound. We have validated this method both in vivo and in vitro in monitoring the heating patterns produced by noninvasive HIFU source and minimally-invasive RF ablation device, respectively. In addition, a nonlinear method for imaging the quadratic echo components from HIFU-induced lesions has also been developed and tested in vivo. Illustrative results from both modes of imaging are presented. These results demonstrate the unique advantages of ultrasound as an image-guidance modality. Specifically, the high spatial and temporal resolutions that allow for imaging highly-localized short-duration therapeutic and sub-therapeutic HIFU beams. With the advent of highperformance computing hardware, these imaging modes are now implementable in real-time. This will lead to active realtime monitoring and control of a range of thermal therapies in the very near future. PMID:19963819

  8. Trapping of interstitials in metals

    SciTech Connect

    Wert, C.A.; Frank, R.C.

    1983-01-01

    The term trapping is used extensively to refer to the fact that interstitial atoms often find interstices associated with lattice imperfections to be energetically preferable to normal sites. This preference results in a delay of diffusion of interstitial atoms near these sites. As understanding of the details of lattice imperfections has improved, understanding of the effect of traps on the diffusion process has increased. Trapping is often illustrated by the use of a potential energy diagram. This simple model is characterized by a potential energy well deeper than those of surrounding interstitial sites. The energy required for the interstitial to jump into the trap is the same as that required for jumping into other adjacent interstitial sites, but that required for jumping out is greater. The additional energy required to leave the site is often designated as the trap binding energy, E/sub B/. Potential energy diagrams appropriate for most traps in metals are likely to be more complicated, but this simple model is a starting point for more sophisticated models of trapping. Imperfections may occasionally produce interstitial sites less favorable than normal sites and thus be less preferred. Little experimental exploration of this anti-trapping phenomenon has been carried out, however. Developments in understanding at various levels of trapping of interstitial impurities by lattice imperfections are examined.

  9. Cryo-thermal therapy elicits potent anti-tumor immunity by inducing extracellular Hsp70-dependent MDSC differentiation.

    PubMed

    Zhu, Jun; Zhang, Yan; Zhang, Aili; He, Kun; Liu, Ping; Xu, Lisa X

    2016-01-01

    Achieving control of metastatic disease is a long-sought goal in cancer therapy. Treatments that encourage a patient's own immune system are bringing new hopes in reaching such a goal. In clinic, local hyperthermia and cryoablation have been explored to induce anti-tumor immune responses against tumors. We have also developed a novel therapeutic modality of cryo-thermal treatment by alternating liquid nitrogen (LN2) cooling and radio frequency (RF) heating, and better therapeutic effect was achieved in treating metastatic cancer in animal model. In this study, we investigated the mechanism of systemic immune response elicited by cryo-thermal therapy. In the 4T1 murine mammary carcinoma model, we found that local cryo-thermal therapy resulted in a considerable reduction of distant lung metastases, and improved long-term survival. Moreover, results of tumor re-challenge experiments indicated generation of a strong tumor-specific immune memory after the local treatment of primary tumors. Our further study indicated that cryo-thermal therapy caused an elevated extracellular release of Hsp70. Subsequently, Hsp70 induced differentiation of MDSCs into mature DCs, contributing to the relief of MDSCs-mediated immunosuppression and ultimately the activation of strong anti-tumor immune response. Our findings reveal new insight into the mechanism of robust therapeutic effects of cryo-thermal therapy against metastatic cancers. PMID:27256519

  10. Cryo-thermal therapy elicits potent anti-tumor immunity by inducing extracellular Hsp70-dependent MDSC differentiation

    NASA Astrophysics Data System (ADS)

    Zhu, Jun; Zhang, Yan; Zhang, Aili; He, Kun; Liu, Ping; Xu, Lisa X.

    2016-06-01

    Achieving control of metastatic disease is a long-sought goal in cancer therapy. Treatments that encourage a patient’s own immune system are bringing new hopes in reaching such a goal. In clinic, local hyperthermia and cryoablation have been explored to induce anti-tumor immune responses against tumors. We have also developed a novel therapeutic modality of cryo-thermal treatment by alternating liquid nitrogen (LN2) cooling and radio frequency (RF) heating, and better therapeutic effect was achieved in treating metastatic cancer in animal model. In this study, we investigated the mechanism of systemic immune response elicited by cryo-thermal therapy. In the 4T1 murine mammary carcinoma model, we found that local cryo-thermal therapy resulted in a considerable reduction of distant lung metastases, and improved long-term survival. Moreover, results of tumor re-challenge experiments indicated generation of a strong tumor-specific immune memory after the local treatment of primary tumors. Our further study indicated that cryo-thermal therapy caused an elevated extracellular release of Hsp70. Subsequently, Hsp70 induced differentiation of MDSCs into mature DCs, contributing to the relief of MDSCs-mediated immunosuppression and ultimately the activation of strong anti-tumor immune response. Our findings reveal new insight into the mechanism of robust therapeutic effects of cryo-thermal therapy against metastatic cancers.

  11. Cryo-thermal therapy elicits potent anti-tumor immunity by inducing extracellular Hsp70-dependent MDSC differentiation

    PubMed Central

    Zhu, Jun; Zhang, Yan; Zhang, Aili; He, Kun; Liu, Ping; Xu, Lisa X.

    2016-01-01

    Achieving control of metastatic disease is a long-sought goal in cancer therapy. Treatments that encourage a patient’s own immune system are bringing new hopes in reaching such a goal. In clinic, local hyperthermia and cryoablation have been explored to induce anti-tumor immune responses against tumors. We have also developed a novel therapeutic modality of cryo-thermal treatment by alternating liquid nitrogen (LN2) cooling and radio frequency (RF) heating, and better therapeutic effect was achieved in treating metastatic cancer in animal model. In this study, we investigated the mechanism of systemic immune response elicited by cryo-thermal therapy. In the 4T1 murine mammary carcinoma model, we found that local cryo-thermal therapy resulted in a considerable reduction of distant lung metastases, and improved long-term survival. Moreover, results of tumor re-challenge experiments indicated generation of a strong tumor-specific immune memory after the local treatment of primary tumors. Our further study indicated that cryo-thermal therapy caused an elevated extracellular release of Hsp70. Subsequently, Hsp70 induced differentiation of MDSCs into mature DCs, contributing to the relief of MDSCs-mediated immunosuppression and ultimately the activation of strong anti-tumor immune response. Our findings reveal new insight into the mechanism of robust therapeutic effects of cryo-thermal therapy against metastatic cancers. PMID:27256519

  12. Similarities between interstitial cystitis/bladder pain syndrome and vulvodynia: implications for patient management

    PubMed Central

    Moldwin, Robert M.

    2015-01-01

    Interstitial cystitis/bladder pain syndrome (IC/BPS) and vulvodynia are chronic pain syndromes that appear to be intertwined from the perspectives of embryology, pathology and epidemiology. These associations may account for similar responses to various therapies. PMID:26816866

  13. A model evaluation study for treatment planning of laser-induced thermal therapy.

    PubMed

    Fahrenholtz, Samuel J; Moon, Tim Y; Franco, Michael; Medina, David; Danish, Shabbar; Gowda, Ashok; Shetty, Anil; Maier, Florian; Hazle, John D; Stafford, Roger J; Warburton, Tim; Fuentes, David

    2015-01-01

    A cross-validation analysis evaluating computer model prediction accuracy for a priori planning magnetic resonance-guided laser-induced thermal therapy (MRgLITT) procedures in treating focal diseased brain tissue is presented. Two mathematical models are considered. (1) A spectral element discretisation of the transient Pennes bioheat transfer equation is implemented to predict the laser-induced heating in perfused tissue. (2) A closed-form algorithm for predicting the steady-state heat transfer from a linear superposition of analytic point source heating functions is also considered. Prediction accuracy is retrospectively evaluated via leave-one-out cross-validation (LOOCV). Modelling predictions are quantitatively evaluated in terms of a Dice similarity coefficient (DSC) between the simulated thermal dose and thermal dose information contained within N = 22 MR thermometry datasets. During LOOCV analysis, the transient model's DSC mean and median are 0.7323 and 0.8001 respectively, with 15 of 22 DSC values exceeding the success criterion of DSC ≥ 0.7. The steady-state model's DSC mean and median are 0.6431 and 0.6770 respectively, with 10 of 22 passing. A one-sample, one-sided Wilcoxon signed-rank test indicates that the transient finite element method model achieves the prediction success criteria, DSC ≥ 0.7, at a statistically significant level. PMID:26368014

  14. Comparison of cryotherapy and thermal therapy for breast cancer treatment simulations

    NASA Astrophysics Data System (ADS)

    Ryan, Thomas P.

    2001-05-01

    Breast cancer presents an ongoing challenge in regard to treatment efficacy and successful clinical outcomes. There has been a challenge to increase the survival rate over the past 50 years and only recently have clinical outcomes improved, although slightly. Thermal treatment regimes have been evolving and most recently, have been applied in situ. A standalone treatment for malignancies is challenging due to the rigor in achieving homogeneity in the distribution of therapeutic temperatures in the tumor and the lack of therapy in the adjacent normal tissue. Although initial work used lasers, contemporary work utilizes radiofrequency (RF) or cryotherapy as a treatment modality. Both monopolar and bipolar RF devices were modeled for the RF treatments in the breast. Using finite element techniques, these two modalities were simulated in breast tissue and the results of the bioheat equation compared for similar sized devices. The model incorporated changing electrical and thermal properties of tissue with temperature, as well as blood flow changes. For thermal treatment, the isotherm of +55 degree(s)C was considered the margin of coagulation necrosis, while for cryotreatment, the -40 degree(s)C isotherm was used. The comparison aids in the selection of the best method to improve clinical outcomes, while paying attention to the size of the applicator and time length of treatment.

  15. Interstitial Cystitis (IC) Diet

    MedlinePlus

    ... Pain Complementary Therapies Complementary vs. Alternative Herbs, Dietary Supplements, & Biologicals Mind-body Medicine Massage, Manipulation, & Body-based Practices Energy Medicine Bringing Treatments to Market IC Healthcare Provider ...

  16. Interstitial lung disease - adults - discharge

    MedlinePlus

    ... lung disease Pulmonary alveolar proteinosis Rheumatoid lung disease Sarcoidosis Patient Instructions Eating extra calories when sick - adults ... team. Related MedlinePlus Health Topics Interstitial Lung Diseases Sarcoidosis Browse the Encyclopedia A.D.A.M., Inc. ...

  17. Successful alectinib treatment after crizotinib-induced interstitial lung disease.

    PubMed

    Fujiuchi, Satoru; Fujita, Yuka; Sasaki, Takaaki; Ohsaki, Yoshinobu

    2016-05-01

    A 70-year-old woman with lung adenocarcinoma, harbouring anaplastic lymphoma kinase gene rearrangement, was treated with crizotinib as third-line chemotherapy. After 2 months, crizotinib was discontinued because of the development of crizotinib-induced interstitial lung disease (ILD). Steroid treatment was then introduced and tapered off. Following complete resolution of the interstitial shadow, cytotoxic chemotherapy was initiated, and continued for over 2 years, until new intrapulmonary lesions developed. Although there was a risk of drug-induced interstitial pneumonia, alectinib was initiated as the fifth-line therapy, without steroid supplementation, as there was no alternative treatment. No recurrence of ILD was noted at 10 months. To our knowledge, this is the first report of successful alectinib treatment after the development of crizotinib-induced ILD without the use of prednisolone. PMID:27516885

  18. Successful alectinib treatment after crizotinib‐induced interstitial lung disease

    PubMed Central

    Fujita, Yuka; Sasaki, Takaaki; Ohsaki, Yoshinobu

    2016-01-01

    Abstract A 70‐year‐old woman with lung adenocarcinoma, harbouring anaplastic lymphoma kinase gene rearrangement, was treated with crizotinib as third‐line chemotherapy. After 2 months, crizotinib was discontinued because of the development of crizotinib‐induced interstitial lung disease (ILD). Steroid treatment was then introduced and tapered off. Following complete resolution of the interstitial shadow, cytotoxic chemotherapy was initiated, and continued for over 2 years, until new intrapulmonary lesions developed. Although there was a risk of drug‐induced interstitial pneumonia, alectinib was initiated as the fifth‐line therapy, without steroid supplementation, as there was no alternative treatment. No recurrence of ILD was noted at 10 months. To our knowledge, this is the first report of successful alectinib treatment after the development of crizotinib‐induced ILD without the use of prednisolone. PMID:27516885

  19. Dynamic model of thermal reaction of biological tissues to laser-induced fluorescence and photodynamic therapy.

    PubMed

    Seteikin, Alexey Yu; Krasnikov, Ilya V; Drakaki, Eleni; Makropoulou, Mersini

    2013-07-01

    The aim of this work was to evaluate the temperature fields and the dynamics of heat conduction into the skin tissue under several laser irradiation conditions with both a pulsed ultraviolet (UV) laser (λ=337  nm) and a continuous-wave (cw) visible laser beam (λ=632.8  nm) using Monte Carlo modeling. Finite-element methodology was used for heat transfer simulation. The analysis of the results showed that heat is not localized on the surface, but is collected inside the tissue in lower skin layers. The simulation was made with the pulsed UV laser beam (used as excitation source in laser-induced fluorescence) and the cw visible laser (used in photodynamic therapy treatments), in order to study the possible thermal effects. PMID:23839531

  20. [Respiratory bronchiolitis-associated interstitial lung disease (RB-ILD)].

    PubMed

    Goeckenjan, G

    2003-05-01

    prognosis. After smoking cessation lung changes are reversible. Corticosteroid therapy is not necessary. A fatal outcome of RB-ILD has not been reported. Follow-up examinations are advisable in order to preclude other interstitial lung diseases. RB-ILD seems to be more frequent than it is assumed at present. The clinical picture is masked in most cases by the concomitant smoking induced chronic bronchitis. Thus only pronounced cases with structural changes and resulting differential diagnostic problems are diagnosed. PMID:12784181

  1. Magnetomotive optical coherence elastography (MM-OCE) for thermal therapy dosimetry (Conference Presentation)

    NASA Astrophysics Data System (ADS)

    Huang, Pin-Chieh; Marjanovic, Marina; Spillman, Darold R.; Odintsov, Boris M.; Boppart, Stephen A.

    2016-03-01

    Biomechanical properties of tissues have been utilized for disease detection, diagnosis, and progression, however they have not been extensively utilized for therapy dosimetry. Magnetic hyperthermia aims to kill cells and ablate tumors using magnetic nanoparticles (MNPs) either injected in or targeted to tumors. Upon application of an appropriate AC magnetic field, MNPs can heat target tissue while sparing non-targeted healthy tissue. However, a sensitive monitoring technique for the dose of magnetic hyperthermia is needed to prevent over-treatment and collateral injury. During hyperthermia treatments, the viscoelastic properties of tissues are altered due to protein denaturation, coagulation, and tissue dehydration, making these properties candidates for dosimetry. Magnetomotive optical coherence elastography (MM-OCE) utilizes MNPs as internal force transducers to probe the biomechanical properties of tissues. Therefore, we aim to evaluate the hyperthermia dose based on the elastic changes revealed by MM-OCE. In this study, MNPs embedded in tissues were utilized for both hyperthermia and MM-OCE measurements. Tissue temperature and elastic modulus were obtained, where the elastic modulus was extracted from the resonance frequency detected by MM-OCE. Results showed a correlation between stiffness and temperature change following treatment. To investigate the thermal-dose-dependent changes, intervals of hyperthermia treatment were repeatedly performed on the same tissue sequentially, interspersed with MM-OCE. With increasing times of treatment, tissue stiffness increased, while temperature rise remained relatively constant. These results suggest that MM-OCE may potentially identify reversible and irreversible tissue changes during thermal therapy, supporting the use of MM-OCE for dosimetric control of hyperthermia in future applications.

  2. Pain and the thermally injured patient-a review of current therapies.

    PubMed

    Retrouvey, Helene; Shahrokhi, Shahriar

    2015-01-01

    Thermally injured patients experience tremendous pain from the moment of injury to months or years after their discharge from the hospital. Pain is therefore a critical component of proper management of burns. Although the importance of pain is well recognized, it is often undertreated. Acute uncontrolled pain has been shown to increase the incidence of mental health disorders and increase the incidence of suicide after discharge. Long-term poor pain control leads to an increase in the incidence of persistent pain. Most burn centers have used opioids as the mainstay analgesic, but recently, the significant side effects of opioids have led to the implementation of new and combined therapeutics. Pharmacological agents such as gabapentin, clonidine, dexmedetomidine, and ketamine have all been suggested as adjuncts to opioids in the treatment of burn pain. Nonpharmacological therapies such as hypnosis, virtual reality devices, and behavioral therapy are also essential adjuncts to current medications. This review aims at identifying the currently available pharmacological and nonpharmacological options for optimal pain management in the adult burn population. PMID:24823343

  3. Magnetic field activated drug release system based on magnetic PLGA microspheres for chemo-thermal therapy.

    PubMed

    Fang, Kun; Song, Lina; Gu, Zhuxiao; Yang, Fang; Zhang, Yu; Gu, Ning

    2015-12-01

    Controlled drug delivery systems have been extensively investigated for cancer therapy in order to obtain better specific targeting and therapeutic efficiency. Herein, we developed doxorubicin-loaded magnetic PLGA microspheres (DOX-MMS), in which DOX was encapsulated in the core and high contents (28.3 wt%) of γ-Fe2O3 nanoparticles (IOs) were electrostatically assembled on the surface of microsphere to ensure the high sensitivity to response of an external alternating current magnetic field (ACMF). The IOs in PLGA shell can both induce the heat effect and trigger shell permeability enhancement to release drugs when DOX-MMs was activated by ACMF. Results show that the cumulative drug release from DOX-MMs exposed to ACMF for 30 min (21.6%) was significantly higher (approximately 7 times higher) than that not exposed to ACMF (2.8%). The combination of hyperthermia and enhanced DOX release from DOX-MMS is beneficial for in vitro 4T1 breast cancer cell apoptosis as well as effective inhibition of tumor growth in 4T1 tumor xenografts. Therefore, the DOX-MMS can be optimized as powerful delivery system for efficient magnetic responsive drug release and chemo-thermal therapy. PMID:26513754

  4. Multifunctional upconversion nanoprobe for tumor fluorescence imaging and near-infrared thermal therapy

    NASA Astrophysics Data System (ADS)

    Wei, Yanchun; Chen, Qun; Wu, Baoyan; Xing, Da

    2014-09-01

    The combination of diagnostics and therapeutics is growing rapidly in cancer treatment. Here, using upconversion nanoparticles coated with chitosan conjugated with a targeting molecule and loaded with indocyanine green (ICG), an excitation-selectable nanoprobe with highly integrated functionalities, including the emission of visible and near-infrared (NIR) light, strong optical absorption in the NIR region and high photostability was developed. After injected in mice, the nanoprobes targeted to the tumor vascular system. NIR lasers (980 and 808 nm) were then selectively applied to the mice. The results show that, the emitted upconversion fluorescence and NIR fluorescence can be used in a complementary manner for high signal/noise ratio and sensitive tumor imaging for more precise tumor localization; Highly effective photothermal therapy can be realized using 808 nm laser irradiation. The upconversion fluorescence at 654 nm is useful for monitoring treatment effect during thermal therapy. In summary, using the nanoprobes, outstanding therapeutic efficacy could be realized and the nanofabrication strategy would highlight the promise of upconversion nanoparticles in cancer theranostics.

  5. Excitation-Selectable Nanoprobe for Tumor Fluorescence Imaging and Near-Infrared Thermal Therapy.

    PubMed

    Wei, Yanchun; Chen, Qun; Wu, Baoyan; Xing, Da

    2016-01-01

    The combination of diagnostics and therapeutics is growing rapidly in cancer treatment. Here, using upconversion nanoparticles coated with chitosan conjugated with a targeting molecule and loaded with indocyanine green (ICG), we develop an excitation-selectable nanoprobe with highly integrated functionalities, including the emission of visible and near-infrared (NIR) light, strong optical absorption in the NIR region and high photostability. After intravenous injection in tumor bearing mice, the nanoprobes target to the tumor vascular system. NIR lasers (980 and 808 nm) are then selectively applied to the mice. The results show that the emitted upconversion fluorescence and NIR fluorescence can be used in a complementary manner for high signal/noise ratio and sensitive tumor imaging for more precise tumor localization. Highly effective photothermal therapy is realized using 808 nm laser irradiation, and the upconversion fluorescence at 654 nm can be used for monitoring treatment effect during the thermal therapy. In summary, using the nanoprobes, outstanding therapeutic efficacy could be realized through flexible excitation control, precise tumor localization, highly effective photothermal conversion and real-time treatment monitoring. The nanofabrication strategy highlights the promise of nanoparticles in cancer theranostics. PMID:27301175

  6. Interstitial laser immunotherapy for treatment of metastatic mammary tumors in rats

    NASA Astrophysics Data System (ADS)

    Figueroa, Daniel; Joshi, Chet; Wolf, Roman F.; Walla, Jonny; Goddard, Jessica; Martin, Mallory; Kosanke, Stanley D.; Broach, Fred S.; Pontius, Sean; Brown, Destiny; Li, Xiaosong; Howard, Eric; Nordquist, Robert E.; Hode, Tomas; Chen, Wei R.

    2011-03-01

    Thermal therapy has been used for cancer treatment for more than a century. While thermal effect can be direct, immediate, and controllable, it is not sufficient to completely eradicate tumors, particularly when tumors have metastasized locally or to the distant sites. Metastases are the major cause of treatment failure and cancer deaths. Current available therapies, such as surgery, radiation, and chemotherapy, only have limited curative effects in patients with late-stage, metastatic cancers. Immunotherapy has been considered as the ultimate approach for cancer treatment since a systemic, anti-tumor, immunological response can be induced. Using the combination of photothermal therapy and immunotherapy, laser immunotherapy (LIT),a novel immunotherapy modality for late-stage cancer treatment, has been developed. LIT has shown great promise in pre-clinical studies and clinical breast cancer and melanoma pilot trials. However, the skin color and the depth of the tumor have been challenges for effective treatment with LIT. To induce a thermal destruction zone of appropriate size without causing thermal damage on the skin, we have developed interstitial laser immunotherapy (ILIT) using a cylindrical diffuser. To determine the effectiveness of ILIT, we treated the DMBA-4 metastatic tumors in rats. The thermal damage in tumor tissue was studied using TTC immersion and hematoxolin and eosin (H & E) staining. Also observed was the overall survival of the treated animals. Our results demonstrated that the ILIT could impact a much larger tumor area, and it significantly reduced the surface damage compared with the early version of non-invasive LIT. The survival data also indicate that ILIT has the potential to become an effective tool for the treatment of deeper, larger, and metastatic tumors, with reduced side effects.

  7. Characterisation of patients with interstitial pneumonia with autoimmune features.

    PubMed

    Oldham, Justin M; Adegunsoye, Ayodeji; Valenzi, Eleanor; Lee, Cathryn; Witt, Leah; Chen, Lena; Husain, Aliya N; Montner, Steven; Chung, Jonathan H; Cottin, Vincent; Fischer, Aryeh; Noth, Imre; Vij, Rekha; Strek, Mary E

    2016-06-01

    Patients with interstitial lung disease (ILD) may have features of connective tissue disease (CTD), but lack findings diagnostic of a specific CTD. A recent European Respiratory Society/American Thoracic Society research statement proposed criteria for patients with interstitial pneumonia with autoimmune features (IPAF).We applied IPAF criteria to patients with idiopathic interstitial pneumonia and undifferentiated CTD-ILD (UCTD). We then characterised the clinical, serological and morphological features of the IPAF cohort, compared outcomes to other ILD cohorts and validated individual IPAF domains using survival as an endpoint.Of 422 patients, 144 met IPAF criteria. Mean age was 63.2 years with a slight female predominance. IPAF cohort survival was marginally better than patients with idiopathic pulmonary fibrosis, but worse than CTD-ILD. A non-usual interstitial pneumonia pattern was associated with improved survival, as was presence of the clinical domain. A modified IPAF cohort of those meeting the clinical domain and a radiographic or histological feature within the morphological domain displayed survival similar to those with CTD-ILD.IPAF is common among patients with idiopathic interstitial pneumonia and UCTD. Specific IPAF features can identify subgroups with differential survival. Further research is needed to replicate these findings and determine whether patients meeting IPAF criteria benefit from immunosuppressive therapy. PMID:27103387

  8. Thermal neutron irradiation field design for boron neutron capture therapy of human explanted liver.

    PubMed

    Bortolussi, S; Altieri, S

    2007-12-01

    The selective uptake of boron by tumors compared to that by healthy tissue makes boron neutron capture therapy (BNCT) an extremely advantageous technique for the treatment of tumors that affect a whole vital organ. An example is represented by colon adenocarcinoma metastases invading the liver, often resulting in a fatal outcome, even if surgical resection of the primary tumor is successful. BNCT can be performed by irradiating the explanted organ in a suitable neutron field. In the thermal column of the Triga Mark II reactor at Pavia University, a facility was created for this purpose and used for the irradiation of explanted human livers. The neutron field distribution inside the organ was studied both experimentally and by means of the Monte Carlo N-particle transport code (MCNP). The liver was modeled as a spherical segment in MCNP and a hepatic-equivalent solution was used as an experimental phantom. In the as-built facility, the ratio between maximum and minimum flux values inside the phantom ((phi(max)/phi(min)) was 3.8; this value can be lowered to 2.3 by rotating the liver during the irradiation. In this study, the authors proposed a new facility configuration to achieve a uniform thermal neutron flux distribution in the liver. They showed that a phi(max)/phi(min) ratio of 1.4 could be obtained without the need for organ rotation. Flux distributions and dose volume histograms were reported for different graphite configurations. PMID:18196797

  9. Thermal neutron irradiation field design for boron neutron capture therapy of human explanted liver

    SciTech Connect

    Bortolussi, S.; Altieri, S.

    2007-12-15

    The selective uptake of boron by tumors compared to that by healthy tissue makes boron neutron capture therapy (BNCT) an extremely advantageous technique for the treatment of tumors that affect a whole vital organ. An example is represented by colon adenocarcinoma metastases invading the liver, often resulting in a fatal outcome, even if surgical resection of the primary tumor is successful. BNCT can be performed by irradiating the explanted organ in a suitable neutron field. In the thermal column of the Triga Mark II reactor at Pavia University, a facility was created for this purpose and used for the irradiation of explanted human livers. The neutron field distribution inside the organ was studied both experimentally and by means of the Monte Carlo N-particle transport code (MCNP). The liver was modeled as a spherical segment in MCNP and a hepatic-equivalent solution was used as an experimental phantom. In the as-built facility, the ratio between maximum and minimum flux values inside the phantom ({phi}{sub max}/{phi}{sub min}) was 3.8; this value can be lowered to 2.3 by rotating the liver during the irradiation. In this study, the authors proposed a new facility configuration to achieve a uniform thermal neutron flux distribution in the liver. They showed that a {phi}{sub max}/{phi}{sub min} ratio of 1.4 could be obtained without the need for organ rotation. Flux distributions and dose volume histograms were reported for different graphite configurations.

  10. Photo-thermal therapy of bladder cancer with Anti-EGFR antibody conjugated gold nanoparticles.

    PubMed

    Chen, Chieh Hsiao; Wu, Yi-Jhen; Chen, Jia-Jin

    2016-01-01

    The aim of this study was to enhance the effectiveness of photo thermal therapy (PTT) in the targeting of superficial bladder cancers using a green light laser in conjunction with gold nanoparticles (GNPs) conjugated to antibody fragments (anti-EGFR). GNPs conjugated with anti-EGFR-antibody fragments were used as probes in the targeting of tumor cells and then exposed to a green laser (532nm), resulting in the production of sufficient thermal energy to kill urothelial carcinomas both in vitro and in vivo. Nanoparticles conjugated with antibody fragments are capable of damaging cancer cells even at relatively very low energy levels, while non-conjugated nanoparticles would require an energy level of 3 times under the same conditions. The lower energy required by the nanoparticles allows this method to destroy cancerous cells while preserving normal cells when applied in vivo. Nanoparticles conjugated with antibody fragments (anti-EGFR) require less than half the energy of non-conjugated nanoparticles to kill cancer cells. In an orthotopic bladder cancer model, the group treated using PTT presented significant differences in tumor development. PMID:27100501

  11. Methotrexate conjugated magnetic nanoparticle for targeted drug delivery and thermal therapy

    NASA Astrophysics Data System (ADS)

    Gupta, Jagriti; Bhargava, Parag; Bahadur, D.

    2014-05-01

    A simple soft chemical approach is used for the preparation of citrate functionalized iron oxide (Fe3O4) aqueous colloidal magnetic nanoparticles (CA-MNPs) of average size ˜10 nm. The CA-MNPs exhibit superparamagnetic behavior at room temperature with strong field dependent magnetic responsivity. The CA-MNPs can be conjugated with Methotrexate (MTX) drug through amide bonds between the carboxylic group on the surface of MNPs and amine group of MTX. The surface functionalization of Fe3O4 nanoparticles with citric acid and conjugation of MTX drug is evident from FTIR spectroscopy, zeta-potential measurement, and elemental and thermal analyses. From the drug release study, it has been observed that this bonding of MTX conjugated MNPs (MTX-MNPs) is cleaved by the intracellular enzymes in lysosome, and MTX is delivered largely inside target cancerous cells at lower pH, thereby reducing toxicity to normal cells. Also, it has been observed that the intercellular uptake of MTX-MNPs is higher compared to CA-MNPs. In addition, the aqueous colloidal stability, optimal magnetization, and good specific absorption rate (under external AC magnetic field) of CA-MNPs act as effective heating source for thermal therapy. Cytotoxicity study of MTX-MNPs shows the reduction of cellular viability for human cervical cancer cells (HeLa). Further, a synergistic effect of MTX-MNPs shows a more effective tumor cell death due to the combined effect of thermo-chemotherapy.

  12. A NEW SINGLE-CRYSTAL FILTERED THERMAL NEUTRON SOURCE FOR NEUTRON CAPTURE THERAPY RESEARCH AT THE UNIVERSITY OF MISSOURI

    SciTech Connect

    John D. Brockman; David W. Nigg; M. Frederick Hawthorne

    2008-09-01

    Parameter studies, design calculations and initial neutronic performance measurements have been completed for a new thermal neutron beamline to be used for neutron capture therapy cell and small-animal radiobiology studies at the University of Missouri Research Reactor. The beamline features the use of single-crystal silicon and bismuth sections for neutron filtering and for reduction of incident gamma radiation. The calculated and measured thermal neutron flux produced at the irradiation location is on the order of 9.5x108 neutrons/cm2-s, with a measured cadmium ratio (Au foils) of 105, indicating a well-thermalized spectrum.

  13. Initial Performance Characterization for a Thermalized Neutron Beam for Neutron Capture Therapy Research at Washington State University

    SciTech Connect

    David W. Nigg; P.E> Sloan; J.R. Venhuizen; C.A. Wemple

    2005-11-01

    The Idaho National Engineering and Environmental Laboratory (INEEL) and Washington State University (WSU) have constructed a new epithermal-neutron beam for collaborative Boron Neutron Capture Therapy (BNCT) preclinical research at the WSU TRIGATM research reactor facility1. More recently, additional beamline components were developed to permit the optional thermalization of the beam for certain types of studies where it is advantageous to use a thermal neutron source rather than an epithermal source. This article summarizes the results of some initial neutronic performance measurements for the thermalized system, with a comparison to the expected performance from the design computations.

  14. Application of an ultraminiature thermal neutron monitor for irradiation field study of accelerator-based neutron capture therapy

    PubMed Central

    Ishikawa, Masayori; Tanaka, Kenichi; Endo, Satrou; Hoshi, Masaharu

    2015-01-01

    Phantom experiments to evaluate thermal neutron flux distribution were performed using the Scintillator with Optical Fiber (SOF) detector, which was developed as a thermal neutron monitor during boron neutron capture therapy (BNCT) irradiation. Compared with the gold wire activation method and Monte Carlo N-particle (MCNP) calculations, it was confirmed that the SOF detector is capable of measuring thermal neutron flux as low as 105 n/cm2/s with sufficient accuracy. The SOF detector will be useful for phantom experiments with BNCT neutron fields from low-current accelerator-based neutron sources. PMID:25589504

  15. Connective tissue disease-associated interstitial pneumonia and idiopathic interstitial pneumonia: similarity and difference.

    PubMed

    Bryson, Thomas; Sundaram, Baskaran; Khanna, Dinesh; Kazerooni, Ella A

    2014-02-01

    Interstitial lung diseases (ILDs) are increasingly recognized in patients with systemic diseases. Patients with early ILD changes may be asymptomatic. Features of ILD overlap among systemic diseases and with idiopathic variety. High-resolution computed tomography plays a central role in diagnosing ILDs. Imaging features are often nonspecific. Therapy- and complication-related lung changes would pose difficulty in diagnosing and classifying an ILD. Biology and prognosis of secondary ILDs may differ between different disease-related ILDs and idiopathic variety. Combination of clinical features, serological tests, pulmonary and extrapulmonary imaging findings, and pathology findings may help to diagnose ILDs. PMID:24480141

  16. Interstitial Functionalization in elemental Si

    NASA Astrophysics Data System (ADS)

    Kiefer, Boris; Fohtung, Edwin

    Societies in the 21st century will face many challenges. Materials science and materials design will be essential to address and master some if not all of these challenges. Semiconductors are among the most important technological material classes. Properties such as electrical transport are strongly affected by defects and a central goal continues to be the reduction of defect densities as much as possible in these compounds. Here we present results of interstitial Fe doping in elemental Si using first-principles DFT calculations. The preliminary results show that Fe will only occupy octahedral interstitial sites. The analysis of the electronic structure shows that the compounds are ferromagnetic and that a bandgap opens as interstitial Fe concentrations decrease, with a possible intermittent semi-metallic phase. The formation energy for interstitial Fe is unfavorable, as expected, by ~1.5 eV but becomes favorable as the chemical potential of Fe increases. Therefore, we expect that biasing the system with an external electrical field will lead to the formation of these materials. Thus, our results show that interstitial defects can be beneficial for the design of functionalities that differ significantly from those of the host material.

  17. Prediction of heating patterns of a microwave interstitial antenna array at various insertion depths.

    PubMed

    Zhang, Y; Joines, W T; Oleson, J R

    1991-01-01

    Measurements made on the interstitial microwave antennas used for hyperthermia cancer therapy indicate that the heating patterns vary with the insertion depths (defined as the distance from the antenna tip to air-tissue interface). The antennas are made of thin coaxial cables with a radiation gap or gaps on the outer conductor. The antennas are inserted into small polypropylene catheters implanted in the tumour volume. This type of antenna may be simulated as an asymmetric dipole with one arm being the tip section consisting of the expanded extension of the inner conductor, and the other arm being the section of the outer conductor from the gap to the insertion point (air-tissue interface). We use four of the antennas to form a 2 cm x 2 cm array. The antennas are positioned on the corners of a 2 cm square. Measurements on both single antennas and multi-antenna arrays show that the maximum heating is not stationary with position along the antenna when the depth of insertion is changed. This paper investigates the theoretical prediction of the changes in heating patterns of interstitial microwave antennas at different insertion depths. Each of the antennas in the array is simulated as an asymmetric dipole. The SAR (specific absorption rate) is computed by using the insulated dipole theory. The temperature distribution in absence of perfusion is obtained through a thermal simulation routine to convert the SAR pattern into the temperature pattern. Excellent qualitative agreement is found between the theoretical heating pattern and the measured pattern in a non-perfused phantom on a 2 cm x 2 antenna array. Since the insertion depths of the interstitial antennas are different from patient to patient, it is recommended that simulation of the heating be done before treatments, to confirm the delivery of power to the target region. PMID:2051073

  18. Pathology of Idiopathic Interstitial Pneumonias

    PubMed Central

    Hashisako, Mikiko; Fukuoka, Junya

    2015-01-01

    The updated classification of idiopathic interstitial pneumonias (IIPs) in 2013 by American Thoracic Society/European Respiratory Society included several important revisions to the categories described in the 2002 classification. In the updated classification, lymphoid interstitial pneumonia (LIP) was moved from major to rare IIPs, pleuroparenchymal fibroelastosis (PPFE) was newly included in the rare IIPs, acute fibrinous and organizing pneumonia (AFOP) and interstitial pneumonias with a bronchiolocentric distribution are recognized as rare histologic patterns, and unclassifiable IIP (UCIP) was classified as an IIP. However, recent reports indicate the areas of concern that may require further evaluation. Here, we describe the histopathologic features of the updated IIPs and their rare histologic patterns and also point out some of the issues to be considered in this context. PMID:26949346

  19. Genetics and Idiopathic Interstitial Pneumonias.

    PubMed

    Chu, Sarah G; El-Chemaly, Souheil; Rosas, Ivan O

    2016-06-01

    Significant progress has been made in elucidating the genetics of parenchymal lung diseases, particularly idiopathic interstitial pneumonias (IIPs). IIPs are a heterogeneous group of diffuse interstitial lung diseases of uncertain etiology, diagnosed only after known causes of interstitial lung disease have been excluded. Idiopathic pulmonary fibrosis is the most common IIP. Through candidate gene approaches and genome wide association studies, much light has been shed on the genetic origins of IIPs, enhancing our understanding of risk factors and pathogenesis. However, significant work remains to be accomplished in identifying novel genetic variants and characterizing the function of validated candidate genes in lung pathobiology, their interplay with environmental factors, and ultimately translating these discoveries to patient care. PMID:27231858

  20. [A Case of Gastric Cancer Associated with Sjögren's Syndrome and Interstitial Pneumonia].

    PubMed

    Ido, Mirai; Mishima, Hideyuki; Kimura, Kengo; Iwata, Tsutomu; Kiyota, Yoshiharu; Komaya, Kenichi; Saito, Takuya; Ohashi, Norifumi; Arikawa, Takashi; Ishiguro, Seiji; Komatsu, Shunichiro; Miyachi, Masahiko; Sano, Tsuyoshi

    2015-11-01

    A 77-year-old man presented with poor appetite and dyspnea. A gastroendoscopy showed an advanced gastric cancer and a CT scan demonstrated diffuse interstitial infiltrative shadows in both lungs. Laboratory data showed high level of anti-SSA and anti-SSB antibodies, suggestive of interstitial pneumonia associated with Sjögren's syndrome. Although the levels of KL-6 and SP-D, markers of interstitial pneumonia, decreased after steroid and immunosuppressive therapy, the CT findings of interstitial pneumonia showed no remarkable change. Surgery was performed 2 months after the administration of prednisolone since the respiratory function had improved, allowing the administration of general anesthesia. A CT scan revealed remarkable improvement of the lung lesions after the surgery. Therefore, it is likely that Sjögren's syndrome and interstitial pneumonia manifested as paraneoplastic syndromes in the presented case. PMID:26805235

  1. Self-Interstitial in Germanium

    NASA Astrophysics Data System (ADS)

    Carvalho, A.; Jones, R.; Janke, C.; Goss, J. P.; Briddon, P. R.; Coutinho, J.; Öberg, S.

    2007-10-01

    Low-temperature radiation damage in n- and p-type Ge is strikingly different, reflecting the charge-dependent properties of vacancies and self-interstitials. We find, using density functional theory, that in Ge the interstitial is bistable, preferring a split configuration when neutral and an open cage configuration when positively charged. The split configuration is inert while the cage configuration acts as a double donor. We evaluate the migration energies of the defects and show that the theory is able to explain the principal results of low-temperature electron-irradiation experiments.

  2. Microdefects and self-interstitial diffusion in crystalline silicon

    SciTech Connect

    Knowlton, W.B.

    1998-05-01

    In this thesis, a study is presented of D-defects and self-interstitial diffusion in silicon using Li ion (Li{sup +}) drifting in an electric field and transmission electron microscopy (TEM). Obstruction of Li{sup +} drifting has been found in wafers from certain but not all FZ p-type Si. Incomplete Li{sup +} drifting always occurs in the central region of the wafers. This work established that interstitial oxygen is not responsible for hindering Li{sup +} drifting. TEM was performed on a samples from the partially Li{sup +} drifted area and compared to regions without D-defects. Precipitates were found only in the region containing D-defects that had partially Li{sup +} drifted. This result indicates D-defects are responsible for the precipitation that halts the Li{sup +} drift process. Nitrogen (N) doping has been shown to eliminate D-defects as measured by conventional techniques. Li{sup +} drifting and D-defects provide a useful means to study Si self-interstitial diffusion. The process modeling program SUPREM-IV was used to simulate the results of Si self-interstitial diffusion obtained from Li{sup +} drifting experiments. Anomalous results from the Si self-interstitial diffusion experiments forced a re-examination of the possibility of thermal dissociation of D-defects. Thermal annealing experiments that were performed support this possibility. A review of the current literature illustrates the need for more research on the effects of thermal processing on FZ Si to understand the dissolution kinetics of D-defects.

  3. How Is Childhood Interstitial Lung Disease Treated?

    MedlinePlus

    ... the NHLBI on Twitter. How Is Childhood Interstitial Lung Disease Treated? Childhood interstitial lung disease (chILD) is ... prevent acid reflux, which can lead to aspiration. Lung Transplant A lung transplant may be an option ...

  4. Types of Childhood Interstitial Lung Disease

    MedlinePlus

    ... the NHLBI on Twitter. Types of Childhood Interstitial Lung Disease The broad term "childhood interstitial lung disease" ( ... affect are shown in the illustration below. Normal Lungs and Lung Structures Figure A shows the location ...

  5. A unified approach to combine temperature estimation and elastography for thermal lesion determination in focused ultrasound thermal therapy.

    PubMed

    Liu, Hao-Li; Li, Meng-Lin; Tsui, Po-Hsiang; Lin, Ming-Shi; Huang, Sheng-Min; Bai, Jing

    2011-01-01

    Sonogram-based temperature estimation and elastography have both shown promise as methods of monitoring focused ultrasound (FUS) treatments to induce thermal ablation in tissue. However, each method has important limitations. Temperature estimates based on echo delays become invalid when the relationship between sound speed and temperature is nonlinear, and are further complicated by thermal expansion and other changes in tissue. Elastography can track thermal lesion formation over a wider range of elasticity, but with low specificity and high noise. Furthermore, this method is poor at small lesion detection. This study proposes integrating the two estimates to improve the quality of monitoring FUS-induced thermal lesions. Our unified computational kernel is tested on three types of phantoms. Experiments with type I and type II phantoms were conducted to calibrate the thermal mapping and elastography methods, respectively. The optimal settings were then used in experiments with the type III phantom, which contains ex vivo swine liver tissue. Three different spatial-peak temporal-average intensities (I(spta); 35, 133 and 240 W cm(-2)) were delivered with a sonication time of 60 s. The new procedure can closely monitor heating while identifying the dimensions of the thermal lesion, and is significantly better at the latter task than either approach alone. This work may help improve the current clinical practice, which employs sonograms to guide the FUS-induced thermal ablation procedure. PMID:21149945

  6. A unified approach to combine temperature estimation and elastography for thermal lesion determination in focused ultrasound thermal therapy

    NASA Astrophysics Data System (ADS)

    Liu, Hao-Li; Li, Meng-Lin; Tsui, Po-Hsiang; Lin, Ming-Shi; Huang, Sheng-Min; Bai, Jing

    2011-01-01

    Sonogram-based temperature estimation and elastography have both shown promise as methods of monitoring focused ultrasound (FUS) treatments to induce thermal ablation in tissue. However, each method has important limitations. Temperature estimates based on echo delays become invalid when the relationship between sound speed and temperature is nonlinear, and are further complicated by thermal expansion and other changes in tissue. Elastography can track thermal lesion formation over a wider range of elasticity, but with low specificity and high noise. Furthermore, this method is poor at small lesion detection. This study proposes integrating the two estimates to improve the quality of monitoring FUS-induced thermal lesions. Our unified computational kernel is tested on three types of phantoms. Experiments with type I and type II phantoms were conducted to calibrate the thermal mapping and elastography methods, respectively. The optimal settings were then used in experiments with the type III phantom, which contains ex vivo swine liver tissue. Three different spatial-peak temporal-average intensities (Ispta; 35, 133 and 240 W cm-2) were delivered with a sonication time of 60 s. The new procedure can closely monitor heating while identifying the dimensions of the thermal lesion, and is significantly better at the latter task than either approach alone. This work may help improve the current clinical practice, which employs sonograms to guide the FUS-induced thermal ablation procedure.

  7. Thermal distribution in biological tissue at laser induced fluorescence and photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Krasnikov, I. V.; Seteikin, A. Yu.; Drakaki, E.; Makropoulou, M.

    2012-03-01

    Laser induced fluorescence spectroscopy and photodynamic therapy (PDT) are techniques currently introduced in clinical applications for visualization and local destruction of malignant tumours as well as premalignant lesions. During the laser irradiation of tissues for the diagnostic and therapeutic purposes, the absorbed optical energy generates heat, although the power density of the treatment light for surface illumination is normally low enough not to cause any significantly increased tissue temperature. In this work we tried to evaluate the utility of Monte Carlo modeling for simulating the temperature fields and the dynamics of heat conduction into the skin tissue under several laser irradiation conditions with both a pulsed UV laser and a continuous wave visible laser beam. The analysis of the results showed that heat is not localized on the surface, but it is collected inside the tissue. By varying the boundary conditions on the surface and the type of the laser radiation (continuous or pulsed) we can reach higher than normal temperature inside the tissue without simultaneous formation of thermally damaged tissue (e.g. coagulation or necrosis zone).

  8. Thermal distribution in biological tissue at laser induced fluorescence and photodynamic therapy

    NASA Astrophysics Data System (ADS)

    Krasnikov, I. V.; Seteikin, A. Yu.; Drakaki, E.; Makropoulou, M.

