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ABSTRACT: OBJECTIVES: Oesophagectomy is at present considered to be the optimal curative treatment for patients with severe oesophageal disease. Postoperative pain, both acute and chronic, plays a significant role in the quality of life for post-oesophagectomy patients. The present study compared the effects of two methods-application of a non-divided intercostal muscle flap (NIMF) and intercostal nerve cryoanalgesia (INC) treatment-in reducing neuropathic pain in post-oesophagectomy patients. METHODS: From June 2009 to June 2010, a total of 160 patients who underwent posterolateral thoracotomy and oesophagectomy were subsequently recruited to our study and divided into NIMF groups and INC groups at random. Patient follow-up studies were conducted for one year on all the subjects and the resultant postoperative pain, chronic pain, rehabilitation and complication scored were measured and documented. RESULTS: INC treatment was more time-intensive than NIMF treatment (P < 0.05). Also, additional chest tube drainage and subsequent extubation were often necessary in the INC group (P < 0.001). No statistically significant differences were found between the two groups regarding the number of subjects who required oral medication one month postoperative with respect to pain score. The chronic pain level, as well as the number of patients requiring oral pain medication, increased significantly by the sixth month following operation and notably increased until the 12th postoperative month in the INC group (P < 0.05). CONCLUSIONS: Both NIMF and INC treatments were effective and safe for the treatment of acute pain after oesophagectomy. NIMF was the better technique in reducing chronic postoperative pain.
European journal of cardio-thoracic surgery: official journal of the European Association for Cardio-thoracic Surgery 12/2012; · 2.40 Impact Factor
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ABSTRACT: PURPOSE: This study evaluates the influence of transcatheter arterial infusion with heated saline on hepatic arterial and portal venous blood flows to tumor and normal hepatic tissues in a rabbit VX2 tumor model. METHODS: All animal experiments were approved by the institutional animal care and use committee. Twenty rabbits with VX2 liver tumors were divided into the following two groups: (a) the treated group (n = 10), which received a 60 mL transarterial injection of 60 °C saline via the hepatic artery; (b) the control group (n = 10), which received a 60 mL injection of 37 °C saline via the hepatic artery. Using ultrasonography, the blood flows in both the portal vein and hepatic artery were measured, and the changes in the hemodynamic indices were recorded before and immediately after the injection. The changes in the tumor and normal liver tissues of the two groups were histopathologically examined by hematoxylin and eosin staining after the injection. RESULTS: After the transcatheter arterial heated infusion, there was a decrease in the hepatic arterial blood flow to the tumor tissue, a significant decrease in the hepatic artery mean velocity (P < 0.05), and a significant increase in the resistance index (P < 0.05). On hematoxylin and eosin staining, there were no obvious signs of tissue destruction in the normal liver tissue or the tumor tissue after heated perfusion, and coagulated blood plasma was observed in the cavities of intratumoral blood vessels in the treated group. CONCLUSIONS: The changes in tumor blood flow in the rabbit VX2 tumor model were presumably caused by microthrombi in the tumor vessels, and the portal vein likely mediated the heat loss in normal liver tissue during the transarterial heated infusion.
CardioVascular and Interventional Radiology 08/2012; · 2.09 Impact Factor
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ABSTRACT: Microwave ablation (MWA) has attracted a worldwide attention gradually in treating inoperable pulmonary malignancies. However, in the lung tissues treated with MWA recurrence of tumor may still occur and few data in large patient groups till now were reported about the safety or effectiveness of microwave ablation in treating primary lung cancer and metastatic pulmonary malignancies. The purpose of this study is to evaluate the clinical curative effect (local control, survival data) MWA and its safety as well.
From 1 January 2005 to 1 January 2008, retrospective analyses, 69 patients underwent computed tomography (CT)-guided percutaneous MWA of pulmonary malignancies. All patients were deemed medically inoperable. The correlation of tumor sizes and local progression after ablation was analyzed and the survival rates within 3 years post surgery were compared between non-small-cell lung cancer and pulmonary metastases groups also.
