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Journal of the American Heart... May 2024Transcatheter renal denervation (RDN) has had inconsistent efficacy and concerns for durability of denervation. We aimed to investigate long-term safety and efficacy of... (Comparative Study)
Comparative Study
BACKGROUND
Transcatheter renal denervation (RDN) has had inconsistent efficacy and concerns for durability of denervation. We aimed to investigate long-term safety and efficacy of transcatheter microwave RDN in vivo in normotensive sheep in comparison to conventional radiofrequency ablation.
METHODS AND RESULTS
Sheep underwent bilateral RDN, receiving 1 to 2 microwave ablations (maximum power of 80-120 W for 240 s-480 s) and 12 to 16 radiofrequency ablations (180 s-240 s) in the main renal artery in a paired fashion, alternating the side of treatment, euthanized at 2 weeks (acute N=15) or 5.5 months (chronic N=15), and compared with undenervated controls (N=4). Microwave RDN produced substantial circumferential perivascular injury compared with radiofrequency at both 2 weeks [area 239.8 (interquartile range [IQR] 152.0-343.4) mm versus 50.1 (IQR, 32.0-74.6) mm, <0.001; depth 16.4 (IQR, 13.9-18.9) mm versus 7.5 (IQR, 6.0-8.9) mm <0.001] and 5.5 months [area 20.0 (IQR, 3.4-31.8) mm versus 5.0 (IQR, 1.4-7.3) mm, =0.025; depth 5.9 (IQR, 1.9-8.8) mm versus 3.1 (IQR, 1.2-4.1) mm, =0.005] using mixed models. Renal denervation resulted in significant long-term reductions in viability of renal sympathetic nerves [58.9% reduction with microwave (=0.01) and 45% reduction with radiofrequency (=0.017)] and median cortical norepinephrine levels [71% reduction with microwave ( <0.001) and 72.9% reduction with radiofrequency ( <0.001)] at 5.5 months compared with undenervated controls.
CONCLUSIONS
Transcatheter microwave RDN produces deep circumferential perivascular ablations without significant arterial injury to provide effective and durable RDN at 5.5 months compared with radiofrequency RDN.
Topics: Animals; Microwaves; Sympathectomy; Renal Artery; Kidney; Sheep; Catheter Ablation; Time Factors; Disease Models, Animal; Blood Pressure; Female; Radiofrequency Ablation
PubMed: 38664237
DOI: 10.1161/JAHA.123.031795 -
Scientific Reports Oct 2023Heart rate (HR) is a crucial physiological signal that can be used to monitor health and fitness. Traditional methods for measuring HR require wearable devices, which...
Heart rate (HR) is a crucial physiological signal that can be used to monitor health and fitness. Traditional methods for measuring HR require wearable devices, which can be inconvenient or uncomfortable, especially during sleep and meditation. Noncontact HR detection methods employing microwave radar can be a promising alternative. However, the existing approaches in the literature usually use high-gain antennas and require the sensor to face the user's chest or back, making them difficult to integrate into a portable device and unsuitable for sleep and meditation tracking applications. This study presents a novel approach for noncontact HR detection using a miniaturized Soli radar chip embedded in a portable device (Google Nest Hub). The chip has a [Formula: see text] dimension and can be easily integrated into various devices. The proposed approach utilizes advanced signal processing and machine learning techniques to extract HRs from radar signals. The approach is validated on a sleep dataset (62 users, 498 h) and a meditation dataset (114 users, 1131 min). The approach achieves a mean absolute error (MAE) of 1.69 bpm and a mean absolute percentage error (MAPE) of [Formula: see text] on the sleep dataset. On the meditation dataset, the approach achieves an MAE of 1.05 bpm and a MAPE of [Formula: see text]. The recall rates for the two datasets are [Formula: see text] and [Formula: see text], respectively. This study represents the first application of the noncontact HR detection technology to sleep and meditation tracking, offering a promising alternative to wearable devices for HR monitoring during sleep and meditation.
Topics: Humans; Heart Rate; Meditation; Sleep; Monitoring, Physiologic; Heart Rate Determination
PubMed: 37865634
DOI: 10.1038/s41598-023-44714-2 -
PloS One 2023Heat-induced destruction of cancer cells via microwave ablation (MWA) is emerging as a viable treatment of primary and metastatic liver cancer. Prediction of the...