    2011-10-01

    Laser induced fluorescence spectroscopy and photodynamic therapy (PDT) are techniques currently introduced in clinical applications for visualization and local destruction of malignant tumours as well as premalignant lesions. During the laser irradiation of tissues for the diagnostic and therapeutic purposes, the absorbed optical energy generates heat, although the power density of the treatment light for surface illumination is normally low enough not to cause any significantly increased tissue temperature. In this work we tried to evaluate the utility of Monte Carlo modeling for simulating the temperature fields and the dynamics of heat conduction into the skin tissue under several laser irradiation conditions with both a pulsed UV laser and a continuous wave visible laser beam. The analysis of the results showed that heat is not localized on the surface, but it is collected inside the tissue. By varying the boundary conditions on the surface and the type of the laser radiation (continuous or pulsed) we can reach higher than normal temperature inside the tissue without simultaneous formation of thermally damaged tissue (e.g. coagulation or necrosis zone).

  9. Thermal effectiveness of different IR radiators employed in rheumatoid hand therapy as assessed by thermovisual examination.

    PubMed

    Rutkowski, Radosław; Straburzyńska-Lupa, Anna; Korman, Paweł; Romanowski, Wojciech; Gizińska, Małgorzata

    2011-01-01

    We conducted a thermovisual comparison of mean hand surface temperature changes upon local heating with two different IR sources. Sixty-six patients with rheumatoid arthritis (47 women and 19 men; average age, 56.1 ± 8.6 years) were subjected to topical heat therapy for one hand with either the standard IR radiator (SIR) or the water filter IRA (wIRA). The surface temperature of the dorsal side of both hands was measured, and thermal images were taken before and up to 2 h after treatment. At 1 min after treatment, SIR application increased the surface skin temperature of the heated hand from 31.5 ± 1.9 to 35.0 ± 1.9 °C (P<0.05), while wIRA increased it from 32.1 ± 1.6 to 34.2 ± 1.1 °C (P<0.05). Constant decline in temperature was observed immediately after treatment, with the temperatures reaching baseline in about 30 and 120 min after wIRA and SIR treatment, respectively. Similar temperature changes were observed in the heated hands for wIRA and SIR, except at 1 min after treatment. Changes in the untreated hands indicated contralateral reaction. The temperature of the warmed hand showed a correlation to the body mass index. PMID:21827500

  10. A Preclinical System Prototype for Focused Microwave Thermal Therapy of the Breast

    PubMed Central

    Stang, John; Haynes, Mark; Carson, Paul; Moghaddam, Mahta

    2016-01-01

    A preclinical prototype of a transcutaneous thermal therapy system has been developed for the targeted treatment of breast cancer cells using focused microwaves as an adjuvant to radiation, chemotherapy, and high intensity focused ultrasound (HIFU). The prototype system employs a 2D array of tapered microstrip patch antennas operating at 915 MHz to focus continuous-wave microwave energy transcutaneously into the pendent breast suspended in a coupling medium. Prior imaging studies are used to ascertain the material properties of the breast tissue, and this data is incorporated into a multiphysics model. Time-reversal techniques are employed to find a solution (relative amplitudes and phase) for focusing at a given location. Modeling tests of this time-reversal focusing method have been performed which demonstrate good targeting accuracy within heterogeneous breast tissue. Experimental results using the laboratory prototype to perform focused heating in tissue-mimicking gelatin phantoms have demonstrated 1.5 cm diameter focal spot sizes and differential heating at the desired focus sufficient to achieve an antitumor effect confined to the target region. PMID:22614518

  11. Combined chemo- and photo-thermal therapy delivered by multifunctional theranostic gold nanorod-loaded microcapsules.

    PubMed

    Chen, Haiyan; Di, Yingfeng; Chen, Dan; Madrid, Kyle; Zhang, Min; Tian, Caiping; Tang, Liping; Gu, Yueqing

    2015-05-21

    A polyelectrolyte microcapsule-based, cancer-targeting, and controlled drug delivery system has been developed as a multifunctional theranostic agent for synergistic cancer treatment. This new system, called FA-MC@GNR, is composed of folic acid (FA)-modified, multi-layered, hollow microcapsules loaded with gold nanorods (GNRs), and undergoes thermal degradation under near infrared (NIR) light. Either an NIR dye (MPA) or anti-cancer drug (doxorubicin, DOX) was loaded into the microcapsules via physical adsorption, yielding FA-MC@GNRs/MPA or FA-MC@GNRs/DOX, both of which exhibit no obvious toxicity, high stability, and remarkably improved tumor-targeting capabilities in vivo. Utilizing the strong NIR absorption of FA-MC@GNRs/DOX, we demonstrate the system's ability to simultaneously elicit photothermal therapy and controlled chemotherapy, achieving synergistic cancer treatment both in vitro cellular and in vivo animal experiments. Our study presents a new type of multifunctional micro-carrier for the delivery of chemotherapeutic drugs and photothermal agents, which has been shown to be an effective therapeutic approach for combined cancer treatment. PMID:25913201

  12. Combined chemo- and photo-thermal therapy delivered by multifunctional theranostic gold nanorod-loaded microcapsules

    NASA Astrophysics Data System (ADS)

    Chen, Haiyan; di, Yingfeng; Chen, Dan; Madrid, Kyle; Zhang, Min; Tian, Caiping; Tang, Liping; Gu, Yueqing

    2015-05-01

    A polyelectrolyte microcapsule-based, cancer-targeting, and controlled drug delivery system has been developed as a multifunctional theranostic agent for synergistic cancer treatment. This new system, called FA-MC@GNR, is composed of folic acid (FA)-modified, multi-layered, hollow microcapsules loaded with gold nanorods (GNRs), and undergoes thermal degradation under near infrared (NIR) light. Either an NIR dye (MPA) or anti-cancer drug (doxorubicin, DOX) was loaded into the microcapsules via physical adsorption, yielding FA-MC@GNRs/MPA or FA-MC@GNRs/DOX, both of which exhibit no obvious toxicity, high stability, and remarkably improved tumor-targeting capabilities in vivo. Utilizing the strong NIR absorption of FA-MC@GNRs/DOX, we demonstrate the system's ability to simultaneously elicit photothermal therapy and controlled chemotherapy, achieving synergistic cancer treatment both in vitro cellular and in vivo animal experiments. Our study presents a new type of multifunctional micro-carrier for the delivery of chemotherapeutic drugs and photothermal agents, which has been shown to be an effective therapeutic approach for combined cancer treatment.

  13. Computerized Tomography: Its Role in Interstitial Brachytherapy of Pelvic Malignancies

    PubMed Central

    Kumar, P. Pradeep; Taylor, Judith; Jones, E.O.; McAnulty, Bruce

    1986-01-01

    The advantages of computerized tomography (CT) in the treatment planning of external beam radiation therapy have been shown in several studies. The authors extended the use of CT to the interstitial brachytherapy treatment planning of pelvic malignancies. CT was found to be invaluable in localizing pelvic tumors, selecting implant techniques, and checking the accuracy of the implant. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5 PMID:3950985

  14. Ultrasound in Rheumatologic Interstitial Lung Disease: A Case Report of Nonspecific Interstitial Pneumonia in Rheumatoid Arthritis.

    PubMed

    Laria, A; Lurati, A; Scarpellini, M

    2015-01-01

    According to the American Thoracic Society (ATS)/European Respiratory Society consensus classification, idiopathic interstitial pneumonias (IIPs) include several clinic-radiologic-pathologic entities: idiopathic pulmonary fibrosis (IPF), usual interstitial pneumonia (UIP), nonspecific interstitial pneumonia (NSIP), cryptogenic organizing pneumonia, acute interstitial pneumonia, respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia, and lymphoid interstitial pneumonia. Ultrasound Lung Comets (ULCs) are an echographic chest-sonography hallmark of pulmonary interstitial fibrosis. We describe the ultrasound (US) findings in the follow-up of a NSIP's case in rheumatoid arthritis (RA). PMID:26240772

  15. [Lung transplantation in patients with interstitial lung disease/idiopathic pulmonary fibrosis].

    PubMed

    Murer, Christian; Benden, Christian

    2016-01-01

    Lung transplantation is an established therapy for advanced lung disease. Among the common disease indications for lung transplantation, patients with interstitial lung disease, in particular, idiopathic pulmonary fibrosis (IPF), have the worst prognosis. Thus referral to a transplant center should ideally be realised at the time of diagnosis of usual interstitial pneumonitis (UIP), regardless of lung function, in order to carry out a through initial assessment and evaluation. PMID:26884220

  16. Interstitial-phase precipitation in iron-base alloys: a comparative study

    SciTech Connect

    Pelton, A.R.

    1982-06-01

    Recent developments have elucidated the atomistic mechanisms of precipitation of interstitial elements in simple alloy systems. However, in the more technologically important iron base alloys, interstitial phase precipitation is generally not well understood. The present experimental study was therefore designed to test the applicability of these concepts to more complex ferrous alloys. Hence, a comparative study was made of interstitial phase precipitation in ferritic Fe-Si-C and in austenitic phosphorus-containing Fe-Cr-Ni steels. These systems were subjected to a variety of quench-age thermal treatments, and the microstructural development was subsequently characterized by transmission electron microscopy.

  17. MRI-compatible ultrasound heating system with ring-shaped phased arrays for breast tumor thermal therapy.

    PubMed

    Chen, Hung-Nien; Chen, Guan-Ming; Lin, Bo-Sian; Lien, Pi-Hsien; Chen, Yung-Yaw; Chen, Gin-Shin; Lin, Win-Li

    2013-01-01

    Therapeutic ultrasound transducers can carry out precise and efficient power deposition for tumor thermal therapy under the guidance of magnetic resonance imaging. For a better heating, organ-specific ultrasound transducers with precision location control system should be developed for tumors located at various organs. It is feasible to perform a better heating for breast tumor thermal therapy with a ring-shaped ultrasound phased-array transducer. In this study, we developed ring-shaped phased-array ultrasound transducers with 1.0 and 2.5 MHz and a precision location control system to drive the transducers to the desired location to sonicate the designated region. Both thermo-sensitive hydrogel phantom and ex vivo fresh pork were used to evaluate the heating performance of the transducers. The results showed that the ring-shaped phased array ultrasound transducers were very promising for breast tumor heating with the variation of heating patterns and without overheating the ribs. PMID:24110540

  18. A Numerical Investigation of the Electric and Thermal Cell Kill Distributions in Electroporation-Based Therapies in Tissue

    PubMed Central

    Garcia, Paulo A.; Davalos, Rafael V.; Miklavcic, Damijan

    2014-01-01

    Electroporation-based therapies are powerful biotechnological tools for enhancing the delivery of exogeneous agents or killing tissue with pulsed electric fields (PEFs). Electrochemotherapy (ECT) and gene therapy based on gene electrotransfer (EGT) both use reversible electroporation to deliver chemotherapeutics or plasmid DNA into cells, respectively. In both ECT and EGT, the goal is to permeabilize the cell membrane while maintaining high cell viability in order to facilitate drug or gene transport into the cell cytoplasm and induce a therapeutic response. Irreversible electroporation (IRE) results in cell kill due to exposure to PEFs without drugs and is under clinical evaluation for treating otherwise unresectable tumors. These PEF therapies rely mainly on the electric field distributions and do not require changes in tissue temperature for their effectiveness. However, in immediate vicinity of the electrodes the treatment may results in cell kill due to thermal damage because of the inhomogeneous electric field distribution and high current density during the electroporation-based therapies. Therefore, the main objective of this numerical study is to evaluate the influence of pulse number and electrical conductivity in the predicted cell kill zone due to irreversible electroporation and thermal damage. Specifically, we simulated a typical IRE protocol that employs ninety 100-µs PEFs. Our results confirm that it is possible to achieve predominant cell kill due to electroporation if the PEF parameters are chosen carefully. However, if either the pulse number and/or the tissue conductivity are too high, there is also potential to achieve cell kill due to thermal damage in the immediate vicinity of the electrodes. Therefore, it is critical for physicians to be mindful of placement of electrodes with respect to critical tissue structures and treatment parameters in order to maintain the non-thermal benefits of electroporation and prevent unnecessary damage to

  19. SU-E-J-161: Inverse Problems for Optical Parameters in Laser Induced Thermal Therapy

    SciTech Connect

    Fahrenholtz, SJ; Stafford, RJ; Fuentes, DT

    2014-06-01

    Purpose: Magnetic resonance-guided laser-induced thermal therapy (MRgLITT) is investigated as a neurosurgical intervention for oncological applications throughout the body by active post market studies. Real-time MR temperature imaging is used to monitor ablative thermal delivery in the clinic. Additionally, brain MRgLITT could improve through effective planning for laser fiber's placement. Mathematical bioheat models have been extensively investigated but require reliable patient specific physical parameter data, e.g. optical parameters. This abstract applies an inverse problem algorithm to characterize optical parameter data obtained from previous MRgLITT interventions. Methods: The implemented inverse problem has three primary components: a parameter-space search algorithm, a physics model, and training data. First, the parameter-space search algorithm uses a gradient-based quasi-Newton method to optimize the effective optical attenuation coefficient, μ-eff. A parameter reduction reduces the amount of optical parameter-space the algorithm must search. Second, the physics model is a simplified bioheat model for homogeneous tissue where closed-form Green's functions represent the exact solution. Third, the training data was temperature imaging data from 23 MRgLITT oncological brain ablations (980 nm wavelength) from seven different patients. Results: To three significant figures, the descriptive statistics for μ-eff were 1470 m{sup −1} mean, 1360 m{sup −1} median, 369 m{sup −1} standard deviation, 933 m{sup −1} minimum and 2260 m{sup −1} maximum. The standard deviation normalized by the mean was 25.0%. The inverse problem took <30 minutes to optimize all 23 datasets. Conclusion: As expected, the inferred average is biased by underlying physics model. However, the standard deviation normalized by the mean is smaller than literature values and indicates an increased precision in the characterization of the optical parameters needed to plan MRg

  20. A Directional Interstitial Antenna for Microwave Tissue Ablation: Theoretical and Experimental Investigation.

    PubMed

    McWilliams, Brogan T; Schnell, Emily E; Curto, Sergio; Fahrbach, Thomas M; Prakash, Punit

    2015-09-01

    Microwave ablation (MWA) is a minimally invasive thermal therapy modality increasingly employed for the treatment of tumors and benign disease. For successful treatment, complete thermal coverage of the tumor and margin of surrounding healthy tissue must be achieved. Currently available interstitial antennas for MWA have cylindrically symmetric radiation patterns. Thus, when treating targets in proximity to critical structures, caution must be taken to prevent unintended thermal damage. A novel coaxial antenna design for MWA with an asymmetrical cylindrical heating pattern is presented in this paper. This radiation pattern is achieved by employing a hemicylindrical reflector positioned at a critical distance from a conventional coaxial monopole antenna. Finite-element method simulations were employed to optimize the geometric dimensions of the antenna with the objective of minimizing the antenna reflection coefficient at the 2.45-GHz operating frequency, and maximizing volume of the ablation zone. Prototype antennas were fabricated and experimentally evaluated. Simulations indicated an optimal S11 of -32 dB at 2.45 GHz in close agreement with experimental measurements of -29 dB. Ex vivo experiments were performed to validate simulations and observe effects to the antennas' heating pattern with the varying input power and geometry of the reflector. Ablation zones up to 20 mm radially were observed in the forward direction, with minimal heating (less than 4 mm) behind the reflector. PMID:25794385

  1. Speed of sound estimation with active PZT element for thermal monitoring during ablation therapy: feasibility study

    NASA Astrophysics Data System (ADS)

    Kim, Younsu; Guo, Xiaoyu; Cheng, Alexis; Boctor, Emad M.

    2016-04-01

    Controlling the thermal dose during ablation therapy is instrumental to successfully removing the tumor while preserving the surrounding healthy tissue. In the practical scenario, surgeons must be able to determine the ablation completeness in the tumor region. Various methods have been proposed to monitor it, one of which uses ultrasound since it is a common intraoperative imaging modality due to its non-invasive, cost-effective, and convenient natures. In our approach, we propose to use time of flight (ToF) information to estimate speed of sound changes. Accurate speed of sound estimation is crucial because it is directly correlated with temperature change and subsequent determination of ablation completeness. We divide the region of interest in a circular fashion with a variable radius from the ablator tip. We introduce the concept of effective speed of sound in each of the sub-regions. Our active PZT element control system facilitates this unique approach by allowing us to acquire one-way ToF information between the PZT element and each of the ultrasound elements. We performed a simulation and an experiment to verify feasibility of this method. The simulation result showed that we could compute the effective speed of sound within 0.02m/s error in our discrete model. We also perform a sensitivity analysis for this model. Most of the experimental results had less than 1% error. Simulation using a Gaussian continuous model with multiple PZT elements is also demonstrated. We simulate the effect of the element location one the optimization result.

  2. Treatment of malignant melanoma by selective thermal neutron capture therapy using melanoma-seeking compound

    SciTech Connect

    Mishima, Y.; Ichihashi, M.; Tsuji, M.; Hatta, S.; Ueda, M.; Honda, C.; Suzuki, T.

    1989-05-01

    As pigment cells undergo melanoma genesis, accentuated melanogenesis concurrently occurs in principle. Subsequent to the understanding of intrinsic factors controlling both processes, we found our selective melanoma neutron capture therapy (NCT) using 10B-dopa (melanin substrate) analogue, 10B1-p-boronophenylalanine (10B1-BPA), followed by 10B(n, alpha)7Li reaction, induced by essentially harmless thermal neutrons, which releases energy of 2.33 MeV to 14 mu, the diameter of melanoma cells. In vitro/in vivo radiobiological analysis revealed the highly enhanced melanoma killing effect of 10B1-BPA. Chemical and prompt gamma ray spectrometry assays of 10B accumulated within melanoma cells after 10B1-BPA administration in vitro and in vivo show high affinity, e.g., 10B melanoma/blood ratio of 11.5. After successfully eradicating melanoma transplanted into hamsters with NCT, we advanced to preclinical studies using spontaneously occurring melanoma in Duroc pig skin. We cured three melanoma cases, 4.6 to 12 cm in diameter, by single neutron capture treatment. Complete disappearance of melanoma was obtained without substantial side effects. Acute and subacute toxicity as well as pharmacodynamics of 10B1-BPA have been studied in relation to therapeutic dosage requirements. Clinical radiation dosimetry using human phantom has been carried out. Further preclinical studies using human melanoma transplanted into nude mouse have been a useful model for obtaining optimal results for each melanoma type. We recently treated the first human melanoma patient with our NCT, using essentially the method for Duroc pig melanoma, and obtained similar regression time course leading to cure.

  3. Smoking and interstitial lung diseases.

    PubMed

    Margaritopoulos, George A; Vasarmidi, Eirini; Jacob, Joseph; Wells, Athol U; Antoniou, Katerina M

    2015-09-01

    For many years has been well known that smoking could cause lung damage. Chronic obstructive pulmonary disease and lung cancer have been the two most common smoking-related lung diseases. In the recent years, attention has also focused on the role of smoking in the development of interstitial lung diseases (ILDs). Indeed, there are three diseases, namely respiratory bronchiolitis-associated ILD, desquamative interstitial pneumonia and pulmonary Langerhans cell histiocytosis, that are currently considered aetiologically linked to smoking and a few others which are more likely to develop in smokers. Here, we aim to focus on the most recent findings regarding the role of smoking in the pathogenesis and clinical behaviour of ILDs. PMID:26324804

  4. [Interstitial granulomatous dermatitis with arthritis].

    PubMed

    Ebschner, U; Hartschuh, W; Petzoldt, D

    2000-02-01

    Interstitial granulomatous dermatitis with arthritis is a rare dermatologic disorder seen in patients suffering from diseases in which circulating immune complexes occur. The typical cutaneous signs are linear cords usually located on the lateral aspect of the trunk. The characteristic, although not specific, histology reveals a dense diffuse infiltrate composed mostly of histiocytes, accompanied by neutrophils and eosinophils, and degenerated collagen surrounded by palisades of histiocytes. We discuss this disorder and its differential diagnosis. PMID:10743580

  5. Suspected acute interstitial nephritis induced by colistin.

    PubMed

    Kallel, Hatem; Hamida, Chokri Ben; Ksibi, Hichem; Bahloul, Mabrouk; Hergafi, Leila; Chaari, Anis; Chelly, Hedi; Bouaziz, Mounir

    2005-01-01

    We describe a 35-year-old male admitted to the intensive care unit (ICU) for acute exacerbation of chronic obstructive pulmonary disease (COPD). He developed ventilator-associated pneumonia caused by multidrug-resistant Pseudomonas aeruginosa and was treated with imipenem and colistin without any renal toxicity. The patient was readmitted to the ICU for a 2nd and a 3rd exacerbation of COPD and was again treated with imipenem and colistin. In both episodes, he developed rapid worsening in renal function, which improved following colistin withdrawal. Use of the Naranjo ADR probability scale indicated a probable relationship between the renal failure and the colistin therapy. In addition, the time course of events suggested that colistin was the cause of acute interstitial nephritis in this patient. We conclude that our patient had a possible acute allergic reaction to colistin since the 1st introduction was not associated with any renal toxicity and renal failure was observed on the 1st day of the 2nd and the 3rd initiation of colistin therapy, respectively. PMID:16013023

  6. Transurethral ultrasound applicators with dynamic multi-sector control for prostate thermal therapy: In vivo evaluation under MR guidance

    SciTech Connect

    Kinsey, Adam M.; Diederich, Chris J.; Rieke, Viola; Nau, William H.; Pauly, Kim Butts; Bouley, Donna; Sommer, Graham

    2008-05-15

    The purpose of this study was to explore the feasibility and performance of a multi-sectored tubular array transurethral ultrasound applicator for prostate thermal therapy, with potential to provide dynamic angular and length control of heating under MR guidance without mechanical movement of the applicator. Test configurations were fabricated, incorporating a linear array of two multi-sectored tubular transducers (7.8-8.4 MHz, 3 mm OD, 6 mm length), with three 120 deg. independent active sectors per tube. A flexible delivery catheter facilitated water cooling (100 ml min{sup -1}) within an expandable urethral balloon (35 mm longx10 mm diameter). An integrated positioning hub allows for rotating and translating the transducer assembly within the urethral balloon for final targeting prior to therapy delivery. Rotational beam plots indicate {approx}90 deg. - 100 deg. acoustic output patterns from each 120 deg. transducer sector, negligible coupling between sectors, and acoustic efficiencies between 41% and 53%. Experiments were performed within in vivo canine prostate (n=3), with real-time MR temperature monitoring in either the axial or coronal planes to facilitate control of the heating profiles and provide thermal dosimetry for performance assessment. Gross inspection of serial sections of treated prostate, exposed to TTC (triphenyl tetrazolium chloride) tissue viability stain, allowed for direct assessment of the extent of thermal coagulation. These devices created large contiguous thermal lesions (defined by 52 deg. C maximum temperature, t{sub 43}=240 min thermal dose contours, and TTC tissue sections) that extended radially from the applicator toward the border of the prostate ({approx}15 mm) during a short power application ({approx}8-16 W per active sector, 8-15 min), with {approx}200 deg. or 360 deg. sector coagulation demonstrated depending upon the activation scheme. Analysis of transient temperature profiles indicated progression of lethal temperature

  7. Objective and Longitudinal Assessment of Dermatitis After Postoperative Accelerated Partial Breast Irradiation Using High-Dose-Rate Interstitial Brachytherapy in Patients With Breast Cancer Treated With Breast Conserving Therapy: Reduction of Moisture Deterioration by APBI

    SciTech Connect

    Tanaka, Eiichi; Yamazaki, Hideya; Yoshida, Ken; Takenaka, Tadashi; Masuda, Norikazu; Kotsuma, Tadayuki; Yoshioka, Yasuo; Inoue, Takehiro

    2011-11-15

    Purpose: To objectively evaluate the radiation dermatitis caused by accelerated partial breast irradiation (APBI) using high-dose-rate interstitial brachytherapy. Patients and Methods: The skin color and moisture changes were examined using a newly installed spectrophotometer and corneometer in 22 patients who had undergone APBI using open cavity implant high-dose-rate interstitial brachytherapy (36 Gy in six fractions) and compared with the corresponding values for 44 patients in an external beam radiotherapy (EBRT) control group (50-60 Gy in 25-30 fractions within 5-6 weeks) after breast conserving surgery. Results: All values changed significantly as a result of APBI. The extent of elevation in a Asterisk-Operator (reddish) and reduction in L Asterisk-Operator (black) values caused by APBI were similar to those for EBRT, with slightly delayed recovery for 6-12 months after treatment owing to the surgical procedure. In contrast, only APBI caused a change in the b Asterisk-Operator values, and EBRT did not, demonstrating that the reduction in b Asterisk-Operator values (yellowish) depends largely on the surgical procedure. The changes in moisture were less severe after APBI than after EBRT, and the recovery was more rapid. The toxicity assessment using the Common Toxicity Criteria, version 3, showed that all dermatitis caused by APBI was Grade 2 or less. Conclusion: An objective analysis can quantify the effects of APBI procedures on color and moisture cosmesis. The radiation dermatitis caused by APBI using the present schedule showed an equivalent effect on skin color and a less severe effect on moisture than the effects caused by standard EBRT.

  8. The difference of the PDT's effects between interstitial lighting and continuous lighting in low oxygen density

    NASA Astrophysics Data System (ADS)

    Yang, Jiumin; Li, Yingxin; Liu, Tiegen; Xu, Tao

    2008-02-01

    Tumor oxygen depletion plays an important role in the process of Photodynamic Therapy (PDT). The paper focuses on the improvement of the lighting mode to carry out this cancer therapy more effectively in low oxygen content. The effect of interstitial lighting was compared with that of continuous lighting in different oxygen density measured with a homemade device in PDT. 90 mice were divided into 3 groups: the contrast group, the continuous lighting group and the interstitial lighting group. The initial oxygen content was measured with a homemade device before the treatment. To examine the different effects, both the interstitial lighting and the continuous lighting have the same fluent rates (30mW/cm2, 32.4J/ cm2). The continuous lighting lasted 18 minutes while the interstitial lighting lasted 36 minutes with 1 second's idle time and 1 second's effective time of each pulse. The result shows that the volume of tumor doubling duration in interstitial lighting group is longer in the condition of low initial oxygen content. Thus with low initial oxygen content, the interstitial lighting is more effective than the continuous lighting during PDT.

  9. Interstitial Cystitis: Characterization and Management of an Enigmatic Urologic Syndrome

    PubMed Central

    Nickel, J. Curtis

    2002-01-01

    The enigmatic urologic condition known as interstitial cystitis has an estimated prevalence of 0.01% to 0.50% of the female population. Its etiology is unknown but may involve microbiologic, immunologic, mucosal, neurogenic, and/or other, as yet undefined, agents. There is no gold standard for the diagnosis of interstitial cystitis; rather, it is a diagnosis of exclusion. It is impossible to provide a purely evidence-based treatment strategy, but review of available evidence suggests that conservative supportive therapy (including diet modification); oral treatment with pentosan polysulfate, amitriptyline, hydroxyzine, or cimetidine; and intravesical treatments with heparinoids, dimethyl sulfoxide, alkalized lidocaine, or bacille Calmette-Guérin may be effective in some patients. PMID:16985667

  10. Ultrasound-induced thermal therapy of hyperplasia in ringed expanded polytetrafluoroethylene (eptfe) access grafts

    NASA Astrophysics Data System (ADS)

    Query, Michael Earl

    Hemodialysis vascular access, the interface between a dialysis patient and a dialysis machine, is quite literally the lifeblood of a patient's health. Vascular access dysfunction is the leading cause of hospitalization in hemodialysis patients. The occlusive growth of neointimal hyperplasia (NH) in expanded polytetrafluoroethylene (ePTFE) ringed grafts is the primary cause of failure. To further develop a proposed thermal ultrasound treatment to reduce or prevent NH in arteriovenous vascular grafts, the acoustic properties of ePTFE were studied in water and alcohol solutions. Previous reports of ePTFE acoustic properties are critiqued. It was found that the acoustic transmission and attenuation through ePTFE, and therefore the potential for an ultrasound-based therapy for NH, are heavily dependent on the medium in which the graft is immersed, suggesting that the acoustic properties of implanted grafts will change as grafts mature in vivo. The acoustic impedance and attenuation of water-soaked ePTFE were 0.478 +/- 1.43 x 10-2 MRayl and 1.78 +/- 0.111 Np/cm*MHz, respectively, while the acoustic impedance and attenuation of ePTFE in alcohol were 1.49 +/- 0.149 MRayl and 0.77 +/- 1.1 x 10-2 Np/cm*MHz, respectively. The use of focused ultrasound to heat implanted ringed ePTFE grafts was numerically modeled from 1.35- and 1.443-MHz transducers for in vitro geometries. Power deposition and heating, in turn, differed by an order of magnitude between various graft acoustic properties. Graft rings were predicted to be substantial absorbing and scattering features. In vitro phantom models were constructed: one with and one without thermocouples. At 1 W of acoustic power, the maximum temperature rise was 8˚ C. The thermocouple model containing a water-soaked graft did not experience heating in the far graft wall. The MRTI model confirmed that the graft rings are an absorbing/scattering feature. Heating was not prevented in the presence of water flow through the graft. Water

  11. Sub-100nm gold nanomatryoshkas improve photo-thermal therapy efficacy in large and highly aggressive triple negative breast tumors.

    PubMed

    Ayala-Orozco, Ciceron; Urban, Cordula; Bishnoi, Sandra; Urban, Alexander; Charron, Heather; Mitchell, Tamika; Shea, Martin; Nanda, Sarmistha; Schiff, Rachel; Halas, Naomi; Joshi, Amit

    2014-10-10

    There is an unmet need for efficient near-infrared photothermal transducers for the treatment of highly aggressive cancers and large tumors where the penetration of light can be substantially reduced, and the intra-tumoral nanoparticle transport is restricted due to the presence of hypoxic or necrotic regions. We report the performance advantages obtained by sub 100nm gold nanomatryushkas, comprising concentric gold-silica-gold layers compared to conventional ~150nm silica core gold nanoshells for photothermal therapy of triple negative breast cancer. We demonstrate that a 33% reduction in silica-core-gold-shell nanoparticle size, while retaining near-infrared plasmon resonance, and keeping the nanoparticle surface charge constant, results in a four to five fold tumor accumulation of nanoparticles following equal dose of injected gold for both sizes. The survival time of mice bearing large (>1000mm(3)) and highly aggressive triple negative breast tumors is doubled for the nanomatryushka treatment group under identical photo-thermal therapy conditions. The higher absorption cross-section of a nanomatryoshka results in a higher efficiency of photonic to thermal energy conversion and coupled with 4-5× accumulation within large tumors results in superior therapy efficacy. PMID:25051221

  12. Sub-100 nm Gold Nanomatryoshkas Improve Photo-thermal Therapy Efficacy in Large and Highly Aggressive Triple Negative Breast Tumors

    PubMed Central

    Bishnoi, Sandra; Urban, Alexander; Charron, Heather; Mitchell, Tamika; Shea, Martin; Nanda, Sarmistha; Schiff, Rachel; Halas, Naomi; Joshi, Amit

    2014-01-01

    There is an unmet need for efficient near-infrared photothermal transducers for the treatment of highly aggressive cancers and large tumors where the penetration of light can be substantially reduced, and the intra-tumoral nanoparticle transport is restricted due to the presence of hypoxic or nectrotic regions. We report the performance advantages obtained by sub 100 nm gold nanomatryushkas, comprising of concentric gold-silica-gold layers compared to conventional ~150 nm silica core gold nanoshells for photothermal therapy of triple negative breast cancer. We demonstrate that a 33% reduction in silica-core-gold-shell nanoparticle size, while retaining near-infrared plasmon resonance, and keeping the nanoparticle surface charge constant, results in a four to five fold tumor accumulation of nanoparticles following equal dose of injected gold for both sizes. The survival time of mice bearing large (>1000 mm3) and highly aggressive triple negative breast tumors is doubled for the nanomatryushka treatment group under identical photo-thermal therapy conditions. The higher absorption cross-section of a nanomatryoshka results in a higher efficiency of photonic to thermal energy conversion and coupled with 4-5X accumulation within large tumors results in superior therapy efficacy. PMID:25051221

  13. Ultrasound-Stimulated Acoustic Emission in Thermal Image-Guided HIFU Therapy: A Phantom Study

    SciTech Connect

    Jiang, C. P.; Lin, W. T.; Chen, W. S.

    2006-05-08

    Magnetic resonance image (MRI) is a promising monitoring tool for non-invasive real-time thermal guidance in high intensity focused ultrasound (HIFU) during thermal ablation surgery. However, this approach has two main drawbacks: 1) majority of components need to be redesigned to be MR compatible in order to avoid effecting MR images, and 2) the cost of operating MRI facilities is high. Alternately, ultrasound-stimulated acoustic emission (USAE) method has been applied for detecting thermal variations in tissues. An optical transparent phantom, made from polyacrylamide, containing thermal sensitive indicator protein (Bovine Serum Albumin), was prepared for observing the HIFU-induced denaturalization. A thermal-couple was set up for validation of temperature distribution. Experimental results show that thermal image can be captured clearly under stationary conditions.

  14. Granulomatous interstitial nephritis and Crohn's disease.

    PubMed

    Timmermans, Sjoerd A M E G; Christiaans, Maarten H L; Abdul-Hamid, Myrurgia A; Stifft, Frank; Damoiseaux, Jan G M C; van Paassen, Pieter

    2016-08-01

    Granulomatous interstitial nephritis has been observed in <1% of native renal biopsies. Here, we describe two patients with granulomatous interstitial nephritis in relation to Crohn's disease. Circulating helper and cytotoxic T cells were highly activated, and both cell types predominated in the interstitial infiltrate, indicating a cellular autoimmune response. After immunosuppressive treatment, renal function either improved or stabilized in both patients. In conclusion, granulomatous interstitial nephritis is a genuine extraintestinal manifestation of Crohn's disease, the treatment of which should include immunosuppressive agents. PMID:27478596

  15. Thermal Tomography Imaging in Photonic Traditional Chinese Medicine Information Therapy with Holistic Effect for Health Whole Nursing

    PubMed Central

    Ye, Binggang; Guo, Zhouyi; Huang, Hanchuan; Yang, Xicheng

    2015-01-01

    A photonic traditional Chinese medicine (TCM) information therapy was developed that has applications in whole health nursing including the prevention and treatment of ischemic cardiovascular and cerebrovascular diseases as well as the conditioning of the subhealth state. This therapy utilizes the beam of a 630 nm LED light to irradiate the oropharynx, while simultaneously employing two beams of 650 nm LED light to irradiate corresponding acupuncture points resulting in a synergistic outcome. This method was named “1 + 2 phototherapy.” The principle mechanism of the therapy is a series of photon induced biological effects that are triggered by stimulating the photosensitive tissues of the oropharynx. This tissue includes the oral mucosa, capillaries, lymph nodes, saliva glands, nerves, and Jingluo and is stimulated by light beams of certain photon energy and imitative acupuncture information. Thermal tomography imaging shows that the average temperature of the upper-body was improved significantly after oropharyngeal irradiation under irradiation of “Futu point”: the heat radiation of the spine, as well as chest, shoulders, arms, and clavicle, increased under irradiation of “Hoku,” whereas the overall average temperature was below the temperature before irradiation. The experiment indicates that this therapy can promote blood circulation, regulate varied physiological parameters, and have holistic effects in whole health nursing. PMID:25821805

  16. Analysis of thermal effects in endoscopic nanocarriers-based photodynamic therapy applied to esophageal diseases

    NASA Astrophysics Data System (ADS)

    Salas-García, I.; Fanjul-Vélez, F.; Ortega-Quijano, N.; Wilfert, O.; Hudcova, L.; Poliak, J.; Barcik, P.; Arce-Diego, J. L.

    2014-02-01

    In this work we propose a predictive model that allows the study of thermal effects produced when the optical radiation interacts with an esophageal or stomach disease with gold nanoparticles embedded. The model takes into account light distribution in the tumor tissue by means of a Monte Carlo method. Mie theory is used to obtain the gold nanoparticles optical properties and the thermal model employed is based on the bio-heat equation. The complete model was applied to two types of tumoral tissue (squamous cell carcinoma located in the esophagus and adenocarcinoma in the stomach) in order to study the thermal effects induced by the inclusion of gold nanoparticles.

  17. Acute interstitial nephritis - a reappraisal and update.

    PubMed

    Raghavan, Rajeev; Eknoyan, Garabed

    2014-09-01

    Acute interstitial nephritis (AIN) is an under recognized and under diagnosed cause of acute kidney injury (AKI). It is estimated to account for 15 - 20% of cases of AKI; it is the reported diagnosis in 2.8% of all kidney biopsies, and 13.5% of biopsies done specifically for acute renal failure. Considerable evidence implicates antigen initiated cell-mediated injury in the pathogenesis of AIN. Drugs account for 70% of all cases, with over 150 different agents incriminated. The remaining cases are due to infections, autoimmune diseases, and rarely idiopathic. The central component of renal injury in AIN is altered tubular function, which usually precedes decrements in filtration rate. The key to early diagnosis is vigilance for the presence of tubular dysfunction in non-oliguric individuals, especially in patients with modest but gradual increments in creatinine level. The utility of urinary biomarkers to diagnose AIN in its early nascent and potentially reversible stage remains to be determined. Prompt recognition, elimination of the offending source of antigen, and use of a limited course of steroid therapy where indicated, will result in complete resolution in ~ 65% of cases, partial resolution in up to 20%, and irreversible damage in the rest. PMID:25079860

  18. [Interstitial lung diseases associated with smoking].

    PubMed

    Nová, Markéta; Hornychová, Helena; Matěj, Radoslav

    2016-01-01

    There are many different interstitial lung diseases associated with smoking. This short review describes officially recognized disorders (desquamative interstitial pneumonia, respiratory bronchiolitis and pulmonary Langerhans´cells histiocytosis) and entities with uncertain relationship to smoking, which have recently been published in the literature. Histopathological pictures and differential diagnosis of smoking-related diseases of the lungs are discussed. PMID:27223588

  19. Thermal Ablative Therapies and Immune Checkpoint Modulation: Can Locoregional Approaches Effect a Systemic Response?

    PubMed Central

    Mehta, Amol; Oklu, Rahmi

    2016-01-01

    Percutaneous image-guided ablation is an increasingly common treatment for a multitude of solid organ malignancies. While historically these techniques have been restricted to the management of small, unresectable tumors, there is an expanding appreciation for the systemic effects these locoregional interventions can cause. In this review, we summarize the mechanisms of action for the most common thermal ablation modalities and highlight the key advances in knowledge regarding the interactions between thermal ablation and the immune system. PMID:27051417

  20. Control of diffusion of implanted boron in preamorphized Si: Elimination of interstitial defects at the amorphous-crystal interface

    NASA Astrophysics Data System (ADS)

    Roth, E. G.; Holland, O. W.; Thomas, D. K.

    1999-02-01

    Transient-enhanced diffusion (TED) during thermal annealing of ion-implanted B in Si is well established and attributed to the ion-induced, excess interstitials. On the other hand, the mechanism to account for TED of B in preamorphized (PA) Si remains unclear. Enhanced diffusion of the B persists in regrown layers even though the ion-induced interstitial defects responsible for TED in B+-only implanted Si are eliminated following regrowth. To test the hypothesis that TED in PA Si results from the "excess" interstitial-type defects below the amorphous-crystalline (a-c) interface, a buried PA layer has been recrystallized from the surface inward to the SiO2 interface of silicon-on-insulator material to eliminate all possible sources of excess interstitials. The effect on B diffusion and the role of the residual interstitial-type defects will be discussed.

  1. Current guidelines in the management of interstitial cystitis

    PubMed Central

    Evans, Robert

    2015-01-01

    Interstitial cystitis (IC) is a heterogeneous chronic disease of unknown etiology that impacts a very large number of women. Symptoms are highly variable: patients may suffer from pelvic pain that is exacerbated by bladder filling, and can be associated with a variety of lower urinary tract symptoms including frequency and urgency. Given the varying presentations and severities of corresponding treatment must be tailored to each specific patient. Current American Urological Association (AUA) guidelines separate the IC treatment recommendations into six tiers of increasing invasive therapies. These treatment guidelines begin with education and lifestyle modifications and progress through levels of physical, pharmacological, and ultimately surgical therapies for those that fail the less invasive therapies. The purpose of this review is to outline the recommendations for the treatment of IC and the evidence from which these recommendations arise. Furthermore, we examine the most up to date literature so that we may recognize future directions in the treatment of IC. PMID:26816869

  2. Interstitial lung disease: state of the clinical art.

    PubMed

    Perez, R L; Staton, G W

    1991-10-01

    Interstitial lung diseases pose a great challenge to the clinician because of the indolent and variably active nature of these disorders and the limited number of therapeutic options. Adjunctive therapy includes supplemental oxygen in hypoxic patients, bronchodilators in patients with an obstructive lung component, and aggressive use of antibiotics in febrile patients on potent immunosuppressive therapy and suspected or confirmed infections. In younger patients who present late in their illness or deteriorate on therapy, lung transplantation is the only option. Recent advances in our knowledge of the cellular and molecular mechanisms operating in ILD and techniques which include gene amplification and cloning promise to yield more effective treatments for these diseases which currently produce a high incidence of morbidity and mortality. PMID:1744519

  3. Activatable albumin-photosensitizer nanoassemblies for triple-modal imaging and thermal-modulated photodynamic therapy of cancer.

    PubMed

    Hu, Dehong; Sheng, Zonghai; Gao, Guanhui; Siu, Fungming; Liu, Chengbo; Wan, Qian; Gong, Ping; Zheng, Hairong; Ma, Yifan; Cai, Lintao

    2016-07-01

    Photodynamic therapy (PDT) is a noninvasive and effective approach for cancer treatment. The main bottlenecks of clinical PDT are poor selectivity of photosensitizer and inadequate oxygen supply resulting in serious side effects and low therapeutic efficiency. Herein, a thermal-modulated reactive oxygen species (ROS) strategy using activatable human serum albumin-chlorin e6 nanoassemblies (HSA-Ce6 NAs) for promoting PDT against cancer is developed. Through intermolecular disulfide bond crosslinking and hydrophobic interaction, Ce6 photosensitizer is effectively loaded into the HSA NAs, and the obtained HSA-Ce6 NAs exhibit excellent reduction response, as well as enhanced tumor accumulation and retention. By the precision control of the overall body temperature instead of local tumor temperature increasing from 37 °C to 43 °C, the photosensitization reaction rate of HSA-Ce6 NAs increases 20%, and the oxygen saturation of tumor tissue raise 52%, significantly enhancing the generation of ROS for promoting PDT. Meanwhile, the intrinsic fluorescence and photoacoustic properties, and the chelating characteristic of porphyrin ring can endow the HSA-Ce6 NAs with fluorescence, photoacoustic and magnetic resonance triple-modal imaging functions. Upon irradiation of low-energy near-infrared laser, the tumors are completely suppressed without tumor recurrence and therapy-induced side effects. The robust thermal-modulated ROS strategy combined with albumin-based activatable nanophotosensitizer is highly potential for multi-modal imaging-guided PDT and clinical translation. PMID:27061266

  4. Interstitial laser photocoagulation of uterine leimyoma

    NASA Astrophysics Data System (ADS)

    Gordon, Alastair D.; Buonaccorsi, Giovanni A.; Patel, Bipin L.; Broadbent, Jeff J.; Thurrell, Wendy; Bown, Stephen G.

    1996-01-01

    Uterine leiomyomas (fibroids) are common benign tumors which may cause heavy or painful periods, may present as a pelvic mass and are associated with infertility. Local excision of symptomatic lesions can be difficult and hazardous, and the alternative is hysterectomy. We are investigating interstitial laser photocoagulation (ILP) as a less invasive alternative. Initial experiments were undertaken on 40 fibroids after surgical removal. One or two bare tipped, precharred fibers from a 25 W semiconductor laser (805 nm) were inserted into the center of the fibroid and treatment delivered with 2 - 10 W for 100 - 1000 sec. Specimens were subsequently sectioned perpendicular to the fiber track. Fibroids are very pale and apart from occasional charred tracts there was little evidence of thermal coagulation macroscopically or after haematoxylon and eosin staining. However, using a diaphorase stain technique we were able to demonstrate ellipsoid zones of devitalized tissue up to 20 mm across (15 mm for single fibers). These results suggest that ILP is producing gentle, uniform coagulation which could lead to resorption of treated areas. With appropriate numbers of treatment sites, this could permit minimally invasive management of clinically significant lesions. Clinical studies have commenced treating fibroids with ILP at the time of surgical excision by myomectomy or hysterectomy.

