Thermal and morphological effects of hepatic blood flow variations during liver resections with the Nd-YAG laser

Observations are presented on the thermal and anatomical effects of variations in hepatic blood flow during partial hepatic resection with the neodymium-doped yttrium aluminium garnet (Nd-YAG) laser in a comparative series of 21 pigs. Occlusion of the hepatic vessels both accelerates and prolongs the increase in parenchymal temperature, increases the thickness of surface necrosis and induces clotting in the underlying veins. On postoperative day 3, there is inflammatory cell and fibroblast migration which lasts until day 15. Between days 10 and 60, new vessel formation is apparent in the fibrous tissue underlying the resection site. The inflammatory reaction is less marked when hepatic blood flow is left intact. Clamping the hepatic vessels enhances tumour-cell death during surgery, promotes a local inflammatory response and may enhance the effects of local chemotherapy.

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Les effets thermiques et morphologiques des variations du flux sanguin pédiculaire sur les résections hépatiques partielles au laser YAG-Nd

Résumé Les auteurs présentent les effets thermiques et anatomiques dûs aux variations du flux sanguin hépatique lors des résections partielles du foie au laser YAG-Nd sur une série comparative de 21 porcs. Le clampage pédiculaire augmente l'amplitude et la durée de la réponse thermique, majore l'épaisseur de la nécrose de surface et induit un effet de blocage sur les veines avoisinant la résection. Il entraîne dès le troisième jour post-opératoire (J 3) un afflux de cellules inflammatoires et une fibrose qui s'élargit jusqu'à J15. De J 10 à 2 mois, une importante néovascularisation se développe sur la surface du foie réséqué. Le flux sanguin étant conservé, ces réactions sont retardées et moins intenses. Le clampage est donc proposé pour augmenter la destruction des cellules tumorales lors d'une résection, pour accroître les défenses locales ultérieures et pour faciliter l'action de la chimiothérapie.

     

早期乳腺癌保守性手术后放射治疗进展

保守性手术已成为早期乳腺的主要治疗方式，而放射治疗是乳腺癌保乳综合治疗中一个不可缺少的组成部分，是防止局部复发的根本保证。因此，术后放射治疗很关键。     

超氧化物歧化酶及过氧化氢酶对辐射所致红细胞溶血及脂类过氧化的影响

辐射所致红细胞溶血率不仅随照射剂量增加而增加,而且随放置时间的延长,溶血率也相应增加。加入牛红细胞超氧化物歧化酶或从牛肝中纯化的过氧化氢酶可使溶血率显著减少。辐射可使红细胞发生脂类过氧化,其脂类过氧化值随着照射剂量增加而增加。加入超氧化物歧化酶,对脂类过氧化的减轻作用不明显或很轻微,但加入过氧化氢酶却有较强的减轻脂类过氧化的效果,而且还观察到茜甙减轻脂类过氧化的效能类似维生素E。     

恶性肿瘤术中组织间永久植入125I粒子放疗

125I粒子组织间永久植入治疗恶性肿瘤,具有病变组织接受内辐射剂量大、有效抑制或破坏肿瘤组织、操作简便、无并发症等优点。国外主要通过介导植入法广泛用于前列腺癌的治疗。查金顺     

ORIGINAL ARTICLE: Comparison of a Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility

The aim was to compare a private Commonwealth-initiated regional radiation oncology facility in Toowoomba with a Queensland Health facility (QHF) in Brisbane. The comparison concentrated on staffing, case mix and operational budgets, but was not able to look at changes in access to services. Data were collected from the two facilities from January 2008 to June 2008 inclusive. A number of factors were compared, including case mix, staffing levels, delay times for treatment, research, training and treatment costs. The case mix between the two areas was similar with curative treatments making up just over half the work load in both centres and two-thirds the work being made up of cancers of breast and prostate. Staffing levels were leaner in Toowoomba, especially in the areas of nursing, administration and trial coordinators. Research activity was slightly higher in Toowoomba. The average medicare cost per treatment course was similar in both centres ($5000 per course). Total costs of an average treatment including patient, State and Commonwealth costs, showed a 30% difference in costing favouring Toowoomba. This regional radiation oncology centre has provided state-of-the-art cancer care that is close to home for patients living in the Darling Downs region. Both public and private patients have been treated with modest costs to the patient and significant savings to QH. The case mix is similar to the QHF, and there has been significant activity in clinical research. A paperless working environment is one factor that has allowed staffing levels to be reduced. Ongoing support from Governments are required if private facilities are to participate in important ongoing staff training.     