PURPOSE
Heat-induced destruction of cancer cells via microwave ablation (MWA) is emerging as a viable treatment of primary and metastatic liver cancer. Prediction of the impacted zone where cell death occurs, especially in the presence of vasculature, is challenging but may be achieved via biophysical modeling. To advance and characterize thermal MWA for focal cancer treatment, an in vivo method and experimental dataset were created for assessment of biophysical models designed to dynamically predict ablation zone parameters, given the delivery device, power, location, and proximity to vessels.
MATERIALS AND METHODS
MWA zone size, shape, and temperature were characterized and monitored in the absence of perfusion in ex vivo liver and a tissue-mimicking thermochromic phantom (TMTCP) at two power settings. Temperature was monitored over time using implanted thermocouples with their locations defined by CT. TMTCPs were used to identify the location of the ablation zone relative to the probe. In 6 swine, contrast-enhanced CTs were additionally acquired to visualize vasculature and absence of perfusion along with corresponding post-mortem gross pathology.
RESULTS
Bench studies demonstrated average ablation zone sizes of 4.13±1.56cm2 and 8.51±3.92cm2, solidity of 0.96±0.06 and 0.99±0.01, ablations centered 3.75cm and 3.5cm proximal to the probe tip, and temperatures of 50 ºC at 14.5±13.4s and 2.5±2.1s for 40W and 90W ablations, respectively. In vivo imaging showed average volumes of 9.8±4.8cm3 and 33.2±28.4cm3 and 3D solidity of 0.87±0.02 and 0.75±0.15, and gross pathology showed a hemorrhagic halo area of 3.1±1.2cm2 and 9.1±3.0cm2 for 40W and 90W ablations, respectfully. Temperatures reached 50ºC at 19.5±9.2s and 13.0±8.3s for 40W and 90W ablations, respectively.
CONCLUSION
MWA results are challenging to predict and are more variable than manufacturer-provided and bench predictions due to vascular stasis, heat-induced tissue changes, and probe operating conditions. Accurate prediction of MWA zones and temperature in vivo requires comprehensive thermal validation sets.
Topics: Animals; Swine; Liver; Microwaves; Temperature; Ablation Techniques; Radiofrequency Ablation
PubMed: 37540658
DOI: 10.1371/journal.pone.0289674 -
Bioactive Materials Sep 2023Currently, precise ablation of tumors without damaging the surrounding normal tissue is still an urgent problem for clinical microwave therapy of liver cancer. Herein,...
Currently, precise ablation of tumors without damaging the surrounding normal tissue is still an urgent problem for clinical microwave therapy of liver cancer. Herein, we synthesized Mn-doped Ti MOFs (Mn-Ti MOFs) nanosheets by in-situ doping method and applied them for microwave therapy. Infrared thermal imaging results indicate Mn-Ti MOFs can rapidly increase the temperature of normal saline, attributing to the porous structure improving microwave-induced ion collision frequency. Moreover, Mn-Ti MOFs show higher O output than Ti MOFs under 2 W of low-power microwave irradiation due to the narrower band-gap after Mn doping. At the same time, Mn endows the MOFs with a desirable T contrast of magnetic resonance imaging (r/r = 2.315). Further, results on HepG2 tumor-bearing mice prove that microwave-triggered Mn-Ti MOFs nearly eradicate the tumors after 14 days of treatment. Our study offers a promising sensitizer for synergistic microwave thermal and microwave dynamic therapy of liver cancer.
PubMed: 37006824
DOI: 10.1016/j.bioactmat.2023.03.019 -
Oncology Reviews 2023Liver is the most common site of colorectal cancer (CRC) metastases. Treatment of CRC liver metastases (CRLM) includes different strategies, prevalently based on the... (Review)
Review
Liver is the most common site of colorectal cancer (CRC) metastases. Treatment of CRC liver metastases (CRLM) includes different strategies, prevalently based on the clinical and oncological intent. Valid approaches in liver-limited or liver-prevalent disease include surgery, percutaneous ablative procedures (radiofrequency ablation, microwave ablation), intra-arterial perfusional techniques (chemo-embolization, radio-embolization) as well as stereotactic radiotherapy. Systemic treatments, including chemotherapy, immunotherapy and other biological agents, are the only options for patients with no chance of locoregional approaches. The use of chemotherapy in other settings, such as neoadjuvant, adjuvant or conversion therapy of CRLM, is commonly accepted in the clinical practice, although data from several clinical trials have been mostly inconclusive. The optimal integration of all these strategies, when applicable and clinically indicated, should be ever considered in patients affected by CRLM based on clinical evidence and multidisciplinary experience. Here we revised in detail all the possible therapeutic approaches of CRLM focusing on the current evidences, the studies still in progress and the often contradictory data.