  5. Magnetic Resonance-Guided Laser Induced Thermal Therapy for Glioblastoma Multiforme: A Review

    PubMed Central

    Norred, Sarah E.; Johnson, Jacqueline Anne

    2014-01-01

    Magnetic resonance-guided laser induced thermotherapy (MRgLITT) has become an increasingly relevant therapy for tumor ablation due to its minimally invasive approach and broad applicability across many tissue types. The current state of the art applies laser irradiation via cooled optical fiber applicators in order to generate ablative heat and necrosis in tumor tissue. Magnetic resonance temperature imaging (MRTI) is used concurrently with this therapy to plan treatments and visualize tumor necrosis. Though application in neurosurgery remains in its infancy, MRgLITT has been found to be a promising therapy for many types of brain tumors. This review examines the current use of MRgLITT with regard to the special clinical challenge of glioblastoma multiforme and examines the potential applications of next-generation nanotherapy specific to the treatment of glioblastoma. PMID:24527455

  6. Update on lymphoid interstitial pneumonitis.

    PubMed

    Fishback, N; Koss, M

    1996-09-01

    Lymphoid interstitial pneumonitis (LIP) involves a clinicopathologic pattern of pulmonary disease characterized by diffuse interstitial reactive lymphoid infiltrates. In adults, it occurs most commonly in autoimmune diseases, such as Sjögren's syndrome (0.9% of these patients) and primary biliary cirrhosis, whereas in children it is usually seen in HIV infection. Dysproteinemias (hyper- and hypogammaglobulinemia) are found in more than 60% of patients. Children can show CD8-lymphocytosis in bronchoalveolar lavage fluid, lung tissue, peripheral blood, and salivary gland, associated with HLA-DR5 haplotype. Radiographically, most patients with LIP have reticulonodular infiltrates, with or without patchy areas of consolidation. CT scans can show both small nodular and ground glass patterns, patterns that are diagnostically nonspecific. Reduced lung volumes and diffusing capacities are consistent and sensitive indicators of disease in LIP. In an experimental model, diffusing capacity was the single most sensitive functional index of disease progression. Microscopically, LIP is part of a spectrum of pulmonary lymphoid proliferations, ranging from follicular bronchitis-bronchiolitis and pulmonary lymphoid hyperplasia (the latter in AIDS patients), proliferations largely limited to airways, to low-grade malignant lymphoma. These patterns may be difficult to differentiate from each other. It appears that LIP sometimes evolves to lymphoma; the frequency of this evolution is probably low but is difficult to assess because low-grade lymphomas may mimic LIP. A relatively high frequency of LIP patients have Epstein-Barr virus DNA in their lungs but not all patients with LIP show this finding, suggesting other possible etiologies. PMID:9363179

  7. Development of an endoluminal high-intensity ultrasound applicator for image-guided thermal therapy of pancreatic tumors

    PubMed Central

    Scott, Serena J.; Salgaonkar, Vasant A.; Jones, Peter D.; Plata-Camargo, Juan C.; Sommer, Graham; Diederich, Chris J.

    2015-01-01

    An ultrasound applicator for endoluminal thermal therapy of pancreatic tumors has been introduced and evaluated through acoustic/biothermal simulations and ex vivo experimental investigations. Endoluminal therapeutic ultrasound constitutes a minimally invinvasive conformal therapy and is compatible with ultrasound or MR-based image guidance. The applicator would be placed in the stomach or duodenal lumen, and sonication would be performed through the luminal wall into the tumor, with concurrent water cooling of the wall tissue to prevent its thermal injury. A finite-element (FEM) 3D acoustic and biothermal model was implemented for theoretical analysis of the approach. Parametric studies over transducer geometries and frequencies revealed that operating frequencies within 1-3 MHz maximize penetration depth and lesion volume while sparing damage to the luminal wall. Patient-specific FEM models of pancreatic head tumors were generated and used to assess the feasibility of performing endoluminal ultrasound thermal ablation and hyperthermia of pancreatic tumors. Results indicated over 80% of the volume of small tumors (~2 cm diameter) within 35 mm of the duodenum could be safely ablated in under 30 minutes or elevated to hyperthermic temperatures at steady-state. Approximately 60% of a large tumor (~5 cm diameter) model could be safely ablated by considering multiple positions of the applicator along the length of the duodenum to increase coverage. Prototype applicators containing two 3.2 MHz planar transducers were fabricated and evaluated in ex vivo porcine carcass heating experiments under MR temperature imaging (MRTI) guidance. The applicator was positioned in the stomach adjacent to the pancreas, and sonications were performed for 10 min at 5 W/cm2 applied intensity. MRTI indicated over 40°C temperature rise in pancreatic tissue with heating penetration extending 3 cm from the luminal wall. PMID:26677314

  8. Development of an endoluminal high-intensity ultrasound applicator for image-guided thermal therapy of pancreatic tumors

    NASA Astrophysics Data System (ADS)

    Adams, Matthew S.; Scott, Serena J.; Salgaonkar, Vasant A.; Jones, Peter D.; Plata-Camargo, Juan C.; Sommer, Graham; Diederich, Chris J.

    2015-03-01

    An ultrasound applicator for endoluminal thermal therapy of pancreatic tumors has been introduced and evaluated through acoustic/biothermal simulations and ex vivo experimental investigations. Endoluminal therapeutic ultrasound constitutes a minimally invasive conformal therapy and is compatible with ultrasound or MR-based image guidance. The applicator would be placed in the stomach or duodenal lumen, and sonication would be performed through the luminal wall into the tumor, with concurrent water cooling of the wall tissue to prevent its thermal injury. A finite-element (FEM) 3D acoustic and biothermal model was implemented for theoretical analysis of the approach. Parametric studies over transducer geometries and frequencies revealed that operating frequencies within 1-3 MHz maximize penetration depth and lesion volume while sparing damage to the luminal wall. Patient-specific FEM models of pancreatic head tumors were generated and used to assess the feasibility of performing endoluminal ultrasound thermal ablation and hyperthermia of pancreatic tumors. Results indicated over 80% of the volume of small tumors (~2 cm diameter) within 35 mm of the duodenum could be safely ablated in under 30 minutes or elevated to hyperthermic temperatures at steady-state. Approximately 60% of a large tumor (~5 cm diameter) model could be safely ablated by considering multiple positions of the applicator along the length of the duodenum to increase coverage. Prototype applicators containing two 3.2 MHz planar transducers were fabricated and evaluated in ex vivo porcine carcass heating experiments under MR temperature imaging (MRTI) guidance. The applicator was positioned in the stomach adjacent to the pancreas, and sonications were performed for 10 min at 5 W/cm2 applied intensity. MRTI indicated over 400C temperature rise in pancreatic tissue with heating penetration extending 3 cm from the luminal wall.

  9. Thermal therapy for breast tumors by using a cylindrical ultrasound phased array with multifocus pattern scanning: a preliminary numerical study

    NASA Astrophysics Data System (ADS)

    Ho, Cheng-Shiao; Ju, Kuen-Cheng; Cheng, Tze-Yuan; Chen, Yung-Yaw; Lin, Win-Li

    2007-08-01

    The purpose of this study is to investigate the feasibility of using a 1 MHz cylindrical ultrasound phased array with multifocus pattern scanning to produce uniform heating for breast tumor thermal therapy. The breast was submerged in water and surrounded by the cylindrical ultrasound phased array. A multifocus pattern was generated and electrically scanned by the phased array to enlarge the treatment lesion in single heating. To prevent overheating normal tissues, a large planning target volume (PTV) would be divided into several planes with several subunits on each plane and sequentially treated with a cooling phase between two successive heatings of the subunit. Heating results for different target temperatures (Ttgt), blood perfusion rates and sizes of the PTV have been studied. Furthermore, a superficial breast tumor with different water temperatures was also studied. Results indicated that a higher target temperature would produce a slightly larger thermal lesion, and a higher blood perfusion rate would not affect the heating lesion size but increase the heating time significantly. The acoustic power deposition and temperature elevations in ribs can be minimized by orienting the acoustic beam from the ultrasound phased array approximately parallel to the ribs. In addition, a large acoustic window on the convex-shaped breast surface for the proposed ultrasound phased array and the cooling effect of water would prevent the skin overheating for the production of a lesion at any desired location. This study demonstrated that the proposed cylindrical ultrasound phased array can provide effective heating for breast tumor thermal therapy without overheating the skin and ribs within a reasonable treatment time.

  10. [Interstitial cystitis/bladder pain syndrome (IC/BPS)].

    PubMed

    Scheiner, David A; Perucchini, Daniele; Fink, Daniel; Betschart, Cornelia

    2015-08-19

    Interstitial cystitis/bladder pain syndrome (BPS) is still an etiologically poorly understood chronic pain syndrome. BPS is a clinical diagnosis. The current treatment modalities are aimed at symptom relief because no cure is possible. Analgesics may be used at any point in treatment but preferably for short-term relief for flares or bladder pain. AUA has issued clinical practice guidelines with a stepwise approach. The first-line therapy begins with self-care and behavior modification. Physical therapy and oral medications such as amitriptyline, PPS, or antihistamines belong to the second-line therapy. Third-line therapy requires cystoscopy and hydrodistension, treatment of Hunner lesions, or intravesical use of e.g. DMSO. Neuromodulation is considered a fourth-line therapy in patients who have failed third-line treatments. Fifth-line therapies consist of intravesical injection of BoNT or oral cyclosporin A. Cystectomy is the sixth-line therapy and the treatment of last resort. PMID:26286495

  11. Treatment of a supratentorial primitive neuroectodermal tumor using magnetic resonance-guided laser-induced thermal therapy.

    PubMed

    Jethwa, Pinakin R; Lee, Jason H; Assina, Rachid; Keller, Irwin A; Danish, Shabbar F

    2011-11-01

    Supratentorial primitive neuroectodermal tumors (PNETs) are rare tumors that carry a poorer prognosis than those arising from the infratentorial compartment (such as medulloblastoma). The overall prognosis for these patients depends on several factors including the extent of resection, age at diagnosis, CSF dissemination, and site in the supratentorial space. The authors present the first case of a patient with a newly diagnosed supratentorial PNET in which cytoreduction was achieved with MR-guided laser-induced thermal therapy. A 10-year-old girl presented with left-sided facial weakness and a large right thalamic mass extending into the right midbrain. The diagnosis of supratentorial PNET was made after stereotactic biopsy. Therapeutic options for this lesion were limited because of the risks of postoperative neurological deficits with resection. The patient underwent MR-guided laser-induced thermal ablation of her tumor. Under real-time MR thermometry, thermal energy was delivered to the tumor at a core temperature of 90°C for a total of 960 seconds. The patient underwent follow-up MR imaging at regular intervals to evaluate the tumor response to the thermal ablation procedure. Initial postoperative scans showed an increase in the size of the lesion as well as the amount of the associated edema. Both the size of the lesion and the edema stabilized by 1 week and then decreased below preablation levels at the 3-month postsurgical follow-up. There was a slight increase in the size of the lesion and associated edema at the 6-month follow-up scan, presumably due to concomitant radiation she received as part of her postoperative care. The patient tolerated the procedure well and has had resolution of her symptoms since surgery. Further study is needed to assess the role of laser-induced thermal therapy for the treatment of intracranial tumors. As such, it is a promising tool in the neurosurgical armamentarium. Postoperative imaging has shown no evidence of definitive

  12. Proposal of thermal imaging application in photodynamic therapy-Preliminary report.

    PubMed

    Cholewka, Armand; Stanek, Agata; Kwiatek, Sebastian; Cholewka, Agnieszka; Cieślar, Grzegorz; Straszak, Dariusz; Gibińska, Joanna; Sieroń-Stołtny, Karolina

    2016-06-01

    There are many different skin lesions that manifest a skin temperature gradient. Basal cell carcinoma (BCC) is the most frequently occurring type of malignant skin lesion (almost 95% of all skin tumors). BCC is sometimes treated by using photodynamic therapy which is very well tolerated by patients and provides good results, especially in superficial skin layer lesions. The results of our studies showed significant changes in the area of temperature gradient due to photodynamic therapy. It seems that the ability to acquire knowledge of such area changes may provide additional useful information to physicians. The increase of observed isotherm area in comparison to lesion size on the skin was a few times higher. It may suggest the range of areas where the metabolism processes take place. Due to the accumulation of photosensitivity only in tumor cells, we theorize that such a large region of increased metabolism observed during therapy may be connected with a larger range of tumor cells than was previously predicted through diagnosis. However, it should be noted that the region can be much bigger due to the existing heat transfer. The results obtained have a potential meaning in describing the range of chemical and physiological processes occurring during photodynamic therapy. PMID:26687617

  13. Pietro Anzolino da Eboli and the thermal therapy of renal pathologies.

    PubMed

    Mezzogiorno, Antonio; Caruso, Arturo Armone; Lorio, Luigi; Papa, Michele; Esposito, Vincenzo

    2004-01-01

    In the Campi Flegrei area of Campania, a region of Southern Italy, some thermal baths still exist, known for the therapeutical properties of their waters. Utilized since remote ages for the treatment of a variety of pathologies. In "De Balneis Terrae Laboris", an Italian poet of the Middle Ages and scientist, Pietro Anzolino da Eboli, reports every detail about more than thirty different thermal sites in the Campi Flegrei, including all therapeutic effects of their waters. Based on Pietro's manuscript, we report in the current paper all the sites whose waters were - among other indications - also recommended for the treatment of some urinary diseases. PMID:15293539

  14. UK trainee experience in interstitial lung disease: results from a British Thoracic Society survey.

    PubMed

    Sharp, Charles; Maher, Toby M; Welham, Sally; Gibbons, Michael

    2015-02-01

    Interstitial lung disease (ILD) is a growing field of respiratory medicine in which novel therapies are emerging. It is important that trainees gain competence and confidence in this area. To explore the training experiences of specialty trainees, we conducted a survey of their practical experience and confidence in diagnosing and managing ILD. PMID:25352531

  15. Blindness, Diabetes, and Amputation: Alleviation of Depression and Pain through Thermal Biofeedback Therapy.

    ERIC Educational Resources Information Center

    Needham, W. E.; And Others

    1993-01-01

    A 39-year-old man who was blind, diabetic, and had a double amputation with chronic renal failure and peripheral vascular disease was treated with thermal biofeedback to reduce his depression through increased self-control, to minimize pain, and to facilitate healing of a pregangrenous hand. On treatment discharge, his mental and physical states…

  16. Structure and high-temperature properties of Ti{sub 5}Si{sub 3} with interstitial additions

    SciTech Connect

    Williams, Jason

    1999-12-01

    This study was motivated by the fact that previous research on the structure and properties of Ti{sub 5}Si{sub 3} showed unacceptably inconsistent results. The primary reason for these inconsistencies was interstitial contamination of Ti{sub 5}Si{sub 3} by carbon, nitrogen and oxygen. Thus, this study measured the effects that these interstitial atoms have on some of the previously reported properties. These properties include crystalline structure, thermal expansion anisotropy, electronic structure and bonding, and high temperature oxidation resistance. In Chapter 2 of this study, the lattice parameters and atomic positions of Ti{sub 5}Si{sub 3} as a function of carbon, nitrogen or oxygen content were measured via x-ray and neutron diffraction. Comparing these lattice parameters to those reported in other studies on supposedly pure Ti{sub 5}Si{sub 3} confirmed that the majority of the previous studies had samples with a considerable amount of interstitial impurities. In fact, the lattice parameter trends given in Chapter 2 can be used to estimate the types and level of impurities in these studies. Furthermore, Chapter 2 discusses how atomic positions change as interstitial atoms are incorporated into the lattice. These changes in atomic separations suggest that strong bonds form between the interstitial atoms and the surrounding titanium atoms. This is in full agreement with the electronic structure calculations given in Chapter 4. These calculations show that bonding does occur between titanium d-states and interstitial atom p-states at the expense of bonding between some of the titanium and silicon atoms. In addition, carbon seems to be the most strongly bonded interstitial atom. Knowledge of the exact interstitial content and its effect on bonding is important because Chapters 3 and 5 have shown that interstitial atoms have a marked effect on the thermal expansion and oxidation resistance. As discussed in Chapter 3, all interstitial atoms lower the thermal

  17. Thermal therapy of pancreatic tumors using endoluminal ultrasound: parametric and patient-specific modeling

    PubMed Central

    Adams, Matthew S.; Scott, Serena J.; Salgaonkar, Vasant A.; Sommer, Graham; Diederich, Chris J.

    2016-01-01

    Purpose To investigate endoluminal ultrasound applicator configurations for volumetric thermal ablation and hyperthermia of pancreatic tumors using 3D acoustic and biothermal finite element models. Materials and Methods Parametric studies compared endoluminal heating performance for varying applicator transducer configurations (planar, curvilinear-focused, or radial-diverging), frequencies (1–5 MHz), and anatomical conditions. Patient-specific pancreatic head and body tumor models were used to evaluate feasibility of generating hyperthermia and thermal ablation using an applicator positioned in the duodenal or stomach lumen. Temperature and thermal dose were calculated to define ablation (>240 EM43°C) and moderate hyperthermia (40–45 °C) boundaries, and to assess sparing of sensitive tissues. Proportional-integral control was incorporated to regulate maximum temperature to 70–80 °C for ablation and 45 °C for hyperthermia in target regions. Results Parametric studies indicated that 1–3 MHz planar transducers are most suitable for volumetric ablation, producing 5–8 cm3 lesion volumes for a stationary 5 minute sonication. Curvilinear-focused geometries produce more localized ablation to 20–45 mm depth from the GI tract and enhance thermal sparing (Tmax<42 °C) of the luminal wall. Patient anatomy simulations show feasibility in ablating 60.1–92.9% of head/body tumor volumes (4.3–37.2 cm3) with dose <15 EM43°C in the luminal wall for 18–48 min treatment durations, using 1–3 applicator placements in GI lumen. For hyperthermia, planar and radial-diverging transducers could maintain up to 8 cm3 and 15 cm3 of tissue, respectively, between 40–45 °C for a single applicator placement. Conclusions Modeling studies indicate the feasibility of endoluminal ultrasound for volumetric thermal ablation or hyperthermia treatment of pancreatic tumor tissue. PMID:27097663

  18. Functional respiratory assessment in interstitial lung disease.

    PubMed

    Miguel-Reyes, José Luis; Gochicoa-Rangel, Laura; Pérez-Padilla, Rogelio; Torre-Bouscoulet, Luis

    2015-01-01

    Interstitial lung diseases are a heterogeneous group of disorders that affect, to a greater or lesser degree, the alveolus, peripheral airway, and septal interstitium. Functional assessment in patients suspected of having an interstitial lung disease has implications for diagnosis and makes it possible to objectively analyze both response to treatment and prognosis. Recently the clinical value of lung-diffusing capacity and the six-minute walking test has been confirmed, and these are now important additions to the traditional assessment of lung function that is based on spirometry. Here we review the state-of-the-art methods for the assessment of patients with interstitial lung disease. PMID:25857578

  19. Interstitial Ectopic Pregnancy: Conservative Surgical Management

    PubMed Central

    Warda, Hussein; Mamik, Mamta M.; Ashraf, Mohammad

    2014-01-01

    Introduction: Interstitial pregnancy is a rare and life-threatening condition. Diagnosis and appropriate management are critical in preventing morbidity and death. Case Description: Four cases of interstitial pregnancy are presented. Diagnostic laparoscopy followed by laparotomy and cornuostomy with removal of products of conception was performed in 1 case. Laparoscopic cornuostomy and removal of products of conception were performed in the subsequent 3 cases with some modifications of the technique. Subsequent successful reproductive outcomes are also presented. Discussion: Progressively conservative surgical measures are being used to treat interstitial pregnancy successfully, with no negative impact on subsequent pregnancies. PMID:24960482

  20. HIFU Therapy Compared with Other Thermal Ablation Methods in a Perfused Organ Model

    NASA Astrophysics Data System (ADS)

    Jenne, Jürgen W.; Risse, Frank; Häcker, Axel; Peters, Kristina; Siegler, Peter; Divkovic, Gabriela Wilzbach; Huber, Peter E.

    2007-05-01

    Therapy with high intensity focused ultrasound (HIFU) has been shown to be both safe and clinically practical in a growing number of patient studies for a variety of different target organs. Especially in cancer therapy there are comparable ablation methods like radio frequency (RFA) or laser (LITT) ablation, which are clinically more accepted. In an ongoing study we compare HIFU with RF- and laser ablation under MRI guidance in a perfused organ model. All evaluated techniques were appropriate to induce defined and localized ablation necrosis in the renal cortex. Our HIFU system and the laser system were completely MRI compatible. The tested RF- system showed local needle artefacts and disturbed the MR images during operation. The ablation rate of HIFU using a spot scanning technique was clearly lower compared to the other ablation techniques. However, advanced HIFU scanning methods might overcome this limitation. In addition HIFU is the only complete non-invasive ablation technique.

  1. IMPROVED COMPUTATIONAL CHARACTERIZATION OF THE THERMAL NEUTRON SOURCE FOR NEUTRON CAPTURE THERAPY RESEARCH AT THE UNIVERSITY OF MISSOURI

    SciTech Connect

    Stuart R. Slattery; David W. Nigg; John D. Brockman; M. Frederick Hawthorne

    2010-05-01

    Parameter studies, design calculations and initial neutronic performance measurements have been completed for a new thermal neutron beamline to be used for neutron capture therapy cell and small-animal radiobiology studies at the University of Missouri Research Reactor. The beamline features the use of single-crystal silicon and bismuth sections for neutron filtering and for reduction of incident gamma radiation. The computational models used for the final beam design and performance evaluation are based on coupled discrete-ordinates and Monte Carlo techniques that permit detailed modeling of the neutron transmission properties of the filtering crystals with very few approximations. This is essential for detailed dosimetric studies required for the anticipated research program.

  2. [Chronic interstitial lung disease in children: Diagnostic approach and management].

    PubMed

    Fuger, M; Clair, M-P; El Ayoun Ibrahim, N; L'Excellent, S; Nizery, L; O'Neill, C; Tabone, L; Truffinet, O; Yakovleff, C; de Blic, J

    2016-05-01

    Chronic interstitial lung disease (ILD) in children is a heterogeneous group of rare lung disorders characterized by an inflammatory process of the alveolar wall and the pulmonary interstitium that induces gas exchange disorders. The diagnostic approach to an ILD involves three essential steps: recognizing the ILD, appreciating the impact, and identifying the cause. The spectrum of clinical findings depends to a large extent on age. In the newborn, the beginning is often abrupt (neonatal respiratory distress), whereas there is a more gradual onset in infants (failure to thrive, tachypnea, indrawing of the respiratory muscles). In older children, the onset is insidious and the diagnosis can only be made at an advanced stage of the disease. The diagnosis is based on noninvasive methods (clinical history, respiratory function tests, chest X-ray, and high-resolution CT scan) and invasive techniques (bronchoalveolar lavage, transbronchial biopsy, video-assisted thoracoscopic biopsy, and open lung biopsy). The treatment of interstitial lung disease in children depends on the nature of the underlying pathology. The most common therapeutic approach involves the use of corticosteroids and immunosuppressive agents for their anti-inflammatory and antifibrotic effects. Children with ILD also need support therapy (oxygen therapy, nutritional support, treatment of pulmonary arterial hypertension, vaccination). Lung transplantation is discussed in patients with severe respiratory failure. PMID:27021883

  3. Histological Evaluation of Prostate Tissue Response to Image-Guided Transurethral Thermal Therapy After a 48h Recovery Period

    NASA Astrophysics Data System (ADS)

    Boyes, Aaron; Tang, Kee; Chopra, Rajiv; Bronskill, Michael

    2009-04-01

    Image-guided transurethral ultrasound thermal therapy shows strong potential for sparing of critical adjacent structures during prostate cancer treatment. Preclinical experiments were conducted to provide further information on the extent of the treatment margin. Four experiments were carried out in a canine model to investigate the pathology of this margin during the early stages of recovery and were compared to previous results obtained immediately post-treatment. Sedated animals were placed in a 1.5T clinical MRI, and the heating device was positioned accurately within the prostatic urethra with image guidance. Using an MRI-compatible system, the ultrasound device was rotated 365° treating a prescribed volume contained within the gland. Quantitative temperature maps were acquired throughout the treatment, providing feedback information for device control. Animals were allowed to recover and, after 48h, an imaging protocol including T2 and contrast enhanced (CE) MRI was repeated before the animals were sacrificed. Prostate sections were stained with H&E. Careful slice alignment methods during histological procedures and image registration were employed to ensure good correspondence between MR images and microscopy. Although T2 MRI revealed no lesion acutely, a hypo-intense region was clearly visible 2 days post-treatment. The lesion volume defined by CE-MRI increased appreciably during this time. Whole-mount H&E sections showed that the margin between coagulated and normal-appearing cells narrowed during recovery, typically to a width of under 1mm compared to 3mm acutely. These results illustrate the high level of precision achievable with transurethral thermal therapy and suggest methods to monitor the physiological response non-invasively.

  4. Imaging of Childhood Interstitial Lung Disease

    PubMed Central

    2010-01-01

    The aphorism that children are not little adults certainly applies for the imaging of interstitial lung disease. Acquiring motion-free images of fine pulmonary structures at desired lung volumes is much more difficult in children than in adults. Several forms of interstitial lung disease are unique to children, and some forms of interstitial lung disease encountered in adults rarely, if ever, occur in children. Meticulous attention to imaging technique and specialized knowledge are required to properly perform and interpret chest imaging studies obtained for the evaluation of childhood interstitial lung disease (chILD). This review will address technique recommendations for imaging chILD, the salient imaging findings in various forms of chILD, and the efficacy of imaging in the diagnosis and management of chILD. PMID:22332031

  5. Non-thermal plasmas: novel preventive and curative therapy against melanomas?

    PubMed

    Gesbert, Franck; Larue, Lionel

    2014-10-01

    Malignant melanoma is a very aggressive cancer with a very poor short-term prognosis once metastatic. For years, there was no efficient adjuvant therapy after surgery. Chemotherapy and immunotherapy provided hope, but not victory. Further efforts are therefore required, to find new ways to cure this disease. Physics has, once again, opened up new possibilities for treatment, through the use of non-equilibrium atmospheric pressure plasma (NEAPP). The curative potential of this technique was initially assessed on cancer cells, among which melanoma. In a recent issue, Yajima et al. use NEAPP on benign nevi, as a preventive treatment. PMID:24980188

  6. Interstitial thermotherapy with bipolar electrosurgical devices

    NASA Astrophysics Data System (ADS)

    Desinger, Kai; Stein, Thomas; Boehme, A.; Mack, Martin G.; Mueller, Gerhard J.

    1998-01-01

    In addition to the laser, microwave or other energy sources, interstitial thermotherapy with radio-frequency current (RFITT) in bipolar technique has already been shown in vitro to be a safe and economical alternative energy source with a comparable operating performance. The bipolar technique is, from the technical point of view, completely without risk whereas with monopolar devices, where a neutral electrode has to be applied, an uncontrolled current flow passes through the patient's body. The therapeutical application efficiency of these bipolar RF-needle applicators was evaluated using newly designed high performance flushed and cooled probes (qq 3 mm). These can be used to create large coagulation volumes in tissue such as for the palliative treatment of liver metastases or the therapy of the benign prostate hyperplasia. As a result, the achievable lesion size resulting from these flushed and internally cooled RF- probes could be increased by a factor of three compared to a standard bipolar probe. With these bipolar power RF- applicators, coagulation dimensions of 5 cm length and 4 cm diameter with a power input of 40 watt could be achieved within 20 minutes. No carbonization and electrode tissue adherence was found. Investigations in vitro with adapted RFITT-probes using paramagnetic materials such as titanium alloys and high performance plastic have shown that monitoring under MRI (Siemens Magnetom, 1.5 Tesla), allows visualization of the development of the spatial temperature distribution in tissue using an intermittent diagnostic and therapeutical application. This does not lead to a loss in performance compared to continuous application. A ratio of 1:4 (15 s Thermo Flash MRI, 60 s RF-energy) has shown to be feasible.

  7. Lupus-erythematous-associated interstitial granulomatous dermatitis.

    PubMed

    Marmon, Shoshana; Robinson, Maria; Meehan, Shane A; Franks, Andrew G

    2012-12-01

    A 41-year-old woman with a prior diagnosis of lupus erythematous presented with a five-year history of small, erythematous, flesh-colored papules and nodules that coalesced into symmetrically-distributed plaques on her upper back. A biopsy specimen showed an interstitial, granulomatous mixed-cell dermatitis with eosinophils. These clinicopathologic findings are consistent with a diagnosis of lupus erythematous-associated interstitial granulomatous dermatitis. PMID:23286821

  8. Interstitial zinc clusters in zinc oxide

    NASA Astrophysics Data System (ADS)

    Gluba, M. A.; Nickel, N. H.; Karpensky, N.

    2013-12-01

    Doped zinc oxide (ZnO) exhibits anomalous Raman modes in the range of 270 to 870 cm-1. Commonly, the resonance at 275 cm-1 is attributed to the local vibration of Zn atoms in the vicinity of extrinsic dopants. We revisit this assignment by investigating the influence of isotopically purified zinc oxide thin films on the frequency of the vibrational mode around 275 cm-1. For this purpose, undoped and nitrogen-doped ZnO thin-films with Zn isotope compositions of natural Zn, 64Zn, 68Zn, and a 1:1 mixture of 64Zn and 68Zn were grown by pulsed laser deposition. The isotopic shift and the line shape of the Raman resonance around 275 cm-1 are analyzed in terms of three different microscopic models, which involve the vibration of (i) interstitial zinc atoms bound to extrinsic defects, (ii) interstitial diatomic Zn molecules, and (iii) interstitial zinc clusters. The energy diagram of interstitial Zn-Zn bonds in a ZnO matrix is derived from density functional theory calculations. The interstitial Zn-Zn bond is stabilized by transferring electrons from the antibonding orbital into the ZnO conduction band. This mechanism facilitates the formation of interstitial Zn clusters and fosters the common n-type doping asymmetry of ZnO.

  9. Human telomeric proteins occupy selective interstitial sites

    PubMed Central

    Yang, Dong; Xiong, Yuanyan; Kim, Hyeung; He, Quanyuan; Li, Yumei; Chen, Rui; Songyang, Zhou

    2011-01-01

    Human telomeres are bound and protected by protein complexes assembled around the six core telomeric proteins RAP1, TRF1, TRF2, TIN2, TPP1, and POT1. The function of these proteins on telomeres has been studied extensively. Recently, increasing evidence has suggested possible roles for these proteins outside of telomeres. However, the non-canonical (extra-telomeric) function of human telomeric proteins remains poorly understood. To this end, we systematically investigated the binding sites of telomeric proteins along human chromosomes, by performing whole-genome chromatin immunoprecipitation (ChIP) for RAP1 and TRF2. ChIP sequencing (ChIP-seq) revealed that RAP1 and TRF2 could be found on a small number of interstitial sites, including regions that are proximal to genes. Some of these binding sites contain short telomere repeats, suggesting that telomeric proteins could directly bind to interstitial sites. Interestingly, only a small fraction of the available interstitial telomere repeat-containing regions were occupied by RAP1 and TRF2. Ectopically expressed TRF2 was able to occupy additional interstitial telomere repeat sites, suggesting that protein concentration may dictate the selective targeting of telomeric proteins to interstitial sites. Reducing RAP1 and TRF2 expression by RNA interference led to altered transcription of RAP1- and TRF2-targeted genes. Our results indicate that human telomeric proteins could occupy a limited number of interstitial sites and regulate gene transcription. PMID:21423278

  10. An inverse problem approach to recovery of in vivo nanoparticle concentrations from thermal image monitoring of MR-guided laser induced thermal therapy.

    PubMed

    Fuentes, D; Elliott, A; Weinberg, J S; Shetty, A; Hazle, J D; Stafford, R J

    2013-01-01

    Quantification of local variations in the optical properties of tumor tissue introduced by the presence of gold-silica nanoparticles (NP) presents significant opportunities in monitoring and control of NP-mediated laser induced thermal therapy (LITT) procedures. Finite element methods of inverse parameter recovery constrained by a Pennes bioheat transfer model were applied to estimate the optical parameters. Magnetic resonance temperature imaging (MRTI) acquired during a NP-mediated LITT of a canine transmissible venereal tumor in brain was used in the presented statistical inverse problem formulation. The maximum likelihood (ML) value of the optical parameters illustrated a marked change in the periphery of the tumor corresponding with the expected location of NP and area of selective heating observed on MRTI. Parameter recovery information became increasingly difficult to infer in distal regions of tissue where photon fluence had been significantly attenuated. Finite element temperature predictions using the ML parameter values obtained from the solution of the inverse problem are able to reproduce the NP selective heating within 5 °C of measured MRTI estimations along selected temperature profiles. Results indicate the ML solution found is able to sufficiently reproduce the selectivity of the NP mediated laser induced heating and therefore the ML solution is likely to return useful optical parameters within the region of significant laser fluence. PMID:22918665

  11. Management of granulomatous lymphocytic interstitial lung disease in a patient with common variable immune deficiency.

    PubMed

    Pathria, Mohini; Urbine, Daniel; Zumberg, Marc Stuart; Guarderas, Juan

    2016-01-01

    A 61-year-old woman presented with longstanding cough and progressive dyspnoea. She underwent an extensive evaluation and was diagnosed with common variable immunodeficiency (CVID) with granulomatous lymphocytic interstitial lung disease (GLILD). She was initially treated with subcutaneous immunoglobulin therapy, having declined intravenous immunoglobulin (IVIG) therapy. She also declined treatment with oral glucocorticoids. Over several months, she became increasingly symptomatic and developed increased pulmonary infiltrates, pleural effusions, mediastinal adenopathy, splenomegaly, pancytopenia and ascites. An interdisciplinary team composed of an immunologist, pulmonologist and haematologist deliberated over a therapeutic management approach. The patient received a recently reported immunotherapy regimen with azathioprine and rituximab. The therapy led to rapid improvement of her constitutional and respiratory symptoms, with clinical and radiographic improvement in her interstitial lung disease, lymphadenopathy, pleural effusions and ascites. This case report reviews the literature surrounding the diagnosis and management of GLILD. PMID:27335365

  12. Highly directional transurethral ultrasound applicators with rotational control for MRI-guided prostatic thermal therapy

    NASA Astrophysics Data System (ADS)

    Ross, Anthony B.; Diederich, Chris J.; Nau, William H.; Gill, Harcharan; Bouley, Donna M.; Daniel, Bruce; Rieke, Viola; Butts, R. Kim; Sommer, Graham

    2004-01-01

    Transurethral ultrasound applicators with highly directional energy deposition and rotational control were investigated for precise treatment of benign prostatic hyperplasia (BPH) and adenocarcinoma of the prostate (CaP). Two types of catheter-based applicators were fabricated, using either 90° sectored tubular (3.5 mm OD × 10 mm) or planar transducers (3.5 mm × 10 mm). They were constructed to be MRI compatible, minimally invasive and allow for manual rotation of the transducer array within a 10 mm cooling balloon. In vivo evaluations of the applicators were performed in canine prostates (n = 3) using MRI guidance (0.5 T interventional magnet). MR temperature imaging (MRTI) utilizing the proton resonance frequency shift method was used to acquire multiple-slice temperature overlays in real time for monitoring and guiding the thermal treatments. Post-treatment T1-weighted contrast-enhanced imaging and triphenyl tetrazolium chloride stained tissue sections were used to define regions of tissue coagulation. Single sonications with the 90° tubular applicator (9-15 W, 12 min, 8 MHz) produced coagulated zones covering an 80° wedge of the prostate extending from 1-2 mm outside the urethra to the outer boundary of the gland (16 mm radial coagulation). Single sonications with the planar applicator (15-20 W, 10 min, ~8 MHz) generated thermal lesions of ~30° extending to the prostate boundary. Multiple sequential sonications (sweeping) of a planar applicator (12 W with eight rotations of 30° each) demonstrated controllable coagulation of a 270° contiguous section of the prostate extending to the capsule boundary. The feasibility of using highly directional transurethral ultrasound applicators with rotational capabilities to selectively coagulate regions of the prostate while monitoring and controlling the treatments with MRTI was demonstrated in this study.

  13. Interstitial granulomatous drug reaction with a histological pattern of interstitial granulomatous dermatitis.

    PubMed

    Perrin, C; Lacour, J P; Castanet, J; Michiels, J F

    2001-08-01

    The interstitial granulomatous drug reaction (IGDR) is a novel drug-associated entity, characterized by violaceous plaques with a predilection for skin fold areas. Light microscopically, it resembles the incipient diffuse interstitial phase of granuloma annulare. Differentiating light microscopic features include the absence of complete collagen necrobiosis, the presence of interface dermatitis, and variable lymphoid atypia. The lack of vasculitis rules out the extravascular necrotizing granuloma (Winkelmann granuloma) associated with systemic disease. The differential diagnosis with interstitial granulomatous dermatitis with arthritis as defined by Ackerman et al. has not been studied until now. Our aim was to determine the histologic criteria allowing us to differentiate IGDR without interface dermatitis and lymphoid atypia from interstitial granulomatous dermatitis. We report three patients with IGDR triggered, in two cases by respectively angiotensin convertin enzyme (ACE) inhibitors and furosemide, and in one case by the association of an ACE inhibitor, furosemide, and fluindione. Histologic examination showed a histological pattern of interstitial granulomatous dermatitis. We found a dense, diffuse histiocytic infiltrate distributed interstitially and in palisaded array within the reticular dermis. Eosinophils and some neutrophils were scattered throughout the infiltrate. In some tiny foci, enveloped by histiocytes, thick collagen bundles associated with basophilic nuclear debris or "flame figures" were seen. Vasculitis, interface dermatitis, or lymphoid atypia were absent. Our study allowed us to expand the histological spectrum of IGDR including a histological pattern similar to interstitial granulomatous dermatitis. The lack of degenerated collagen could be a subtle clue in favor of interstitial granulomatous dermatitis triggered by a drug. PMID:11481519

  14. Nonspecific interstitial pneumonitis: a common cause of pulmonary disease in the acquired immunodeficiency syndrome

    SciTech Connect

    Suffredini, A.F.; Ognibene, F.P.; Lack, E.E.; Simmons, J.T.; Brenner, M.; Gill, V.J.; Lane, H.C.; Fauci, A.S.; Parrillo, J.E.; Masur, H.

    1987-07-01

    During a 4.4-year period, nonspecific interstitial pneumonitis was seen in 41 of 110 (38%) patients with the acquired immunodeficiency syndrome and accounted for 32% (48/152) of all episodes of clinical pneumonitis. Diffuse alveolar damage was typically a feature of nonspecific interstitial pneumonitis, but neither lung biopsy nor bronchoalveolar lavage detected a pathogen. Of these 41 patients, 13 had no associated pulmonary tumor and had not been exposed to pulmonary toxins, whereas 28 patients had either concurrent pulmonary Kaposi sarcoma, previous experimental therapies, or a history of pneumocystis pneumonia or drug abuse. Of these 41, 23 had normal chest radiographs. The clinical features of patients with nonspecific interstitial pneumonitis were similar to those of patients with pneumocystis pneumonia, although histologic findings showed less severe alveolar damage in patients with nonspecific interstitial pneumonitis (p less than 0.001). Pathologic evaluation and clinical follow-up suggest that many clinical episodes of pneumonitis in patients with the acquired immunodeficiency syndrome are due to nonspecific interstitial pneumonitis of unknown cause.

  15. Identification of the interstitial Mn site in ferromagnetic (Ga,Mn)As

    SciTech Connect

    Lima, T. A. L.; Augustyns, V.; Temst, K.; Vantomme, A.; Pereira, L. M. C.; Wahl, U.; Costa, A.; Correia, J. G.; Silva, D. J.; Araújo, J. P.; Houben, K.; Van Bael, M. J.; Edmonds, K. W.; Gallagher, B. L.; Campion, R. P.; Silva, M. R. da

    2015-01-05

    We determined the lattice location of Mn in ferromagnetic (Ga,Mn)As using the electron emission channeling technique. We show that interstitial Mn occupies the tetrahedral site with As nearest neighbors (T{sub As}) both before and after thermal annealing at 200 °C, whereas the occupancy of the tetrahedral site with Ga nearest neighbors (T{sub Ga}) is negligible. T{sub As} is therefore the energetically favorable site for interstitial Mn in isolated form as well as when forming complexes with substitutional Mn. These results shed new light on the long standing controversy regarding T{sub As} versus T{sub Ga} occupancy of interstitial Mn in (Ga,Mn)As.

  16. Facile integration of multiple magnetite nanoparticles for theranostics combining efficient MRI and thermal therapy

    NASA Astrophysics Data System (ADS)

    Huang, Guoming; Zhu, Xianglong; Li, Hui; Wang, Lirong; Chi, Xiaoqin; Chen, Jiahe; Wang, Xiaomin; Chen, Zhong; Gao, Jinhao

    2015-01-01

    Multifunctional nanostructures with both diagnostic and therapeutic capabilities have attracted considerable attention in biomedical research because they can offer great advantages in disease management and prognosis. In this work, a facile way to transfer the hydrophobic iron oxide (IO) nanoparticles into aqueous media by employing carboxylic graphene oxide (GO-COOH) as the transferring agent has been reported. In this one-step process, IO nanoparticles adhere to GO-COOH and form water-dispersible clusters via hydrophobic interactions between the hydrophobic ligands of IO nanoparticles and the basal plane of GO-COOH. The multiple IO nanoparticles on GO-COOH sheets (IO/GO-COOH) present a significant increase in T2 contrast enhancement. Moreover, the IO/GO-COOH nanoclusters also display a high photothermal conversion efficiency and can effectively inhibit tumor growth through the photothermal effects. It is envisioned that such IO/GO-COOH nanocomposites combining efficient MRI and photothermal therapy hold great promise in theranostic applications.Multifunctional nanostructures with both diagnostic and therapeutic capabilities have attracted considerable attention in biomedical research because they can offer great advantages in disease management and prognosis. In this work, a facile way to transfer the hydrophobic iron oxide (IO) nanoparticles into aqueous media by employing carboxylic graphene oxide (GO-COOH) as the transferring agent has been reported. In this one-step process, IO nanoparticles adhere to GO-COOH and form water-dispersible clusters via hydrophobic interactions between the hydrophobic ligands of IO nanoparticles and the basal plane of GO-COOH. The multiple IO nanoparticles on GO-COOH sheets (IO/GO-COOH) present a significant increase in T2 contrast enhancement. Moreover, the IO/GO-COOH nanoclusters also display a high photothermal conversion efficiency and can effectively inhibit tumor growth through the photothermal effects. It is envisioned

  17. Facile integration of multiple magnetite nanoparticles for theranostics combining efficient MRI and thermal therapy.

    PubMed

    Huang, Guoming; Zhu, Xianglong; Li, Hui; Wang, Lirong; Chi, Xiaoqin; Chen, Jiahe; Wang, Xiaomin; Chen, Zhong; Gao, Jinhao

    2015-02-14

    Multifunctional nanostructures with both diagnostic and therapeutic capabilities have attracted considerable attention in biomedical research because they can offer great advantages in disease management and prognosis. In this work, a facile way to transfer the hydrophobic iron oxide (IO) nanoparticles into aqueous media by employing carboxylic graphene oxide (GO-COOH) as the transferring agent has been reported. In this one-step process, IO nanoparticles adhere to GO-COOH and form water-dispersible clusters via hydrophobic interactions between the hydrophobic ligands of IO nanoparticles and the basal plane of GO-COOH. The multiple IO nanoparticles on GO-COOH sheets (IO/GO-COOH) present a significant increase in T2 contrast enhancement. Moreover, the IO/GO-COOH nanoclusters also display a high photothermal conversion efficiency and can effectively inhibit tumor growth through the photothermal effects. It is envisioned that such IO/GO-COOH nanocomposites combining efficient MRI and photothermal therapy hold great promise in theranostic applications. PMID:25581879

  18. Invasive diagnostic techniques in idiopathic interstitial pneumonias.

    PubMed

    Poletti, Venerino; Ravaglia, Claudia; Gurioli, Carlo; Piciucchi, Sara; Dubini, Alessandra; Cavazza, Alberto; Chilosi, Marco; Rossi, Andrea; Tomassetti, Sara

    2016-01-01

    Fibrosing interstitial lung diseases (f-ILDs) represent a heterogeneous group of disorders in which the aetiology may be identified or, not infrequently, remain unknown. Establishing a correct diagnosis of a distinct f-ILD requires a multidisciplinary approach, integrating clinical profile, physiological and laboratory data, radiological appearance and, when appropriate, histological findings. Surgical lung biopsy is still considered the most important diagnostic tool as it is able to provide lung samples large enough for identification of complex patterns such as usual interstitial pneumonitis (UIP) and nonspecific interstitial pneumonitis. However, this procedure is accompanied by significant morbidity and mortality. Bronchoalveolar lavage is still a popular diagnostic tool allowing identification of alternative diagnoses in patients with suspected idiopathic pulmonary fibrosis (IPF) when an increase in lymphocytes is detected. Conventional transbronchial lung biopsy has a very low sensitivity in detecting the UIP pattern and its role in this clinical-radiological context is marginal. The introduction of less invasive methods such as transbronchial cryobiopsy show great promise to clinical practice as they can be used to obtain samples large enough to morphologically support a diagnosis of IPF or other idiopathic interstitial pneumonias, along with fewer complications. Recent advances in the field suggest that less invasive methods of lung sampling, without significant side effects, in combination with other diagnostic methods could replace the need for surgical lung biopsy in the future. Indeed, these new multidisciplinary procedures may become the main diagnostic work-up method for patients with suspected idiopathic interstitial pneumonia. PMID:26682637

  19. Interstitial Cells: Regulators of Smooth Muscle Function

    PubMed Central

    Sanders, Kenton M.; Ward, Sean M.; Koh, Sang Don

    2014-01-01

    Smooth muscles are complex tissues containing a variety of cells in addition to muscle cells. Interstitial cells of mesenchymal origin interact with and form electrical connectivity with smooth muscle cells in many organs, and these cells provide important regulatory functions. For example, in the gastrointestinal tract, interstitial cells of Cajal (ICC) and PDGFRα+ cells have been described, in detail, and represent distinct classes of cells with unique ultrastructure, molecular phenotypes, and functions. Smooth muscle cells are electrically coupled to ICC and PDGFRα+ cells, forming an integrated unit called the SIP syncytium. SIP cells express a variety of receptors and ion channels, and conductance changes in any type of SIP cell affect the excitability and responses of the syncytium. SIP cells are known to provide pacemaker activity, propagation pathways for slow waves, transduction of inputs from motor neurons, and mechanosensitivity. Loss of interstitial cells has been associated with motor disorders of the gut. Interstitial cells are also found in a variety of other smooth muscles; however, in most cases, the physiological and pathophysiological roles for these cells have not been clearly defined. This review describes structural, functional, and molecular features of interstitial cells and discusses their contributions in determining the behaviors of smooth muscle tissues. PMID:24987007

  20. The Significance of Interstitial Cells in Neurogastroenterology

    PubMed Central

    Blair, Peter J; Rhee, Poong-Lyul; Sanders, Kenton M; Ward, Sean M

    2014-01-01

    Smooth muscle layers of the gastrointestinal tract consist of a heterogeneous population of cells that include enteric neurons, several classes of interstitial cells of mesenchymal origin, a variety of immune cells and smooth muscle cells (SMCs). Over the last number of years the complexity of the interactions between these cell types has begun to emerge. For example, interstitial cells, consisting of both interstitial cells of Cajal (ICC) and platelet-derived growth factor receptor alpha-positive (PDGFRα+) cells generate pacemaker activity throughout the gastrointestinal (GI) tract and also transduce enteric motor nerve signals and mechanosensitivity to adjacent SMCs. ICC and PDGFRα+ cells are electrically coupled to SMCs possibly via gap junctions forming a multicellular functional syncytium termed the SIP syncytium. Cells that make up the SIP syncytium are highly specialized containing unique receptors, ion channels and intracellular signaling pathways that regulate the excitability of GI muscles. The unique role of these cells in coordinating GI motility is evident by the altered motility patterns in animal models where interstitial cell networks are disrupted. Although considerable advances have been made in recent years on our understanding of the roles of these cells within the SIP syncytium, the full physiological functions of these cells and the consequences of their disruption in GI muscles have not been clearly defined. This review gives a synopsis of the history of interstitial cell discovery and highlights recent advances in structural, molecular expression and functional roles of these cells in the GI tract. PMID:24948131

  1. Monitoring of thermal therapy based on shear modulus changes: I. shear wave thermometry.

    PubMed

    Arnal, Bastien; Pernot, Mathieu; Tanter, Mickael

    2011-02-01

    The clinical applicability of high-intensity focused ultrasound (HIFU) for noninvasive therapy is today hampered by the lack of robust and real-time monitoring of tissue damage during treatment. The goal of this study is to show that the estimation of local tissue elasticity from shear wave imaging (SWI) can lead to the 2-D mapping of temperature changes during HIFU treatments. This new concept of shear wave thermometry is experimentally implemented here using conventional ultrasonic imaging probes. HIFU treatment and monitoring were, respectively, performed using a confocal setup consisting of a 2.5-MHz single-element transducer focused at 30 mm on ex vivo samples and an 8-MHz ultrasound diagnostic probe. Thermocouple measurements and ultrasound-based thermometry were used as a gold standard technique and were combined with SWI on the same device. The SWI sequences consisted of 2 successive shear waves induced at different lateral positions. Each wave was created using 100-μs pushing beams at 3 depths. The shear wave propagation was acquired at 17,000 frames/s, from which the elasticity map was recovered. HIFU sonications were interleaved with fast imaging acquisitions, allowing a duty cycle of more than 90%. Elasticity and temperature mapping was achieved every 3 s, leading to realtime monitoring of the treatment. Tissue stiffness was found to decrease in the focal zone for temperatures up to 43°C. Ultrasound-based temperature estimation was highly correlated to stiffness variation maps (r² = 0.91 to 0.97). A reversible calibration phase of the changes of elasticity with temperature can be made locally using sighting shots. This calibration process allows for the derivation of temperature maps from shear wave imaging. Compared with conventional ultrasound-based approaches, shear wave thermometry is found to be much more robust to motion artifacts. PMID:21342822

  2. On the Origin of Large Interstitial Clusters in Displacement Cascades

    SciTech Connect

    Andrew, Calder F; Barashev, Aleksandr; Bacon, David J; Osetskiy, Yury N

    2010-01-01

    Displacement cascades with wide ranges of primary knock-on atom (PKA) energy and mass in iron were simulated using molecular dynamics. New visualisation techniques are introduced to show how the shock-front dynamics and internal structure of a cascade develop over time. These reveal that the nature of the final damage is determined early on in the cascade process. We define a zone (termed 'spaghetti') in which atoms are moved to new lattice sites and show how it is created by a supersonic shock-front expanding from the primary recoil event. A large cluster of self-interstitial atoms can form on the periphery of the spaghetti if a hypersonic recoil creates damage with a supersonic shock ahead of the main supersonic front. When the two fronts meet, the main one injects atoms into the low-density core of the other: these become interstitial atoms during the rapid recovery of the surrounding crystal. The hypersonic recoil occurs in less than 0.1 ps after the primary recoil and the interstitial cluster is formed before the onset of the thermal spike phase of the cascade process. The corresponding number of vacancies is then formed in the spaghetti core as the crystal cools, i.e. at times one to two orders of magnitude longer. By using the spaghetti zone to define cascade volume, the energy density of a cascade is shown to be almost independent of the PKA mass. This throws into doubt the conventional energy-density interpretation of an increased defect yield with increasing PKA mass in ion irradiation.