Pneumothorax was the most frequent complication and occurred in 24.64% patients after ablation. Neither needle track implantation was found nor did patient death occur in these patients within 30 days. The 1-, 2-, and 3-year overall survival rates were 66.7%, 44.9% and 24.6%, respectively. The overall survival rates for NSCLC patients in 1 year, 2 years, and 3 years were 75.0%, 54.2%, and 29.2%, respectively. The overall survival rates for pulmonary metastatic tumor patients in 1 year, 2 years, and 3 years were 47.6%, 23.8%, and 14.3%, respectively. The recurrence-free survival rates for NSCLC patients in 1 year, 2 years, and 3 years were 72.9%, 50.0%, and 27.1%, respectively. The mortality rates for pulmonary metastatic tumor patients in 1 year, 2 years, and 3 years were 47.6%, 19.0%, and 14.3%, respectively.
Percutaneous microwave coagulation therapy was one safe and effective method and could be beneficial for the improvement of inoperable pulmonary malignancies treatment effect.
World Journal of Surgical Oncology 05/2012; 10:80. · 1.12 Impact Factor
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ABSTRACT: The vascular permeability of tumors can be changed by transarterial infusion heat, but the mechanisms remain unknown. The aim of this study was to analyze the underlying causes of changes in tumor vascular permeability after heated perfusion via two different modes.
Thirty rabbits with VX2 hepatic tumors were randomly divided into three groups of 10 rabbits each. The hepatic artery was selectively catheterized via a femoral approach, and unheated saline (control group) or heated saline (60°C) was then injected in either a continuous (transcatheter arterial continuous perfusion [TACP]) or a pulsed (transcatheter arterial pulsed perfusion [TAPP]) manner. Changes in vascular permeability in the tumors were assessed using the following markers and methods: (1) qualitative assessment by visual estimation on digital subtraction angiography performed after the heat infusion procedure on live animals and quantitative assessment by spectrophotometry using Evans blue dye extravasation on tumor and liver tissue after animals were sacrificed and (2) kinase domain receptor or vascular endothelial growth factor (VEGF), expressed in vascular endothelial cells, assessed by immunohistochemical staining, Western blot analysis, and reverse transcription polymerase chain reaction.
Tumor staining increased in the TAPP group more than in the TACP group, but not in the control group, assessed on digital subtraction angiography. Extracted dye was higher in tumors in the TAPP group than in those in the TACP group; extracted dye in both groups was higher than in the control group. Kinase domain receptor protein and messenger ribonucleic acid expression were both higher in the TAPP group than in the TACP and control groups. VEGF protein expression was lower in the TAPP and TACP groups than in the control group, but VEGF messenger ribonucleic acid expression was higher in the TACP group than in the TAPP and control groups, and VEGF messenger ribonucleic acid expression was lower in the TAPP group than in the control group.
The vascular permeability of rabbit VX2 tumors significantly increased after arterial pulsed heated infusion, and the protein kinase domain receptor may play a key role in this increase of tumor vascular permeability.
Academic radiology 12/2011; 18(12):1569-76. · 2.09 Impact Factor
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ABSTRACT: We aimed to establish a canine model of acute thromboembolic pulmonary hypertension (ATEPH) and to explore the feasibility of diagnosing pulmonary hypertension (PH) through the Doppler flow spectra of the superior vena cava (SVC). A canine model of ATEPH was developed by infusing thrombus into the right femoral vein. The pulmonary arterial pressure was simultaneously measured via a right heart catheter with the guidance of ultrasound. The maximum systolic peak flow velocity (SPV), ventricular reverse peak flow velocity (VRPV), diastolic peak flow velocity (DPV), and atrial reverse peak flow velocity (ARPV) of the SVC were measured by transthoracic echocardiography. ATEPH was successfully established in 24 dogs (88.9%) with the pulmonary arterial systolic pressure (PASP) greater than 30 mmHg. ARPV increased significantly with the increase of PASP, and was positively correlated with PASP (P<0.001). The ARPV/SPV larger than 0.8 could be better adopted to identify all the subjects with PH in this study. The Doppler flow spectra of the SVC could be employed to assess the severity of ATEPH.