PubMed: 38239856
DOI: 10.3389/or.2023.11799 -
Molecules (Basel, Switzerland) Oct 2023Peptides are at the cutting edge of contemporary research for new potent, selective, and safe therapeutical agents. Their rise has reshaped the pharmaceutical landscape,... (Review)
Review
Peptides are at the cutting edge of contemporary research for new potent, selective, and safe therapeutical agents. Their rise has reshaped the pharmaceutical landscape, providing solutions to challenges that traditional small molecules often cannot address. A wide variety of natural and modified peptides have been obtained and studied, and many others are advancing in clinical trials, covering multiple therapeutic areas. As the demand for peptide-based therapies grows, so does the need for sustainable and environmentally friendly synthesis methods. Traditional peptide synthesis, while effective, often involves environmentally draining processes, generating significant waste and consuming vast resources. The integration of green chemistry offers sustainable alternatives, prioritizing eco-friendly processes, waste reduction, and energy conservation. This review delves into the transformative potential of applying green chemistry principles to peptide synthesis by discussing relevant examples of the application of such approaches to the production of active pharmaceutical ingredients (APIs) with a peptide structure and how these efforts are critical for an effective green transition era in the pharmaceutical field.
Topics: Peptides; Chemistry Techniques, Synthetic; Pharmaceutical Preparations
PubMed: 37894644
DOI: 10.3390/molecules28207165 -
Advanced Science (Weinheim,... Jul 2023Microwave (MV)-trigged dynamic therapy based on MV-responsive materials is promising for treating deep infection diseases that cannot be effectively treated by...
Microwave (MV)-trigged dynamic therapy based on MV-responsive materials is promising for treating deep infection diseases that cannot be effectively treated by antibiotics, like life-threatening osteomyelitis. Surface states of materials affect the generation of free charges under the excitation source with energy less than the band gap, consequently influencing the MV dynamic effects. Herein, an MV responsive system with interface confined 2D metal-organic framework (2D MOF) on oxidized carbon nanotube (CNT) is prepared, in which the ultrasmall Cu-based 2D MOF possesses sufficient surface/interface defects, endowing the system a large number of surface states. Under MV irradiation, the synthesized CNT-2D MOF not only efficiently absorbs and converts the microwave into heat for microwaveocaloric therapy (MCT) via enhanced hetero-interfacial polarization, but also generates excited electrons via surface state for microwave dynamic therapy (MDT). This biocompatible CNT-2D MOF exhibits highly effective broad-spectrum antimicrobial activity against seven pathogenic bacteria, including Gram-negative and Gram-positive pathogens, under 7 min MV irradiation. And this system is proven to efficiently eradicate Staphylococcus aureus infected rabbit tibia osteomyelitis. Significantly, MV-excited MCT and MDT of CNT-CuHHTP developed in this study makes a major step forward in antibiotic-free MV therapy in deep tissue bacterial infection diseases.
Topics: Animals; Rabbits; Microwaves; Metal-Organic Frameworks; Anti-Bacterial Agents; Electrons; Osteomyelitis
PubMed: 37203263
DOI: 10.1002/advs.202300084 -
Clinical and Molecular Hepatology Oct 2023There is no clear consensus on the relative ranking of interventional and radiation techniques with indications similar to those of radiofrequency ablation (RFA) for the... (Meta-Analysis)
Meta-Analysis
BACKGROUND/AIMS
There is no clear consensus on the relative ranking of interventional and radiation techniques with indications similar to those of radiofrequency ablation (RFA) for the treatment of early hepatocellular carcinoma (HCC). We used a network meta-analysis to compare the efficacy of non-surgical treatments for early HCC.
METHODS
We searched databases for randomized trials assessing the efficacy of loco-regional treatments for HCCs ≤5 cm with no extrahepatic spread or portal invasion. The primary outcome was the pooled hazard ratio (HR) for overall survival (OS), and secondary outcomes included overall and local progression-free survival (PFS). A frequentist network meta-analysis was performed, and the relative ranking of therapies was assessed with P-scores.