  3. On the origin of large interstitial clusters in displacement cascades

    NASA Astrophysics Data System (ADS)

    Calder, A. F.; Bacon, D. J.; Barashev, A. V.; Osetsky, Yu. N.

    2010-03-01

    Displacement cascades with wide ranges of primary knock-on atom (PKA) energy and mass in iron were simulated using molecular dynamics. New visualisation techniques are introduced to show how the shock-front dynamics and internal structure of a cascade develop over time. These reveal that the nature of the final damage is determined early on in the cascade process. We define a zone (termed 'spaghetti') in which atoms are moved to new lattice sites and show how it is created by a supersonic shock-front expanding from the primary recoil event. A large cluster of self-interstitial atoms can form on the periphery of the spaghetti if a hypersonic recoil creates damage with a supersonic shock ahead of the main supersonic front. When the two fronts meet, the main one injects atoms into the low-density core of the other: these become interstitial atoms during the rapid recovery of the surrounding crystal. The hypersonic recoil occurs in less than 0.1 ps after the primary recoil and the interstitial cluster is formed before the onset of the thermal spike phase of the cascade process. The corresponding number of vacancies is then formed in the spaghetti core as the crystal cools, i.e. at times one to two orders of magnitude longer. By using the spaghetti zone to define cascade volume, the energy density of a cascade is shown to be almost independent of the PKA mass. This throws into doubt the conventional energy-density interpretation of an increased defect yield with increasing PKA mass in ion irradiation.

  4. [Severe interstitial lung disease from pathologic gastroesophageal reflux in children].

    PubMed

    Ahrens, P; Weimer, B; Hofmann, D

    1999-07-01

    Interstitial lung diseases comprise a heterogeneous group of pulmonary conditions that cause restrictive lung disease of poor prognosis, especially if growth failure, pulmonary hypertension and fibrosis appears. We report on the case of a girl of 11 years of age who suffered from severe nonallergic asthma in early childhood and who developed severe interstitial pulmonary disease caused by gastro-oesophageal reflux at the age of 8 years. This diagnosis was established by lung biopsy, bronchoalveolar lavage and a high amount of lipid-laden alveolar macrophages, 2-level pH measurement and oesophageal biopsy. Because therapy with oral and inhaled steroids failed and Omeprazol showed benificial effects, hemifundoplication according to THAL was performed. At present the lung function is clearly normal and there is no need of any medicaments. Following the history, we can assume the pathological gastro-oesophageal reflux to be the cause of the disease. It is important to state that there were no typical symptoms at any time pointing to gastro-oesophageal reflux disease. The development of pulmonary disease by pathological reflux is very often caused by "silent aspiration". Very typically there are no symptoms such as vomiting, heartburn and pain but only signs of chronic lung disease. PMID:10444954

  5. Tumor Interstitial Fluid Formation, Characterization, and Clinical Implications.

    PubMed

    Wagner, Marek; Wiig, Helge

    2015-01-01

    The interstitium, situated between the blood and lymph vessels and the cells, consists of a solid or matrix phase and a fluid phase representing the tissue microenvironment. In the present review, we focus on the interstitial fluid phase of solid tumors, the tumor interstitial fluid (TIF), i.e., the fluid bathing the tumor and stroma cells, also including immune cells. This is a component of the internal milieu of a solid tumor that has attracted regained attention. Access to this space may provide important insight into tumor development and therapy response. TIF is formed by transcapillary filtration, and since this fluid is not readily available we discuss available techniques for TIF isolation, results from subsequent characterization and implications of recent findings with respect to fluid filtration and uptake of macromolecular therapeutic agents. There appear to be local gradients in signaling substances from neoplastic tissue to plasma that may provide new understanding of tumor biology. The development of sensitive proteomic technologies has made TIF a valuable source for tumor specific proteins and biomarker candidates. Potential biomarkers will appear locally in high concentrations in tumors and may eventually be found diluted in the plasma. Access to TIF that reliably reflects the local tumor microenvironment enables identification of substances that can be used in early detection and monitoring of disease. PMID:26075182

  6. Nonspecific Interstitial Pneumonia: What Is the Optimal Approach to Management?

    PubMed

    Tomassetti, Sara; Ryu, Jay H; Piciucchi, Sara; Chilosi, Marco; Poletti, Venerino

    2016-06-01

    We reviewed current aspects of the clinical and pathogenic profile of nonspecific interstitial pneumonia (NSIP), to better elucidate the complex issue of management and treatment options for NSIP patients. Recent findings suggest that idiopathic NSIP is a complex clinical entity with a disease spectrum that includes at least three different phenotypes: NSIP associated with autoimmune features, emphysema, and familial interstitial lung disease. This distinction, based mainly on clinical findings, may be of critical importance when it comes to making a decision on patients' management. This hypothesis warrants further studies. Currently, two major radiologic-pathologic different profiles have been well established. First, the "inflammatory type" characterized by prominent lymphocytic inflammation both on biopsy and bronchoalveolar lavage (BAL), and high-resolution computed tomography (HRCT) with mixed NSIP/organizing pneumonia pattern that tends to have a better response to corticosteroid and immunosuppressive treatment. Second, the "highly fibrotic" subgroup that shows prominent reticular changes and traction bronchiectasis by HRCT, high fibrotic background on biopsy, and no lymphocytosis on BAL. The latter fibrotic NSIP is the subgroup with less potential to respond to immunosuppressive treatment and a marginal risk to evolve into "full-blown idiopathic pulmonary fibrosis." The management of patients with fibrotic, progressive, and immunosuppressive treatment, refractory NSIP remains uncertain, and further studies are needed to address the role of antifibrotic drug in this settings. Oxygen therapy, pulmonary rehabilitation, and lung transplantation are of importance in the current management of severe, progressive, and refractory NSIP patients. PMID:27231862

  7. Timolol-induced interstitial lung disease

    PubMed Central

    Patel, Hetain; Wilches, Lina Vanessa; Guerrero, Jorge

    2015-01-01

    Timolol maleate is a non-selective beta-adrenergic receptor blocking agent with demonstrated efficacy in the treatment of open-angle glaucoma. A 76 year old female who presented with productive cough, progressive dyspnea and hypoxia after starting timolol maleate opthalamic drops following glaucoma surgery. The patient was diagnosed with interstitial lung disease secondary to timolol treatment and after cessation of the offending agent along with corticosteroid treatment, symptoms improved drastically. Elimination of other possible causes of disease along with evolution of radiological and functional signs left us with a diagnosis of timolol-induced interstitial lung disease. To our knowledge, this is the second reported case of timolol-induced interstitial lung disease. PMID:26236595

  8. Wear evaluation of high interstitial stainless steel

    SciTech Connect

    Rawers, J.C.; Tylczak, J.H.

    2008-07-01

    A new series of high nitrogen-carbon manganese stainless steel alloys are studied for their wear resistance. High nitrogen and carbon concentrations were obtained by melting elemental iron-chromium-manganese (several with minor alloy additions of nickel, silicon, and molybdenum) in a nitrogen atmosphere and adding elemental graphite. The improvement in material properties (hardness and strength) with increasing nitrogen and carbon interstitial concentration was consistent with previously reported improvements in similar material properties alloyed with nitrogen only. Wear tests included: scratch, pin-on-disk, sand-rubber-wheel, impeller, and jet erosion. Additions of interstitial nitrogen and carbon as well as interstitial nitrogen and carbide precipitates were found to greatly improve material properties. In general, with increasing nitrogen and carbon concentrations, strength, hardness, and wear resistance increased.

  9. Immune complexes, gallium lung scans, and bronchoalveolar lavage in idiopathic interstitial pneumonitis-fibrosis

    SciTech Connect

    Gelb, A.F.; Dreisen, R.B.; Epstein, J.D.; Silverthorne, J.D.; Bickel, Y.; Fields, M.; Border, W.A.; Taylor, C.R.

    1983-08-01

    We obtained results of lung immune complexes (LIC), circulating immune complexes (CIC), 48-hour gallium lung scans (scans), bronchoalveolar lavage (BAL), and pulmonary function tests in 20 patients with idiopathic interstitial pneumonitis-fibrosis. Sixteen patients had predominantly interstitial (13 cases UIP) and/or intraalveolar (3 cases DIP) cellular disease (group 1). Prior to corticosteroid therapy in group 1, scans were positive in 75 percent, CIC were elevated in 86 percent, LIC were present in 64 percent, and BAL was abnormal in 90 percent. Duration of follow-up after treatment was 3.5 +/- 1.0 year. In group 1 after treatment with corticosteroids in 13 patients and corticosteroids and penicillamine (three patients) and plasmapheresis (one patient), only four patients remain stable or improved. After corticosteroid therapy, elevated CIC returned to normal values despite progressive patient deterioration. In three patients, lung immune complexes were still detected after circulating immune complexes had returned to normal after corticosteroid therapy. In group 2 were four patients with fibrotic disease; scans and CIC were uniformly negative, LIC were weakly present in only one patient, and BAL was abnormal in all. Despite corticosteroid therapy, all have died or deteriorated. These results suggest that positive gallium lung scans, BAL, circulating immune complexes, and to a lesser extent, lung immune complexes are associated with the cellular phase of interstitial pneumonia, but do not reliably identify a corticosteroid-responsive group.

  10. Smoking-related interstitial lung diseases.

    PubMed

    Vassallo, Robert; Ryu, Jay H

    2012-03-01

    Cigarette smoke, a toxic collection of thousands of chemicals generated from combustion of tobacco, is recognized as the primary causative agent of certain diffuse interstitial and bronchiolar lung diseases. Most patients afflicted with these disorders are cigarette smokers, and smoking cessation has been shown to be capable of inducing disease remission and should occupy a pivotal role in the management of all smokers with these diffuse lung diseases. The role of pharmacotherapy with corticosteroids or other immunomodulating agents is not well established but may be considered in patients with progressive forms of smoking-related interstitial lung diseases. PMID:22365253

  11. Conjugated polymer and drug co-encapsulated nanoparticles for Chemo- and Photo-thermal Combination Therapy with two-photon regulated fast drug release

    NASA Astrophysics Data System (ADS)

    Yuan, Youyong; Wang, Zuyong; Cai, Pingqiang; Liu, Jie; Liao, Lun-De; Hong, Minghui; Chen, Xiaodong; Thakor, Nitish; Liu, Bin

    2015-02-01

    The spatial-temporal synchronization of photothermal therapy and chemotherapy is highly desirable for an efficient cancer treatment with synergistic effect. Herein, we developed a chemotherapeutic drug doxorubicin (DOX) and photothermal conjugated polymer (CP) co-loaded nanoplatform using a near-infrared (NIR) laser responsive amphiphilic brush copolymer as the encapsulation matrix. The obtained nanoparticles (NPs) exhibit good monodispersity and excellent stability, which can efficiently convert laser energy into thermal energy for photothermal therapy. Moreover, the hydrophobic polymer matrix bearing a number of 2-diazo-1,2-naphthoquinones (DNQ) moieties could be transformed to a hydrophilic one upon NIR two-photon laser irradiation, which leads to fast drug release. Furthermore, the surface modification of the NPs with cyclic arginine-glycine-aspartic acid (cRGD) tripeptide significantly enhances the accumulation of the NPs within integrin αvβ3 overexpressed cancer cells. The half-maximal inhibitory concentration (IC50) of the combination therapy is 13.7 μg mL-1, while the IC50 for chemotherapy and photothermal therapy alone is 147.8 μg mL-1 and 36.2 μg mL-1, respectively. The combination index (C.I.) is 0.48 (<1), which indicates the synergistic effect for chemotherapy and PTT. These findings provide an excellent NIR laser regulated nanoplatform for combined cancer treatment with synergistic effect due to the synchronous chemo- and photo-thermal therapy.

  12. Temperature dependence of the optoacoustic transformation efficiency in ex vivo tissues for application in monitoring thermal therapies

    NASA Astrophysics Data System (ADS)

    Nikitin, Sergey M.; Khokhlova, Tatiana D.; Pelivanov, Ivan M.

    2012-06-01

    The calibration dependencies of the optoacoustic (OA) transformation efficiency on tissue temperature are obtained for the application in OA temperature monitoring during thermal therapies. Accurate measurement of the OA signal amplitude versus temperature is performed in different ex vivo tissues in the temperature range 25°C to 80°C. The investigated tissues were selected to represent different structural components: chicken breast (skeletal muscle), porcine lard (fatty tissue), and porcine liver (richly perfused tissue). Backward mode of the OA signal detection and a narrow probe laser beam were used in the experiments to avoid the influence of changes in light scattering with tissue coagulation on the OA signal amplitude. Measurements were performed in heating and cooling regimes. Characteristic behavior of the OA signal amplitude temperature dependences in different temperature ranges were described in terms of changes in different structural components of the tissue samples. The accuracy of temperature reconstruction from the obtained calibration dependencies for the investigated tissue types is evaluated.

  13. Hyperfine interactions at nitrogen interstitial defects in diamond

    NASA Astrophysics Data System (ADS)

    Atumi, M. K.; Goss, J. P.; Briddon, P. R.; Shrif, F. E.; Rayson, M. J.

    2013-02-01

    Diamond has many extreme physical properties and it can be used in a wide range of applications. In particular it is a highly effective particle detection material, where radiation damage is an important consideration. The WAR9 and WAR10 are electron paramagnetic resonance centres seen in irradiated, nitrogen-containing diamond. These S = 1/2 defects have C2v and C1h symmetry, respectively, and the experimental spectra have been interpreted as arising from nitrogen split-interstitial centres. Based upon the experimental and theoretical understanding of interstitial nitrogen defect structures, the AIMPRO density functional code has been used to assess the assignments for the structures of WAR9 and WAR10. Although the calculated hyperfine interaction tensors are consistent with the measured values for WAR9, the thermal stability renders the assignment problematic. The model for the WAR10 centre yields principal directions of the hyperfine tensor at variance with observation. Alternative models for both centres are discussed in this paper, but no convincing structures have been found.

  14. Multiparametric fat–water separation method for fast chemical-shift imaging guidance of thermal therapies

    PubMed Central

    Lin, Jonathan S.; Hwang, Ken-Pin; Jackson, Edward F.; Hazle, John D.; Jason Stafford, R.; Taylor, Brian A.

    2013-01-01

    ) and fat (0.763 ± 0.006, 0.980 ± 0.004, and 0.941 ± 0.002 for DSC, sensitivity, and specificity, respectively). Temperature uncertainties, based on PRF uncertainties from a 5 × 5-voxel ROI, were 0.342 and 0.351 °C for pure and mixed fat/water regions, respectively. Algorithm speed was tested using 25 × 25-voxel and whole image ROIs containing both fat and water, resulting in average processing times per acquisition of 2.00 ± 0.07 s and 146 ± 1 s, respectively, using uncompiled MATLAB scripts running on a shared CPU server with eight Intel XeonTM E5640 quad-core processors (2.66 GHz, 12 MB cache) and 12 GB RAM. Conclusions: Results from both the mathematical and physical phantom suggest the k-means-based classification algorithm could be useful for rapid, dynamic imaging in an ROI for thermal interventions. Successful separation of fat/water information would aid in reducing errors from the nontemperature sensitive fat PRF, as well as potentially facilitate using fat as an internal reference for PRF shift thermometry when appropriate. Additionally, the T1-W or R2* signals may be used for monitoring temperature in surrounding adipose tissue. PMID:24089932

  15. Thermoseeds for interstitial magnetic hyperthermia: from bioceramics to nanoparticles

    NASA Astrophysics Data System (ADS)

    Baeza, A.; Arcos, D.; Vallet-Regí, M.

    2013-12-01

    The development of magnetic materials for interstitial hyperthermia treatment of cancer is an ever evolving research field which provides new alternatives to antitumoral therapies. The development of biocompatible magnetic materials has resulted in new biomaterials with multifunctional properties, which are able to adapt to the complex scenario of tumoral processes. Once implanted or injected in the body, magnetic materials can behave as thermoseeds under the effect of AC magnetic fields. Magnetic bioceramics aimed to treat bone tumors and magnetic nanoparticles are among the most studied thermoseeds, and supply different solutions for the different scenarios in cancerous processes. This paper reviews some of the biomaterials used for bone cancer treatment and skeletal reinforcing, as well as the more complex topic of magnetic nanoparticles for intracellular targeting and hyperthermia.

  16. Management of interstitial lung disease associated with connective tissue disease.

    PubMed

    Mathai, Stephen C; Danoff, Sonye K

    2016-01-01

    The lung is a common site of complications of systemic connective tissue disease (CTD), and lung involvement can present in several ways. Interstitial lung disease (ILD) and pulmonary hypertension are the most common lung manifestations in CTD. Although it is generally thought that interstitial lung disease develops later on in CTD it is often the initial presentation ("lung dominant" CTD). ILD can be present in most types of CTD, including rheumatoid arthritis, scleroderma, systemic lupus erythematosus, polymyositis or dermatomyositis, Sjögren's syndrome, and mixed connective tissue disease. Despite similarities in clinical and pathologic presentation, the prognosis and treatment of CTD associated ILD (CTD-ILD) can differ greatly from that of other forms of ILD, such as idiopathic pulmonary fibrosis. Pulmonary hypertension (PH) can present as a primary vasculopathy in pulmonary arterial hypertension or in association with ILD (PH-ILD). Therefore, detailed history, physical examination, targeted serologic testing, and, occasionally, lung biopsy are needed to diagnose CTD-ILD, whereas both non-invasive and invasive assessments of pulmonary hemodynamics are needed to diagnose pulmonary hypertension. Immunosuppression is the mainstay of treatment for ILD, although data from randomized controlled trials (RCTs) to support specific treatments are lacking. Furthermore, treatment strategies vary according to the clinical situation-for example, the treatment of a patient newly diagnosed as having CTD-ILD differs from that of someone with an acute exacerbation of the disease. Immunosuppression is indicated only in select cases of pulmonary arterial hypertension related to CTD; more commonly, selective pulmonary vasodilators are used. For both diseases, comorbidities such as sleep disordered breathing, symptoms of dyspnea, and cough should be evaluated and treated. Lung transplantation should be considered in patients with advanced disease but is not always feasible because

  17. Edemagenic gain and interstitial fluid volume regulation.

    PubMed

    Dongaonkar, R M; Quick, C M; Stewart, R H; Drake, R E; Cox, C S; Laine, G A

    2008-02-01

    Under physiological conditions, interstitial fluid volume is tightly regulated by balancing microvascular filtration and lymphatic return to the central venous circulation. Even though microvascular filtration and lymphatic return are governed by conservation of mass, their interaction can result in exceedingly complex behavior. Without making simplifying assumptions, investigators must solve the fluid balance equations numerically, which limits the generality of the results. We thus made critical simplifying assumptions to develop a simple solution to the standard fluid balance equations that is expressed as an algebraic formula. Using a classical approach to describe systems with negative feedback, we formulated our solution as a "gain" relating the change in interstitial fluid volume to a change in effective microvascular driving pressure. The resulting "edemagenic gain" is a function of microvascular filtration coefficient (K(f)), effective lymphatic resistance (R(L)), and interstitial compliance (C). This formulation suggests two types of gain: "multivariate" dependent on C, R(L), and K(f), and "compliance-dominated" approximately equal to C. The latter forms a basis of a novel method to estimate C without measuring interstitial fluid pressure. Data from ovine experiments illustrate how edemagenic gain is altered with pulmonary edema induced by venous hypertension, histamine, and endotoxin. Reformulation of the classical equations governing fluid balance in terms of edemagenic gain thus yields new insight into the factors affecting an organ's susceptibility to edema. PMID:18056984

  18. Mica-associated pulmonary interstitial fibrosis.

    PubMed

    Landas, S K; Schwartz, D A

    1991-09-01

    We present the clinical and biopsy findings of a 63-yr-old white male with interstitial pulmonary fibrosis and a long history of extensive exposure to mica while working in the rubber industry. The patient presented 30 yr after the initial exposure with complaints of progressive shortness of breath and a chronic nonproductive cough. Pulmonary function testing revealed restrictive lung function with a mild reduction in the total lung capacity (80% of predicted) and a moderate-to-severe reduction in the diffusing capacity of carbon monoxide (50% of predicted). The chest radiogram and high-resolution chest CT scan showed diffuse fibrosis and focal honeycombing involving the upper and lower lung zones bilaterally. Bronchoalveolar lavage revealed 20% neutrophils in the lavage fluid with abundant rectangular flaking crystals. Open-lung biopsy exhibited extensive fibrosis and architectural remodeling with abundant sheets and fragments of engulfed polarizable crystalline material. Energy-dispersive spectroscopy and electron diffraction studies confirmed the material to have the features of mica. Asbestos and other silicates were not identified. The documentation of prolonged exposure to mica, the clinical and radiographic features of severe interstitial fibrosis, and the histopathologic delineation of the interstitial lesion, including spectroscopic and crystallographic verification of crystalline mica, support the causal relationship between mica and interstitial fibrosis. PMID:1892315

  19. Low Power Interstitial Laser Hyperthermia - Potential For Clinical Use

    NASA Astrophysics Data System (ADS)

    Steger, Adrian C.; Lees, William R.; Bown, S. G.

    1989-06-01

    The use of single fibre for interstitial low power laser hyperthermia (1-2 W) is associated with the development of a lesion of thermal necrosis measuring 1.4-1.8 cm in liver, pancreas and prostate. These lesions heal safely and can be well visualised with ultrasound. The use of a multiple fibre (4) system has enabled the production of larger lesions in all these organs which take a longer time to heal than single fibre lesions, but do so safely. Again, ultrasound enables these lesions to be studied in their creation and in their resolution. Following this experimental work early clinical application to a variety of otherwise untreatable tumours (breast, skin, pancreas and liver) has been carried out. This has resulted in a partial response in all treated and complete response in a smaller number of cases. The method appears to be safe and practical for the treatment of some tumours.

  20. Collective action of nanopatterned pins: barrier towards creating interstitial vortices

    NASA Astrophysics Data System (ADS)

    Shaw, Gorky; Mohan, Shyam; Sinha, Jaivardhan; Banerjee, Satyajit

    2009-03-01

    We show that by nano-patterning a superconductor (NbSe2 singlecrystal) with an array of blind holes produces significant magnetic field sweep rate dependent metastable magnetization response[1]. Our results are explained on the basis of a unique collective action of the blind holes pins which creates a barrier against vortex redistribution inside the sample. We propose that this barrier leads to a phase separation creating distinct population of vortices viz., those pinned on blind holes and those confined in the interstitials between the holes [1]. We find that due to the barrier, there is a significant enhancement in the stability of vortices against thermal fluctuations. [1] Gorky Shaw, Shyam Mohan, Jaivardhan Sinha and S. S. Banerjee* (submitted; xxx.lanl.gov/abs/0811.1256) *satyajit@iitk.ac.in

  1. Salvage high-dose-rate interstitial brachytherapy for locally recurrent rectal cancer*

    PubMed Central

    Pellizzon, Antônio Cássio Assis

    2016-01-01

    For tumors of the lower third of the rectum, the only safe surgical procedure is abdominal-perineal resection. High-dose-rate interstitial brachytherapy is a promising treatment for local recurrence of previously irradiated lower rectal cancer, due to the extremely high concentrated dose delivered to the tumor and the sparing of normal tissue, when compared with a course of external beam radiation therapy. PMID:27403021

  2. Failure to thrive, interstitial lung disease, and progressive digital necrosis with onset in infancy.

    PubMed

    Chia, Justin; Eroglu, Fehime Kara; Özen, Seza; Orhan, Dicle; Montealegre-Sanchez, Gina; de Jesus, Adriana A; Goldbach-Mansky, Raphaela; Cowen, Edward W

    2016-01-01

    Key teaching points • SAVI is a recently described interferonopathy resulting from constitutive action of STING and up-regulation of IFN-β signaling. • SAVI is characterized by facial erythema with telangiectasia, acral/cold-sensitive tissue ulceration and amputations, and interstitial lung disease. It has overlapping features with Aicardi-Goutières syndrome and familial chilblain lupus. • Traditional immunosuppressive medications and biologic therapies appear to be of limited benefit, but JAK inhibitors may impact disease progression. PMID:26584874

  3. Radiation injury of boron neutron capture therapy using mixed epithermal- and thermal neutron beams in patients with malignant glioma.

    PubMed

    Kageji, T; Nagahiro, S; Mizobuchi, Y; Toi, H; Nakagawa, Y; Kumada, H

    2004-11-01

    The purpose of this study was to clarify the radiation injury in acute or delayed stage after boron neutron capture therapy (BNCT) using mixed epithermal- and thermal neutron beams in patients with malignant glioma. Eighteen patients with malignant glioma underwent mixed epithermal- and thermal neutron beam and sodium borocaptate between 1998 and 2004. The radiation dose (i.e. physical dose of boron n-alpha reaction) in the protocol used between 1998 and 2000 (Protocol A, n = 8) prescribed a maximum tumor volume dose of 15 Gy. In 2001, a new dose-escalated protocol was introduced (Protocol B, n = 4); it prescribes a minimum tumor volume dose of 18 Gy or, alternatively, a minimum target volume dose of 15 Gy. Since 2002, the radiation dose was reduced to 80-90% dose of Protocol B because of acute radiation injury. A new Protocol was applied to 6 glioblastoma patients (Protocol C, n = 6). The average values of the maximum vascular dose of brain surface in Protocol A, B and C were 11.4+/-4.2 Gy, 15.7+/-1.2 and 13.9+/-3.6 Gy, respectively. Acute radiation injury such as a generalized convulsion within 1 week after BNCT was recognized in three patients of Protocol B. Delayed radiation injury such as a neurological deterioration appeared 3-6 months after BNCT, and it was recognized in 1 patient in Protocol A, 5 patients in Protocol B. According to acute radiation injury, the maximum vascular dose was 15.8+/-1.3 Gy in positive and was 12.6+/-4.3 Gy in negative. There was no significant difference between them. According to the delayed radiation injury, the maximum vascular dose was 13.8+/-3.8 Gy in positive and was 13.6+/-4.9 Gy in negative. There was no significant difference between them. The dose escalation is limited because most patients in Protocol B suffered from acute radiation injury. We conclude that the maximum vascular dose does not exceed over 12 Gy to avoid the delayed radiation injury, especially, it should be limited under 10 Gy in the case that tumor

  4. Hyaluronan in Tubular and Interstitial Nephrocalcinosis

    NASA Astrophysics Data System (ADS)

    Verkoelen, Carl F.

    2007-04-01

    Hyaluronan (HA) is the major glycosaminoglycan (GAG) component of the renal medullary interstitium. HA is extremely large (up to 104 kDa) and composed of thousands repeating disaccharides of glucuronic acid (GlcUA) and N-acetylglucosamine (GlcNAc). HA is synthesized by hyaluronan synthases (HASs) and degraded by hyaluronidases (Hyals). The production of HA by renomedullary interstitial cells is mediated by local osmolality. When excess water needs to be excreted, increased interstitial HA seems to antagonize water reabsorption, while the opposite occurs during water conservation. Hence, papillary interstitial HA is low and Hyal high during anti-diuresis, whereas during diuresis HA is high and Hyal low. The polyanion HA plays a role in the reabsorption of hypotonic fluid by immobilizing cations (Na+) via the carboxylate (COO-) groups of GlcUA. The binding of Ca2+ to anionic HA is probably also responsible for the fact that the papilla does not become a stone despite the extremely high interstitial phosphate and oxalate. HA is also an excellent crystal binding molecule. The expression of HA at the luminal surface of renal tubular cells leads to tubular nephrocalcinosis (tubular NC). Calcium staining methods (Von Kossa, Yasue) demonstrated that crystallization inhibitors cannot avoid the occasional precipitation of calcium phosphate in the papillary interstitium (interstitial NC). These crystals are probably immediately immobilized by the gel-like HA matrix. After ulcerating through the pelvic wall the calcified matrix becomes a Randall's plaque. The attachment of calcium oxalate crystals from the primary urine to plaque may ultimately lead to the development of clinical stones in the renal calyces (nephrolithiasis).

  5. Recent Advances and Future Needs in Interstitial Lung Diseases.

    PubMed

    Jones, Mark G; Richeldi, Luca

    2016-06-01

    Interstitial lung diseases (ILDs) are a diverse range of conditions affecting the lung interstitium. The prototypic ILD, idiopathic pulmonary fibrosis (IPF), is a chronic progressive fibrotic lung disease with a median survival of only 3 years from the time of diagnosis. Recently significant progress has been made in both our understanding of the pathogenesis and of the therapeutic targeting of IPF. This culminated in the worldwide approval of the first antifibrotic therapies nintedanib and pirfenidone. While an important first step, patients continue to progress and better therapies are urgently required. The aim of this article is to highlight some of the recent advances that have been made in our understanding of genetics, disease classification, clinical trial design, and novel antifibrotic therapy in IPF. It discusses future priorities if we are to continue to increase the length and quality of life of patients with IPF, and considers possible approaches to translate the progress made in IPF to other progressive fibrotic lung diseases where our understanding remains limited. PMID:27231869

  6. Interleukin-6 Induced "Acute" Phenotypic Microenvironment Promotes Th1 Anti-Tumor Immunity in Cryo-Thermal Therapy Revealed By Shotgun and Parallel Reaction Monitoring Proteomics.

    PubMed

    Xue, Ting; Liu, Ping; Zhou, Yong; Liu, Kun; Yang, Li; Moritz, Robert L; Yan, Wei; Xu, Lisa X

    2016-01-01

    Cryo-thermal therapy has been emerged as a promising novel therapeutic strategy for advanced breast cancer, triggering higher incidence of tumor regression and enhanced remission of metastasis than routine treatments. To better understand its anti-tumor mechanism, we utilized a spontaneous metastatic mouse model and quantitative proteomics to compare N-glycoproteome changes in 94 serum samples with and without treatment. We quantified 231 highly confident N-glycosylated proteins using iTRAQ shotgun proteomics. Among them, 53 showed significantly discriminated regulatory patterns over the time course, in which the acute phase response emerged as the most enhanced pathway. The anti-tumor feature of the acute response was further investigated using parallel reaction monitoring target proteomics and flow cytometry on 23 of the 53 significant proteins. We found that cryo-thermal therapy reset the tumor chronic inflammation to an "acute" phenotype, with up-regulation of acute phase proteins including IL-6 as a key regulator. The IL-6 mediated "acute" phenotype transformed IL-4 and Treg-promoting ICOSL expression to Th1-promoting IFN-γ and IL-12 production, augmented complement system activation and CD86(+)MHCII(+) dendritic cells maturation and enhanced the proliferation of Th1 memory cells. In addition, we found an increased production of tumor progression and metastatic inhibitory proteins under such "acute" environment, favoring the anti-metastatic effect. Moreover, cryo-thermal on tumors induced the strongest "acute" response compared to cryo/hyperthermia alone or cryo-thermal on healthy tissues, accompanying by the most pronounced anti-tumor immunological effect. In summary, we demonstrated that cryo-thermal therapy induced, IL-6 mediated "acute" microenvironment shifted the tumor chronic microenvironment from Th2 immunosuppressive and pro-tumorigenic to Th1 immunostimulatory and tumoricidal state. Moreover, the magnitude of "acute" and "danger" signals play a key

  7. Folic acid-conjugated silica-modified gold nanorods for X-ray/CT imaging-guided dual-mode radiation and photo-thermal therapy.

    PubMed

    Huang, Peng; Bao, Le; Zhang, Chunlei; Lin, Jing; Luo, Teng; Yang, Dapeng; He, Meng; Li, Zhiming; Gao, Guo; Gao, Bing; Fu, Shen; Cui, Daxiang

    2011-12-01

    Multifunctional nanoprobes are designed to own various functions such as tumor targeting, imaging and selective therapy, which offer great promise for the future of cancer prevention, diagnosis, imaging and treatment. Herein, silica was applied to replace cetyltrimethylammonium bromide (CTAB) molecules on the surface of gold nanorods (GNRs) by the classic Stöber method, thus eliminating their cytotoxicity and improving their biocompatibility. Folic acid molecule was covalently anchored on the surface of GNRs with silane coupling agent. The resultant folic acid-conjugated silica-modified GNRs show highly selective targeting, enhanced radiation therapy (RT) and photo-thermal therapy (PTT) effects on MGC803 gastric cancer cells, and also exhibited strong X-ray attenuation for in vivo X-ray and computed tomography (CT) imaging. In conclusion, the as-prepared nanoprobe is a good candidate with excellent imaging and targeting ability for X-ray/CT imaging-guided targeting dual-mode enhanced RT and PTT. PMID:21917309

  8. Interstitial laser irradiation of metastatic mammary tumors in combination with intratumoral injection of immunoadjuvant

    NASA Astrophysics Data System (ADS)

    Joshi, Chet; Jose, Jessnie; Figueroa, Daniel; Goddard, Jessica; Li, Xiaosong; Liu, Hong; Nordquist, Robert E.; Hode, Tomas; Chen, Wei R.

    2012-03-01

    Laser immunotherapy (LIT) was developed to treat metastatic cancers using a combination of laser irradiation and immunological stimulation. The original design of LIT employs a non-invasive, selective laser photothermal interaction, using an in situ light-absorbing dye. However, this non-invasive treatment mode faces challenges in treating deep, large tumors. Furthermore, it has difficulties in the cases of highly pigmented skin overlying target tumors. To overcome these limitations, interstitial laser immunotherapy (ILIT) was proposed. In ILIT, a cylindrical, side-fire fiber diffuser is placed inside the target tumor to induce thermal damage. To enhance the interstitial irradiation induced photothermal interaction, an immunological modifier, glycated chitosan (GC), is injected into the tumor after the laser treatment. In this study, a cylindrical diffuser with an active length of 1 cm was used to treat tumors of 1 to 1.5 cm in size. Different laser powers (1 to 3 watts) and different irradiation durations (10 to 30 minutes) were used to test the thermal effects of ILIT. Different doses of the GC (1.0%, 0.1 to 0.6 ml per rat) were used to determine the immunological effects of ILIT. Our results show that the animal survival depends on both laser dose and GC dose. A dose of 0.2 ml per tumor appeared to result in the highest survival rate under interstitial laser irradiation with 2.5 watts and 20 minutes. While the results in this study are not conclusive, they indicate that interstitial laser irradiation can be combined with immunotherapy to treat metastatic cancers. Furthermore, our results suggest that an optimal combination of laser dose and GC dose could be obtained for future clinical protocols using interstitial laser immunotherapy.

  9. Genetic Analysis of Sporadic and Familial Interstitial Pneumonia

    PubMed Central

    Schwartz, David A.

    2008-01-01

    Although much progress has been made in understanding the biology and clinical course of interstitial pneumonia, the etiology of this disease remains elusive. Epidemiologic studies have consistently identified cigarette smoke as an important exposure; however, most smokers do not develop interstitial pneumonia and many individuals with interstitial pneumonia do not smoke cigarettes. Moreover, interstitial pneumonias have been reported to cluster in families. Thus, a more thorough understanding of the genetic etiology of interstitial pneumonia may prove critically important in defining the biology and clinical course of this complex human disease. PMID:18403331

  10. The Chinese approach to complementary and alternative medicine treatment for interstitial cystitis/bladder pain syndrome.

    PubMed

    Pang, Ran; Ali, Abdullah

    2015-12-01

    Management of interstitial cystitis/bladder pain syndrome (IC/BPS) remains a challenge due to poor understanding on its etiology. Complementary and alternative medicine (CAM), as an optional treatment, has been widely used, because no definitive conventional therapy is available. The different domain of CAM provides miscellaneous treatments for IC/BPS, which mainly include dietary modification, nutraceuticals, bladder training, biofeedback, yoga, massage, physical therapy, Qigong, traditional Chinese medicine and acupuncture. Clinical evidence has shown that each therapy can certainly benefit a portion of IC/BPS patients. However, the target patient group of each therapy has not been well studied and randomized, controlled trials are needed to further confirm the efficacy and reliability of CAM on managing IC/BPS. Despite these limitations, CAM therapeutic characteristics including non-invasive and effectiveness for specific patients allow clinicians and patients to realize multimodal and individualized therapy for IC/BPS. PMID:26816867

  11. The Chinese approach to complementary and alternative medicine treatment for interstitial cystitis/bladder pain syndrome

    PubMed Central

    Ali, Abdullah

    2015-01-01

    Management of interstitial cystitis/bladder pain syndrome (IC/BPS) remains a challenge due to poor understanding on its etiology. Complementary and alternative medicine (CAM), as an optional treatment, has been widely used, because no definitive conventional therapy is available. The different domain of CAM provides miscellaneous treatments for IC/BPS, which mainly include dietary modification, nutraceuticals, bladder training, biofeedback, yoga, massage, physical therapy, Qigong, traditional Chinese medicine and acupuncture. Clinical evidence has shown that each therapy can certainly benefit a portion of IC/BPS patients. However, the target patient group of each therapy has not been well studied and randomized, controlled trials are needed to further confirm the efficacy and reliability of CAM on managing IC/BPS. Despite these limitations, CAM therapeutic characteristics including non-invasive and effectiveness for specific patients allow clinicians and patients to realize multimodal and individualized therapy for IC/BPS. PMID:26816867

  12. SU-E-J-04: Integration of Interstitial High Intensity Therapeutic Ultrasound Applicators On a Clinical MRI-Guided High Intensity Focused Ultrasound Treatment Planning Software Platform

    SciTech Connect

    Ellens, N; Partanen, A; Ghoshal, G; Burdette, E; Farahani, K

    2015-06-15

    Purpose: Interstitial high intensity therapeutic ultrasound (HITU) applicators can be used to ablate tissue percutaneously, allowing for minimally-invasive treatment without ionizing radiation [1,2]. The purpose of this study was to evaluate the feasibility and usability of combining multielement interstitial HITU applicators with a clinical magnetic resonance imaging (MRI)-guided focused ultrasound software platform. Methods: The Sonalleve software platform (Philips Healthcare, Vantaa, Finland) combines anatomical MRI for target selection and multi-planar MRI thermometry to provide real-time temperature information. The MRI-compatible interstitial US applicators (Acoustic MedSystems, Savoy, IL, USA) had 1–4 cylindrical US elements, each 1 cm long with either 180° or 360° of active surface. Each applicator (4 Fr diameter, enclosed within a 13 Fr flexible catheter) was inserted into a tissue-mimicking agar-silica phantom. Degassed water was circulated around the transducers for cooling and coupling. Based on the location of the applicator, a virtual transducer overlay was added to the software to assist targeting and to allow automatic thermometry slice placement. The phantom was sonicated at 7 MHz for 5 minutes with 6–8 W of acoustic power for each element. MR thermometry data were collected during and after sonication. Results: Preliminary testing indicated that the applicator location could be identified in the planning images and the transducer locations predicted within 1 mm accuracy using the overlay. Ablation zones (thermal dose ≥ 240 CEM43) for 2 active, adjacent US elements ranged from 18 mm × 24 mm (width × length) to 25 mm × 25 mm for the 6 W and 8 W sonications, respectively. Conclusion: The combination of interstitial HITU applicators and this software platform holds promise for novel approaches in minimally-invasive MRI-guided therapy, especially when bony structures or air-filled cavities may preclude extracorporeal HIFU.[1] Diederich et al

  13. Potentiation of thermal inactivation of glyceraldehyde-3-phosphate dehydrogenase by photodynamic treatment. A possible model for the synergistic interaction between photodynamic therapy and hyperthermia.

    PubMed Central

    Prinsze, C; Dubbelman, T M; Van Steveninck, J

    1991-01-01

    Thermal inactivation of glyceraldehyde-3-phosphate dehydrogenase appeared to be caused by a conformational mechanism, without involvement of covalent reactions. On the other hand, photodynamic inactivation of the enzyme (induced by illumination in the presence of Photofrin II) was caused by photo-oxidation of the essential thiol group in the active centre. A short photodynamic treatment of the enzyme, leading to only a limited inactivation, caused a pronounced potentiation of subsequent thermal inactivation, as measured over the temperature range 40-50 degrees C. Analysis of the experimental results according to the Arrhenius equation revealed that both the activation energy of thermal inactivation and the frequency factor (the proportionality constant) were significantly decreased by the preceding photodynamic treatment. The experimental results indicate a mechanism in which limited photodynamic treatment induced a conformational change of the protein molecule. This conformational change did not contribute to photodynamic enzyme inhibition, but was responsible for the decreased frequency factor and activation energy of subsequent thermal inactivation of the enzyme. The opposing effects of decreased activation energy and decreased frequency factor resulted in potentiation of thermal inactivation of the enzyme over the temperature range 40-50 degrees C. With other proteins, different results were obtained. With amylase the combined photodynamic and thermal effects were not synergistic, but additive, and photodynamic treatment had no effect on the frequency factor and the activation energy of thermal inactivation. With respect to myoglobin denaturation, the photodynamic and thermal effects were antagonistic over the whole practically applicable temperature range. Limited photodynamic treatment protected the protein against heat-induced precipitation, concomitantly increasing both the frequency factor and the activation energy of the process. These results offer a

  14. Contribution of interstitial OH groups to the incorporation of water in forsterite

    NASA Astrophysics Data System (ADS)

    Balan, Etienne; Blanchard, Marc; Lazzeri, Michele; Ingrin, Jannick

    2014-02-01

    Water incorporation in forsterite samples synthesized under low to medium silica-activity conditions mostly occurs via a substitutional mechanism in which a Si vacancy is compensated by four protons. Corresponding IR absorption spectra display a cluster of narrow and weakly anharmonic OH-stretching bands at wavenumbers above 3,500 cm-1. However, this diagnostic spectrum is often superimposed to one broader absorption band, rarely two, displaying pronounced temperature-dependent properties and tentatively assigned to H atoms in interstitial position (Ingrin et al. in Phys Chem Miner 40:499-510, 2013). Here, we investigate the structural and vibrational properties of selected interstitial H-bearing defects in forsterite using a first-principles modeling approach. We show that the broad bands discussed by Ingrin et al. (Phys Chem Miner 40:499-510, 2013) are most likely related to interstitial OH groups in the vacant octahedral sites alternating with the M2 sites along the c axis of the forsterite structure. The corresponding OH defects lead to the formation of fivefold coordinated Si species. Their peculiar thermal properties stem from the vibrational phase relaxation due to the anharmonic coupling of the high-energy local OH-stretching mode with a low-energy vibrational mode. This "exchange mode" corresponds to the hindered longitudinal translation of the OH group. These results suggest that at high pressure, hydrogen incorporation in forsterite is dominated by coexisting interstitial OH groups and (4H)Si defects.