Echocardiography 09/2011; 28(9):941-7. · 1.24 Impact Factor
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ABSTRACT: To evaluate the effect of transarterial pulsed perfusion with 60 °C saline on vascular permeability of tumor tissue, as well as its hepatic and renal toxicity, in a rabbit VX2 liver model.
VX2 carcinomas were grown in rabbit livers, forty male New Zealand white tumor-bearing rabbits were randomly divided into four groups, followed by transarterial perfusion with 37 °C saline 60 ml (n=10) (control 1 group), transarterial pulsed perfusion with 37 °C saline 60 ml (n=10) (control 2 group), transarterial continuous perfusion with 60 °C saline 60 ml (n=10) (TCP group), transarterial pulsed perfusion with 60 °C saline 60 ml (n=10) (TPP group), the duration of time for tumor tissues in the range 43-45 °C of the treated groups was measured with needle thermometer during perfusion. Vascular permeability was assessed using the extravasation of Evans blue (EB) dye in the tumor or normal liver tissues of the four groups separately, the tumor or normal liver tissues of the four groups were estimated by histopathologic examination, and hepatic and renal toxicity was evaluated by means of blood biochemical analysis. The vascular endothelial cells in the tumor were observed by transmission electron microscopy (TEM).
The duration of time for tumor tissues in the range 43-45 °C of TPP group showed significantly longer than that of TCP group (12.3±3.3 min vs. 5.7±2.5 min) (P<0.01). After perfusion, the EB content of tumor tissue in TPP group showed significantly higher than that in TCP group (15.21±0.94 μg/100 mg vs. 10.71±0.84 μg/100 mg) (P<0.01), and also showed significantly higher than that in the two control group (3.42±0.87 μg/100 mg, 3.57±0.64 μg/100 mg) (P<0.01). Blood chemical analysis indicating there was an increase (P<0.05) in the serum ALT, AST levels in the two heated perfusion groups at 1, 2, 4, 8 h after infusion when compared to that in the two control group, but there was no significant difference in the serum ALT, AST levels among the four groups at 24 h after perfusion (P>0.05), and there was no significant difference in the serum BUN, Cr levels among the four groups at 1, 2, 4, 8, 24 h after perfusion. Observed by hematoxylin and eosin staining, there were no obvious signs of tissue destruction in liver tissue and tumor tissue. TEM indicating the endothelial cell gap was broadened and the endothelial cells' microvillus was decreased after heated perfusion.
The vascular permeability of the rabbit VX2 tumor was significantly increased after transarterial pulsed perfusion with 60°C saline without significant increase in hepatic and renal toxicity.
European journal of radiology 02/2011; 81(3):e209-16. · 2.65 Impact Factor
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ABSTRACT: To evaluate the therapeutic effect of heated (60 degrees C) lipiodol via hepatic artery administration in a rabbit model of VX2 liver cancer.
Thirty male New Zealand white rabbits were randomly divided into three groups with 10 rabbits assigned to each group. VX2 carcinoma cells were surgically implanted into the left hepatic lobe. The tumors were allowed to grow for 2 weeks, and studies were performed until the diameter of the tumors detected by ultrasonograph reached 2-3cm. Under anesthesia, trans-catheter hepatic arterial embolization was performed and doxorubicin-lipiodol (37 degrees C) (1mL), lipiodol (60 degrees C) (1mL) or control (physiological saline (37 degrees C) (1mL)) solution was injected into the hepatic arteries of animals in the three groups. One week later, the volume of the tumor was measured by ultrasonograph again. The serum of all rabbits was collected before injection and at 4 and 7 days after injection, and the level of aspartate aminotransferase (AST) was checked. The survival period of the three groups of rabbits after treatment was also recorded. During the last course of their disease, the rabbits were given analgesics to relieve suffering.