Phloroglucinol (PG) purified from Ecklonia cava attenuates radiation-induced apoptosis in blood lymphocytes and splenocytes

Phloroglucinol (PG), a polyphenol compound of Eckloniacava known as brown algae abundant in Jeju island, has been proposed to exert the antioxidative and cytoprotective effects against oxidative stress. In this study, we confirmed that PG protected mice from damages caused by ionizing radiation and investigated its protection mechanism in detail. The result showed that PG increased the viability of splenocytes without cytotoxicity. Also, PG significantly enhanced the proliferation of splenocytes by limiting the increment of sub-G₁ DNA contents via the inhibition of reactive oxygen species production in 2 Gy-irradiated splenocytes. In addition, PG significantly decreased DNA damage and the number of apoptotic fragments in lymphocytes against oxidative stress. Also, PG increased the counts of endogenous spleen CFUs, compared with only ionizing radiation-irradiated mice. These results demonstrate the multi-faceted protection mechanisms of PG in mice against oxidative stress caused by ionizing radiation, providing the benefit of inhibiting apoptosis and strengthening hematopoiesis.     

A case of radiation‐induced osteosarcoma of the skull presenting as a cutaneous epidermotropic tumor with a short latent period

Radiation‐induced sarcoma (RIS) is an unusual but well documented tumor. The frequency of RIS of the head and neck region has been reported as 0.143%. In the literature the median interval between irradiation and development of sarcoma is 11 years. Cases of RIS with a short latent period, that is, less than 4 years are rare. We report a case of a 34‐year‐old female who developed an osteosarcoma of the scalp, over a previous craniotomy scar, 3 years after excision of a frontal anaplastic oligodendroglioma which had been followed by a course of 6 weeks radiotherapy (58 Gy) and 6 cycles of temozolomide. The histological features were those of a high‐grade osteosarcoma with epidermotropism of tumor cells. Lymph nodes were partially replaced by high‐grade metastatic osteosarcoma, with extra‐nodal lymphatic tumor thrombi. To our knowledge the only other case report of post‐radiation osteosarcoma with a short latency period was a case of osteosarcoma in the craniofacial bone 3 years after radiotherapy for maxillary squamous cell carcinoma. The histological finding of prominent replacement of the epidermis by osteosarcoma has not been reported before.     

Radiochemical and biological evaluation of novel 153Sm/166Ho‐amino acid–chitosan complexes

¹⁵³Sm/¹⁶⁶Ho‐chitosan complexes have been considered promising agents for internal radiation therapy. By direct administration, complexes solution converts into a gel, at physiological pH, allowing its retention for a long time. Herein, we report on the synthesis of ¹⁵³Sm/¹⁶⁶Ho complexes with the novel amino acid–chitosan polymers, N‐(γ‐propanoyl‐valin)–chitosan (CHICO‐val) and N‐(γ‐propanoyl‐aspartic acid)–chitosan (CHICO‐asp). The main goal of this study was to obtain data on the radiochemical and biological behaviour of these complexes and information regarding their therapeutic potential when compared to ¹⁵³Sm/¹⁶⁶Ho‐chitosan. Radiolabelling yield of ¹⁵³Sm/¹⁶⁶Ho‐amino acid–chitosan complexes was dependent on polymer concentration but less dependent on pH. Radiochemical stability was shown to be higher for amino acid–chitosans than for chitosan, with ¹⁵³Sm/¹⁶⁶Ho‐CHICO‐val being stable up to 3 h, while ¹⁵³Sm/¹⁶⁶Ho‐CHICO‐asp is stable up to 24 h. In the presence of ascorbic acid radiochemical stability of ¹⁵³Sm/¹⁶⁶Ho‐CHICO‐val and ¹⁵³Sm/¹⁶⁶Ho‐CHICO was improved, decreasing for ¹⁵³Sm/¹⁶⁶Ho‐CHICO‐asp. In vivo behaviour of ¹⁵³Sm complexes was studied in mice. The radioactive amino acid–chitosans can be directly injected into blood stream without significant retention on injection site, being trapped by liver. Biodistribution studies suggest that the radioactive amino acid–chitosans, due to its water solubility and stability may be considered potential candidates to be further explored for liver targeted nuclear therapy. Copyright © 2008 John Wiley & Sons, Ltd.