  15. Predicting vacancy-mediated diffusion of interstitial solutes in α -Fe

    NASA Astrophysics Data System (ADS)

    Barouh, Caroline; Schuler, Thomas; Fu, Chu-Chun; Jourdan, Thomas

    2015-09-01

    Based on a systematic first-principles study, the lowest-energy migration mechanisms and barriers for small vacancy-solute clusters (VnXm ) are determined in α -Fe for carbon, nitrogen, and oxygen, which are the most frequent interstitial solutes in several transition metals. We show that the dominant clusters present at thermal equilibrium (V X and V X2 ) have very reduced mobility compared to isolated solutes, while clusters composed of a solute bound to a small vacancy cluster may be significantly more mobile. In particular, V3X is found to be the fastest cluster for all three solutes. This result relies on the large diffusivity of the most compact trivacancy in a bcc lattice. Therefore, it may also be expected for interstitial solutes in other bcc metals. In the case of iron, we find that V3X may be as fast as or even more mobile than an interstitial solute. At variance with common assumptions, the trapping of interstitial solutes by vacancies does not necessarily decrease the mobility of the solute. Additionally, cluster dynamics simulations are performed considering a simple iron system with supersaturation of vacancies, in order to investigate the impacts of small mobile vacancy-solute clusters on properties such as the transport of solute and the cluster size distributions.

  16. Pancreas tumor interstitial pressure catheter measurement

    NASA Astrophysics Data System (ADS)

    Nieskoski, Michael D.; Gunn, Jason; Marra, Kayla; Trembly, B. Stuart; Pogue, Brian W.

    2016-03-01

    This paper highlights the methodology in measuring interstitial pressure in pancreatic adenocarcinoma tumors. A Millar Mikrotip pressure catheter (SPR-671) was used in this study and a system was built to amplify and filter the output signal for data collection. The Millar pressure catheter was calibrated prior to each experiment in a water column at 37°C, range of 0 to 60 inH2O (112 mmHg), resulting in a calibration factor of 33 mV / 1 inH2O. The interstitial pressures measured in two orthotopically grown pancreatic adenocarcinoma tumor were 57 mmHg and 48 mmHg, respectively. Verteporfin uptake into the pancreatic adenocarcinoma tumor was measured using a probe-based experimental dosimeter.

  17. Surface effects in Si interstitial formation energies

    NASA Astrophysics Data System (ADS)

    Mattsson, Ann E.; Wixom, Ryan R.; Armiento, Rickard

    2007-03-01

    We are calculating Si self-interstitial formation energies using Density Functional Theory and several different exchange-correlation energy functionals. We show that the difference in results obtained with the LDA, PBE, PW91, and AM05 [1] functionals can be explained by the functionals' different surface intrinsic errors. We explain why surface effects are important for formation energies of interstitials in semi-conductors. Surface effects have previously been studied for metal vacancy formation energies. Sandia is a multiprogram laboratory operated by Sandia Corporation, a Lockheed Martin Company, for the United States Department of Energy's National Nuclear Security Administration under contract DE-AC04-94AL85000. [1] R. Armiento and A. E. Mattsson, Phys. Rev. B 72, 085108 (2005).

  18. [Computer-assisted system for interstitial hyperthermia].

    PubMed

    Kneschaurek, P; Weisser, M

    1987-03-01

    The combination of interstitial radiotherapy and interstitial hyperthermia is more promising in the treatment of tumors than one of these methods alone. The unit developed by us uses the afterloading needles for heating up the tumor tissue with ohm current and for controlling the distribution of temperature in the target volume. Up to twelve needles are provided by one commutator with the R.F. current controlled by the computer. The temperature is measured by three thermistors per needle which are arranged at an axial distance of 2 cm each. The linearization of the thermistor characteristics and the control of cummutator and R.F. generator is performed by the computer over an interface constructed by us. In order to achieve a homogeneous distribution of temperature in the target volume and to avoid hot spots, we have examined several needle configurations by measuring in an homogeneous phantom. PMID:3563878

  19. Breast conservation treatment with perioperative interstitial irradiation

    SciTech Connect

    Krishnan, L.; Mansfield, C.M.; Jewell, W.R.; Reddy, E.K.; Thomas, J.H.; Krishnan, E.C.

    1987-10-01

    Limited resection of the breast combined with radiation has proved to be as effective as more radical surgery in treating early breast cancer. At the University of Kansas Medical Center, the radiotherapy consists of an interstitial implant at the time of lumpectomy to deliver an interstitial boost dose to the tumor bed with iridium-192 immediately following the surgical procedure. An axillary node dissection is also performed at the time of lumpectomy. A dose of 2000 cGy is delivered to the tumor bed between 40 and 60 h. Two to three weeks later, 4500-5000 cGy is delivered to the entire breast with external beam radiation over 5-5.5 weeks. One hundred breasts in 98 patients were so treated between June 1982 and February 1986, with 2 carcinomas in situ, 40 stage I, 51 stage II, and 7 stage III cancers, consisting of 2 TIS, 54 T1, 39 T2, and 5 T3 lesions. Locoregional control with a median follow-up of 31 months was 98%. One recurrence was in a different quadrant, and the other revealed predominantly the in situ component. Immediate implant did not compromise wound healing or cosmesis. The cosmetic result was graded as good to excellent in 88% of the breasts. Our preliminary results appear to suggest a better local control with immediate interstitial irradiation.

  20. Interstitial loop transformations in FeCr

    DOE PAGESBeta

    Béland, Laurent Karim; Osetsky, Yuri N.; Stoller, Roger E.; Xu, Haixuan

    2015-03-27

    Here, we improve the Self-Evolving Atomistic Kinetic Monte Carlo (SEAKMC) algorithm by integrating the Activation Relaxation Technique nouveau (ARTn), a powerful open-ended saddle-point search method, into the algorithm. We use it to investigate the reaction of 37-interstitial 1/2[1 1 1] and 1/2[View the MathML source] loops in FeCr at 10 at.% Cr. They transform into 1/2[1 1 1], 1/2[View the MathML source], [1 0 0] and [0 1 0] 74-interstitial clusters with an overall barrier of 0.85 eV. We find that Cr decoration locally inhibits the rotation of crowdions, which dictates the final loop orientation. Moreover, the final loop orientationmore » depends on the details of the Cr decoration. Generally, a region of a given orientation is favored if Cr near its interface with a region of another orientation is able to inhibit reorientation at this interface more than the Cr present at the other interfaces. Also, we find that substitutional Cr atoms can diffuse from energetically unfavorable to energetically favorable sites within the interlocked 37-interstitial loops conformation with barriers of less than 0.35 eV.« less

  1. Interstitial loop transformations in FeCr

    SciTech Connect

    Béland, Laurent Karim; Osetsky, Yuri N.; Stoller, Roger E.; Xu, Haixuan

    2015-03-27

    Here, we improve the Self-Evolving Atomistic Kinetic Monte Carlo (SEAKMC) algorithm by integrating the Activation Relaxation Technique nouveau (ARTn), a powerful open-ended saddle-point search method, into the algorithm. We use it to investigate the reaction of 37-interstitial 1/2[1 1 1] and 1/2[View the MathML source] loops in FeCr at 10 at.% Cr. They transform into 1/2[1 1 1], 1/2[View the MathML source], [1 0 0] and [0 1 0] 74-interstitial clusters with an overall barrier of 0.85 eV. We find that Cr decoration locally inhibits the rotation of crowdions, which dictates the final loop orientation. Moreover, the final loop orientation depends on the details of the Cr decoration. Generally, a region of a given orientation is favored if Cr near its interface with a region of another orientation is able to inhibit reorientation at this interface more than the Cr present at the other interfaces. Also, we find that substitutional Cr atoms can diffuse from energetically unfavorable to energetically favorable sites within the interlocked 37-interstitial loops conformation with barriers of less than 0.35 eV.

  2. Interstitial pericytes decrease in aged mouse kidneys.

    PubMed

    Stefanska, Ania; Eng, Diana; Kaverina, Natalya; Duffield, Jeremy S; Pippin, Jeffrey W; Rabinovitch, Peter; Shankland, Stuart J

    2015-06-01

    With increasing age, the kidney undergoes characteristic changes in the glomerular and tubulo-interstitial compartments, which are ultimately accompanied by reduced kidney function. Studies have shown age-related loss of peritubular vessels. Normal peritubular vessel tone, function and survival depend on neighboring pericytes. Pericyte detachment leads to vascular damage, which can be accompanied by their differentiation to fibroblasts and myofibroblasts, a state that favors matrix production. To better understand the fate of pericytes in the aged kidney, 27 month-old mice were studied. Compared to 3 month-old young adult mice, aged kidneys showed a substantial decrease in capillaries, identified by CD31 staining, in both cortex and medulla. This was accompanied by a marked decrease in surrounding NG2+ / PDGFRβ+ pericytes. This decrease was more pronounced in the medulla. Capillaries devoid of pericytes were typically dilated in aged mice. Aged kidneys were also characterized by interstitial fibrosis due to increased collagen-I and -III staining. This was accompanied by an increase in the number of pericytes that acquired a pro-fibrotic phenotype, identified by increased PDGFRβ+ / αSMA+ staining. These findings are consistent with the decline in kidney interstitial pericytes as a critical step in the development of changes to the peritubular vasculature with aging, and accompanying fibrosis. PMID:26081073

  3. Interstitial pericytes decrease in aged mouse kidneys

    PubMed Central

    Stefanska, Ania; Eng, Diana; Kaverina, Natalya; Duffield, Jeremy S.; Pippin, Jeffrey W.; Rabinovitch, Peter; Shankland, Stuart J.

    2015-01-01

    With increasing age, the kidney undergoes characteristic changes in the glomerular and tubulo-interstitial compartments, which are ultimately accompanied by reduced kidney function. Studies have shown age-related loss of peritubular vessels. Normal peritubular vessel tone, function and survival depend on neighboring pericytes. Pericyte detachment leads to vascular damage, which can be accompanied by their differentiation to fibroblasts and myofibroblasts, a state that favors matrix production. To better understand the fate of pericytes in the aged kidney, 27 month-old mice were studied. Compared to 3 month-old young adult mice, aged kidneys showed a substantial decrease in capillaries, identified by CD31 staining, in both cortex and medulla. This was accompanied by a marked decrease in surrounding NG2+/PDGFRß+ pericytes. This decrease was more pronounced in the medulla. Capillaries devoid of pericytes were typically dilated in aged mice. Aged kidneys were also characterized by interstitial fibrosis due to increased collagen-I and -III staining. This was accompanied by an increase in the number of pericytes that acquired a pro-fibrotic phenotype, identified by increased PDGFRß+/αSMA+ staining. These findings are consistent with the decline in kidney interstitial pericytes as a critical step in the development of changes to the peritubular vasculature with aging, and accompanying fibrosis. PMID:26081073

  4. Pulmonary Hypertension in Patients with Chronic Fibrosing Idiopathic Interstitial Pneumonias

    PubMed Central

    Hoeper, Marius M.; Behr, Juergen; Held, Matthias; Grunig, Ekkehard; Vizza, C. Dario; Vonk-Noordegraaf, Anton; Lange, Tobias J.; Claussen, Martin; Grohé, Christian; Klose, Hans; Olsson, Karen M.; Zelniker, Thomas; Neurohr, Claus; Distler, Oliver; Wirtz, Hubert; Opitz, Christian; Huscher, Doerte; Pittrow, David; Gibbs, J. Simon R.

    2015-01-01

    Background Pulmonary hypertension (PH) is a common finding in patients with chronic fibrosing idiopathic interstitial pneumonias (IIP). Little is known about the response to pulmonary vasodilator therapy in this patient population. COMPERA is an international registry that prospectively captures data from patients with various forms of PH receiving pulmonary vasodilator therapies. Methods We retrieved data from COMPERA to compare patient characteristics, treatment patterns, response to therapy and survival in newly diagnosed patients with idiopathic pulmonary arterial hypertension (IPAH) and PH associated with IIP (PH-IIP). Results Compared to patients with IPAH (n = 798), patients with PH-IIP (n = 151) were older and predominantly males. Patients with PH-IIP were treated predominantly with phosphodiesterase-5 inhibitors (88% at entry, 87% after 1 year). From baseline to the first follow-up visit, the median improvement in 6MWD was 30 m in patients with IPAH and 24.5 m in patients with PH-IIP (p = 0.457 for the difference between both groups). Improvements in NYHA functional class were observed in 22.4% and 29.5% of these patients, respectively (p = 0.179 for the difference between both groups). Survival rates were significantly worse in PH-IIP than in IPAH (3-year survival 34.0 versus 68.6%; p<0.001). Total lung capacity, NYHA class IV, and mixed-venous oxygen saturation were independent predictors of survival in patients with PH-IIP. Conclusions Patients with PH-IIP have a dismal prognosis. Our results suggest that pulmonary vasodilator therapy may be associated with short-term functional improvement in some of these patients but it is unclear whether this treatment affects survival. Trial Registration clinicaltrials.gov NCT01347216 PMID:26630396

  5. Diagnosis and treatment of interstitial cystitis in adolescents.

    PubMed

    Yoost, J L; Hertweck, S P; Loveless, M

    2012-06-01

    Interstitial cystitis (IC), or painful bladder syndrome, is characterized by irritative voiding symptoms and can be a challenging problem that affects children and adolescents. Diagnosis and management in children and adolescents is challenging because of strict diagnostic criteria and the paucity of investigations focusing on this age group, which often can lead to delayed or missed diagnosis. Clinical features suggestive of IC include bladder pain, urgency, frequency, nocturia, and pressure. Symptoms may wax and wane and often are exacerbated by menstruation, intercourse, dietary triggers, and stress. Diagnosis can be made by history, physical exam findings such as suprapubic tenderness, voiding diaries, and exclusion of other etiologies. Some diagnostic tests such as the potassium sensitivity test and cystoscopy are invasive and often impractical in younger patients. Treatment of IC consists of a multimodal approach that should be tailored to the individual needs of the patient. Therapies for younger patients include oral medication, intravesical therapy, cystoscopy with hydrodistention, and conservative measures such as dietary modification. This review of the literature focuses on diagnosing IC in younger patients and on what treatment modalities are appropriate and effective for this age group. PMID:21600805

  6. Experimental depletion of different renal interstitial cell populations

    SciTech Connect

    Bohman, S.O.; Sundelin, B.; Forsum, U.; Tribukait, B.

    1988-04-01

    To define different populations of renal interstitial cells and investigate some aspects of their function, we studied the kidneys of normal rats and rats with hereditary diabetes insipidus (DI, Brattleboro) after experimental manipulations expected to alter the number of interstitial cells. DI rats showed an almost complete loss of interstitial cells in their renal papillae after treatment with a high dose of vasopressin. In spite of the lack of interstitial cells, the animals concentrated their urine to the same extent as vasopressin-treated normal rats, indicating that the renomedullary interstitial cells do not have an important function in concentrating the urine. The interstitial cells returned nearly to normal within 1 week off vasopressin treatment, suggesting a rapid turnover rate of these cells. To further distinguish different populations of interstitial cells, we studied the distribution of class II MHC antigen expression in the kidneys of normal and bone-marrow depleted Wistar rats. Normal rats had abundant class II antigen-positive interstitial cells in the renal cortex and outer medulla, but not in the inner medulla (papilla). Six days after 1000 rad whole body irradiation, the stainable cells were almost completely lost, but electron microscopic morphometry showed a virtually unchanged volume density of interstitial cells in the cortex and outer medulla, as well as the inner medulla. Thus, irradiation abolished the expression of the class II antigen but caused no significant depletion of interstitial cells.

  7. Interstitial space and collagen alterations of the developing rat diaphragm

    NASA Technical Reports Server (NTRS)

    Gosselin, L. E.; Martinez, D. A.; Vailas, A. C.; Sieck, G. C.

    1993-01-01

    The effect of growth on the relative interstitial space [%total cross-sectional area (CSA)] and collagen content of the rat diaphragm muscle was examined at postnatal ages of 0, 7, 14, and 21 days as well as in adult males. The proportion of interstitial space relative to total muscle CSA was determined by computerized image analysis of lectin-stained cross sections of diaphragm muscle. To assess collagen content and extent of collagen maturation (i.e., cross-linking), high-pressure liquid chromatography analysis was used to measure hydroxyproline concentration and the nonreducible collagen cross-link hydroxylysylpyridinoline (HP), respectively. At birth, interstitial space accounted for approximately 47% of total diaphragm muscle CSA. During postnatal growth, the relative contribution of interstitial space decreased such that by adulthood the interstitial space accounted for approximately 18% of total muscle CSA. The change in relative interstitial space occurred without a concomitant change in hydroxyproline concentration. However, the concentration of HP markedly increased with age such that the adult diaphragm contained approximately 17 times more HP than at birth. These results indicate that during development the relative CSA occupied by interstitial space decreases as muscle fiber size increases. However, the reduction in relative interstitial space is not associated with a change in collagen concentration. Thus collagen density in the interstitial space may increase with age. It is possible that the observed changes in relative interstitial space and collagen influence the passive length-force properties of the diaphragm.

  8. Thermal contact conductance across filled polyimide films at cryogenic temperatures

    NASA Astrophysics Data System (ADS)

    Zhao, L.; Phelan, P. E.

    1999-12-01

    Thermal contact resistance arises in the region of contact where two solid specimens are pressed together. The thermal resistance can be controlled by inserting an interstitial material at the interface, such as Kapton MT, a polyimide film containing alumina particles, which has a relatively low thermal resistance, but yet a high voltage standoff capability. The thermal resistance consists of two components: thermal contact resistance at the copper/Kapton MT interfaces, and the thermal conduction resistance across the Kapton MT film. The measured thermal resistance at low temperatures indicates that increasing the contact pressure reduces the thermal resistance, to a limit determined by the film conduction resistance. The effects of the contact pressure, the average interface temperature and the thickness of the interstitial layer are evaluated. A novel dimensionless correlation is derived from the experimental results that describes the thermal contact conductance of joints which include a soft interstitial material, at cryogenic temperatures.

  9. Interstitial silicon ions in rutile Ti O2 crystals

    NASA Astrophysics Data System (ADS)

    Golden, E. M.; Giles, N. C.; Yang, Shan; Halliburton, L. E.

    2015-04-01

    Electron paramagnetic resonance (EPR) is used to identify a new and unique photoactive silicon-related point defect in single crystals of rutile Ti O2 . The importance of this defect lies in its assignment to interstitial silicon ions and the unexpected establishment of silicon impurities as a major hole trap in Ti O2 . Principal g values of this new S =1 /2 center are 1.9159, 1.9377, and 1.9668 with principal axes along the [1 ¯10 ],[001 ] , and [110 ] directions, respectively. Hyperfine structure in the EPR spectrum shows the unpaired spin interacting equally with two Ti nuclei and unequally with two Si nuclei. These silicon ions are present in the Ti O2 crystals as unintentional impurities. Principal values for the larger of the two Si hyperfine interactions are 91.4, 95.4, and 316.4 MHz with principal axes also along the [1 ¯10 ],[001 ] , and [110 ] directions. The model for the defect consists of two adjacent Si ions, one at a tetrahedral interstitial site and the other occupying a Ti site. Together, they form a neutral nonparamagnetic [Siint-S iTi] 0 complex. When a crystal is illuminated below 40 K with 442-nm laser light, holes are trapped by these silicon complexes and form paramagnetic [Siint-S iTi] + defects, while electrons are trapped at oxygen vacancies. Thermal anneal results show that the [Siint-S iTi] + EPR signal disappears in two steps, coinciding with the release of electrons from neutral oxygen vacancies and singly ionized oxygen vacancies. These released electrons recombine with the holes trapped at the silicon complexes.

  10. Clinical significance and new detection system of autoantibodies in myositis with interstitial lung disease.

    PubMed

    Nakashima, R; Hosono, Y; Mimori, T

    2016-07-01

    Anti-aminoacyl-tRNA synthetase (ARS) and anti-melanoma differentiation-associated gene 5 (MDA5) antibodies are closely associated with interstitial lung disease in polymyositis and dermatomyositis. Anti-ARS-positive patients develop common clinical characteristics termed anti-synthetase syndrome and share a common clinical course, in which they respond well to initial treatment with glucocorticoids but in which disease tends to recur when glucocorticoids are tapered. Anti-MDA5 antibody is associated with rapidly progressive interstitial lung disease and poor prognosis, particularly in Asia. Therefore, intensive immunosuppressive therapy is required for anti-MDA5-positive patients from the early phase of the disease. New enzyme-linked immunosorbent assays to detect anti-ARS and anti-MDA5 antibodies have recently been established and are suggested to be efficient and useful. These assays are expected to be widely applied in daily practice. PMID:27252271

  11. Combined external and interstitial irradiation in the treatment of stage III breast cancer

    SciTech Connect

    Puthawala, A.A.; Syed, A.M.N.; Sheikh, K.M.; Gowdy, R.A.; McNamara, C.S.

    1984-12-01

    One hundred six patients with locally advanced carcinoma of the breast underwent definitive radiation therapy for loco-regional control following incisional and/or needle biopsy. Doses of external and interstitial irradiation were 5000 rad (50 Gy) in 5 to 6 weeks, and 3000 to 4000 rad (30-40 Gy) in 60 to 80 hours, respectively. Forty-eight of 106 patients (45%) also received adjuvant systemic chemotherapy. Loco-regional control was observed in 93 of the 106 patients (88%), with five-year disease-free survival of 47%. Distant metastases developed in 59 of the 106 patients (56%). Good to satisfactory cosmetic results were obtained in the majority of these patients; morbidity was at an acceptable level. Locally advanced breast cancer can be treated adequately and satisfactorily without mastectomy by a combination of external and interstitial irradiation.

  12. Ultrasonography in acute interstitial laser irradiation of the pig brain: preliminary results.

    PubMed

    Menovsky, T; Beek, J F; Phoa, S S; Brouwer, P A; Klein, M G; Verlaan, C W; van Acker, R E; van Gemert, M J

    1995-01-01

    In this preliminary study, the use of real-time ultrasonography to visualize the effects of acute interstitial Nd:YAG laser irradiation was investigated in the normal pig brain. In six pigs, a craniotomy was performed. In the frontal or temporal lobe, a thermal laser lesion was made using a 600-micron-diameter optical fiber at powers of 1 W, 2 W, and 4 W with exposure times of 5 min and 10 min. Ten to thirty minutes after laser irradiation, the pigs were sacrificed. Ultrasound imaging was performed before, during, and after laser irradiation. During laser irradiation, a clear hyperechogenic area was observed around the fiber tip. The onset of the changes and the extent of the lesion were dependent on the power and exposure time. Histologic examination showed thermal lesions consisting of coagulation necrosis and edema. The size of the lesions correlated well with size on ultrasound imaging. The maximal lesion dimension was 12 mm in diameter (4 W for 5 min). In conclusion, within the limitations of this experimental setup, it is feasible to visualize interstitial laser-induced lesions in the brain by ultrasonography. This method is safe and simple and may be helpful in future applications of interstitial thermotherapy in brain tissue. PMID:9079450

  13. New thermal neutron capture therapy for malignant melanoma: melanogenesis-seeking 10B molecule-melanoma cell interaction from in vitro to first clinical trial

    SciTech Connect

    Mishima, Y.; Ichihashi, M.; Hatta, S.; Honda, C.; Yamamura, K.; Nakagawa, T. )

    1989-07-01

    Human melanoma regression by single thermal neutron capture therapy (NCT) using melanoma-seeking 10B compounds has been achieved. Since 1972, the aim of my team has been to synthesize tumor-seeking 10B-compounds possessing selective affinity for specific metabolic activity of the target cancer cells. Once the melanoma takes up these 10B compounds, thermal neutrons, which cause insignificant cell damage, are easily absorbed by nonradioactive 10B, inducing the 10B(n, alpha)7Li reaction and releasing the high LET particles to 14 mu melanoma cell diameter, destroying the tumor without damaging surrounding tissue. Radiobiological and preclinical studies culminated in the first successful human NCT treatment, with no recurrence of the treated melanoma since July, 1987.23 references.

  14. Interleukin-6 Induced “Acute” Phenotypic Microenvironment Promotes Th1 Anti-Tumor Immunity in Cryo-Thermal Therapy Revealed By Shotgun and Parallel Reaction Monitoring Proteomics

    PubMed Central

    Xue, Ting; Liu, Ping; Zhou, Yong; Liu, Kun; Yang, Li; Moritz, Robert L.; Yan, Wei; Xu, Lisa X.

    2016-01-01

    Cryo-thermal therapy has been emerged as a promising novel therapeutic strategy for advanced breast cancer, triggering higher incidence of tumor regression and enhanced remission of metastasis than routine treatments. To better understand its anti-tumor mechanism, we utilized a spontaneous metastatic mouse model and quantitative proteomics to compare N-glycoproteome changes in 94 serum samples with and without treatment. We quantified 231 highly confident N-glycosylated proteins using iTRAQ shotgun proteomics. Among them, 53 showed significantly discriminated regulatory patterns over the time course, in which the acute phase response emerged as the most enhanced pathway. The anti-tumor feature of the acute response was further investigated using parallel reaction monitoring target proteomics and flow cytometry on 23 of the 53 significant proteins. We found that cryo-thermal therapy reset the tumor chronic inflammation to an “acute” phenotype, with up-regulation of acute phase proteins including IL-6 as a key regulator. The IL-6 mediated “acute” phenotype transformed IL-4 and Treg-promoting ICOSL expression to Th1-promoting IFN-γ and IL-12 production, augmented complement system activation and CD86+MHCII+ dendritic cells maturation and enhanced the proliferation of Th1 memory cells. In addition, we found an increased production of tumor progression and metastatic inhibitory proteins under such “acute” environment, favoring the anti-metastatic effect. Moreover, cryo-thermal on tumors induced the strongest “acute” response compared to cryo/hyperthermia alone or cryo-thermal on healthy tissues, accompanying by the most pronounced anti-tumor immunological effect. In summary, we demonstrated that cryo-thermal therapy induced, IL-6 mediated “acute” microenvironment shifted the tumor chronic microenvironment from Th2 immunosuppressive and pro-tumorigenic to Th1 immunostimulatory and tumoricidal state. Moreover, the magnitude of “acute” and

  15. International registry results for an interstitial laser BPH treatment device

    NASA Astrophysics Data System (ADS)

    Conn, Richard L.; Muschter, Rolf; Adams, Curtis S.; Esch, Victor C.

    1996-05-01

    Benign prostatic hyperplasia (BPH) can significantly impair quality of life in older men. Most men over 60 experience some symptoms due to BPH and it is thought that essentially all men would eventually be affected by it if they lived long enough. At present, transurethral resection of the prostate (TURP), a surgical treatment for BPH, is one of the more common procedures performed in the developed world, particularly in the United States. A number of other treatments are also often used, including open prostatectomy, side-firing lasers, and drug therapy. With the population in the developed world rapidly aging, BPH is expected to affect an even larger group of men in the future. Current methods of therapy carry significant disadvantages. Open prostatectomy carries a fairly high risk of impotence and incontinence, as well as sometimes significant risk of death depending on the patient's age and medical conditions. TURP also carries similar risks, albeit reduced, including the risk of substantial blood loss and a small but meaningful risk of death. Side-firing lasers are thought to have a reduced risk of death compared to TURP due to significantly reduced bleeding; however, patients often experience an extended period of pain during voiding due to prolonged tissue sloughing. Drug treatment, although useful for some patients, does not strongly improve symptoms in the majority of patients. Even with the current range of treatments, many patients with symptomatic BPH elect to avoid any current treatment due to risks and side effects. As a possible solution to this problem, previous writers have suggested the possibility of treating BPH through interstitial thermotherapy. In this treatment, prostatic tissue is heated from within the prostate to the point of irreversible necrosis. Healing processes then reduce the volume of the affected tissue, even in the absence of sloughing. This study covers initial human use of such a device, using an 810 nm wavelength diode laser

  16. Macrophage polarization in interstitial lung diseases

    PubMed Central

    Mierzejewski, Michał; Osińska, Iwona; Domagała-Kulawik, Joanna

    2016-01-01

    The role of bronchoalveolar lavage fluid (BALf) examination in differential diagnosis of interstitial lung diseases (ILD) was established. Currently, functional polarization into M1 (pro-inflammatory) and M2 (anti-inflammatory) subpopulations is emphasized. The aim of our study was to compare the proportion of M1 and M2 in BALf of patients with different ILD. BALf samples were collected from 75 ILD patients: sarcoidosis (SA, 36), hypersensitivity pneumonitis (HP, 10), non-specific interstitial pneumonia (NSIP, 8), idiopathic pulmonary fibrosis (IPF, 6) and other ILD (15). Phenotyping was performed by immunocytochemistry with anti-CD40 and CD163 antibodies (for M1 and M2, respectively). For both, CD40 and CD163, three populations of cells have been specified: small cells with strong (+++), large cells with weak (+) and cells with no (–) reaction. Due to lack of statistically significant differences between patients with HP, NSIP and IPF, they were classified into a common group and compared to the group of patients with sarcoidosis. The median proportion of macrophage population was as follows: for CD40: 61%, 35%, 2% in patients with SA and 49%, 47%, 3% in patients with other ILD and for CD163: 55%, 35%, 5% in SA and 53%, 43%, 1% in ILD patients, respectively. We found a significantly higher proportion of M1 in SA when compared with other ILD. Our study showed no evidence of defined polarization of alveolar macrophages in different types of interstitial lung diseases. However, we emphasized the role of CD40 positive cells in sarcoidosis and the role of CD163 positive cells in fibrotic diffuse lung diseases. PMID:27536201

  17. Intraluminal fibrosis in interstitial lung disorders.

    PubMed Central

    Basset, F.; Ferrans, V. J.; Soler, P.; Takemura, T.; Fukuda, Y.; Crystal, R. G.

    1986-01-01

    The histopathologic and ultrastructural features of intraluminal organizing and fibrotic changes were studied in open lung biopsies and autopsy specimens from 373 patients with interstitial lung disorders, including hypersensitivity pneumonitis (n = 44), idiopathic pulmonary fibrosis (n = 92), collagen-vascular diseases (n = 20), chronic eosinophilic pneumonia (n = 10), pulmonary histiocytosis X (n-90), pulmonary sarcoidosis (n = 62), pneumoconioses (n = 25), Legionnaire's disease (n = 5), drug- and toxin-induced pneumonitis (n = 4), radiation-induced pneumonitis (n = 2), lymphangioleiomyomatosis (n = 11), and chronic organizing pneumonia of unknown cause (n = 8). Three patterns of intraluminal organization and fibrosis were recognized: 1) intraluminal buds, which partially filled the alveoli, alveolar ducts and/or distal bronchioles; 2) obliterative changes, in which loose connective tissue masses obliterated the lumens of alveoli, alveolar ducts or distal bronchioles, and 3) mural incorporation of previously intraluminal connective tissue masses, which fused with alveolar, alveolar ductal, or bronchiolar structures and frequently became reepithelialized. All three patterns had common morphologic features, suggesting that, regardless of their severity, they resulted from a common pathogenetic mechanism, ie, the migration of activated connective tissue cells, through defects in the epithelial lining and its basement membrane, from the interstitial into the intraluminal compartment. Intraluminal buds were observed most frequently in hypersensitivity pneumonitis, chronic eosinophilic pneumonia, and organizing pneumonia of unknown cause. Mural incorporation and, to a lesser extent, obliterative changes were observed in most interstitial disorders and were very prominent in idiopathic pulmonary fibrosis. Mural incorporation and obliterative changes play an important role in pulmonary remodeling, especially when several adjacent alveoli and/or other air spaces are

  18. Idiopathic non-specific interstitial pneumonia.

    PubMed

    Belloli, Elizabeth A; Beckford, Rosemarie; Hadley, Ryan; Flaherty, Kevin R

    2016-02-01

    Non-specific interstitial pneumonia (NSIP) is an interstitial lung disease that may be idiopathic or secondary to connective tissue disease, toxins or numerous other causes. Idiopathic NSIP is a rare diagnosis and requires exclusion of these other possible causes. Patients typically present in mid-adulthood with dyspnoea, cough and often constitutional symptoms including fever and fatigue. The disease has a female predominance, and more than 50% of patients have never smoked. Physical exam features mild hypoxaemia and inspiratory rales. Pulmonary function tests demonstrate restriction and a low diffusing capacity for carbon monoxide. High-resolution computed tomography abnormalities include predominantly lower lobe subpleural reticular changes, traction bronchiectasis and ground-glass opacities; honeycombing is rarely seen. An evaluation of the underlying pathology is necessary for a firm diagnosis. Histologically, alveolar and interstitial mononuclear cell inflammation and fibrosis are seen in a temporally uniform pattern with preserved underlying alveolar architecture. NSIP must be differentiated from other parenchymal lung diseases including idiopathic pulmonary fibrosis and hypersensitivity pneumonitis. A thorough exposure history and assessment for underlying connective tissue diseases are highly important, as positive findings in these categories would likely denote a case of secondary NSIP. A multi-disciplinary discussion that includes pulmonologist(s), radiologist(s) and pathologist(s) assists in reaching a consensus diagnosis and improves diagnostic accuracy. Treatment of idiopathic NSIP, although not well proven, is generally instituted in the form of immunosuppression. Prognosis is favourable compared with idiopathic pulmonary fibrosis, although the diagnosis still carries an attributable mortality. Herein we will summarize the clinical characteristics and management of idiopathic NSIP. PMID:26564810

  19. Desquamative alveolar disease (desquamative interstitial pneumonia): case report 1

    PubMed Central

    Cruz, Edgardo; Rodriguez, Jaime; Lisboa, Carmen; Ferretti, Ricardo

    1969-01-01

    Desquamative interstitial pneumonia is a disease characterized by massive alveolar cell proliferation and desquamation with sparse interstitial involvement. The reported case shows an unusually widespread radiographic reticulo-nodular image and abundant alveolar cells in the sputum. Functional studies reveal the expected diffusion defect with practically normal mechanical properties of the lung, in contrast with interstitial fibrosing lung diseases. On the basis of the pathological findings, especially the behaviour of alveolar cells, the individuality of this disease is discussed. We think that it is different from other diseases classed as varieties of a single disease or as different entities under the names of primary interstitial fibrosis or chronic fibrosing alveolitis. Images PMID:5822250

  20. Interstitial gas effect on vibrated granular columns

    NASA Astrophysics Data System (ADS)

    Pastenes, Javier C.; Géminard, Jean-Christophe; Melo, Francisco

    2014-06-01

    Vibrated granular materials have been intensively used to investigate particle segregation, convection, and heaping. We report on the behavior of a column of heavy grains bouncing on an oscillating solid surface. Measurements indicate that, for weak effects of the interstitial gas, the temporal variations of the pressure at the base of the column are satisfactorily described by considering that the column, despite the observed dilation, behaves like a porous solid. In addition, direct observation of the column dynamics shows that the grains of the upper and lower surfaces are in free fall in the gravitational field and that the dilation is due to a small delay between their takeoff times.

  1. Transplantation stimulates interstitial cell migration in hydra

    SciTech Connect

    Fujisawa, T.; David, C.N.; Bosch, T.C. )

    1990-04-01

    Migration of interstitial cells and nerve cell precursors was analyzed in Hydra magnipapillata and Hydra vulgaris (formerly Hydra attenuata). Axial grafts were made between ({sup 3}H)thymidine-labeled donor and unlabeled host tissue. Migration of labeled cells into the unlabeled half was followed for 4 days. The results indicate that the rate of migration was initially high and then slowed on Days 2-4. Regrafting fresh donor tissue on Days 2-4 maintained high levels of migration. Thus, migration appears to be stimulated by the grafting procedure itself.

  2. Interstitial point radiance spectroscopy of turbid media

    NASA Astrophysics Data System (ADS)

    Chin, Lee C. L.; Lloyd, Brendan; Whelan, William M.; Vitkin, I. Alex

    2009-05-01

    We present an optical technique, point radiance spectroscopy, to directly recover chromophore concentrations and the reduced optical scattering coefficient spectrum from continuous wave interstitial point radiance measurements at a single-source-detector separation in turbid, tissuelike media. The method employs a spectral algorithm to fit the relative radiance data, using the P3 approximation, at only two detection angles (0° and 90°). The spectral fitting algorithm is applied to simulated data of relative point fluence and relative point radiance data with added 1% noise and shows that even under realistic experimental conditions, only point radiance information is able to provide quantitative information regarding chromophore concentrations and scattering power at distances greater than two to three mean free paths from the source. Furthermore, experimental measurements in tissue-simulating phantoms demonstrate that dye concentrations and scattering parameters can be recovered to within ˜10%. The developed point radiance technique bridges a technological gap between local surface reflectance and spatially resolved interstitial fluence methods in optical assessment of random media such as biological tissue.

  3. Expansion of Interstitial Telomeric Sequences in Yeast.

    PubMed

    Aksenova, Anna Y; Han, Gil; Shishkin, Alexander A; Volkov, Kirill V; Mirkin, Sergei M

    2015-11-24

    Telomeric repeats located within chromosomes are called interstitial telomeric sequences (ITSs). They are polymorphic in length and are likely hotspots for initiation of chromosomal rearrangements that have been linked to human disease. Using our S. cerevisiae system to study repeat-mediated genome instability, we have previously shown that yeast telomeric (Ytel) repeats induce various gross chromosomal rearrangements (GCR) when their G-rich strands serve as the lagging strand template for replication (G orientation). Here, we show that interstitial Ytel repeats in the opposite C orientation prefer to expand rather than cause GCR. A tract of eight Ytel repeats expands at a rate of 4 × 10(-4) per replication, ranking them among the most expansion-prone DNA microsatellites. A candidate-based genetic analysis implicates both post-replication repair and homologous recombination pathways in the expansion process. We propose a model for Ytel repeat expansions and discuss its applications for genome instability and alternative telomere lengthening (ALT). PMID:26586439

  4. Interstitial Fe in MgO

    SciTech Connect

    Mølholt, T. E. Gislason, H. P.; Ólafsson, S.; Mantovan, R.; Gunnlaugsson, H. P.; Svane, A.; Weyer, G.; Masenda, H.; Naidoo, D.; Bharuth-Ram, K.; Fanciulli, M.; Johnston, K.; Sielemann, R.

    2014-01-14

    Isolated {sup 57}Fe atoms were studied in MgO single-crystals by emission Mössbauer spectroscopy following implantation of {sup 57}Mn decaying to {sup 57}Fe. Four Mössbauer spectral components were found corresponding to different Fe lattice positions and/or charge states. Two components represent Fe atoms substituting Mg as Fe{sup 2+} and Fe{sup 3+}, respectively; a third component is due to Fe in a strongly implantation-induced disturbed region. The fourth component, which is the focus of this paper, can be assigned to Fe at an interstitial site. Comparison of its measured isomer shift with ab initio calculations suggests that the interstitial Fe is located on, or close to, the face of the rock-salt MgO structure. To harmonize such an assignment with the measured near-zero quadrupole interaction a local motion process (cage motion) of the Fe has to be stipulated. The relation of such a local motion as a starting point for long range diffusion is discussed.

  5. Enhanced thermal stability of silica-coated gold nanorods for photoacoustic imaging and image-guided therapy

    PubMed Central

    Chen, Yun-Sheng; Frey, Wolfgang; Kim, Seungsoo; Homan, Kimberly; Kruizinga, Pieter; Sokolov, Konstantin; Emelianov, Stanislav

    2010-01-01

    Photothermal stability and, therefore, consistency of both optical absorption and photoacoustic response of the plasmonic nanoabsorbers is critical for successful photoacoustic image-guided photothermal therapy. In this study, silica-coated gold nanorods were developed as a multifunctional molecular imaging and therapeutic agent suitable for image-guided photothermal therapy. The optical properties and photothermal stability of silica-coated gold nanorods under intense irradiation with nanosecond laser pulses were investigated by UV-Vis spectroscopy and transmission electron microscopy. Silica-coated gold nanorods showed increased photothermal stability and retained their superior optical properties under much higher fluences. The changes in photoacoustic response of PEGylated and silica-coated nanorods under laser pulses of various fluences were compared. The silica-coated gold nanorods provide a stable photoacoustic signal, which implies better imaging capabilities and make silica-coated gold nanorods a promising imaging and therapeutic nano-agent for photoacoustic imaging and image-guided photothermal therapy. PMID:20588732

  6. Acute interstitial nephritis – a reappraisal and update

    PubMed Central

    Raghavan, Rajeev; Eknoyan, Garabed

    2014-01-01

    Acute interstitial nephritis (AIN) is an under recognized and under diagnosed cause of acute kidney injury (AKI). It is estimated to account for 15 – 20% of cases of AKI; it is the reported diagnosis in 2.8% of all kidney biopsies, and 13.5% of biopsies done specifically for acute renal failure. Considerable evidence implicates antigen initiated cell-mediated injury in the pathogenesis of AIN. Drugs account for 70% of all cases, with over 150 different agents incriminated. The remaining cases are due to infections, autoimmune diseases, and rarely idiopathic. The central component of renal injury in AIN is altered tubular function, which usually precedes decrements in filtration rate. The key to early diagnosis is vigilance for the presence of tubular dysfunction in non-oliguric individuals, especially in patients with modest but gradual increments in creatinine level. The utility of urinary biomarkers to diagnose AIN in its early nascent and potentially reversible stage remains to be determined. Prompt recognition, elimination of the offending source of antigen, and use of a limited course of steroid therapy where indicated, will result in complete resolution in ~ 65% of cases, partial resolution in up to 20%, and irreversible damage in the rest. PMID:25079860

  7. Interstitial Lung Disease in Children Younger Than 2 Years.

    PubMed

    Spagnolo, Paolo; Bush, Andrew

    2016-06-01

    Childhood interstitial lung disease (chILD) represents a highly heterogeneous group of rare disorders associated with substantial morbidity and mortality. Although our understanding of chILD remains limited, important advances have recently been made, the most important being probably the appreciation that disorders that present in early life are distinct from those occurring in older children and adults, albeit with some overlap. chILD manifests with diffuse pulmonary infiltrates and nonspecific respiratory signs and symptoms, making exclusion of common conditions presenting in a similar fashion an essential preliminary step. Subsequently, a systematic approach to diagnosis includes a careful history and physical examination, computed tomography of the chest, and some or all of bronchoscopy with bronchoalveolar lavage, genetic testing, and if diagnostic uncertainty persists, lung biopsy. This review focuses on chILD presenting in infants younger than 2 years of age and discusses recent advances in the classification, diagnostic approach, and management of chILD in this age range. We describe novel genetic entities, along with initiatives that aim at collecting clinical data and biologic samples from carefully characterized patients in a prospective and standardized fashion. Early referral to expert centers and timely diagnosis may have important implications for patient management and prognosis, but effective therapies are often lacking. Following massive efforts, international collaborations among the key stakeholders are finally starting to be in place. These have allowed the setting up and conducting of the first randomized controlled trial of therapeutic interventions in patients with chILD. PMID:27245831

  8. The role played by perivascular cells in kidney interstitial injury

    PubMed Central

    Rojas, Andres; Chang, Fan-Chi; Lin, Shuei-Liong; Duffield, Jeremy S.

    2012-01-01

    Fibrosis of the kidney is a disease affecting millions worldwide and is a harbinger of progressive loss of organ function resulting in organ failure. Recent findings suggest that understanding mechanisms of development and progression of fibrosis will lead to new therapies urgently required to counteract loss of organ function. Recently, little-known cells that line the kidney microvasculature, known as pericytes, were identified as the precursor cells which become the scar-forming myofibroblasts. Kidney pericytes are extensively branched cells located in the wall of capillaries, embedded within the microvascular basement membrane, and incompletely envelope endothelial cells with which they establish focal contacts. In response to kidney injuries, pericytes detach from endothelial cells and migrate into the interstitial space where they undergo a transition into myofibroblasts. Detachment leads to fibrosis but also leaves an unstable endothelium, prone to rarefaction. Endothelial-pericyte crosstalk at the vascular endothelial growth factor receptors and platelet derived growth factor receptors in response to injury have been identified as major new targets for therapeutic intervention. PMID:22551886

  9. Botulinum Toxin A for Bladder Pain Syndrome/Interstitial Cystitis

    PubMed Central

    Chiu, Bin; Tai, Huai-Ching; Chung, Shiu-Dong; Birder, Lori A.