The tumor growth rate in the lipiodol (60 degrees C) group (0.92+/-0.21, tumor volume from 1811+/-435 to 1670+/-564mm(3)) was significantly lower than that in the control group (3.48+/-1.17, tumor volume from 1808+/-756 to 5747+/-1341mm(3)) (P<0.05) and in the doxorubicin-lipiodol (37 degrees C) group (1.69+/-0.26, tumor volume from 1881+/-641 to 2428+/-752mm(3)) (P<0.05). Consequently, the survival period of the animals in the lipiodol (60 degrees C) group (41.0+/-3.0 days) was significantly greater than that in the doxorubicin-lipiodol (37 degrees C) group (38.0+/-2.5 days) (P<0.05). On the other hand, there was no statistically significant difference in serum AST levels between the lipiodol (60 degrees C) group (148.2+/-11.3UL(-1)) and the doxorubicin-lipiodol (37 degrees C) group (139.7+/-12.3UL(-1)) (P>0.05). However, the serum AST level in the lipiodol (60 degrees C) group was significantly higher at 4 days after injection (P<0.05) than in the control group (68.6+/-6.6UL(-1)).
Treatment with lipiodol (60 degrees C) resulted in an effect on serum AST levels similar to that caused by treatment with doxorubicin-lipiodol (37 degrees C). Thus, lipiodol (60 degrees C) treatment could greatly prolong the survival period of rabbits with VX2 cancer by inhibiting tumor growth.
European journal of radiology 12/2008; 73(2):412-9. · 2.65 Impact Factor
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ABSTRACT: A rabbit model of acute thrombo-embolic pulmonary hypertension was developed by infusing self-thrombi into the right femoral vein and simultaneously measuring the pulmonary artery pressure via a right heart catheter and echocardiography. The model was used to explore the usefulness of an ultrasound-guided protocol. In the present study, acute thrombo-embolic pulmonary hypertension was produced in 25 of 30 healthy New Zealand rabbits; the success rate was 83%. A significant and positive correlation between the right ventricle-right atrial pressure gradient, an estimate of the pulmonary artery systolic pressure derived from tricuspid regurgitation and the pulmonary artery systolic pressure measured using the right heart catheter (r=0.765, P=0.002) was noted. During the process of establishing a rabbit model of acute thrombo-embolic pulmonary hypertension, it was demonstrated that echocardiography can be used to guide the right heart catheter to obtain pulmonary artery systolic pressure measurements, to quantify the tricuspid regurgitation jet to assess the pulmonary artery systolic pressure and to observe cardiac morphologic changes so as to evaluate cardiac function. Based on the present study, it is clear that echocardiography is valuable in improving the success rate of producing the animal model of acute thrombo-embolic pulmonary hypertension. This could ultimately facilitate preclinical research and clinical research in humans.
Ultrasound in Medicine & Biology 03/2008; 34(2):221-7. · 2.29 Impact Factor
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ABSTRACT: Hepatic arteriovenous fistula (HAVF) can be caused by trauma, hepatic biopsy, bile duct radiology, etc. Small intrahepatic HAVF can be found in lesions of carcinoma and hepatocirrhosis. Accurate detection of HAVF was magnitude in the process to take appropriate treatment in clinic. The aim of this article is to evaluate the imaging diagnostic value on HAVF and to study the imaging character of HAVF in patients with hepatocellular carcinoma (HCC), and to evaluate the role of ultrasonographic and radiological techniques in the diagnosis and management of developmental intrahepatic shunts so as to assess the imaging diagnostic evaluation in a follow-up study.