    2016-01-01

    Botulinum neurotoxin A (BoNT-A), derived from Clostridium botulinum, has been used clinically for several diseases or syndrome including chronic migraine, spasticity, focal dystonia and other neuropathic pain. Chronic pelvic or bladder pain is the one of the core symptoms of bladder pain syndrome/interstitial cystitis (BPS/IC). However, in the field of urology, chronic bladder or pelvic pain is often difficult to eradicate by oral medications or bladder instillation therapy. We are looking for new treatment modality to improve bladder pain or associated urinary symptoms such as frequency and urgency for patients with BPS/IC. Recent studies investigating the mechanism of the antinociceptive effects of BoNT A suggest that it can inhibit the release of peripheral neurotransmitters and inflammatory mediators from sensory nerves. In this review, we will examine the evidence supporting the use of BoNTs in bladder pain from basic science models and review the clinical studies on therapeutic applications of BoNT for BPS/IC. PMID:27376330

  10. Recent Treatment of Interstitial Lung Disease with Idiopathic Inflammatory Myopathies

    PubMed Central

    Kawasumi, Hidenaga; Gono, Takahisa; Kawaguchi, Yasushi; Yamanaka, Hisashi

    2015-01-01

    Interstitial lung disease (ILD) is a prognostic factor for poor outcome in polymyositis (PM)/dermatomyositis (DM). The appropriate management of ILD is very important to improve the prognosis of patients with PM/DM. ILD activity and severity depend on the disease subtype. Therefore, clinicians should determine therapeutic strategies according to the disease subtype in each patient with PM/DM. Anti–melanoma differentiation-associated gene 5 antibody and hyperferritinemia predict the development and severity of rapidly progressive (RP) ILD, particularly in East Asian patients. Combination therapy with corticosteroids, intravenous cyclophosphamide pulse, and calcineurin inhibitors should be administered in RP-ILD. In contrast, patients with anti–aminoacyl-tRNA synthetase (ARS) show better responses to corticosteroids alone. However, ILDs with anti-ARS often display disease recurrence or become refractory to corticosteroid monotherapy. Recent studies have demonstrated that the administration of tacrolimus or rituximab in addition to corticosteroids may be considered in ILD patients with anti-ARS. Large-scale, multicenter randomized clinical trials should be conducted in the future to confirm that the aforementioned agents exhibit efficacy in ILD patients with PM/DM. The pathophysiology of ILD with PM/DM should also be elucidated in greater detail to develop effective therapeutic strategies for patients with ILD in PM/DM. PMID:26279636

  11. Interstitial Solutes and Deformation in Nb and Nb Single Crystals

    SciTech Connect

    R. E. Ricker; D. J. Pitchure; and G. R. Myneni

    2006-10-30

    Experiments were conducted on high purity single and polycrystalline niobium to determine the influence of low concentrations of interstitial impurities on mechanical properties and to evaluate the feasibility of using measurements of mechanical properties to detect, identify, and quantify the diffusible interstitial content.

  12. Cold Work Embrittlement of Interstitial-Free Steels

    SciTech Connect

    2005-09-01

    Interstitial-free (IF) steels are defined by their low amounts of solute interstitial elements, such as carbon and nitrogen. During secondary forming, strain can be localized at the grain boundaries of these steels, resulting in secondary cold work embrittlement (CWE).

  13. Free-floating collagen fibers in interstitial mycosis fungoides.

    PubMed

    Ferrara, Gerardo; Crisman, Giuliana; Zalaudek, Iris; Argenziano, Giuseppe; Stefanato, Catherine M

    2010-06-01

    We present a case of interstitial mycosis fungoides showing pseudodovascular clefts with "free-floating" collagen fibers surrounded by neoplastic T lymphocytes. Such a finding further expands the histopathologic spectrum of mycosis fungoides and could be taken into account in its differential diagnosis from granuloma annulare, inflammatory morphea, and interstitial granulomatous drug reaction. PMID:20145533

  14. Mesalizine-Induced Acute Pancreatitis and Interstitial Pneumonitis in a Patient with Ulcerative Colitis

    PubMed Central

    Chung, Min Jae; Lee, Jae Hee

    2015-01-01

    Ulcerative colitis (UC) is a chronic idiopathic inflammatory bowel disease. Mesalizine for the first-line therapy of UC has adverse effects include pancreatitis, pneumonia and pericarditis. UC complicated by two coexisting conditions, however, is very rare. Moreover, drug-related pulmonary toxicity is particularly rare. An 11-year-old male patient was hospitalized for recurring upper abdominal pain after meals with vomiting, hematochezia and exertional dyspnea developing at 2 weeks of mesalizine therapy for UC. The serum level of lipase was elevated. Chest X-ray and thorax computed tomography showed interstitial pneumonitis. Mesalizine was discontinued and steroid therapy was initiated. Five days after admission, symptoms were resolved and mesalizine was resumed after a drop in amylase and lipase level. Symptoms returned the following day, however, accompanied by increased the serum levels of amylase and lipase. Mesalizine was discontinued again and recurring symptoms rapidly improved. PMID:26770905

  15. Radiobiological advantages of an immediate interstitial boost dose in conservative treatment of breast cancer

    SciTech Connect

    Krishnan, E.C.; Krishnan, L.; Cytaki, E.P.; Woolf, C.D.; Henry, M.M.; Lin, F.; Jewell, W.R. )

    1990-02-01

    Minimum surgery with irradiation is emerging as one of the main modalities of therapy for operable early breast cancer. Between June 1982 and June 1986, 110 breasts with Tis, T1 to T3 lesions have been treated at our institution with lumpectomy and interstitial irradiation to the tumor bed with Iridium-192 perioperatively followed by external beam irradiation. There have been two local recurrences at or near the vicinity of the primary, at a median follow-up of 60 months. To analyze the parameters that might have contributed to the local control, we have examined the treatment volumes, prescribed dose to the tumor bed, dose at the core of the tumor bed, and dose to the surrounding normal tissue. Immediate interstitial implant has the radiobiological advantage of delivering continuous low dose irradiation, immediately upon removal of gross tumor to residual foci. Implantation of the afterloading catheters intraoperatively facilitates accurate dose delivery and avoidance of geographical misses. By precise treatment of any residual foci, immediately upon removal of the gross mass, perioperative interstitial irradiation improves local control and by facilitating less radical surgical excision, leads to better cosmetic results.

  16. The interstitial granulomatous drug reaction: a distinctive clinical and pathological entity.

    PubMed

    Magro, C M; Crowson, A N; Schapiro, B L

    1998-02-01

    We present 20 patients in whom drug therapy was associated with interstitial histiocytic infiltrates with variable degeneration of collagen and elastic fibers mimicking early lesions of granuloma annulare (GA). Most patients had a reproducible clinical presentation comprising erythematous-to-violaceous, nonpruritic plaques, often with an annular pattern, predominantly involving inner aspects of the arms, medial thighs and intertriginous areas. The most frequent clinical differential diagnoses included cutaneous T cell lymphoma, erythema annulare centrifigum (EAC), GA, and lupus erythematosus. A drug reaction was suspected in only 3 cases. The implicated drug classes included calcium channel blockers, angiotensin converting enzyme inhibitors, beta-blockers, lipid-lowering agents, antihistamines, anticonvulsants and antidepressants. Patients were often on two or more of these drugs; all have been associated with pseudolymphomatous infiltrates of the skin, the presumptive basis of which is iatrogenic pertubation of immune function. The defining histomorphology was diffuse infiltration of the interstitium by lymphocytes and histiocytes with piecemeal fragmentation of collagen and elastic fibers in concert with a vacuolar interface dermatitis. Ten cases showed intermediate and transformed lymphocytes with hyperchromatic convoluted nuclei disposed interstitially within the dermis or along the dermoepiderma junction with variable epidermotropism. In the 15 patients who discontinued the implicated drug, lesional resolution occurred. We propose the designations interstitial granulomatous drug reaction for this novel cutaneous reaction pattern. PMID:9521495

  17. An oral fluoropyrimidine agent S-1 induced interstitial lung disease: A case report

    PubMed Central

    Yamane, Hiromichi; Kinugawa, Masahide; Umemura, Shigeki; Shiote, Yasuhiro; Kudo, Kenichiro; Suwaki, Toshimitsu; Kamei, Haruhito; Takigawa, Nagio; Kiura, Katsuyuki

    2011-01-01

    A 66-year-old Japanese man with pancreatic cancer received eleven courses of gemcitabine monotherapy. The tumor responded to gemcitabine until metastatic liver tumors progressed. Subsequently, he was treated with S-1, an oral fluoropyrimidine anticancer agent, as salvage chemotherapy. Forty-two days after initiating S-1, he presented with dyspnea and fever. Chest computed tomography showed diffuse interstitial lesions with thickening of the alveolar septa and ground glass opacity. Serum KL-6 level was elevated to 1,230 U/mL and he did not use any other drugs except insulin. Thus, the development of interstitial lung disease (ILD) was considered to be due to S-1. Arterial blood oxygen pressure was 49.6 Torr in spite of oxygen administration (5 L/min). Steroid therapy improved his symptoms and the interstitial shadows on chest radiograph. Although S-1-induced ILD has mostly been reported to be mild, clinicians should be aware that S-1 has the potential to cause fatal ILD. PMID:21773080

  18. Smoking-related idiopathic interstitial pneumonia: A review.

    PubMed

    Margaritopoulos, George A; Harari, Sergio; Caminati, Antonella; Antoniou, Katerina M

    2016-01-01

    For many years, cigarette smoking has been considered as the leading cause of chronic obstructive pulmonary disease and lung cancer. Recently, however, it has also been associated with the development of diffuse interstitial lung diseases. In the latest classification of the major idiopathic interstitial pneumonias (IIP), the term smoking-related IIP has been introduced, including two entities, namely desquamative interstitial pneumonia (DIP) and respiratory bronchiolitis-interstitial lung disease (RB-ILD). Other entities in which smoking has a definite or suggested role include pulmonary Langerhan's cell histiocytosis, smoking-related interstitial fibrosis, combined pulmonary fibrosis and emphysema syndrome and idiopathic pulmonary fibrosis. In this review, we will focus on the mechanisms of smoking-related lung damage and on the clinical aspects of these disorders with the exception of idiopathic pulmonary fibrosis, which will be reviewed elsewhere in this review series. PMID:26138798

  19. Interstitial laser coagulation of the prostate: experimental studies

    NASA Astrophysics Data System (ADS)

    McNicholas, Thomas A.; Steger, Adrian C.; Bown, Stephen G.; O'Donoghue, Neil

    1991-07-01

    A percutaneous, low power, interstitial method of controlled tissue coagulation by laser light has been developed and assessed as a possible alternative to existing therapy for benign and malignant prostatic disease. For prostate cancer this technique may be of importance when the tumor volume is small and well defined, particularly as these tumors can increasingly be identified by transrectal ultrasound (TRUS) and are unlikely to have metastasised. The possibility therefore arises of destruction of such small lesions in situ, thereby avoiding the need for radical surgery or radiotherapy. Using the male beagle prostate model, one or more 150-400 micron fibers was implanted within the substance of the prostate through which a Yttrium Aluminum Garnet (YAG) laser energy could be transmitted. Using long exposures and lower powers than used in routine endoscopic laser therapy, well-defined areas of coagulative necrosis could be created without extensive tissue charring or damage to the fiber. For an energy dose of 1000J a lesion approximately 1 cm in diameter results at four days. The ultrasound scanning methods can detect the fiber(s) and the area(s) of coagulation. At 6/52 months following treatment, healing was by fibrosis or cystic degeneration. There were no ill effects on the subjects following coagulation of the prostate. Multiple fiber experiments produced larger volume lesions relevant to more extensive cancer or for the coagulation of benign adenomatous hyperplasia causing outflow symptoms. Ultrasound guided clinical treatments in patients with cutaneous metastases or hepatic and pancreatic tumors have confirmed the experimental results so far obtained. The technique may prove of value for the destruction of early, small, focal tumors of the prostate and for the treatment of moderate benign enlargement. Clinical trial for both benign and malignant disease has commenced.

  20. Normalization of lung function following treatment of secondary usual interstitial pneumonia: a case report.

    PubMed

    Hohberger, Laurie A; Montero-Arias, Felicia; Roden, Anja C; Vassallo, Robert

    2015-01-01

    Usual interstitial pneumonia (UIP) is the most common idiopathic interstitial pneumonia (IIP) and is associated with a poor prognosis and poor responsiveness to immunosuppressive therapy. We present a case of a woman with steroid-responsive biopsy-proven UIP with significant and sustained improvement in pulmonary function. A female in her 40s presented following a one-year history of progressive dyspnea, a 20 lb weight loss, and fatigue. Imaging of the chest with computed tomography (CT) showed bibasilar subpleural reticular opacities and minimal peripheral honeycombing. Comprehensive connective tissue disease (CTD) antibody testing was negative. Pulmonary function testing showed moderate impairment with reduction in forced vital capacity (FVC, 69% predicted), forced expiratory volume in one second (FEV1 73% predicted), and diffusing capacity for carbon monoxide (DLCO, 52% predicted). Surgical lung biopsy showed UIP with prominent inflammatory infiltrates. Following treatment with prednisone and azathioprine, the patient's symptoms resolved, while objective pulmonary function testing showed normalization of lung function, which is sustained at >4 years of follow-up. Improvement in lung function following immunosuppressive therapy is distinctly uncommon in either idiopathic or secondary UIP. This report suggests that occasionally, patients with secondary UIP occurring in the context of otherwise undefinable autoimmune clinical syndromes may be responsive to immunosuppressive therapy. PMID:25922588

  1. Carboplatin plus paclitaxel in combination with bevacizumab for the treatment of adenocarcinoma with interstitial lung diseases

    PubMed Central

    SUZUKI, HIDEKAZU; HIRASHIMA, TOMONORI; KOBAYASHI, MASASHI; OKAMOTO, NORIO; MATSUURA, YUKA; TAMIYA, MOTOHIRO; MORISHITA, NAOKO; OKAFUJI, KOHEI; SHIROYAMA, TAKAYUKI; MORIMURA, OSAMU; MORITA, SATOMU; KAWASE, ICHIRO

    2013-01-01

    Interstitial lung diseases (ILDs) are frequently associated with lung cancer. The safety of carboplatin plus paclitaxel in combination with bevacizumab (CP-B) in patients with ILD and lung cancer (ILD-LC) remains to be clarified. In the present study, the safety and efficacy of CP-B treatment in ILD-LC patients were retrospectively investigated. Four patients, who completed CP-B therapy, were included in this study. The dose of carboplatin was the area under the curve 5, paclitaxel was 200 mg/m2 and bevacizumab was 15 mg/kg at treatment initiation. The patients were males, had histologically confirmed adenocarcinoma, were smokers and demonstrated non-usual interstitial pneumonia (non-UIP) patterns on computed tomography (CT). Patients received 1–6 cycles of CP-B therapy. Three of the four patients received maintenance bevacizumab therapy for 3–10 cycles. Only one patient demonstrated a partial response. Neutropenia was the most frequent adverse event. One patient experienced gut perforation during the first course of CP-B. No pulmonary toxicity was observed. Thus, treatment of ILD-LC patients with CP-B was not associated with pulmonary toxicity, however, this study population appeared to be at a low risk. PMID:24649195

  2. Benefit of adjunctive tacrolimus in connective tissue disease-interstitial lung disease.

    PubMed

    Witt, Leah J; Demchuk, Carley; Curran, James J; Strek, Mary E

    2016-02-01

    We evaluated the safety and effectiveness of adjunctive tacrolimus therapy with conventional immunosuppression in patients with severe connective tissue disease-related interstitial lung disease (CTD-ILD). We included patients from our interstitial lung disease (ILD) registry with CTD-ILD, in whom tacrolimus was added to corticosteroids and an additional immunosuppressive agent. Demographic data, clinical features, lung function, radiographic images, and pathologic findings were reviewed. Effectiveness was assessed by comparing pulmonary function tests (PFTs) closest to tacrolimus initiation to PFTs approximately 6-12 months later. Corticosteroid dose at these time points was also evaluated. We report adverse events attributed to tacrolimus. Seventeen patients with CTD-ILD were included in adverse event analysis; twelve were included in efficacy analysis. Length of tacrolimus therapy ranged from 6 to 110 months (mean 38.8 months ± 31.4). The mean improvement in percent predicted total lung capacity was 7.5% ± 11.7 (p = 0.02). Forced vital capacity mean improvement was 7.4% ± 12.5 (p = 0.06). The average decrease in corticosteroid dose at follow-up was 20.3 mg ± 25.2 (p = 0.02) with complete discontinuation in six patients. No patients experienced a life-threatening adverse event attributed to tacrolimus. Tacrolimus can be effective and is well tolerated as an adjunctive therapy and allows tapering of corticosteroids. PMID:26762710

  3. Normalization of Lung Function Following Treatment of Secondary Usual Interstitial Pneumonia: A Case Report

    PubMed Central

    Hohberger, Laurie A; Montero-Arias, Felicia; Roden, Anja C; Vassallo, Robert

    2015-01-01

    Usual interstitial pneumonia (UIP) is the most common idiopathic interstitial pneumonia (IIP) and is associated with a poor prognosis and poor responsiveness to immunosuppressive therapy. We present a case of a woman with steroid-responsive biopsy-proven UIP with significant and sustained improvement in pulmonary function. A female in her 40s presented following a one-year history of progressive dyspnea, a 20 lb weight loss, and fatigue. Imaging of the chest with computed tomography (CT) showed bibasilar subpleural reticular opacities and minimal peripheral honeycombing. Comprehensive connective tissue disease (CTD) antibody testing was negative. Pulmonary function testing showed moderate impairment with reduction in forced vital capacity (FVC, 69% predicted), forced expiratory volume in one second (FEV1 73% predicted), and diffusing capacity for carbon monoxide (DLCO, 52% predicted). Surgical lung biopsy showed UIP with prominent inflammatory infiltrates. Following treatment with prednisone and azathioprine, the patient’s symptoms resolved, while objective pulmonary function testing showed normalization of lung function, which is sustained at >4 years of follow-up. Improvement in lung function following immunosuppressive therapy is distinctly uncommon in either idiopathic or secondary UIP. This report suggests that occasionally, patients with secondary UIP occurring in the context of otherwise undefinable autoimmune clinical syndromes may be responsive to immunosuppressive therapy. PMID:25922588

  4. Multi-functional magnesium alloys containing interstitial oxygen atoms

    NASA Astrophysics Data System (ADS)

    Kang, H.; Choi, H. J.; Kang, S. W.; Shin, S. E.; Choi, G. S.; Bae, D. H.

    2016-03-01

    A new class of magnesium alloys has been developed by dissolving large amounts of oxygen atoms into a magnesium lattice (Mg-O alloys). The oxygen atoms are supplied by decomposing titanium dioxide nanoparticles in a magnesium melt at 720 °C the titanium is then completely separated out from the magnesium melt after solidification. The dissolved oxygen atoms are located at the octahedral sites of magnesium, which expand the magnesium lattice. These alloys possess ionic and metallic bonding characteristics, providing outstanding mechanical and functional properties. A Mg-O-Al casting alloy made in this fashion shows superior mechanical performance, chemical resistance to corrosion, and thermal conductivity. Furthermore, a similar Mg-O-Zn wrought alloy shows high elongation to failure (>50%) at room temperature, because the alloy plastically deforms with only multiple slips in the sub-micrometer grains (<300 nm) surrounding the larger grains (~15 μm). The metal/non-metal interstitial alloys are expected to open a new paradigm in commercial alloy design.

  5. Multi-functional magnesium alloys containing interstitial oxygen atoms.

    PubMed

    Kang, H; Choi, H J; Kang, S W; Shin, S E; Choi, G S; Bae, D H

    2016-01-01

    A new class of magnesium alloys has been developed by dissolving large amounts of oxygen atoms into a magnesium lattice (Mg-O alloys). The oxygen atoms are supplied by decomposing titanium dioxide nanoparticles in a magnesium melt at 720 °C; the titanium is then completely separated out from the magnesium melt after solidification. The dissolved oxygen atoms are located at the octahedral sites of magnesium, which expand the magnesium lattice. These alloys possess ionic and metallic bonding characteristics, providing outstanding mechanical and functional properties. A Mg-O-Al casting alloy made in this fashion shows superior mechanical performance, chemical resistance to corrosion, and thermal conductivity. Furthermore, a similar Mg-O-Zn wrought alloy shows high elongation to failure (>50%) at room temperature, because the alloy plastically deforms with only multiple slips in the sub-micrometer grains (<300 nm) surrounding the larger grains (~15 μm). The metal/non-metal interstitial alloys are expected to open a new paradigm in commercial alloy design. PMID:26976372

  6. Multi-functional magnesium alloys containing interstitial oxygen atoms

    PubMed Central

    Kang, H.; Choi, H. J.; Kang, S. W.; Shin, S. E.; Choi, G. S.; Bae, D. H.

    2016-01-01

    A new class of magnesium alloys has been developed by dissolving large amounts of oxygen atoms into a magnesium lattice (Mg-O alloys). The oxygen atoms are supplied by decomposing titanium dioxide nanoparticles in a magnesium melt at 720 °C; the titanium is then completely separated out from the magnesium melt after solidification. The dissolved oxygen atoms are located at the octahedral sites of magnesium, which expand the magnesium lattice. These alloys possess ionic and metallic bonding characteristics, providing outstanding mechanical and functional properties. A Mg-O-Al casting alloy made in this fashion shows superior mechanical performance, chemical resistance to corrosion, and thermal conductivity. Furthermore, a similar Mg-O-Zn wrought alloy shows high elongation to failure (>50%) at room temperature, because the alloy plastically deforms with only multiple slips in the sub-micrometer grains (<300 nm) surrounding the larger grains (~15 μm). The metal/non-metal interstitial alloys are expected to open a new paradigm in commercial alloy design. PMID:26976372

  7. Low-power interstitial laser photocoagulation for breast cancer

    NASA Astrophysics Data System (ADS)

    Harries, Simon A.; Amin, Zahir; Lees, William R.; Cooke, J.; Smith, Mark; Cook, Martin; Scurr, John H.; Kissin, Mark W.; Bown, Stephen G.

    1994-02-01

    Interstitial laser photocoagulation (ILP) is a new minimally invasive technique which can produce localized necrosis in the center of solid organs. Breast cancer can now be treated safely in selected patients by lumpectomy followed by radiotherapy. Taking the concept of conservative treatment a step further would it be possible to destroy breast cancers in situ leaving the area to heal by resorption and fibrosis? Thirty seven patients with early breast cancer scheduled for surgery underwent ILP in the interval between diagnosis and surgery. The technique was performed under local anaesthesia, and ultrasound (US) used to place an optical fiber into the tumor. Treatment was curtailed in 4 patients because of pain. Thermal necrosis varied from 2 - 25 mm as measured microscopically but in 4 patients no necrosis was evident. No complications arose as a result of treatment. When charring was present in the excised tumor a larger diameter of necrosis was evident than when charring was absent (mean 15 mm vs 5 mm) and a study in 10 patients using a pre-charred fiber produced a more predictable and larger diameter of necrosis (mean 17 mm). Ultrasound did not accurately predict the extent of laser induced necrosis (although it was better at predicting tumor size).

  8. Balance point characterization of interstitial fluid volume regulation.

    PubMed

    Dongaonkar, R M; Laine, G A; Stewart, R H; Quick, C M

    2009-07-01

    The individual processes involved in interstitial fluid volume and protein regulation (microvascular filtration, lymphatic return, and interstitial storage) are relatively simple, yet their interaction is exceedingly complex. There is a notable lack of a first-order, algebraic formula that relates interstitial fluid pressure and protein to critical parameters commonly used to characterize the movement of interstitial fluid and protein. Therefore, the purpose of the present study is to develop a simple, transparent, and general algebraic approach that predicts interstitial fluid pressure (P(i)) and protein concentrations (C(i)) that takes into consideration all three processes. Eight standard equations characterizing fluid and protein flux were solved simultaneously to yield algebraic equations for P(i) and C(i) as functions of parameters characterizing microvascular, interstitial, and lymphatic function. Equilibrium values of P(i) and C(i) arise as balance points from the graphical intersection of transmicrovascular and lymph flows (analogous to Guyton's classical cardiac output-venous return curves). This approach goes beyond describing interstitial fluid balance in terms of conservation of mass by introducing the concept of inflow and outflow resistances. Algebraic solutions demonstrate that P(i) and C(i) result from a ratio of the microvascular filtration coefficient (1/inflow resistance) and effective lymphatic resistance (outflow resistance), and P(i) is unaffected by interstitial compliance. These simple algebraic solutions predict P(i) and C(i) that are consistent with reported measurements. The present work therefore presents a simple, transparent, and general balance point characterization of interstitial fluid balance resulting from the interaction of microvascular, interstitial, and lymphatic function. PMID:19420292

  9. Er,Cr:YSGG laser therapy for oral leukoplakia minimizes thermal artifacts on surgical margins: a pilot study.

    PubMed

    Seoane, J; González-Mosquera, A; López-Niño, J; García-Caballero, L; Aliste, C; Seoane-Romero, J M; Varela-Centelles, P

    2013-11-01

    Laser use for biopsy of suspicious lesions may simulate cytological atypia at the margin of the incisions, challenging pathological diagnosis. Erbium, chromium: yttrium-scandium-gallium-garnet (Er,Cr:YSGG) laser has shown promising results in experimental models by inducing fewer artifacts. The aims of this study were to examine the thermal wounds induced by Er,Cr:YSGG laser in a short series of oral leukoplakias in terms of cytological and epithelial architectural changes and also to assess the width of the thermal damage lateral to the incision. Four oral leukoplakia patients entered the study and underwent complete surgical excision of their lesions by using Er,Cr:YSGG laser. Patients were weekly controlled until complete healing was accomplished. The patients were included on the existing follow-up program for these lesions thereafter. Study samples were routinely processed by the same technician and double-blindedly studied by two pathologists until a consensus was reached for each case. The pathological analysis of the samples revealed no autolysis and no fixation- or handling-related artifacts. However, cellular and nuclear polymorphism could be observed in two samples. Loss of intercellular adherence was the most frequent thermal artifact in this series; all pseudodysplastic artifacts recognized in the study were of low intensity and located at the basal and suprabasal layers of the leukoplakias' epithelium. The width of the thermal damage at the edge of the incision scored an average of 26.60 ± 25.3 μm. It is concluded that irradiation with Er,Cr:YSGG laser induces a minimal amount of thermal artifacts at the surgical margins of oral leukoplakias and avoids diagnostic interferences with real dysplastic borders. PMID:23324955

  10. Effect of photon energy in collagen generation by interstitial low level laser stimulation

    NASA Astrophysics Data System (ADS)

    Jun, Eunkwon; Ha, Myungjin; Lee, Sangyeob; Radfar, Edalat; Park, Jihoon; Jung, Byungjo

    2015-03-01

    Although the mechanism of low level laser therapy (LLLT) is unclear, many studies demonstrated the positive clinical performance of LLLT for skin rejuvenation. An increase in dermal collagen plays an important role in skin rejuvenation and wound healing. This study aimed to investigate collagen generation after interstitial low level laser stimulation (ILLS). Rabbits were divided into two groups: surfacing irradiation and minimally invasive irradiation. 660nm diode laser of 20mW with 10J, 13J and 15J was applied to the backside of rabbits. Collagen formation was evaluated with ultrasound skin scanner every 12 hours. Results shows that ILLS groups have denser collagen density than surfacing groups.

  11. Treatment of interstitial cystitis/painful bladder syndrome as a neuropathic pain condition

    PubMed Central

    Vas, Lakshmi; Pattanik, Manorama; Titarmore, Vaishali

    2014-01-01

    A lady of 52 years with painful bladder syndrome/interstitial cystitis (PBS/IC) presented with chronic pelvic pain, irritative voiding with sphincter dominance on urodynamics. 3 yrs of oral analgesics, antispasmodics and intravesical therapy was ineffective. We surmised her pain, and irritative voiding to be secondary to constant straining against a dysfunctional pelvic floor. We treated PBS/IC as a neuropathic phenomenon with a combination of neuromodulator medications and continuous caudal epidural analgesia to reduce the pain induced peripheral and central sensitisation. Botulinum toxin type A injection into pelvic floor muscles appeared to address their dysfuction. Clinical and urodynamics response was encouraging. PMID:25097327

  12. Unclassifiable interstitial lung disease: A review.

    PubMed

    Skolnik, Kate; Ryerson, Christopher J

    2016-01-01

    Accurate classification of interstitial lung disease (ILD) requires a multidisciplinary approach that incorporates input from an experienced respirologist, chest radiologist and lung pathologist. Despite a thorough multidisciplinary evaluation, up to 15% of ILD patients have unclassifiable ILD and cannot be given a specific diagnosis. The objectives of this review are to discuss the definition and features of unclassifiable ILD, identify the barriers to ILD classification and outline an approach to management of unclassifiable ILD. Several recent studies have described the characteristics of these patients; however, there are inconsistencies in the definition and terminology of unclassifiable ILD due to limited research in this population. Additional studies are required to determine the appropriate evaluation and management of patients with unclassifiable ILD. PMID:26059704

  13. Pulmonary Vein Stenosis Mimicking Nonspecific Interstitial Pneumonia

    PubMed Central

    Linga, Karthika R.; Khoor, Andras; Phelan, Jonathan A.; Mira-Avendano, Isabel

    2015-01-01

    Pulmonary vein stenosis (PVS) is a known complication after catheter ablation of arrhythmias. Surprisingly, little information is available on its manifestations in the lung. We describe the case of a 39-year-old woman who presented from an outside hospital with worsening shortness of breath after catheter ablation of pulmonary veins for atrial fibrillation. After an initial diagnosis of pneumonia and its nonimprovement with antibiotics, a surgical lung biopsy was done and interpreted as nonspecific interstitial pneumonia (NSIP) with vascular changes consistent with pulmonary arterial hypertension. Later, she was admitted to our institution where a transthoracic echocardiogram (TTE) and subsequent computed tomography (CT) angiogram of the heart showed severe stenosis of all four pulmonary veins. The previous lung biopsy was rereviewed and reinterpreted as severe parenchymal congestion mimicking NSIP. Our case demonstrates that PVS is an underrecognized complication of catheter ablation, and increased awareness among both clinicians and pathologists is necessary to avoid misdiagnosis. PMID:26779359

  14. Engineering evaluation of alternatives: Technologies for monitoring interstitial liquids in single-shell tanks

    SciTech Connect

    Brevick, C.H.; Jenkins, C.E.

    1996-02-01

    A global search of mature, emerging, and conceptual tank liquid monitoring technologies, along with a historical review of Hanford tank farm waste monitoring instrumentation, was conducted to identify methods for gauging the quantity of interstitial waste liquids contained in Hanford SSTs. Upon completion of the search, an initial screening of alternatives was conducted to identify candidates which might be capable of monitoring interstitial tank liquids. The nine candidate technologies that were selected, evaluated, and ranked are summarized. Hydrostatic tank gauging (HTG) is the technology generally recommended for gauging the quantity of process materials contained in Hanford SSTs. HTG is a mass-based technique that has the capability for continuous remote monitoring. HTG has the advantages of no moving parts, intrinsic safety, and potentially gauging a one-million gal tank with a precision of approximately {+-}500 pounds (i.e., {+-}62 gal of water or {+-}0.02 in. of level in a 75 ft diameter tank). HTG is relatively inexpensive and probe design, construction, testing, installation, and operation should be straightforward. HTG should be configured as part of a hybrid tank gauging system. A hybrid system employs two or more independent measurement systems which function in concert to provide redundancy, improved accuracy, and maximum information at minimum cost. An excellent hybrid system choice for monitoring interstitial liquids in SSTs might be the combination of HTG with thermal differential technology.

  15. The multiple faces of leukocyte interstitial migration

    PubMed Central

    Lämmermann, Tim; Germain, Ronald N.

    2014-01-01

    Spatiotemporal control of leukocyte dynamics within tissues is critical for successful innate and adaptive immune responses. Homeostatic trafficking and coordinated infiltration into and within sites of inflammation and infection rely on signaling in response to extracellular cues that in turn controls a variety of intracellular protein networks regulating leukocyte motility, migration, chemotaxis, positioning, and cell–cell interaction. In contrast to mesenchymal cells, leukocytes migrate in an amoeboid fashion by rapid cycles of actin polymerization and actomyosin contraction, and their migration in tissues is generally referred to as low adhesive and nonproteolytic. The interplay of actin network expansion, contraction, and adhesion shapes the exact mode of amoeboid migration, and in this review, we explore how leukocyte subsets potentially harness the same basic biomechanical mechanisms in a cell-type-specific manner. Most of our detailed understanding of these processes derives from in vitro migration studies in three-dimensional gels and confined spaces that mimic geometrical aspects of physiological tissues. We summarize these in vitro results and then critically compare them to data from intravital imaging of leukocyte interstitial migration in mouse tissues. We outline the technical challenges of obtaining conclusive mechanistic results from intravital studies, discuss leukocyte migration strategies in vivo, and present examples of mode switching during physiological interstitial migration. These findings are also placed in the context of leukocyte migration defects in primary immunodeficiencies. This overview of both in vitro and in vivo studies highlights recent progress in understanding the molecular and biophysical mechanisms that shape robust leukocyte migration responses in physiologically complex and heterogeneous environments. PMID:24573488

  16. [Interstitial laser coagulation of benign prostatic hyperplasia].

    PubMed

    Muschter, R; Hessel, S; Hofstetter, A; Keiditsch, E; Rothenberger, K H; Schneede, P; Frank, F

    1993-07-01

    We report on the new method of interstitial laser coagulation for the treatment of benign prostatic hyperplasia (BPH). The procedure is based on the interstitial application of Nd:YAG laser irradiation, delivered through a new light guide system. Such light applicators coagulate constant tissue volumes in a homogeneous manner, as proven by in vitro studies in different tissues, including surgically removed prostate adenoma. The extent of the coagulation is determined by laser power and irradiation time. At 5 W, for example, and during a 10-min period, this zone reached a diameter of up to 20 mm. Temperatures generated in the process were over 100 degrees C, as measured by time/space resolution. These results were confirmed by in vivo studies in canine prostates. In the course of 7 weeks, the coagulated areas formed scars with degeneration and fibrosis, accompanied by marked shrinking. Neighbouring organs were not affected. The method was successfully transferred to clinical practice. The application of the light guides to the lateral lobes was performed percutaneously from the perineum under transrectal ultrasound guidance. The median lobe was punctured transurethrally under direct vision. Twenty-seven patients with an average age of 67.7 years were treated between July 1991 and March 1992. At the time of evaluation 15 patients had a follow-up of more than 2 months. They experienced a mean increase of peak flow rate from 6.6 to 15.2 ml/s and a mean decrease of residual volume from 206 to 38 ml. This was accompanied by a marked lessening of symptoms. The average prostate weight decreased from 63 to 44 g. Sexually active patients did not experience retrograde ejaculation.(ABSTRACT TRUNCATED AT 250 WORDS) PMID:7690498

  17. Comparative studies on extraction of sediment interstitial waters: Discussion and comment on the current state of interstitial water studies

    USGS Publications Warehouse

    Manheim, F. T.

    1974-01-01

    The implication by Murthy and Ferrell (1972)that interstitial water studies are in a confused state is criticized on the basis that the authors have not drawn on a considerable body of data, especially Soviet studies since the 1950's, and results of the Deep Sea Drilling Project. Pressure filtration systems for extracting interstitial waters are currently the methods of choice for marine studies and have achieved substantial reliability and reproducibility. Although gaps and problems remain, many aspects of interstitial composition of marine sediments have been clarified; these include the substantial constancy of composition of interstitial waters in deep sea pelagic deposits, depletion of interstitial cations owing to authigenic mineral formation in more rapidly accumulated (especially terrigenous) sediments, and special phenomena in sediments overlying salt deposits. ?? 1974.

  18. Plasmonic fluorescent CdSe/Cu2S hybrid nanocrystals for multichannel imaging and cancer directed photo-thermal therapy.

    PubMed

    Sheikh Mohamed, M; Poulose, Aby Cheruvathoor; Veeranarayanan, Srivani; Romero Aburto, Rebecca; Mitcham, Trevor; Suzuki, Yuko; Sakamoto, Yasushi; Ajayan, Pulickel M; Bouchard, Richard R; Yoshida, Yasuhiko; Maekawa, Toru; Sakthi Kumar, D

    2016-04-14

    A simple, crude Jatropha curcas (JC) oil-based synthesis approach, devoid of any toxic phosphine and pyrophoric ligands, to produce size and shape tuned CdSe QDs and a further copper sulfide (Cu2S) encasing is presented. The QDs exhibited excellent photoluminescent properties with narrow band gap emission. Furthermore, the Cu2S shell rendered additional cytocompatibility and stability to the hybrid nanomaterial, which are major factors for translational and clinical applications of QDs. The nanocomposites were PEGylated and folate conjugated to augment their cytoamiability and enhance their specificity towards cancer cells. The nanohybrids possess potentials for visible, near infrared (NIR), photoacoustic (PA) and computed tomography (μCT) imaging. The diverse functionality of the composite was derived from the multi-channel imaging abilities and thermal competence on NIR laser irradiation to specifically actuate the photo-thermal ablation of brain cancer cells. PMID:26584976

  19. Laser-induced interstitial thermotherapy of benign prostatic hyperplasia and prostate cancer

    NASA Astrophysics Data System (ADS)

    Muschter, Rolf

    1994-12-01

    Urinary outflow obstruction by prostatic enlargement is usually treated by resection or, recently, less invasively by thermal `ablation' of tissue through the urethra. With the latter technique, the amount of tissue that can be removed is limited by the limited penetration depth of suitable radiation sources, e.g. lasers, or conduction of heat. Interstitial thermotherapy was expected to overcome this problem. Our initial in vitro and animal studies with different light guides for interstitial application of Nd:YAG laser radiation showed small carbonized lesions with bare fibers, but large homogeneous coagulation zones with special `ITT' (interstitial thermotherapy) fibers. Further studies using these applicators resulted in a technique to be apt for clinical routine in the treatment of symptomatic prostatic enlargement. The tip of the light guide was repeatedly inserted into the prostate either transurethrally through a cystoscope under direct vision or percutaneously from the perineum under transrectal ultrasound guidance. The number of fiber placements depended on the size and configuration of the gland. Irradiation was performed either for 10 min with 5 or 7 W or in the advanced `turbo'- mode for 5 or 3 min per fiber placement using automatically stepwise reduced power (20 W for 30 s, 15 W for 30 s, 10 W for 30 s, and 7 W for 210 or 90 s). By optical feedback control the laser was switched off automatically in the case of carbonization to avoid fiber damage. From July 15, 1991 to October 1, 1993 239 patients with BPH and 14 patients with advanced prostate cancer, suffering from severe urinary outflow obstruction, were treated by laser induced interstitial thermotherapy. The results and complications of treatment are reported.

  20. Interstitial ultrasound ablation of vertebral and paraspinal tumours: Parametric and patient-specific simulations

    PubMed Central

    Scott, Serena J.; Salgaonkar, Vasant; Prakash, Punit; Burdette, E. Clif; Diederich, Chris J.

    2015-01-01

    Purpose Theoretical parametric and patient-specific models are applied to assess the feasibility of interstitial ultrasound ablation of tumours in and near the spine and to identify potential treatment delivery strategies. Methods 3D patient-specific finite element models (n=11) of interstitial ultrasound ablation of tumours associated with spine were generated. Gaseous nerve insulation and various applicator configurations, frequencies (3 and 7 MHz), placement trajectories, and tumour locations were simulated. Parametric studies with multilayered models investigated the impacts of tumour attenuation, tumour dimension, and the thickness of bone insulating critical structures. Temperature and thermal dose were calculated to define ablation (>240 equivalent minutes at 43°C (EM43°C)) and safety margins (<45°C & <6 EM43°C), and to determine performance and required delivery parameters. Results Osteolytic tumours (≤44 mm) encapsulated by bone could be successfully ablated with 7 MHz interstitial ultrasound (8.1-16.6 W/cm2, 120-5900 J, 0.4-15 min). Ablation of tumours (94.6-100% volumetric) 0-14.5 mm from the spinal canal was achieved within 3-15 min without damaging critical nerves. 3 MHz devices provided faster ablation (390 versus 930 s) of an 18 mm diameter osteoblastic (high bone content) volume than 7 MHz devices. Critical anatomy in proximity to the tumour could be protected by selection of appropriate applicator configurations, active sectors, and applied power schemas, and through gaseous insulation. Preferential ultrasound absorption at bone surfaces facilitated faster, more effective ablations in osteolytic tumours and provided isolation of ablative energies and temperatures. Conclusions Parametric and patient-specific studies demonstrated the feasibility and potential advantages of interstitial ultrasound ablation treatment of paraspinal and osteolytic vertebral tumours. PMID:25017322

  1. Modulation of the interstitial fluid pressure by high intensity focused ultrasound as a way to alter local fluid and solute movement: insights from a mathematical model.

    PubMed

    Sassaroli, E; O'Neill, B E

    2014-11-21

    High intensity focused ultrasound (HIFU) operated in thermal mode has been reported to reduce interstitial fluid pressure and improve the penetration of large macromolecules and nanoparticles in tumor and normal tissue. Little is understood about how the interstitial fluid pressure and velocity as well as the interstitial macromolecule transport are affected by HIFU exposure. A mathematical model is presented here which sheds light on the initial biophysical changes brought about HIFU. Our continuum model treats tissue as an effective poro-elastic material that reacts to elevated temperatures with a rapid drop in interstitial elastic modulus. Using parameters from the literature, the model is extrapolated to derive information on the effect in tumors, and to predict its impact on the convective and diffusive transport of macromolecular drugs. The model is first solved using an analytical approximation with step-wise changes at each boundary, and then solved numerically starting from a Gaussian beam approximation of the ultrasound treatment. Our results indicate that HIFU causes a rapid drop in interstitial fluid pressure that may be exploited to facilitate convection of macromolecules from vasculature to the exposed region. However, following a short recovery period in which the interstitial fluid pressure is normalized, transport returns to normal and the advantages disappear over time. The results indicate that this effect is strongest for the delivery of large molecules and nanoparticles that are in the circulation at the time of treatment. The model may be easily applied to more complex situations involving effects on vascular permeability and diffusion. PMID:25327766

  2. Modulation of the interstitial fluid pressure by high intensity focused ultrasound as a way to alter local fluid and solute movement: insights from a mathematical model

    NASA Astrophysics Data System (ADS)

    Sassaroli, E.; O'Neill, B. E.

    2014-11-01

    High intensity focused ultrasound (HIFU) operated in thermal mode has been reported to reduce interstitial fluid pressure and improve the penetration of large macromolecules and nanoparticles in tumor and normal tissue. Little is understood about how the interstitial fluid pressure and velocity as well as the interstitial macromolecule transport are affected by HIFU exposure. A mathematical model is presented here which sheds light on the initial biophysical changes brought about HIFU. Our continuum model treats tissue as an effective poro-elastic material that reacts to elevated temperatures with a rapid drop in interstitial elastic modulus. Using parameters from the literature, the model is extrapolated to derive information on the effect in tumors, and to predict its impact on the convective and diffusive transport of macromolecular drugs. The model is first solved using an analytical approximation with step-wise changes at each boundary, and then solved numerically starting from a Gaussian beam approximation of the ultrasound treatment. Our results indicate that HIFU causes a rapid drop in interstitial fluid pressure that may be exploited to facilitate convection of macromolecules from vasculature to the exposed region. However, following a short recovery period in which the interstitial fluid pressure is normalized, transport returns to normal and the advantages disappear over time. The results indicate that this effect is strongest for the delivery of large molecules and nanoparticles that are in the circulation at the time of treatment. The model may be easily applied to more complex situations involving effects on vascular permeability and diffusion.

  3. Modulation of the interstitial fluid pressure by high intensity focused ultrasound as a way to alter local fluid and solute movement: insights from a mathematical model

    PubMed Central

    Sassaroli, E; O’Neill, B E

    2014-01-01

    High intensity focused ultrasound (HIFU) operated in thermal mode has been reported to reduce interstitial fluid pressure and improve the penetration of large macromolecules and nanoparticles in tumor and normal tissue. Little is understood about how the interstitial fluid pressure and velocity as well as the interstitial macromolecule transport are affected by HIFU exposure. A mathematical model is presented here which sheds light on the initial biophysical changes brought about HIFU. Our continuum model treats tissue as an effective poro-elastic material that reacts to elevated temperatures with a rapid drop in interstitial elastic modulus. Using parameters from the literature, the model is extrapolated to derive information on the effect in tumors, and to predict its impact on the convective and diffusive transport of macromolecular drugs. The model is first solved using an analytical approximation with step-wise changes at each boundary, and then solved numerically starting from a Gaussian beam approximation of the ultrasound treatment. Our results indicate that HIFU causes rapid drop in interstitial fluid pressure that may be exploited to facilitate convection of macromolecules from vasculature to the exposed region. However, following a short recovery period in which the interstitial fluid pressure is normalized, transport returns to normal and the advantages disappear over time. The results indicate that this effect is strongest for the delivery of large molecules and nanoparticles that are in the circulation at the time of treatment. The model may be easily applied to more complex situations involving effects on vascular permeability and diffusion. PMID:25327766

  4. Plasmonic fluorescent CdSe/Cu2S hybrid nanocrystals for multichannel imaging and cancer directed photo-thermal therapy

    NASA Astrophysics Data System (ADS)

    Sheikh Mohamed, M.; Poulose, Aby Cheruvathoor; Veeranarayanan, Srivani; Romero Aburto, Rebecca; Mitcham, Trevor; Suzuki, Yuko; Sakamoto, Yasushi; Ajayan, Pulickel M.; Bouchard, Richard R.; Yoshida, Yasuhiko; Maekawa, Toru; Sakthi Kumar, D.