Seventy-eight patients diagnosed with HCC were enrolled in this study, and retrospective analysis of ultrasonographic and radiological data was carried out on all 78 patients, and 25 patients suspected of having HAVF were selected. The results from ultrasonography were compared with that from digital subtraction angiography (DSA) as a gold standard. The portal and hepatic veins, hepatic arteries and vessels around and inside the tumour patients were detected and the haemodynamic indices were recorded with ultrasonography. Ten patients with HAVF were followed up after the therapy of arterial embolization and the reversal effect of the therapy was observed. Associations of HAVF with clinical and ultrasonographic features were evaluated by stepwise logistic regression analysis.
Twenty-five of 78 HAVF patients were detected by ultrasonography and other imaging methods. Ultrasonographic parameters made excellent predictions for the patients with HAVF; sensitivity (SE) 83.3%, specificity (SP) 90.7%, positive predictive value (pPV, 80.0%), negative predictive value (nPV) 92.5% and accuracy 88.5%. Among the 25 HAVF patients, 16 were central hepatic artery-portal vein fistulae, seven were peri-hepatic artery-portal vein fistulae and two were hepatic artery-vein shunts. Characteristic ultrasonographic methods of hepatic artery-portal vein fistulae were as follows: 10 patients with hepatic artery-portal vein fistula were followed up after embolization. Compared with that of preembolization, seven cases returned to normal and in three patients abnormalities were still detected.
Ultrasonographic evaluation of HAVF is easy to perform, reproducible and, when present, gives a high degree of certainty for the diagnosis of HAVF. Ultrasonography is a valuable method for the diagnoses HAVF; it can offer imaging evidence after the treatment of hepatic cell cancer. HAVF in patients with HCC can be detected by ultrasonographic methods, which are characterized by changes of hepatic arteries and veins involved in fistulas. These can be used for diagnosing HAVF and evaluating its arterial embolization effect in patients with HCC.
Liver international: official journal of the International Association for the Study of the Liver 09/2007; 27(6):869-75. · 3.82 Impact Factor
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ABSTRACT: It has been proved that vital signs of organism can be influenced by heat infusion and the thermochemotherapy with Adriamycin (ADM) is more effective than the general chemotherapy in inhibiting extraneous rabbit VX-2 cells. Intermittent thermochemotherapeutic infusion and continuous thermochemotherapeutic infusion with ADM were performed respectively on the rabbits to evaluate the effectiveness and safety of intermittent thermochemotherapeutic intra artery infusion by comparing their respiration rate, heart rate, body temperature, and the ADM concentration in VX-2 carcinoma.
VX-2 tumor models were established in the hind legs of 30 New Zealand rabbits, and then they were divided into three groups (10 in each group) randomly. 100 ml saline and ADM in room temperature were infused, 100 ml saline and ADM in 60 degrees C were intermittently infused, and 100 ml saline and ADM in 60 degrees C were continuously infused into the tumor nutrient arteries, which were confirmed by DSA, of the rabbits in each group respectively. During the infusion, the 43-45 degrees C lasting time of the tumor tissues in the two 60 degrees C infusion groups was measured. After the infusion,the respiratory rate,heart rate,body temperature,and the concentration of ADM within the tumors were determined.
The concentration of ADM was 7.115+/-2.180 microg/ml in the room temperature infusion group,17.213+/-1.657 microg/ml in the 60 degrees C continuous infusion group, and 16.545+/-3.426 microg/ml in the 60 degrees C intermittent infusion group. There was no significant difference between the 60 degrees C intermittent infusion group and the 60 degrees C continuous infusion group (P >0.05), while there was significant difference between the 60 degrees C intermittent infusion groups and the room temperature infusion group,so was between 60 degrees C continuous infusion groups and the room temperature group (P< 0.05). The 43-45 degrees C lasting time was 22.53+/-1.44 minutes in the continuous infusion group and 24.31+/-2.45 minutes in the intermittent infusion group. There was no significant difference between these two groups (P >0.05). There was no significant difference in the respiration rate, heart rate, and body temperature between the 60 degrees C intermittent infusion group and the room temperature infusion group (P >0.05).
Compared with continuous infusion, intermittent thermochemotherapy intra artery infusion is a more effective and safer interventional thermochemotherapy.
Ai zheng = Aizheng = Chinese journal of cancer 05/2004; 23(4):372-5.
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ABSTRACT: It was reported that heating could enhance the sensitivity of chemotherapy with Adriamycin and increase the intracellular content of Adriamycin. The aim of this study was to investigate the effect of interventional chemothermotherapy on vascular permeability of tumor liver tissue and normal liver tissue in VX-2 tumor-bearing rabbits.
Thirty rabbits used as implanted hepatocarcinoma model were randomly divided into 3 groups: non-perfusion group (injected only with 1% Evans blue after catheterization), normothermic perfusion group (the perfusion fluid was 25 degrees C normal solution), and hyperthermic perfusion group(the perfusion fluid was 60 degrees C normal solution). The contents of Evans blue in the tissues of three groups, which were used as the indices of vascular permeability, were calculated by the standard curve and spectrophotometry.
The Evans blue contents in tumor liver tissue and normal liver tissue is statistically different (P < 0.05). There was no over difference of the Evans blue contents in two kinds of tissue between normal perfusion group and non-perfusion group. There was overt difference of the Evans blue contents in two kinds of tissue between hyperthermic perfusion group and normothermic perfusion group.
Interventional chemothermotherapy could increase the vascular permeability of normal liver tissue and tumor liver tissue.
Ai zheng = Aizheng = Chinese journal of cancer 09/2002; 21(9):954-6.
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Hong-xin Zhang,
Yan Liu, Wei Cao,
Zhi-min Wang,
Wei-ping Guo,
Dai-hui Ni,
Yi-yong Liu,
Yi-qing Wang,
Wen-xian Li,
Ai-lin Fan,
Rui-yang Han
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ABSTRACT: It was reported that heating can enhance sensitivity of rabbit VX2 cell to adriamycin and increase intracellular concentration of adriamycin. This study was designed to evaluate the anti-tumor effects of interventional hyperthermia and interventional chemotheramotherapy on VX2 carcinoma in rabbit liver.
VX2 carcinoma cells were surgically implanted into the right liver lobe of 60 male New Zealand white rabbits, which were randomly divided into 4 groups(15 rabbits per group). To inject physiological saline(37 degrees C), adriamycin (37 degrees C), physiological saline(60 degrees C), and adriamycin (60 degrees C) in different groups via hepatic artery of the rabbits with liver cancer. One week later, to observe the volume of tumor, the serum level of aspartate transaminase(AST), and observe the survival period of VX2 rabbits.
In group of ADM(60 degrees C), the tumor growth rate (0.53 +/- 0.21)% was significantly lower than group 2(1.09 +/- 0.26)%, group 3(3.32 +/- 1.28)%, and group 4(3.48 +/- 1.17)% (P < 0.05, P < 0.05, P < 0.01, respectively). The survival period of adriamycin (60 degrees C) group (50.0 +/- 2.0)d was significantly higher than the untreated control group (40.5 +/- 3.0)d, (P < 0.05). The serum level of AST of TNP-470 with lipiodol group was not higher than the other treated groups(P > 0.05), but being significantly higher than the untreated control group after treated(P < 0.05).
Adriamycin (60 degrees C) greatly decreases the tumour growth rate, and prolongs the survival period.
Ai zheng = Aizheng = Chinese journal of cancer 08/2002; 21(8):843-5.
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Zhonghua gan zang bing za zhi = Zhonghua ganzangbing zazhi = Chinese journal of hepatology 05/2002; 10(2):149.