    2016-04-01

    A simple, crude Jatropha curcas (JC) oil-based synthesis approach, devoid of any toxic phosphine and pyrophoric ligands, to produce size and shape tuned CdSe QDs and a further copper sulfide (Cu2S) encasing is presented. The QDs exhibited excellent photoluminescent properties with narrow band gap emission. Furthermore, the Cu2S shell rendered additional cytocompatibility and stability to the hybrid nanomaterial, which are major factors for translational and clinical applications of QDs. The nanocomposites were PEGylated and folate conjugated to augment their cytoamiability and enhance their specificity towards cancer cells. The nanohybrids possess potentials for visible, near infrared (NIR), photoacoustic (PA) and computed tomography (μCT) imaging. The diverse functionality of the composite was derived from the multi-channel imaging abilities and thermal competence on NIR laser irradiation to specifically actuate the photo-thermal ablation of brain cancer cells.A simple, crude Jatropha curcas (JC) oil-based synthesis approach, devoid of any toxic phosphine and pyrophoric ligands, to produce size and shape tuned CdSe QDs and a further copper sulfide (Cu2S) encasing is presented. The QDs exhibited excellent photoluminescent properties with narrow band gap emission. Furthermore, the Cu2S shell rendered additional cytocompatibility and stability to the hybrid nanomaterial, which are major factors for translational and clinical applications of QDs. The nanocomposites were PEGylated and folate conjugated to augment their cytoamiability and enhance their specificity towards cancer cells. The nanohybrids possess potentials for visible, near infrared (NIR), photoacoustic (PA) and computed tomography (μCT) imaging. The diverse functionality of the composite was derived from the multi-channel imaging abilities and thermal competence on NIR laser irradiation to specifically actuate the photo-thermal ablation of brain cancer cells. Electronic supplementary information (ESI

  5. Early SiO 2 precipitates in Si: Vacancy-oxygen versus interstitial-oxygen clusters

    NASA Astrophysics Data System (ADS)

    Torres, V. J. B.; Coutinho, J.; Jones, R.; Barroso, M.; Öberg, S.; Briddon, P. R.

    2006-04-01

    Oxygen precipitation in Si strongly depends on the undergoing thermal treatment. Between 350 and 450 °C thermal donor formation is activated by a 1.4-1.6 eV barrier. On the other hand, at T>500C, SiO 2 cluster formation is limited by the interstitial oxygen (Oi) migration barrier of ∼2.5 eV. Volumetric arguments imply that the formation of silica precipitates during anneals of oxygen-rich Si crystals, must be accompanied by the ejection of approximately one Si self-interstitial (Sii) per SiO 2 unit that is formed. We report on ab-initio density-functional studies of small oxygen aggregates in Si, to show that the On→VOn+Sii reaction is exothermic for n⩾4. The large energy barrier required to form an intermediate Sii defect prevents the formation of VOn complexes at temperatures as low as 450 °C. Our results imply that thermal donors are not thermodynamically stable clusters, and their formation is driven by kinetics. Infra-red absorption studies can discriminate VOn and On defects. We report their local vibrational modes and compare them with the available experimental data.

  6. The structures of interstitial hydrogen centers in VO2 in the dilute limit from their vibrational properties and theory.

    PubMed

    Yin, Weikai; Qin, Ying; Fowler, W Beall; Stavola, Michael; Boatner, Lynn A

    2016-10-01

    The introduction of a large concentration of H into VO2 is known to suppress the insulating phase of the metal-insulator transition that occurs upon cooling below 340 K. We have used infrared spectroscopy and complementary theory to study the properties of interstitial H and D in VO2 in the dilute limit to determine the vibrational frequencies, thermal stabilities, and equilibrium positions of isolated interstitial H and D centers. The vibrational lines of several OH and OD centers were observed to have thermal stabilities similar to that of the hydrogen that suppresses the insulating phase. Theory associates two of the four possible OH configurations for Hi in the insulating VO2 monoclinic phase with OH lines seen by experiment. Furthermore, theory predicts the energies and vibrational frequencies for configurations with Hi trapped near a substitutional impurity and suggests such defects as candidates for additional OH centers that have been observed. PMID:27465290

  7. The structures of interstitial hydrogen centers in VO2 in the dilute limit from their vibrational properties and theory

    DOE PAGESBeta

    Yin, W.; Qin, Ying; Fowler, W. B.; Stavola, M.; Boatner, Lynn A.

    2016-07-28

    The introduction of a large concentration of H into VO2 is known to suppress the insulating phase of the metal-insulator transition that occurs upon cooling below 340 K. We have used infrared spectroscopy and complementary theory to study the properties of interstitial H and D in VO2 in the dilute limit to determine the vibrational frequencies, thermal stabilities, and equilibrium positions of isolated interstitial H and D centers. The vibrational lines of several OH and OD centers were observed to have thermal stabilities similar to that of the hydrogen that suppresses the insulating phase. Theory associates two of the fourmore » possible OH configurations for Hi in the insulating VO2 monoclinic phase with OH lines seen by experiment. Furthermore, theory predicts the energies and vibrational frequencies for configurations with Hi trapped near a substitutional impurity and suggests such defects as candidates for additional OH centers that have been observed.« less

  8. Evolution kinetics of interstitial loops in irradiated materials: a phase-field model

    SciTech Connect

    Hu, Shenyang Y.; Henager, Charles H.; Li, Yulan; Gao, Fei; Sun, Xin; Khaleel, Mohammad A.

    2012-01-01

    Interstitial loops are one of the principal evolving defects in irradiated materials. The evolution of interstitial loops, including spatial and size distributions, affects both vacancy and interstitial accumulations in the matrix, hence, void formation and volumetric swelling. In this work, a phase-field model to simulate the growth kinetics of interstitial loops in irradiated materials during aging is developed. The diffusion of vacancies and interstitials and the elastic interaction between interstitial loops and point defects are accounted in the model. The effects of interstitial concentration, chemical potential, and elastic interaction on the growth kinetics and stability of interstitial loops are investigated in two and three dimensions. It is found that the elastic interaction enhances the growth kinetics of interstitial loops. The elastic interaction also affects the stability of a small interstitial loop adjacent to a larger loop. The model predicts linear growth rates for interstitial loops that is in agreement with the previous theoretical predictions and experimental observations.

  9. Regulation of tumor invasion by interstitial fluid flow

    NASA Astrophysics Data System (ADS)

    Shieh, Adrian C.; Swartz, Melody A.

    2011-02-01

    The importance of the tumor microenvironment in cancer progression is undisputed, yet the significance of biophysical forces in the microenvironment remains poorly understood. Interstitial fluid flow is a nearly ubiquitous and physiologically relevant biophysical force that is elevated in tumors because of tumor-associated angiogenesis and lymphangiogenesis, as well as changes in the tumor stroma. Not only does it apply physical forces to cells directly, but interstitial flow also creates gradients of soluble signals in the tumor microenvironment, thus influencing cell behavior and modulating cell-cell interactions. In this paper, we highlight our current understanding of interstitial fluid flow in the context of the tumor, focusing on the physical changes that lead to elevated interstitial flow, how cells sense flow and how they respond to changes in interstitial flow. In particular, we emphasize that interstitial flow can directly promote tumor cell invasion through a mechanism known as autologous chemotaxis, and indirectly support tumor invasion via both biophysical and biochemical cues generated by stromal cells. Thus, interstitial fluid flow demonstrates how important biophysical factors are in cancer, both by modulating cell behavior and coupling biophysical and biochemical signals.

  10. Acute Interstitial Nephritis Following Multiple Asian Giant Hornet Stings

    PubMed Central

    Li, Xiang-Dong; Liu, Zheng; Zhai, Ying; Zhao, Ming; Shen, Hai-Yan; Li, Yi; Zhang, Bo; Liu, Tao

    2015-01-01

    Patient: Male, 42 Final Diagnosis: Acute interstitial nephritis Symptoms: Difficulty breathing • headache • numbness • oliguria Medication: Methylprednisolone Clinical Procedure: Plasma exchange Specialty: Nephrology Objective: Rare disease Background: The Asian giant hornet is the largest wasp species in the world. Its stings can cause acute interstitial nephritis and acute renal failure. From July to October, 2013, Asian giant hornet attacks have killed 42 people and injured 1675 people with their powerful venomous stings in Hanzhong, Ankang, and Shangluo, three cities in the southern part of Shaanxi Province, China. Case Report: We report here a case of a 42-year-old man with acute interstitial nephritis following multiple Asian giant hornet stings. On admission, the patient had difficulty breathing, headache, and numbness in both limbs (arm and leg). He was treated in the Emergency Department and Department of Nephrology with plasma exchange and dialysis within 24 hours after being stung. A kidney biopsy revealed acute interstitial nephritis with interstitial infiltrations of eosinophils and lymphocytes. After intensive treatment, his liver function recovered within 10 days. Along with oral methylprednisolone, his renal function recovered 1 month later. Conclusions: This case shows that acute interstitial nephritis happens several days after being stung. Since the number of deaths in southern Shaanxi province is much higher than other places, our report draws the attention of fellow clinicians to the acute interstitial nephritis following multiple Asian giant hornet stings. PMID:26076055

  11. Magnetic thermal ablation using ferrofluids: influence of administration mode on biological effect in different porcine tissues.

    PubMed

    Bruners, Philipp; Hodenius, Michael; Baumann, Martin; Oversohl, Jessica; Günther, Rolf W; Schmitz-Rode, Thomas; Mahnken, Andreas H

    2008-01-01

    The purpose of this study was to compare the effects of magnetic thermal ablation in different porcine tissues using either a singular injection or a continuous infusion of superparamagnetic iron oxide nanoparticles. In the first setting samples of three ferrofluids containing different amounts of iron (1:171, 2:192, and 3:214 mg/ml) were singularly interstitially injected into specimens of porcine liver, kidney, and muscle (n = 5). Then the specimens were exposed to an alternating magnetic field (2.86 kA/m, 190 kHz) generated by a circular coil for 5 min. In the second experimental setup ferrofluid samples were continuously interstitially infused into the tissue specimens during the exposure to the magnetic field. To measure the temperature increase two fiber-optic temperature probes with a fixed distance of 0.5 cm were inserted into the specimens along the puncture tract of the injection needle and the temperature was measured every 15 s. Finally, the specimens were dissected, the diameters of the created thermal lesions were measured, and the volumes were calculated and compared. Compared to continuous infusion, a single injection of ferrofluids resulted in smaller coagulation volumes in all tissues. Significant differences regarding coagulation volume were found in kidney and muscle specimens. The continuous infusion technique led to more elliptically shaped coagulation volumes due to larger diameters along the puncture tract. Our data show the feasibility of magnetic thermal ablation using either a single interstitial injection or continuous infusion for therapy of lesions in muscle, kidney, and liver. Continuous infusion of ferrofluids results in larger zones of necrosis compared to a single injection technique. PMID:18592306

  12. Magnetic Thermal Ablation Using Ferrofluids: Influence of Administration Mode on Biological Effect in Different Porcine Tissues

    SciTech Connect

    Bruners, Philipp Hodenius, Michael Baumann, Martin Oversohl, Jessica; Guenther, Rolf W.; Schmitz-Rode, Thomas Mahnken, Andreas H.

    2008-11-15

    The purpose of this study was to compare the effects of magnetic thermal ablation in different porcine tissues using either a singular injection or a continuous infusion of superparamagnetic iron oxide nanoparticles. In the first setting samples of three ferrofluids containing different amounts of iron (1:171, 2:192, and 3:214 mg/ml) were singularly interstitially injected into specimens of porcine liver, kidney, and muscle (n = 5). Then the specimens were exposed to an alternating magnetic field (2.86 kA/m, 190 kHz) generated by a circular coil for 5 min. In the second experimental setup ferrofluid samples were continuously interstitially infused into the tissue specimens during the exposure to the magnetic field. To measure the temperature increase two fiber-optic temperature probes with a fixed distance of 0.5 cm were inserted into the specimens along the puncture tract of the injection needle and the temperature was measured every 15 s. Finally, the specimens were dissected, the diameters of the created thermal lesions were measured, and the volumes were calculated and compared. Compared to continuous infusion, a single injection of ferrofluids resulted in smaller coagulation volumes in all tissues. Significant differences regarding coagulation volume were found in kidney and muscle specimens. The continuous infusion technique led to more elliptically shaped coagulation volumes due to larger diameters along the puncture tract. Our data show the feasibility of magnetic thermal ablation using either a single interstitial injection or continuous infusion for therapy of lesions in muscle, kidney, and liver. Continuous infusion of ferrofluids results in larger zones of necrosis compared to a single injection technique.

  13. Non-thermal irreversible electroporation (N-TIRE) and adjuvant fractionated radiotherapeutic multimodal therapy for intracranial malignant glioma in a canine patient.

    PubMed

    Garcia, P A; Pancotto, T; Rossmeisl, J H; Henao-Guerrero, N; Gustafson, N R; Daniel, G B; Robertson, J L; Ellis, T L; Davalos, R V

    2011-02-01

    Non-thermal irreversible electroporation (N-TIRE) has shown promise as an ablative therapy for a variety of soft-tissue neoplasms. Here we describe the therapeutic planning aspects and first clinical application of N-TIRE for the treatment of an inoperable, spontaneous malignant intracranial glioma in a canine patient. The N-TIRE ablation was performed safely, effectively reduced the tumor volume and associated intracranial hypertension, and provided sufficient improvement in neurological function of the patient to safely undergo adjunctive fractionated radiotherapy (RT) according to current standards of care. Complete remission was achieved based on serial magnetic resonance imaging examinations of the brain, although progressive radiation encephalopathy resulted in the death of the dog 149 days after N-TIRE therapy. The length of survival of this patient was comparable to dogs with intracranial tumors treated via standard excisional surgery and adjunctive fractionated external beam RT. Our results illustrate the potential benefits of N-TIRE for in vivo ablation of undesirable brain tissue, especially when traditional methods of cytoreductive surgery are not possible or ideal, and highlight the potential radiosensitizing effects of N-TIRE on the brain. PMID:21214290

  14. Non-Thermal Irreversible Electroporation (N-TIRE) and Adjuvant Fractionated Radiotherapeutic Multimodal Therapy for Intracranial Malignant Glioma in a Canine Patient

    PubMed Central

    Garcia, P. A.; Pancotto, T.; Rossmeisl, J. H.; Henao-Guerrero, N.; Gustafson, N. R.; Daniel, G. B.; Robertson, J. L.; Ellis, T. L.; Davalos, R. V.

    2011-01-01

    Non-thermal irreversible electroporation (N-TIRE) has shown promise as an ablative therapy for a variety of soft-tissue neoplasms. Here we describe the therapeutic planning aspects and first clinical application of N-TIRE for the treatment of an inoperable, spontaneous malignant intracranial glioma in a canine patient. The N-TIRE ablation was performed safely, effectively reduced the tumor volume and associated intracranial hypertension, and provided sufficient improvement in neurological function of the patient to safely undergo adjunctive fractionated radiotherapy (RT) according to current standards of care. Complete remission was achieved based on serial magnetic resonance imaging examinations of the brain, although progressive radiation encephalopathy resulted in the death of the dog 149 days after N-TIRE therapy. The length of survival of this patient was comparable to dogs with intracranial tumors treated via standard excisional surgery and adjunctive fractionated external beam RT. Our results illustrate the potential benefits of N-TIRE for in vivo ablation of undesirable brain tissue, especially when traditional methods of cytoreductive surgery are not possible or ideal, and highlight the potential radiosensitizing effects of N-TIRE on the brain. PMID:21214290

  15. Bladder afferent hyperexcitability in bladder pain syndrome/interstitial cystitis

    PubMed Central

    Yoshimura, Naoki; Oguchi, Tomohiko; Yokoyama, Hitoshi; Funahashi, Yasuhito; Yoshikawa, Satoru; Sugino, Yoshio; Kawamorita, Naoki; Kashyap, Mahendra P; Chancellor, Michael B; Tyagi, Pradeep; Ogawa, Teruyuki

    2014-01-01

    Bladder pain syndrome/interstitial cystitis is a disease with lower urinary tract symptoms, such as bladder pain and urinary frequency, which results in seriously impaired quality of life of patients. The extreme pain and urinary frequency are often difficult to treat. Although the etiology of bladder pain syndrome/interstitial cystitis is still not known, there is increasing evidence showing that afferent hyperexcitability as a result of neurogenic bladder inflammation and urothelial dysfunction is important to the pathophysiological basis of symptom development. Further investigation of the pathophysiology will lead to the effective treatment of patients with bladder pain syndrome/interstitial cystitis. PMID:24807488

  16. [Suicide attempt by an interstitial cystitis patient : a case report].

    PubMed

    Suzuki, Takahisa; Otsuka, Atsushi; Kato, Taiki; Furuse, Hiroshi; Ozono, Seiichiro

    2014-11-01

    We report a suicide attempt by an interstitial cystitis patient. A 68-year-old woman consulted several clinics with complaints of urinary frequency and bladder pain, but her symptoms did not improve. She was admitted to our hospital and diagnosed with interstitial cystitis. Hydrodistention was performed, and the urethral catheter removed one day after surgery. The next day, the patient was afraid that her symptoms had not improved and, due to this physical and mental distress, cut her wrist with a razor. Vascular anastomosis and neuroanastomosis were performed accordingly. Eighteen months after hydrodistention, the patient's symptoms of interstitial cystitis have much improved. PMID:25511944

  17. Interstitial lung disease in infancy: A general approach.

    PubMed

    Hines, Erica J; Walsh, Mark; Armes, Jane E; Douglas, Tonia; Chawla, Jasneek

    2016-04-01

    Childhood Interstitial lung disease (chILD) is an umbrella term used to define a broad range of rare, diffuse pulmonary disorders with altered interstitial structure that leads to abnormal gas exchange. Presentation of chILD in infancy can be difficult to differentiate from other common causes of diffuse lung disease. This article aimed at paediatricians provides an overview of interstitial lung disease presenting in infancy and includes key clinical features, a suggested approach to investigation and a summary of management. An overview of three clinical cases has been included to demonstrate the diagnostic approach, characteristic investigation findings and varied clinical outcomes. PMID:27145498

  18. Real-time monitoring of high-intensity focused ultrasound thermal therapy using the manifold learning method.

    PubMed

    Rangraz, Parisa; Behnam, Hamid; Sobhebidari, Pooya; Tavakkoli, Jahan

    2014-12-01

    High-intensity focused ultrasound (HIFU) induces thermal lesions by increasing the tissue temperature in a tight focal region. The main ultrasound imaging techniques currently used to monitor HIFU treatment are standard pulse-echo B-mode ultrasound imaging, ultrasound temperature estimation and elastography-based methods. The present study was carried out on ex vivo animal tissue samples, in which backscattered radiofrequency (RF) signals were acquired in real time at time instances before, during and after HIFU treatment. The manifold learning algorithm, a non-linear dimensionality reduction method, was applied to RF signals whichconstruct B-mode images to detect the HIFU-induced changes among the image frames obtained during HIFU treatment. In this approach, the embedded non-linear information in the region of interest of sequential images is represented in a 2-D manifold with the Isomap algorithm, and each image is depicted as a point on the reconstructed manifold. Four distinct regions are chosen in the manifold corresponding to the four phases of HIFU treatment (before HIFU treatment, during HIFU treatment, immediately after HIFU treatment and 10-min after HIFU treatment). It was found that disorganization of the points is achieved by increasing the acoustic power, and if the thermal lesion has been formed, the regions of points related to pre- and post-HIFU significantly differ. Moreover, the manifold embedding was repeated on 2-D moving windows in RF data envelopes related to pre- and post-HIFU exposure data frames. It was concluded that if mean values of the points related to pre- and post-exposure frames in the reconstructed manifold are estimated, and if the Euclidean distance between these two mean values is calculated and the sliding window is moved and this procedure is repeated for the whole image, a new image based on the Euclidean distance can be formed in which the HIFU thermal lesion is detectable. PMID:25438863

  19. Directional interstitial brachytherapy from simulation to application

    NASA Astrophysics Data System (ADS)

    Lin, Liyong

    Organs at risk (OAR) are sometimes adjacent to or embedded in or overlap with the clinical target volume (CTV) to be treated. The purpose of this PhD study is to develop directionally low energy gamma-emitting interstitial brachytherapy sources. These sources can be applied between OAR to selectively reduce hot spots in the OARs and normal tissues. The reduction of dose over undesired regions can expand patient eligibility or reduce toxicities for the treatment by conventional interstitial brachytherapy. This study covers the development of a directional source from design optimization to construction of the first prototype source. The Monte Carlo code MCNP was used to simulate the radiation transport for the designs of directional sources. We have made a special construction kit to assemble radioactive and gold-shield components precisely into D-shaped titanium containers of the first directional source. Directional sources have a similar dose distribution as conventional sources on the treated side but greatly reduced dose on the shielded side, with a sharp dose gradient between them. A three-dimensional dose deposition kernel for the 125I directional source has been calculated. Treatment plans can use both directional and conventional 125I sources at the same source strength for low-dose-rate (LDR) implants to optimize the dose distributions. For prostate tumors, directional 125I LDR brachytherapy can potentially reduce genitourinary and gastrointestinal toxicities and improve potency preservation for low risk patients. The combination of better dose distribution of directional implants and better therapeutic ratio between tumor response and late reactions enables a novel temporary LDR treatment, as opposed to permanent or high-dose-rate (HDR) brachytherapy for the intermediate risk T2b and high risk T2c tumors. Supplemental external-beam treatments can be shortened with a better brachytherapy boost for T3 tumors. In conclusion, we have successfully finished the

  20. Interstitial rotating shield brachytherapy for prostate cancer

    SciTech Connect

    Adams, Quentin E. Xu, Jinghzu; Breitbach, Elizabeth K.; Li, Xing; Rockey, William R.; Kim, Yusung; Wu, Xiaodong; Flynn, Ryan T.; Enger, Shirin A.

    2014-05-15

    Purpose: To present a novel needle, catheter, and radiation source system for interstitial rotating shield brachytherapy (I-RSBT) of the prostate. I-RSBT is a promising technique for reducing urethra, rectum, and bladder dose relative to conventional interstitial high-dose-rate brachytherapy (HDR-BT). Methods: A wire-mounted 62 GBq{sup 153}Gd source is proposed with an encapsulated diameter of 0.59 mm, active diameter of 0.44 mm, and active length of 10 mm. A concept model I-RSBT needle/catheter pair was constructed using concentric 50 and 75 μm thick nickel-titanium alloy (nitinol) tubes. The needle is 16-gauge (1.651 mm) in outer diameter and the catheter contains a 535 μm thick platinum shield. I-RSBT and conventional HDR-BT treatment plans for a prostate cancer patient were generated based on Monte Carlo dose calculations. In order to minimize urethral dose, urethral dose gradient volumes within 0–5 mm of the urethra surface were allowed to receive doses less than the prescribed dose of 100%. Results: The platinum shield reduced the dose rate on the shielded side of the source at 1 cm off-axis to 6.4% of the dose rate on the unshielded side. For the case considered, for the same minimum dose to the hottest 98% of the clinical target volume (D{sub 98%}), I-RSBT reduced urethral D{sub 0.1cc} below that of conventional HDR-BT by 29%, 33%, 38%, and 44% for urethral dose gradient volumes within 0, 1, 3, and 5 mm of the urethra surface, respectively. Percentages are expressed relative to the prescription dose of 100%. For the case considered, for the same urethral dose gradient volumes, rectum D{sub 1cc} was reduced by 7%, 6%, 6%, and 6%, respectively, and bladder D{sub 1cc} was reduced by 4%, 5%, 5%, and 6%, respectively. Treatment time to deliver 20 Gy with I-RSBT was 154 min with ten 62 GBq {sup 153}Gd sources. Conclusions: For the case considered, the proposed{sup 153}Gd-based I-RSBT system has the potential to lower the urethral dose relative to HDR-BT by 29

  1. Histologic differences between cryothermic and hyperthermic therapies

    NASA Astrophysics Data System (ADS)

    Coad, James E.; Bischof, John C.

    2003-06-01

    Minimally invasive cryothermic and hyperthermic therapies are being increasingly used to destroy dysfunctional and neoplastic tissues in several organ systems. This report morphologically compares the acute tissue response that follow cryothermic and microwave therapy in porcine kidneys. Three cryothermic and hyperthermic groups of treated kidneys were pooled from other studies for evaluation: 1) in vitro treated non-perfused, 2) in situ treated with 2-hour post in vivo perfusion, and 3) in situ treated with 3-day or 7-day post in vivo perfusion. The cryolesions showed uniform central coagulative-type necrosis and interstitial hemorrhage. The hyperthermic lesions showed central thermal fixation and a rim of coagulative necrosis. The cryothermic and hyperthermic lesions both had a similar narrow transition zone of partial cell injury. The cryothermic lesions developed a wound healing response that advanced into the central lesion. In contrast, the heat-treated tissues lacked a prominent wound healing response and appeared to resist breakdown/repair by the body. Thus, the tissue effects of and response to cryothermic and heat injury appear to be different.

  2. Dramatic improvement of anti-SS-A/Ro-associated interstitial lung disease after immunosuppressive treatment.

    PubMed

    Paola, Caramaschi; Giuliana, Festi; Giovanni, Orsolini; Cristian, Caimmi; Domenico, Biasi

    2016-07-01

    The aim of the study was to report three patients affected by interstitial lung disease associated with positive anti-SS-A/Ro autoantibody who showed a dramatic improvement after immunosuppressive treatment. Medical charts were reviewed to obtain clinical data, laboratory parameters, lung function tests, high-resolution computed tomography results and response to immunosuppressive treatment. The three patients showed a clinical picture of a lung-dominant connective tissue disease characterized by a sudden onset with dyspnea, cough and subtle extrathoracic features together with positive anti-SS-A/Ro antibody and weak titer antinuclear antibodies. All three patients responded favorably to immunosuppressive therapy: Two cases were treated with a combination of corticosteroid and cyclophosphamide followed by mycophenolate mofetil; in the third patient, clinical benefit was obtained after rituximab was added to corticosteroid and immunosuppressant drug. In spite of an abrupt onset with significant lung function impairment, all three patients had a favorable clinical response to immunosuppressive therapy. This report may be useful in making therapeutic decisions in case of interstitial lung disease associated with anti-SS-A antibody. PMID:27021338

  3. Intravesical Liposome and Antisense Treatment for Detrusor Overactivity and Interstitial Cystitis/Painful Bladder Syndrome

    PubMed Central

    Kashyap, Mahendra P.; Kawamorita, Naoki; Yoshizawa, Tsuyoshi; Chancellor, Michael

    2014-01-01

    Purpose. The following review focuses on the recent advancements in intravesical drug delivery, which brings added benefit to the therapy of detrusor overactivity and interstitial cystitis/painful bladder syndrome (IC/PBS). Results. Intravesical route is a preferred route of administration for restricting the action of extremely potent drugs like DMSO for patients of interstitial cystitis/painful bladder syndrome (IC/PBS) and botulinum toxin for detrusor overactivity. Patients who are either refractory to oral treatment or need to mitigate the adverse effects encountered with conventional routes of administration also chose this route. Its usefulness in some cases can be limited by vehicle (carrier) toxicity or short duration of action. Efforts have been underway to overcome these limitations by developing liposome platform for intravesical delivery of biotechnological products including antisense oligonucleotides. Conclusions. Adoption of forward-thinking approaches can achieve advancements in drug delivery systems targeted to future improvement in pharmacotherapy of bladder diseases. Latest developments in the field of nanotechnology can bring this mode of therapy from second line of treatment for refractory cases to the forefront of disease management. PMID:24527221

  4. Failure of Gallium-67 scintigraphy to identify reliably noninfectious interstitial nephritis: concise communication

    SciTech Connect

    Graham, G.D.; Lundy, M.M.; Moreno, A.J.

    1983-07-01

    Gallium-67 scintigraphy has been reported to be useful in the diagnosis of noninfectious interstitial nephritis. We studied 12 patients with Ga-67 citrate that were diagnosed as having noninfectious interstitial nephritis on renal biopsy. Only seven of the twelve patients with interstitial nephritis on biopsy were scan-positive. Gallium-67 scintigraphy may not reliably identify noninfectious interstitial nephritis.

  5. View of first level from north showing interstitial structural columns ...

    Library of Congress Historic Buildings Survey, Historic Engineering Record, Historic Landscapes Survey

    View of first level from north showing interstitial structural columns for the Shuttle assemble configuration. - Marshall Space Flight Center, Saturn V Dynamic Test Facility, East Test Area, Huntsville, Madison County, AL

  6. Phenotypic characterization of rare interstitial deletion of chromosome 4

    PubMed Central

    Ismail, Samira; Helmy, Nivine A.; Mahmoud, Wael M.; El-Ruby, Mona O.

    2012-01-01

    Interstitial deletion of the long arm of chromosome 4 is rare. Patients with interstitial deletion of the long arm of chromosome 4 differ from those with terminal deletions. Phenotypes may be variable, depending upon the specific length and location of the deleted portion. Here, we report on a boy exhibiting most of the congenital malformations encountered in terminal 4q syndrome. The conventional karyotyping and Fluorescence in-situ hybridization revealed a de novo interstitial del (4)(q31q32). The current report is a further document highlighting that deletion of segment q31 could be contributing to the expression of most of the phenotype of 4q deletion syndrome. Using array comparative genome hybridization methodology is recommended for investigating further cases with similar segmental interstitial deletions to support and delineate findings and to define genes implicated in the pathogenesis of the disorder.

  7. CT in the diagnosis of interstitial lung disease

    SciTech Connect

    Bergin, C.J.; Mueller, N.L.

    1985-09-01

    The computed tomographic (CT) appearance of interstitial lung disease was assessed in 23 patients with known interstitial disease. These included seven patients with fibrosing alveolitis, six with silicosis, two with hypersensitivity pneumonitis, three with lymphangitic spread of tumor, two with sarcoidosis, one with rheumatoid lung disease, and two with neurofibromatosis. The CT appearance of the interstitial changes in the different disease entities was assessed. Nodules were a prominent CT feature in silicosis, sarcoidosis, and lymphangitic spread of malignancy. Distribution of nodules and associated interlobular septal thickening provided further distinguishing features in these diseases. Reticular densities were the predominant CT change in fibrosing alveolitis, rheumatoid lung disease, and extrinsic allergic alveolitis. CT can be useful in the investigation of selected instances of interstitial pulmonary disease.

  8. Evaluation of the wear properties of high interstitial stainless steels

    SciTech Connect

    Tylczak, J.H.; Rawers, J.C.; Alman, D.E.

    2007-04-01

    Adding carbon to high nitrogen steels increases interstitial concentrations over what can be obtained with nitrogen addition alone. This can results in an increase in hardness, strength, and wear resistance. The alloys produced for this study were all based on commercially available high-nitrogen Fe-18Cr-18Mn stainless steel. This study is the first significant wear study of these new high interstitial nitrogen-carbon stainless steel alloys. Wear tests included: scratch, pin-on-disk abrasion, dry sand/rubber wheel abrasion, impeller impact, and jet erosion. Increasing interstitial concentration increased strength and hardness and improved wear resistance under all test conditions. The results are discussed in terms of overall interstitial alloy concentration.

  9. Complexes of self-interstitials with oxygen atoms in Ge

    SciTech Connect

    Khirunenko, L. I.; Pomozov, Yu. V.; Sosnin, M. G.; Abrosimov, N. V.; Riemann, H.

    2014-02-21

    Interactions of germanium self-interstitials with interstitial oxygen atoms in Ge subjected to irradiation at ∼80 K and subsequently to annealing have been studied. To distinguish the processes involving vacancies and self-interstitials the doping with tin was used. It was shown that absorption lines with maximum at 602, 674, 713 and 803 cm{sup −1} are self-interstitials-related. Two lines at 602 and 674, which develop upon annealing in the temperature range 180–240 K, belong to IO complexes, while the bands at 713 and 803 cm{sup −1}, which emerge after annealing at T>220 K, are associated with I{sub 2}O. It is argued that the annealing of IO occurs by two mechanisms: by dissociation and by diffusion.

  10. Indication for Interstitial Brachytherapy in Carcinoma of the Uterine Cervix

    PubMed Central

    Kumar, P. Pradeep; Taylor, Judith; Scott, Joseph C.; Jacobs, Allan J.; Rojas, John

    1984-01-01

    More than 40 patients with gynecological, genitourinary, and gastrointestinal malignancies, both primary and recurrent but confined to the pelvis, were treated with interstitial irradiation over a four-year period. Interstitial irradiation was the choice of treatment for early carcinoma of the prostate, carcinoma of the anal canal less than T2, recurrent carcinoma of the uterine cervix, and carcinoma of the cervical stump. The authors' experience in treating recurrent carcinoma of the uterine cervix with interstitial irradiation is the basis for the indications for selecting the technique of interstitial irradiation presented. ImagesFigure 1Figure 2Figure 3Figure 4Figure 5Figure 6Figure 7Figure 8Figure 9Figure 10 PMID:6471113

  11. Nonspecific interstitial pneumonia and usual interstitial pneumonia: comparison of the clinicopathologic features and prognosis

    PubMed Central

    Xu, Jinfu; Liu, Jinming; Yi, Xianghua; Sun, Xiwen; Shi, Jingyun

    2014-01-01

    Background Nonspecific interstitial pneumonia (NSIP) has recently been proposed as a histologic type of idiopathic interstitial pneumonia (IIP), but its broad spectrum of clinicopathologic findings and variable prognosis are poorly understood. It is particularly unclear how NSIP and usual interstitial pneumonia (UIP) are related. The present study investigated the clinicopathologic features and prognosis of NSIP, and its differential diagnosis from UIP. Methods The clinicopathologic findings and prognosis in 21 NSIP and 18 UIP patients who underwent surgical or video-assisted thoracoscopic lung biopsy were reviewed. Results NSIP was more frequent in women and showed nonspecific clinical manifestations. High-resolution computed tomography (HRCT) demonstrated ground-glass, net-like, and patchy attenuation in both lungs. Semiquantitative HRCT showed a median fibrosis score of 3 (range, 0 to 7) in NSIP patients and 5 (range, 2 to 7) in UIP patients (P<0.01). On histopathologic examination, NSIP cases were heterogeneous and the findings could be categorized into cellular and fibrosing patterns. The mean age of the NSIP and UIP patients was 48 and 60 years, respectively. The frequencies of fibroblast foci, myogelosis, honeycomb lesions, and pulmonary structural destruction in NSIP and UIP patients were 16.7% and 100% (P<0.001), 22.2% and 85.7% (P<0.05), 16.7% and 92.9% (P<0.001), and 27.8% and 100% (P<0.05), respectively. The responses to glucocorticoid treatment and the prognosis were significantly greater in NSIP than those in UIP. Conclusions NSIP was difficult to be differentiated from UIP by general clinical manifestations, but HRCT can be helpful for this purpose. Definitive diagnosis depends on the results of surgical lung biopsy. PMID:25364525

  12. Standardising Responsibility? The Significance of Interstitial Spaces.

    PubMed

    Wickson, Fern; Forsberg, Ellen-Marie

    2015-10-01

    Modern society is characterised by rapid technological development that is often socially controversial and plagued by extensive scientific uncertainty concerning its socio-ecological impacts. Within this context, the concept of 'responsible research and innovation' (RRI) is currently rising to prominence in international discourse concerning science and technology governance. As this emerging concept of RRI begins to be enacted through instruments, approaches, and initiatives, it is valuable to explore what it is coming to mean for and in practice. In this paper we draw attention to a realm that is often backgrounded in the current discussions of RRI but which has a highly significant impact on scientific research, innovation and policy-namely, the interstitial space of international standardization. Drawing on the case of nanoscale sciences and technologies to make our argument, we present examples of how international standards are already entangled in the development of RRI and yet, how the process of international standardization itself largely fails to embody the norms proposed as characterizing RRI. We suggest that although current models for RRI provide a promising attempt to make research and innovation more responsive to societal needs, ethical values and environmental challenges, such approaches will need to encompass and address a greater diversity of innovation system agents and spaces if they are to prove successful in their aims. PMID:25344842

  13. Interstitial adenosine concentration is increased by dipyridamole

    SciTech Connect

    Gorman, M.W.; Wangler, R.D.; DeWitt, D.F.; Wang, C.Y.; Bassingthwaighte, J.B.; Sparks, H.V.

    1986-03-01

    The authors used the multiple indicator dilution technique to observe the capillary transport of adenosine (ADO) in isolated guinea pig hearts. Radiolabelled albumin, sucrose and ADO were injected on the arterial side and measured in venous samples collected during the following 20 seconds. Transport parameters calculated from these data include permeability-surface area products (PS) for transendothelial diffusion, endothelial cell (EC) uptake at the lumenal and ablumenal membranes, and EC metabolism. With simultaneous measurements of arterial and venous ADO concentrations and flow, the authors calculated the steady-state interstitial fluid (ISF) ADO concentration. Under control conditions the venous ADO concentration was 7.1 +/- 2.8 nM. The calculated ISF concentration depends on whether they assume the venous ADO comes from the ISF, or directly from ECs. These ISF concentrations are 25 +/- 12 nM and 9.8 +/- 4.0 nM, respectively. During dipyridamole infusion (10 uM) the EC transport parameters became nearly zero. Venous and ISF ADO concentrations increased to 33 +/- 8.9 nM and 169 +/- 42 nM, respectively. The authors conclude that the ISF ADO concentration is 1.5-4 fold higher than the venous concentration at rest, and the ISF concentration increases greatly with dipyridamole.

  14. Immunologic Observations in Canine Interstitial Nephritis

    PubMed Central

    Krohn, Kai; Mero, Matti; Oksanen, Aili; Sandholm, Markus

    1971-01-01

    Immunofluorescence studies in cases of chronic interstitial nephritis (CIN) in the dog demonstrated deposition of canine IgC and C'3 in the thickened capillary walls of the glomeruli and in the mesangium. Eluates obtained from the nephritic kidneys contained antibodies of IgG type and reacted with autologous or homologous nephritic kidneys but not with normal kidneys or with any normal canine tissue. The staining pattern of fluorescein-conjugated eluates was similar to that obtained with anti-canine IgG or anti-canine C'3. The eluates did not contain leptospiral antibodies. The findings indicate that complement-fixing immune complexes are deposited in the damaged glomeruli in CIN. The nature of the antigen involved in these complexes is unknown, but it does not seem to be a component of normal canine tissue and could thus be viral or bacterial. ImagesFig 5Fig 6Fig 7Fig 8Fig 13Fig 14Fig 15Fig 16Fig 9Fig 10Fig 11Fig 12Fig 1Fig 2Fig 3Fig 4 PMID:4106382

  15. Granular Material Flows with Interstitial Fluid Effects

    NASA Technical Reports Server (NTRS)

    Hunt, Melany L.; Brennen, Christopher E.

    2004-01-01

    The research focused on experimental measurements of the rheological properties of liquid-solid and granular flows. In these flows, the viscous effects of the interstitial fluid, the inertia of the fluid and particles, and the collisional interactions of the particles may all contribute to the flow mechanics. These multiphase flows include industrial problems such as coal slurry pipelines, hydraulic fracturing processes, fluidized beds, mining and milling operation, abrasive water jet machining, and polishing and surface erosion technologies. In addition, there are a wide range of geophysical flows such as debris flows, landslides and sediment transport. In extraterrestrial applications, the study of transport of particulate materials is fundamental to the mining and processing of lunar and Martian soils and the transport of atmospheric dust (National Research Council 2000). The recent images from Mars Global Surveyor spacecraft dramatically depict the complex sand and dust flows on Mars, including dune formation and dust avalanches on the slip-face of dune surfaces. These Aeolian features involve a complex interaction of the prevailing winds and deposition or erosion of the sediment layer; these features make a good test bed for the verification of global circulation models of the Martian atmosphere.

  16. Modeling of plasmonic heating from individual gold nanoshells for near-infrared laser-induced thermal therapy.

    PubMed

    Cheong, Seong-Kyun; Krishnan, Sunil; Cho, Sang Hyun

    2009-10-01

    Gold nanoparticles can be engineered to target cancerous cells and at the same time designed to absorb specific wavelengths of light. Consequently, with the presence of optically tunable gold nanoparticles such as gold nanoshells, light can be effectively converted to heat via photothermal effect well enough to raise the temperature of medium surrounding gold nanoshells for thermal ablation or hyperthermia treatments of cancers. In this study, the authors proposed a new computational method to estimate thermal response of gold nanoshells embedded in a tissue-like medium when illuminated by a near-infrared (NIR) laser. Specifically, the light transport theory with diffusion approximation was initially applied to model the temperature rise within a medium without gold nanoshells as a result of the dissipation of the NIR laser power throughout the medium. After then, the heat generated by individual gold nanoshells due to photothermal effect was calculated and combined with the results for the medium without gold nanoshells to estimate the global elevation of temperature within the gold nanoshell-laden medium. The current computational model was tested for its validity using two different phantom examples, one of which was similar to a previously reported phantom experiment. The test demonstrated the capability of the current model in terms of producing qualitatively reasonable results, while it also revealed a number of potential differences in the assumptions for the current model and previous experiment. After an adjustment in the model parameters to properly take into account such differences, the computational results and the experimental data matched reasonably well within the average percentage difference of 10%. PMID:19928098

  17. Extradiscal ultrasound thermal therapy (ExDUSTT): evaluation in ex vivo and in vivo spine models (Invited Paper)

    NASA Astrophysics Data System (ADS)

    Diederich, Chris J.; Kinsey, Adam; Nau, William H.; Shu, Richard; Lotz, Jeffrey C.

    2005-04-01

    The application of heat to intervertebral discs is being clinically investigated for the treatment of discogenic back pain. The purpose of this study was to develop and test the feasibility of small ultrasound applicators that can be endoscopically placed adjacent to the disc, and deliver heating energy into the disc without puncturing the annular wall. Prototype devices were fabricated using curvilinear transducers (2.5-3.5 mm wide x 10 mm long, 5.4 - 6.5 MHz) that produce a narrow penetrating beam extending along the length of the ultrasound element. The transducer was affixed to either a flexible or rigid delivery catheter, and enclosed within an asymmetric coupling balloon with water-cooling flow. Bench measurements demonstrated 35-60% acoustic efficiencies, high-power output capabilities, and lightly focused beam patterns. The heating characteristics of these devices were evaluated with ex vivo and in vivo experiments within lumbar and cervical spine segments from sheep models and human cadaveric spine. The applicators were positioned adjacent to the annular wall of the surgically exposed discs. Ultrasound energy was focused directly into the disc to avoid heating the vertebral bodies. Multi-point thermocouple probes were placed throughout the disc to characterize the resultant temperature distributions. These studies demonstrated that ultrasound energy from these applicators penetrated the annular wall of the disc, and produced thermal coagulative temperatures of >60-65°C as far as 10 mm into the tissue. This study also showed that lower power levels and temperatures delivered for 10 minutes can generate a cytotoxic thermal dose of t43°C >240 min penetrating 5-10 mm from the annular wall.

  18. Dose estimation for different skin models in interstitial breast brachytherapy

    PubMed Central

    Kabacińska, Renata; Makarewicz, Roman

    2014-01-01

    Purpose Skin is a major organ at risk in breast-conserving therapy (BCT). The American Brachytherapy Society (ABS) recommendations require monitoring of maximum dose received, however, there is no unambiguous way of skin contouring provided. The purpose of this study was to compare the doses received by the skin in different models. Material and methods Standard treatment plans of 20 patients who underwent interstitial breast brachytherapy were analyzed. Every patient had a new treatment plan prepared according to Paris system and had skin contoured in three different ways. The first model, Skin 2 mm, corresponds to the dermatological breast skin thickness and is reaching 2 mm into an external patient contour. It was rejected in a further analysis, because of distinct discontinuities in contouring. The second model, Skin 4 mm, replaced Skin 2 mm, and is reaching 2 mm inside and 2 mm outside of the External contour. The third model, Skin EXT, is created on the External contour and it expands 4 mm outside. Doses received by the most exposed 0.1 cc, 1 cc, 2 cc, and the maximum doses for Skin 4 mm and Skin EXT were compared. Results Mean, median, maximum, and standard deviation of percentage dose difference between Skin EXT and Skin 4 mm for the most exposed 0.1 cc (D0.1cc) of skin were 18.01%, 17.20%, 27.84%, and 4.01%, respectively. All differences were statistically significant (p < 0.05). Conclusions Monitoring of doses received by skin is necessary to avoid complications and obtain a satisfactory cosmetic effect. It is difficult to assess the compatibility of treatment plans with recommendations, while there is no unambiguous way of skin contouring. Especially, if a mean difference of doses between two models of skin contouring is 18% for the most exposed 0.1 cc and can reach almost 28% in some cases. Differences of this magnitude can result in skin complications during BCT. PMID:25097562

  19. First reported association of chronic lymphocytic leukaemia and interstitial granulomatous dermatitis.

    PubMed

    Riaz, Irbaz Bin; Kamal, Muhammad Umar; Segal, Robert J; Anwer, Faiz

    2016-01-01

    Interstitial granulomatous dermatitis (IGD), a rare disease, is well known to be associated with connective tissue disorders, malignancies and several drugs. We describe this first case of IGD in association with chronic lymphocytic leukaemia/small lymphocytic lymphoma (CLL/SLL). A 66-year-old woman with a 6-year history of untreated CLL/SLL, presented with a 2-month history of progressively worsening eruption of the left thigh, along with fatigue, lymphadenopathy and night sweats. Skin biopsy showed findings consistent with IGD and infiltration of CLL. The eruption was non-responsive to treatment with antibiotics and local steroids. There was a significant improvement in the rash after an initial cycle of chemotherapy (combination therapy with bendamustine and rituximab) and complete resolution by the third cycle, for the treatment of her CLL. We suggest that the possibility of an underlying haematological malignancy should be investigated in patients with a skin rash non-responsive to conventional therapy. PMID:27194675

  20. Adalimumab-induced acute interstitial lung disease in a patient with rheumatoid arthritis*

    PubMed Central

    Dias, Olívia Meira; Pereira, Daniel Antunes Silva; Baldi, Bruno Guedes; Costa, André Nathan; Athanazio, Rodrigo Abensur; Kairalla, Ronaldo Adib; Carvalho, Carlos Roberto Ribeiro

    2014-01-01

    The use of immunobiological agents for the treatment of autoimmune diseases is increasing in medical practice. Anti-TNF therapies have been increasingly used in refractory autoimmune diseases, especially rheumatoid arthritis, with promising results. However, the use of such therapies has been associated with an increased risk of developing other autoimmune diseases. In addition, the use of anti-TNF agents can cause pulmonary complications, such as reactivation of mycobacterial and fungal infections, as well as sarcoidosis and other interstitial lung diseases (ILDs). There is evidence of an association between ILD and the use of anti-TNF agents, etanercept and infliximab in particular. Adalimumab is the newest drug in this class, and some authors have suggested that its use might induce or exacerbate preexisting ILDs. In this study, we report the first case of acute ILD secondary to the use of adalimumab in Brazil, in a patient with rheumatoid arthritis and without a history of ILD. PMID:24626274

  1. Interstitial Fluid Colloid Osmotic Pressure in Healthy Children

    PubMed Central

    Guthe, Hans Jørgen Timm; Indrebø, Marianne; Nedrebø, Torbjørn; Norgård, Gunnar; Wiig, Helge; Berg, Ansgar

    2015-01-01

    Objective The colloid osmotic pressure (COP) of plasma and interstitial fluid play important roles in transvascular fluid exchange. COP values for monitoring fluid balance in healthy and sick children have not been established. This study set out to determine reference values of COP in healthy children. Materials and Methods COP in plasma and interstitial fluid harvested from nylon wicks was measured in 99 healthy children from 2 to 10 years of age. Nylon wicks were implanted subcutaneously in arm and leg while patients were sedated and intubated during a minor surgical procedure. COP was analyzed in a colloid osmometer designed for small fluid samples. Results The mean plasma COP in all children was 25.6 ± 3.3 mmHg. Arbitrary division of children in four different age groups, showed no significant difference in plasma or interstitial fluid COP values for patients less than 8 years, whereas patients of 8-10 years had significant higher COP both in plasma and interstitial fluid. There were no gender difference or correlation between COP in interstitial fluid sampled from arm and leg and no significant effect on interstitial COP of gravity. Prolonged implantation time did not affect interstitial COP. Conclusion Plasma and interstitial COP in healthy children are comparable to adults and COP seems to increase with age in children. Knowledge of the interaction between colloid osmotic forces can be helpful in diseases associated with fluid imbalance and may be crucial in deciding different fluid treatment options. Trial Registration ClinicalTrials.gov NCT01044641 PMID:25853713

  2. Interstitial granulomatous dermatitis: rare cutaneous manifestation of rheumatoid arthritis*

    PubMed Central

    Veronez, Isis Suga; Dantas, Fernando Luiz; Valente, Neusa Yuriko; Kakizaki, Priscila; Yasuda, Thaís Helena; Cunha, Thaís do Amaral

    2015-01-01

    Besides being an uncommon clinicopathological entity, interstitial granulomatous dermatitis, also described as interstitial granulomatous dermatitis with arthritis (IGDA), has shown a wide spectrum of clinical manifestations, such as linear and erythematous lesions, papules, plaques and nodules. Histological features include dense dermal histiocytic infiltrate, usually in a palisade configuration, and scattered neutrophils and eosinophils. We describe a middle aged woman with rheumatoid arthritis of difficult management and cutaneous lesions compatible with IGDA. PMID:26131871

  3. In vivo evaluation of a mechanically oscillating dual-mode applicator for ultrasound imaging and thermal ablation.

    PubMed

    Owen, Neil R; Bouchoux, Guillaume; Seket, Belhassen; Murillo-Rincon, Adriana; Merouche, Samir; Birer, Alain; Paquet, Christian; Delabrousse, Eric; Chapelon, Jean-Yves; Berriet, Rémi; Fleury, Gérard; Lafon, Cyril

    2010-01-01

    Unresectable liver tumors are often treated with interstitial probes that modify tissue temperature, and efficacious treatment relies on image guidance for tissue targeting and assessment. Here, we report the in vivo evaluation of an interstitial applicator with a mechanically oscillating five-element dual-mode transducer. After thoroughly characterizing the transducer, tissue response to high-intensity ultrasound was numerically calculated to select parameters for experimentation in vivo. Using perfused porcine liver, B-mode sector images were formed before and after a 120-s therapy period, and M-mode imaging monitored the therapy axis during therapy. The time-averaged transducer surface intensity was 21 or 27 W/cm (2). Electroacoustic conversion efficiency was maximally 72 +/- 3% and impulse response length was 295 +/- 1.0 ns at -6 dB. The depth of thermal damage measured by gross histology ranged from 10 to 25 mm for 13 insertion sites. For six sites, M-mode data exhibited a reduction in gray-scale intensity that was interpreted as the temporal variation of coagulation necrosis. Contrast ratio analysis indicated that the gray-scale intensity dropped by 7.8 +/- 3.3 dB, and estimated the final lesion depth to an accuracy of 2.3 +/- 2.4 mm. This paper verified that the applicator could induce coagulation necrosis in perfused liver and demonstrated the feasibility of real-time monitoring. PMID:19497808

  4. Computer Simulations of Interstitial Loop Growth Kinetics in irradiated bcc Fe

    SciTech Connect

    Li, Yulan; Hu, Shenyang Y.; Henager, Charles H.; Deng, Huiqiu; Gao, Fei; Sun, Xin; Khaleel, Mohammad A.

    2012-08-01

    The growth kinetics of (001) [001] interstitial loops in bcc Fe is studied by phase-field modeling. The effect of defect (vacancy/interstitial) concentration, generation, recombination, sink strength, and elastic interaction on the growth kinetics of interstitial loops is systematically simulated. Results show that the elastic interaction between the defects and interstitial loops speeds up the growth kinetics and affects the morphology of the interstitial loops. Linear growth rate, i.e., the loop average radius is linear to time, under both aging and irradiation are predicted, which is in agreement with experimental observation. The results also show that the interstitial loop growth rate, which is directly related to the sink strength of the interstitial loop for interstitials, increases linearly with the initial interstitial concentration during aging while changing logarithmically with the interstitial generation rate under irradiation.

  5. Interstitial fluid flow of alveolar primary septa after pneumonectomy.

    PubMed

    Haber, Shimon; Weisbord, Michal; Mishima, Michiaki; Mentzer, Steve J; Tsuda, Akira

    2016-07-01

    Neoalveolation is known to occur in the remaining lung after pneumonectomy. While compensatory lung growth is a complex process, stretching of the lung tissue appears to be crucial for tissue remodeling. Even a minute shear stress exerted on fibroblasts in the interstitial space is known to trigger cell differentiation into myofibroblast that are essential to building new tissues. We hypothesize that the non-uniform motion of the primary septa due to their heterogeneous mechanical properties under tidal breathing induces a spatially unique interstitial flow and shear stress distribution in the interstitial space. This may in turn trigger pulmonary fibroblast differentiation and neoalveolation. In this study, we developed a theoretical basis for how cyclic motion of the primary septal walls with heterogeneous mechanical properties affects the interstitial flow and shear stress distribution. The velocity field of the interstitial flow was expressed by a Fourier (complex) series and its leading term was considered to induce the basic structure of stress distribution as long as the dominant length scale of heterogeneity is the size of collapsed alveoli. We conclude that the alteration of mechanical properties of the primary septa caused by pneumonectomy can develop a new interstitial flow field, which alters the shear stress distribution. This may trigger the differentiation of resident fibroblasts, which may in turn induce spatially unique neoalveolation in the remaining lung. Our example illustrates that the initial forming of new alveoli about half the size of the original ones. PMID:27049045

  6. Multifunctional gold coated thermo-sensitive liposomes for multimodal imaging and photo-thermal therapy of breast cancer cells

    NASA Astrophysics Data System (ADS)

    Rengan, Aravind Kumar; Jagtap, Madhura; de, Abhijit; Banerjee, Rinti; Srivastava, Rohit

    2013-12-01

    Plasmon resonant gold nanoparticles of various sizes and shapes have been extensively researched for their applications in imaging, drug delivery and photothermal therapy (PTT). However, their ability to degrade after performing the required function is essential for their application in healthcare. When combined with biodegradable liposomes, they appear to have better degradation capabilities. They degrade into smaller particles of around 5 nm that are eligible candidates for renal clearance. Distearoyl phosphatidyl choline : cholesterol (DSPC : CHOL, 8 : 2 wt%) liposomes have been synthesized and coated with gold by in situ reduction of chloro-auric acid. These particles of size 150-200 nm are analyzed for their stability, degradation capacity, model drug-release profile, biocompatibility and photothermal effects on cancer cells. It is observed that when these particles are subjected to low power continuous wave near infra-red (NIR) laser for more than 10 min, they degrade into small gold nanoparticles of size 5 nm. Also, the gold coated liposomes appear to have excellent biocompatibility and high efficiency to kill cancer cells through photothermal transduction. These novel materials are also useful in imaging using specific NIR dyes, thus exhibiting multifunctional properties for theranostics of cancer.Plasmon resonant gold nanoparticles of various sizes and shapes have been extensively researched for their applications in imaging, drug delivery and photothermal therapy (PTT). However, their ability to degrade after performing the required function is essential for their application in healthcare. When combined with biodegradable liposomes, they appear to have better degradation capabilities. They degrade into smaller particles of around 5 nm that are eligible candidates for renal clearance. Distearoyl phosphatidyl choline : cholesterol (DSPC : CHOL, 8 : 2 wt%) liposomes have been synthesized and coated with gold by in situ reduction of chloro-auric acid. These

  7. Changes in the dielectric properties of ex vivo bovine liver during microwave thermal ablation at 2.45 GHz

    NASA Astrophysics Data System (ADS)

    Lopresto, Vanni; Pinto, Rosanna; Lovisolo, Giorgio A.; Cavagnaro, Marta

    2012-04-01

    In microwave thermal ablation (MTA) therapy, the dielectric properties of the target tissue play an important role in determining the radiation properties of the microwave ablation antenna. In this work, the ex vivo dielectric properties of bovine liver were experimentally characterized as a function of the temperature during MTA at the frequency of 2.45 GHz. The obtained data were compared with measurements performed at the end of the MTA treatment, and considering the heating achieved with a temperature-controlled water bath. Finally, measured data were used to perform a numerical study evaluating the effects of changes in tissue's dielectric properties during the MTA treatment on the radiation properties of a microwave interstitial ablation antenna, as well as on the obtained thermal lesion. Results evidenced a significant decrease of both relative permittivity (about 38%) and electric conductivity (about 33%) in the tissue during treatment as the temperature increased to over 60 °C, with a dramatic drop when the temperature approached 100 °C. Moreover, the numerical study evidenced that changes in tissue's dielectric properties during the MTA treatment affect the distribution of the power absorbed by the tissue (specific absorption rate—SAR, W kg-1) surrounding the microwave interstitial ablation antenna, leading to a peak SAR up to 20% lower, as well as to a thermal lesion up to 8% longer. This work may represent a preliminary step towards the future development of a procedure for MTA treatment planning.

  8. Vibrational and thermal characterisation of a new chiral drug under investigation for the therapy of congestive heart failure

    NASA Astrophysics Data System (ADS)

    Taddei, Paola; Torreggiani, Armida; Fini, Giancarlo

    2002-12-01

    Racemic (5,6-bis 2-methyl propanoic acid-1,2,3,4-tetrahydro-naphtalen-2-yl)-methylammonium chloride, CHF-1035, under clinical investigation for the treatment of congestive heart failure, was here characterised by Raman and IR spectroscopies coupled with thermal analysis (thermogravimetry and differential scanning calorimetry). These techniques proved suitable for investigating the presence of different polymorphic forms, their relative stability and interconversion tendency in relation to industrial manufacturing processes undergone by the drug (i.e. grinding, compression, heating). Crystallisation experiments were carried out and two different CHF-1035 polymorphic forms were identified. Both grinding and heating revealed to cause a polymorphic transformation of the drug crystal form. It was hypothesised that a change in molecular packing occurs in the drug by effect of both treatments. The possible sources of polymorphism were identified in the -OCOCH(CH 3) groups and in the saturated ring. The non-ground sample showed two endothermic transitions; since they are reversible and not due to desolvation processes the system is probably enantiotropic.

  9. Combined Therapies for the Treatment of Technically Unresectable Liver Malignancies: Bland Embolization and Radiofrequency Thermal Ablation within the Same Session

    SciTech Connect

    Bonomo, Guido Della Vigna, Paolo Monfardini, Lorenzo Orgera, Gianluigi; Chiappa, Antonio; Bianchi, Paolo Pietro; Zampino, Maria Giulia; Orsi, Franco

    2012-12-15

    Purpose: This retrospective study evaluated the feasibility, efficacy, and safety of combining transcatheter arterial embolization (TAE) with radiofrequency thermal ablation (RFA) in a single session for the treatment of technically unresectable liver-only malignancies. Methods: From May 2006 to January 2011, a total of 30 patients affected by liver metastases with single or multiple unresectable liver-only lesions underwent a combined treatment with TAE followed by RFA in the same session, for a total of 36 treated lesions. Patients were extrapolated from a cohort of patients discussed within the weekly institutional tumor board. TAE was performed by using 100 {mu}m microspheres; RFA was performed immediately after TAE by positioning the electrode needle via ultrasound and/or computed tomographic guidance. Local tumor responses and procedure-related complications were evaluated. Results: Completion of both procedures was obtained in all patients for all 36 lesions. Liver lesions had a maximum axial diameter ranging 16-59 mm. Postintervention unenhanced ablated areas ranged 28-104 mm in maximum axial diameter. Safety margins ranged 1-30.5 mm. Complete response, defined as complete devascularization at computed tomography, was obtained in all treated lesions for a maximum period of 12 months. Tumor relapse was observed in one patient at 12 months. Sixteen patients developed new liver lesions or progressive systemic disease during follow-up. Nine patients were still disease-free. Seven patients died as a result of systemic progressive disease. One major treatment-related complication was observed. Conclusions: In patients with technically unresectable liver-only malignancies, single-session combined TAE-RFA is an effective and safe treatment.

  10. Cardiac Magnetic Resonance Assessment of Interstitial Myocardial Fibrosis and Cardiomyocyte Hypertrophy in Hypertensive Mice Treated With Spironolactone

    PubMed Central

    Coelho‐Filho, Otavio R.; Shah, Ravi V.; Neilan, Tomas G.; Mitchell, Richard; Moreno, Heitor; Kwong, Raymond; Jerosch‐Herold, Michael

    2014-01-01

    Background Nearly 50% of patients with heart failure (HF) have preserved LV ejection fraction, with interstitial fibrosis and cardiomyocyte hypertrophy as early manifestations of pressure overload. However, methods to assess both tissue characteristics dynamically and noninvasively with therapy are lacking. We measured the effects of mineralocorticoid receptor blockade on tissue phenotypes in LV pressure overload using cardiac magnetic resonance (CMR). Methods and Results Mice were randomized to l‐nitro‐ω‐methyl ester (l‐NAME, 3 mg/mL in water; n=22), or l‐NAME with spironolactone (50 mg/kg/day in subcutaneous pellets; n=21). Myocardial extracellular volume (ECV; marker of diffuse interstitial fibrosis) and the intracellular lifetime of water (τic; marker of cardiomyocyte hypertrophy) were determined by CMR T1 imaging at baseline and after 7 weeks of therapy alongside histological assessments. Administration of l‐NAME induced hypertensive heart disease in mice, with increases in mean arterial pressure, LV mass, ECV, and τic compared with placebo‐treated controls, while LV ejection fraction was preserved (>50%). In comparison, animals receiving both spironolactone and l‐NAME (“l‐NAME+S”) showed less concentric remodeling, and a lower myocardial ECV and τic, indicating decreased interstitial fibrosis and cardiomyocyte hypertrophy (ECV: 0.43±0.09 for l‐NAME versus 0.25±0.03 for l‐NAME+S, P<0.001; τic: 0.42±0.11 for l‐NAME groups versus 0.12±0.05 for l‐NAME+S group). Mice treated with a combination of l‐NAME and spironolactone were similar to placebo‐treated controls at 7 weeks. Conclusions Spironolactone attenuates interstitial fibrosis and cardiomyocyte hypertrophy in hypertensive heart disease. CMR can phenotype myocardial tissue remodeling in pressure‐overload, furthering our understanding of HF progression. PMID:24965024

  11. Treatment of rheumatoid arthritis-associated interstitial lung disease: a perspective review

    PubMed Central

    Iqbal, Kundan; Kelly, Clive

    2015-01-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting 0.5–1% of the worldwide population. Whilst predominantly causing chronic pain and inflammation in synovial joints, it is also associated with significant extra-articular manifestations in a large proportion of patients. Among the various pulmonary manifestations, interstitial lung disease (ILD), a progressive fibrotic disease of the lung parenchyma, is the commonest and most important, contributing significantly to increased morbidity and mortality. The most frequent patterns of RA-associated ILD (RA-ILD) are usual interstitial pneumonia and nonspecific interstitial pneumonia. New insights during the past several years have highlighted the epidemiological impact of RA-ILD and have begun to identify factors contributing to its pathogenesis. Risk factors include smoking, male sex, human leukocyte antigen haplotype, rheumatoid factor and anticyclic citrullinated protein antibodies (ACPAs). Combined with clinical information, chest examination and pulmonary function testing, high-resolution computed tomography of the chest forms the basis of investigation and allows assessment of subtype and disease extent. The management of RA-ILD is a challenge. Several therapeutic agents have been suggested in the literature but as yet no large randomized controlled trials have been undertaken to guide clinical management. Therapy is further complicated by commonly prescribed drugs of proven articular benefit such as methotrexate, leflunomide (LEF) and anti-tumour necrosis factor α agents having been implicated in both ex novo occurrence and acceleration of existing ILD. Agents that offer promise include immunomodulators such as mycophenolate and rituximab as well as newly studied antifibrotic agents. In this review, we discuss the current literature to evaluate recommendations for the management of RA-ILD and discuss key gaps in our knowledge of this important disease. PMID:26622326

  12. Treatment of rheumatoid arthritis-associated interstitial lung disease: a perspective review.

    PubMed

    Iqbal, Kundan; Kelly, Clive

    2015-12-01

    Rheumatoid arthritis (RA) is a systemic autoimmune disease affecting 0.5-1% of the worldwide population. Whilst predominantly causing chronic pain and inflammation in synovial joints, it is also associated with significant extra-articular manifestations in a large proportion of patients. Among the various pulmonary manifestations, interstitial lung disease (ILD), a progressive fibrotic disease of the lung parenchyma, is the commonest and most important, contributing significantly to increased morbidity and mortality. The most frequent patterns of RA-associated ILD (RA-ILD) are usual interstitial pneumonia and nonspecific interstitial pneumonia. New insights during the past several years have highlighted the epidemiological impact of RA-ILD and have begun to identify factors contributing to its pathogenesis. Risk factors include smoking, male sex, human leukocyte antigen haplotype, rheumatoid factor and anticyclic citrullinated protein antibodies (ACPAs). Combined with clinical information, chest examination and pulmonary function testing, high-resolution computed tomography of the chest forms the basis of investigation and allows assessment of subtype and disease extent. The management of RA-ILD is a challenge. Several therapeutic agents have been suggested in the literature but as yet no large randomized controlled trials have been undertaken to guide clinical management. Therapy is further complicated by commonly prescribed drugs of proven articular benefit such as methotrexate, leflunomide (LEF) and anti-tumour necrosis factor α agents having been implicated in both ex novo occurrence and acceleration of existing ILD. Agents that offer promise include immunomodulators such as mycophenolate and rituximab as well as newly studied antifibrotic agents. In this review, we discuss the current literature to evaluate recommendations for the management of RA-ILD and discuss key gaps in our knowledge of this important disease. PMID:26622326

  13. Clinical presentation and treatment of bladder pain syndrome/interstitial cystitis (BPS/IC) in India

    PubMed Central

    2015-01-01

    Bladder pain syndrome/interstitial cystitis (BPS/IC) is a chronic disease characterized by pelvic pain urgency and frequency. Patients with severe symptoms lead a very miserable life. North American, European and Asian guidelines have been recently promulgated but they differ on many important issues. There is no consensus on its name, definition, investigations and management. Indian guidelines have also been developed and they give more importance to the symptoms in relation to micturition. Though initially believed to be rare or non-existent in India the situation has changed. In Indian patients the presentation is more or less same as the rest of the world but a large percentage have obstructive symptoms and unusual urinary symptoms. Anal discomfort is also common. In India the commonest investigation in all cases of lower urinary tract (LUT) dysfunction is ultrasonography of kidney ureter and bladder with measurement of the post void residual urine volume. Cystoscopy is also done in all the cases to rule out presence of tuberculosis or carcinoma in situ. Bladder pain syndrome/interstitial cystitis (BPS/IC) is not considered to be a clinical disease as it is difficult to rule out all differential diagnosis only from history. Hunner’s lesion is very rare. Cystoscopy with hydro distension, oral therapy, intravesical therapy and surgical therapy form the back bone of management. It is difficult to know which treatment is best for a given patient. A staged protocol is followed and all the treatment modalities are applied to the patients in a sequential fashion—starting from the non-invasive to more invasive. Intravesical botox has not been found to be effective and there is no experience with interstim neuromodulation. PMID:26816851

  14. Hermansky-Pudlak syndrome type 4 with interstitial pneumonia.

    PubMed

    Sakata, Yoshihiko; Kawamura, Kodai; Ichikado, Kazuya; Suga, Moritaka; Yoshioka, Masakazu

    2013-01-01

    Hermansky-Pudlak syndrome (HPS) is an autosomal recessive disorder characterized by oculocutaneous albinism, bleeding tendency, and lysosomal accumulation of ceroid-like material, with occasional development of interstitial pneumonia (IP). Nine genetically distinct subtypes of HPS are known in humans; IP develops primarily in types 1 and 4. Most reported cases of HPS with IP are type 1, and there are no published reports of type 4 in Japanese individuals. A 58-year-old man with congenital oculocutaneous albinism and progressive dyspnea for 1 month was admitted to our hospital. We administered high-dose corticosteroids on the basis of a diagnosis of acute exacerbation of interstitial pneumonia. Respiratory symptoms and the findings of high-resolution computed tomography (CT) showed improvement. He was diagnosed with HPS type 4 with interstitial pneumonia on the basis of gene analysis. He has been receiving pirfenidone for 1 year and his condition is stable. This is the first report on the use of pirfenidone for HPS with IP caused by a novel mutation in the HPS4 gene. We conclude that HPS should be suspected in patients with albinism and interstitial pneumonia. High-dose corticosteroid treatment may be useful in cases of acute exacerbation of interstitial pneumonia due to HPS-4, and pirfenidone may be useful and well tolerated in patients with HPS-4. PMID:26029628

  15. Lymphangiogenesis and Lesion Heterogeneity in Interstitial Lung Diseases

    PubMed Central

    Yamashita, Masahiro

    2015-01-01

    The lymphatic system has several physiological roles, including fluid homeostasis and the activation of adaptive immunity by fluid drainage and cell transport. Lymphangiogenesis occurs in adult tissues during various pathologic conditions. In addition, lymphangiogenesis is closely linked to capillary angiogenesis, and the balanced interrelationship between capillary angiogenesis and lymphangiogenesis is essential for maintaining homeostasis in tissues. Recently, an increasing body of information regarding the biology of lymphatic endothelial cells has allowed us to immunohistochemically characterize lymphangiogenesis in several lung diseases. Particular interest has been given to the interstitial lung diseases. Idiopathic interstitial pneumonias (IIPs) are characterized by heterogeneity in pathologic changes and lesions, as typified by idiopathic pulmonary fibrosis/usual interstitial pneumonia. In IIPs, lymphangiogenesis is likely to have different types of localized functions within each disorder, corresponding to the heterogeneity of lesions in terms of inflammation and fibrosis. These functions include inhibitory absorption of interstitial fluid and small molecules and maturation of fibrosis by excessive interstitial fluid drainage, caused by an unbalanced relationship between capillary angiogenesis and lymphangiogenesis and trafficking of antigen-presenting cells and induction of fibrogenesis via CCL21 and CCR7 signals. Better understanding for regional functions of lymphangiogenesis might provide new treatment strategies tailored to lesion heterogeneity in these complicated diseases. PMID:26823655

  16. Interstitial Lung Disease in Systemic Scleroderma, Complicated with Bilateral Pulmonary Aspergilloma: An Unusual Association.

    PubMed

    Nandi, Saumen; Santra, Avradip; Ghoshal, Loknath; Kundu, Soumya

    2015-12-01

    Aspergilloma or mycetoma is a saprophytic fungal infection that colonizes pre-existing excavated lung lesion. However, its association with systemic sclerosis related interstitial lung disease is unusual and scarcely found in literature. We report a middle aged female with long standing systemic sclerosis, who was on immunosuppressive therapy for many years, presented with repeated haemoptysis. Although provisionally pulmonary tuberculosis was suspected, imaging investigations showed presence of bilateral masses inside bullous air spaces along with air-crescent sign suggestive of fungal ball. Subsequent Computed tomography guided needle aspiration from lung mass confirmed Aspergillus fumigatus as aetiologic agent on fungal culture. Patient was treated conservatively for haemoptysis and with oral antifungal drug as surgical removal of fungal ball was not an option due to poor pulmonary reserve. Although she had been treated with itraconazole for more than three years, she had recurrent haemoptysis during this period without any significant regression of size of the aspergilloma. Management of aspergilloma in a background of extensive interstitial lung disease remains poorly defined and complicated. Thereby, overall prognosis is unfavourable and depends on evolution of both underlying scleroderma as well as aspergilloma. PMID:26816937

  17. Stereotactic interstitial brachytherapy of malignant astrocytomas with remarks on postimplantation computed tomographic appearance

    SciTech Connect

    Willis, B.K.; Heilbrun, M.P.; Sapozink, M.D.; McDonald, P.R.

    1988-09-01

    Seventeen patients were treated with stereotactically implanted high activity iodine-125 seeds, 12 patients for recurrent malignant astrocytomas (Protocol I) and 5 patients for newly diagnosed glioblastomas (Protocol II). Total radiation dosage to the recurrent tumors in Protocol I, including prior external beam irradiation, averaged 13,500 cGy. In the follow-up period of 6 to 50 months, the survival rate was 93% at 6 months, 60% at 12 months, 50% at 18 months, and 38% at 24 months after implantation. In Protocol II, brachytherapy was used as an interstitial radiation boost to the conventional treatment of newly diagnosed glioblastomas. External beam therapy and interstitial brachytherapy provided 11,000 cGy to these tumors. In the follow-up period of 15 to 27 months, there was a 100% survival at 12 months, 75% at 18 months, and 25% at 24 months after implantation. Eight of our 17 patients required reoperation for persistent or recurrent mass lesions at 6 to 15 months postimplantation; 7 were found to harbor masses of radionecrosis containing nests of anaplastic astrocytes; 1 had frank tumor recurrence. Median survival in this group of patients requiring reoperation was 18.7 months postimplantation. In a review of postimplantation computed tomographic scans, significant mass effect and crossover of hypodensity or enhancement into the corpus callosum or opposite hemisphere were found to have prognostic significance; persistent areas of contrast enhancement and excessive peritumoral hypodensity did not.

  18. Interstitial Lung Disease in Systemic Scleroderma, Complicated with Bilateral Pulmonary Aspergilloma: An Unusual Association

    PubMed Central

    Nandi, Saumen; Ghoshal, Loknath; Kundu, Soumya

    2015-01-01

    Aspergilloma or mycetoma is a saprophytic fungal infection that colonizes pre-existing excavated lung lesion. However, its association with systemic sclerosis related interstitial lung disease is unusual and scarcely found in literature. We report a middle aged female with long standing systemic sclerosis, who was on immunosuppressive therapy for many years, presented with repeated haemoptysis. Although provisionally pulmonary tuberculosis was suspected, imaging investigations showed presence of bilateral masses inside bullous air spaces along with air-crescent sign suggestive of fungal ball. Subsequent Computed tomography guided needle aspiration from lung mass confirmed Aspergillus fumigatus as aetiologic agent on fungal culture. Patient was treated conservatively for haemoptysis and with oral antifungal drug as surgical removal of fungal ball was not an option due to poor pulmonary reserve. Although she had been treated with itraconazole for more than three years, she had recurrent haemoptysis during this period without any significant regression of size of the aspergilloma. Management of aspergilloma in a background of extensive interstitial lung disease remains poorly defined and complicated. Thereby, overall prognosis is unfavourable and depends on evolution of both underlying scleroderma as well as aspergilloma. PMID:26816937

  19. Recovery of optical properties using interstitial cylindrical diffusers as source and detector fibers

    NASA Astrophysics Data System (ADS)

    Baran, Timothy M.

    2016-07-01

    We demonstrate recovery of optical properties using arrays of interstitial cylindrical diffusing fibers as sources and detectors. A single 1-cm diffuser delivered laser illumination at 665 nm, while seven 1- and 2-cm diffusers at 1-cm grid spacing acted as detectors. Extraction of optical properties from these measurements was based upon a diffusion model of emission and detection distributions for these diffuser fibers, informed by previous measurements of heterogeneous axial detection. Verification of the technique was performed in 15 liquid tissue-simulating phantoms consisting of deionized water, India ink as absorber, and Intralipid 20% as scatterer. For the range of optical properties tested, mean errors were 4.4% for effective attenuation coefficient, 12.6% for absorption coefficient, and 7.6% for reduced scattering coefficient. Error in recovery tended to increase with decreasing transport albedo. For therapeutic techniques involving the delivery of light to locations deep within the body, such as interstitial photodynamic and photothermal therapies, the methods described here would allow the treatment diffuser fibers also to be used as sources and detectors for recovery of optical properties. This would eliminate the need for separately inserted fibers for spectroscopy, reducing clinical complexity and improving the accuracy of treatment planning.

  20. Interstitial integrals in the multiple-scattering model

    SciTech Connect

    Swanson, J.R.; Dill, D.

    1982-08-15

    We present an efficient method for the evaluation of integrals involving multiple-scattering wave functions over the interstitial region. Transformation of the multicenter interstitial wave functions to a single center representation followed by a geometric projection reduces the integrals to products of analytic angular integrals and numerical radial integrals. The projection function, which has the value 1 in the interstitial region and 0 elsewhere, has a closed-form partial-wave expansion. The method is tested by comparing its results with exact normalization and dipole integrals; the differences are 2% at worst and typically less than 1%. By providing an efficient means of calculating Coulomb integrals, the method allows treatment of electron correlations using a multiple scattering basis set.

  1. Interstitial carbon formation in irradiated copper-doped silicon

    SciTech Connect

    Yarykin, N. A.; Weber, J.

    2015-06-15

    The influence of a copper impurity on the spectrum of defects induced in p-Si crystals containing a low oxygen concentration by irradiation with electrons with an energy of 5 MeV at room temperature is studied by deep-level transient spectroscopy. It is found that interstitial carbon atoms (C{sub i}) which are the dominant defects in irradiated samples free of copper are unobservable immediately after irradiation, if the concentration of mobile interstitial copper atoms (Cu{sub i}) is higher than the concentration of radiation defects. This phenomenon is attributed to the formation of (Cu{sub i}, C{sub i}) complexes, which do not introduce levels into the lower half of the band gap. It is shown that these complexes dissociate upon annealing at temperatures of 300–340 K and, thus, bring about the appearance of interstitial carbon.

  2. Improvement in idiopathic nonspecific interstitial pneumonia after smoking cessation.

    PubMed

    Shinohara, Tsutomu; Kadota, Naoki; Hino, Hiroyuki; Naruse, Keishi; Ohtsuki, Yuji; Ogushi, Fumitaka

    2015-01-01

    Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated. We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking. Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP. PMID:26029566

  3. Improvement in idiopathic nonspecific interstitial pneumonia after smoking cessation

    PubMed Central

    Shinohara, Tsutomu; Kadota, Naoki; Hino, Hiroyuki; Naruse, Keishi; Ohtsuki, Yuji; Ogushi, Fumitaka

    2014-01-01

    Although cigarette smoking has been recognized as a risk factor for the development of several interstitial lung diseases, the relationship between smoking and nonspecific interstitial pneumonia (NSIP) has not yet been fully elucidated. We here present a case of fibrotic NSIP with mild emphysema in an elderly male with normal pulmonary function, whose symptoms, serum KL-6 level, and high-resolution computed tomography findings of interstitial changes markedly improved without medication following the cessation of smoking. Our case suggests that smoking may be an etiological factor in some patients with NSIP and that early smoking cessation before a clinically detectable decline in pulmonary function may be critical for smokers with idiopathic NSIP. PMID:26029566

  4. The lipid geochemistry of interstitial waters of recent marine sediments

    SciTech Connect

    Saliot, A.; Brault, M.; Boussuge, C. )

    1988-04-01

    To elucidate the nature of biogeochemical processes occurring at the water-sediment interface, the authors have analyzed fatty acids, n-alkanes and sterols contained in interstitial waters collected from oxic and anoxic marine sediments in the eastern and western intertropical Atlantic Ocean and in the Arabian Sea. Lipid concentrations in interstitial waters vary widely and are generally much higher than concentrations encountered in the overlying sea water. Higher concentrations in interstitial water are observed in environments favorable for organic input and preservation of the organic matter in the water column and in the surficial sediment. The analysis of biogeochemical markers in the various media of occurrence of the organic matter such as sea water, suspended particles, settling particles and sediment is discussed in terms of differences existing between these media and bio-transformations of the organic matter at the water-sediment interface.

  5. Effect of amlodipine on mouse renal interstitial fibrosis.

    PubMed

    Honma, Shigeyoshi; Nakamura, Kazuki; Shinohara, Masahiro; Mitazaki, Satoru; Abe, Sumiko; Yoshida, Makoto

    2016-06-01

    Unilateral ureteral obstruction (UUO) is a well-established method to study interstitial fibrosis of the kidney. In this study, we investigated the effects of a calcium channel blocker, amlodipine, on UUO-induced renal interstitial fibrosis in mice. UUO significantly increased the fibrotic area in the obstructed kidney, but this change was inhibited by amlodipine (6.7mg/kg/day in drinking water). mRNA expression of heat shock protein (HSP) 47 and type IV collagen was increased in the kidneys of UUO mice. Amlodipine reduced the expression of both HSP47 and type IV collagen mRNAs. Phosphorylation of c-jun-N-terminal kinase (JNK) was significantly increased by UUO, but the change was inhibited by amlodipine. Collectively, these results suggest that amlodipine may inhibit the expression of HSP47 and type IV collagen by reducing phosphorylation of JNK and ameliorating the renal interstitial fibrosis induced by UUO. PMID:27029240

  6. Hermansky-Pudlak syndrome with nonspecific interstitial pneumonia.

    PubMed

    Furuhashi, Kazuki; Enomoto, Noriyuki; Fujisawa, Tomoyuki; Hashimoto, Dai; Inui, Naoki; Nakamura, Yutaro; Suda, Takafumi

    2014-01-01

    We herein report a case of Hermansky-Pudlak syndrome (HPS) with nonspecific interstitial pneumonia (NSIP). A 58-year-old Japanese woman presented with oculocutaneous albinism and dyspnea on exertion. A high resolution computed tomography scan showed areas of reticular and ground glass opacity in the lungs, and a surgical lung biopsy revealed fibrotic NSIP. Foamy type 2 pneumocytes and the absence of dense granules in platelets were also observed, consistent with a diagnosis of HPS. Ultimately, a genetic analysis revealed a mutation in the HPS1 gene. The interstitial pneumonia progressed despite treatment with prednisolone, cyclosporine A and pirfenidone. In this report, we discuss the pathological lung features and treatment of HPS associated with interstitial pneumonia. PMID:24583434

  7. Regional extravascular and interstitial lung water in normal dogs

    SciTech Connect

    Snashall, P.D.; Keyes, S.J.; Morgan, B.; Jones, B.; Murphy, K.

    1980-10-01

    The regional distribution of pulmonary extravascular and interstitial water was measured to examine the possibility that regional differences in microvascular pressure or tissue stress may cause regional differences in lung water. Chloralose-anesthetized dogs were traced in an upright or supine position and injected with 51Cr-labeled albumin to equilibrate with plasma. The data revealed that regional extravascular and interstitial water were constant throughout the lungs in both groups and that there were no significant differences between upright and supine dogs. There were no significant differences in hematocrit between slices. It appears that gravity and body position have no measurable effect on either the total size of the extravascular and interstitial compartments or their regional distribution.

  8. Predictors of Toxicity After Image-guided High-dose-rate Interstitial Brachytherapy for Gynecologic Cancer

    SciTech Connect

    Lee, Larissa J.; Viswanathan, Akila N.

    2012-12-01

    Purpose: To identify predictors of grade 3-4 complications and grade 2-4 rectal toxicity after three-dimensional image-guided high-dose-rate (HDR) interstitial brachytherapy for gynecologic cancer. Methods and Materials: Records were reviewed for 51 women (22 with primary disease and 29 with recurrence) treated with HDR interstitial brachytherapy. A single interstitial insertion was performed with image guidance by computed tomography (n = 43) or magnetic resonance imaging (n = 8). The median delivered dose in equivalent 2-Gy fractions was 72.0 Gy (45 Gy for external-beam radiation therapy and 24 Gy for brachytherapy). Toxicity was reported according to the Common Toxicity Criteria for Adverse Events. Actuarial toxicity estimates were calculated by the Kaplan-Meier method. Results: At diagnosis, the median patient age was 62 years and the median tumor size was 3.8 cm. The median D90 and V100 were 71.4 Gy and 89.5%; the median D2cc for the bladder, rectum, and sigmoid were 64.6 Gy, 61.0 Gy, and 52.7 Gy, respectively. The actuarial rates of all grade 3-4 complications at 2 years were 20% gastrointestinal, 9% vaginal, 6% skin, 3% musculoskeletal, and 2% lymphatic. There were no grade 3-4 genitourinary complications and no grade 5 toxicities. Grade 2-4 rectal toxicity was observed in 10 patients, and grade 3-4 complications in 4; all cases were proctitis with the exception of 1 rectal fistula. D2cc for rectum was higher for patients with grade 2-4 (68 Gy vs 57 Gy for grade 0-1, P=.03) and grade 3-4 (73 Gy vs 58 Gy for grade 0-2, P=.02) rectal toxicity. The estimated dose that resulted in a 10% risk of grade 2-4 rectal toxicity was 61.8 Gy (95% confidence interval, 51.5-72.2 Gy). Discussion: Image-guided HDR interstitial brachytherapy results in acceptable toxicity for women with primary or recurrent gynecologic cancer. D2cc for the rectum is a reliable predictor of late rectal complications. Three-dimensional-based treatment planning should be performed to ensure

  9. Acute interstitial nephritis following kudzu root juice ingestion.

    PubMed

    Jung, Jae Myun; Kwon, Soon Hyo; Noh, Hyunjin; Han, Dong Cheol; Jeon, Jin Seok; Jin, So Young

    2013-10-01

    Recently, the use of herbal remedies and complementary and alternative medicine has increased globally. Kudzu root (Pueraria lobata) is a plant commonly used in traditional medicine to promote health. A middle-aged woman consumed kudzu root juice to promote health and well-being for 10 days. Subsequently, she developed anorexia, epigastric discomfort and azotemia. These symptoms improved rapidly within several days after discontinuation of the suspected offending agent and conservative treatment. Acute interstitial nephritis was diagnosed by renal biopsy. To our knowledge, this is the first case report describing acute interstitial nephritis following the ingestion of kudzu root juice. PMID:24060140

  10. Diffusion of zinc vacancies and interstitials in zinc oxide

    NASA Astrophysics Data System (ADS)

    Erhart, Paul; Albe, Karsten

    2006-05-01

    The self-diffusion coefficient of zinc in ZnO is derived as a function of the chemical potential and Fermi level from first-principles calculations. Density functional calculations in combination with the climbing image-nudged elastic band method are used in order to determine migration barriers for vacancy, interstitial, and interstitialcy jumps. Zinc interstitials preferentially diffuse to second nearest neighbor positions. They become mobile at temperatures as low as 90-130K and therefore allow for rapid defect annealing. Under predominantly oxygen-rich and n-type conditions self-diffusion occurs via a vacancy mechanism.

  11. Ectrodactyly and proximal/intermediate interstitial deletion 7q

    SciTech Connect

    McElveen, C.; Carvajal, M.V.; Moscatello, D.

    1995-03-13

    We report on an individual with severe mental retardation, seizures, microcephaly, unusual face, scoliosis, and cleft feet and cleft right hand. The chromosomal study showed a proximal interstitial deletion 7q (q11.23q22). From our review of the literature, 11 patients have been reported with ectrodactyly (split hand/split foot malformation) and proximal/intermediate interstitial deletions or rearrangements of 7q. The critical segment for ectrodactyly seems to be located between 7q21.2 and 7q22.1. This malformation is present in 41% of the patients whose deletion involves the critical segment. 37 refs., 3 figs., 1 tab.

  12. Association Between Interstitial Lung Abnormalities and All-Cause Mortality

    PubMed Central

    Putman, Rachel K.; Hatabu, Hiroto; Araki, Tetsuro; Gudmundsson, Gunnar; Gao, Wei; Nishino, Mizuki; Okajima, Yuka; Dupuis, Josée; Latourelle, Jeanne C.; Cho, Michael H.; El-Chemaly, Souheil; Coxson, Harvey O.; Celli, Bartolome R.; Fernandez, Isis E.; Zazueta, Oscar E.; Ross, James C.; Harmouche, Rola; Estépar, Raúl San José; Diaz, Alejandro A.; Sigurdsson, Sigurdur; Gudmundsson, Elías F.; Eiríksdottír, Gudny; Aspelund, Thor; Budoff, Matthew J.; Kinney, Gregory L.; Hokanson, John E.; Williams, Michelle C; Murchison, John T.; MacNee, William; Hoffmann, Udo; O’Donnell, Christopher J.; Launer, Lenore J.; Harrris, Tamara B.; Gudnason, Vilmundur; Silverman, Edwin K.; O’Connor, George T.; Washko, George R.; Rosas, Ivan O.; Hunninghake, Gary M.

    2016-01-01

    IMPORTANCE Interstitial lung abnormalities have been associated with decreased six-minute walk distance, diffusion capacity for carbon monoxide and total lung capacity; however to our knowledge, an association with mortality has not been previously investigated. OBJECTIVE To investigate whether interstitial lung abnormalities are associated with increased mortality. DESIGN, SETTING, POPULATION Prospective cohort studies of 2633 participants from the Framingham Heart Study (FHS) (CT scans obtained 9/08–3/11), 5320 from the Age Gene/Environment Susceptibility (AGES)-Reykjavik (recruited 1/02–2/06), 2068 from COPDGene (recruited 11/07–4/10), and 1670 from the Evaluation of COPD Longitudinally to Identify Predictive Surrogate End-points (ECLIPSE) (between 12/05–12/06). EXPOSURES Interstitial lung abnormality status as determined by chest CT evaluation. MAIN OUTCOMES AND MEASURES All cause mortality over approximately 3 to 9 year median follow up time. Cause-of-death information was also examined in the AGES-Reykjavik cohort. RESULTS Interstitial lung abnormalities were present in 177 (7%) of the participants from FHS, 378 (7%) from AGES-Reykjavik, 156 (8%) from COPDGene, and in 157 (9%) from ECLIPSE. Over median follow-up times of ~3–9 years there were more deaths (and a greater absolute rate of mortality) among those with interstitial lung abnormalities compared to those without interstitial lung abnormalities in each cohort; 7% compared to 1% in FHS (6% difference, 95% confidence interval [CI] 2%, 10%), 56% compared to 33% in AGES-Reykjavik (23% difference, 95% CI 18%, 28%), 16% compared to 11% in COPDGene (5% difference, 95% CI −1%, 11%) and 11% compared to 5% in ECLIPSE (6% difference, 95% CI 1%, 11%). After adjustment for covariates, interstitial lung abnormalities were associated with an increase in the risk of death in the FHS (HR=2.7, 95% CI, 1.1–65, P=0.030), AGES-Reykjavik (HR 1.3, 95% CI 1.2–1.4, P<0.001), COPDGene (HR=1.8, 95% CI, 1.1, 2

  13. Suppression of self-interstitials in silicon during ion implantation via in-situ photoexcitation

    SciTech Connect

    Ravi, J.; Erokhin, Yu.; Christensen, K.; Rozgonyi, G.A.; Patnaik, B.K.; White, C.W.

    1995-02-01

    The influence of in-situ photoexcitation during low temperature implantation on self-interstitial agglomeration following annealing has been investigated using transmission electron microscopy (TEM). A reduction in the level of as-implanted damage determined by RBS and TEM occurs athermally during 150 keV self-ion implantation. The damage reduction following a 300 C anneal suggests that it is mostly divacancy related. Subsequent thermal annealing at 800 C resulted in the formation of (311) rod like defects or dislocation loops for samples with and without in-situ photoexcitation, respectively. Estimation of the number of self-interstitials bound by these defects in the sample without in-situ photoexcitation corresponds to the implanted dose; whereas for the in-situ photoexcitation sample a suppression of {approx}2 orders in magnitude is found. The kinetics of the athermal annealing process are discussed within the framework of either a recombination enhanced defect reaction mechanism, or a charge state enhanced defect migration and Coulomb interaction.

  14. Spinal Manipulative Therapy Has an Immediate Effect on Thermal Pain Sensitivity in People With Low Back Pain: A Randomized Controlled Trial

    PubMed Central

    Bishop, Mark D.; Robin