RESULTS
Nineteen studies comparing 11 different strategies in 2,793 patients were included. Chemoembolization plus RFA improved OS better than RFA alone (HR 0.52, 95% confidence interval [CI] 0.33-0.82; P-score=0.951). Cryoablation, microwave ablation, laser ablation, and proton beam therapy had similar effects on OS compared with RFA. For overall PFS, but not local PFS, only chemoembolization plus RFA performed significantly better than RFA (HR 0.61, 95% CI 0.42-0.88; P-score=0.964). Injection of percutaneous ethanol or acetic acid was significantly less effective than RFA for all measured outcomes, while no differences in progression outcomes were identified for other therapies included in the network.
CONCLUSION
Our results suggest that chemoembolization combined with RFA is the best option for local treatment of early HCC. Cases with potential contraindications for RFA may benefit from a tailored approach using thermal or radiation modalities.
Topics: Humans; Carcinoma, Hepatocellular; Liver Neoplasms; Network Meta-Analysis; Catheter Ablation; Radiofrequency Ablation; Chemoembolization, Therapeutic; Treatment Outcome; Retrospective Studies
PubMed: 37403319
DOI: 10.3350/cmh.2023.0131 -
Bioactive Materials Sep 2024Once bone metastasis occurs in lung cancer, the efficiency of treatment can be greatly reduced. Current mainstream treatments are focused on inhibiting cancer cell...
Once bone metastasis occurs in lung cancer, the efficiency of treatment can be greatly reduced. Current mainstream treatments are focused on inhibiting cancer cell growth and preventing bone destruction. Microwave ablation (MWA) has been used to treat bone tumors. However, MWA may damage the surrounding normal tissues. Therefore, it could be beneficial to develop a nanocarrier combined with microwave to treat bone metastasis. Herein, a microwave-responsive nanoplatform (MgFeO@ZOL) was constructed. MgFeO@ZOL NPs release the cargos of Fe, Mg and zoledronic acid (ZOL) in the acidic tumor microenvironment (TME). Fe can deplete intracellular glutathione (GSH) and catalyze HO to generate •OH, resulting in chemodynamic therapy (CDT). In addition, the microwave can significantly enhance the production of reactive oxygen species (ROS), thereby enabling the effective implementation of microwave dynamic therapy (MDT). Moreover, Mg and ZOL promote osteoblast differentiation. In addition, MgFeO@ZOL NPs could target and selectively heat tumor tissue and enhance the effect of microwave thermal therapy (MTT). Both in vitro and in vivo experiments revealed that synergistic targeting, GSH depletion-enhanced CDT, MDT, and selective MTT exhibited significant antitumor efficacy and bone repair. This multimodal combination therapy provides a promising strategy for the treatment of bone metastasis in lung cancer patients.
PubMed: 38883314
DOI: 10.1016/j.bioactmat.2024.04.016 -
Journal of Enzyme Inhibition and... Dec 2023Twenty-five azole compounds (-) were synthesised using regioselective base-metal catalysed and microwave-assisted approaches, fully characterised by high-resolution mass...
Twenty-five azole compounds (-) were synthesised using regioselective base-metal catalysed and microwave-assisted approaches, fully characterised by high-resolution mass spectrometry (HRMS), nuclear magnetic resonance (NMR), and infrared spectra (IR) analyses, and evaluated for anticancer, anti-tyrosinase, and anti-oxidant activities and . exhibited potent anticancer activity against cells of four skin cancer (SC) lines, with selectivity for melanoma (A375, SK-Mel-28) or non-melanoma (A431, SCC-12) SC cells over non-cancerous HaCaT-keratinocytes. Clonogenic, scratch-wound, and immunoblotting assay data were consistent with anti-proliferative results, expression profiling therewith implicating intrinsic and extrinsic apoptosis activation. In a mushroom tyrosinase inhibition assay, was most potent among the compounds (half-maximal inhibitory concentration where 50% of cells are dead, IC 15.9 μM), with activity greater than arbutin and kojic acid. Also, exhibited noteworthy free radical-scavenging activity. Furthermore, docking and absorption, distribution, metabolism, excretion, and toxicity (ADMET) simulations predicted prominent-phenotypic actives to engage diverse cancer/hyperpigmentation-related targets with relatively high affinities. Altogether, promising early-stage hits were identified - some with multiple activities - warranting further hit-to-lead optimisation chemistry with further biological evaluations, towards identifying new skin-cancer and skin-pigmentation renormalising agents.
Topics: Humans; Monophenol Monooxygenase; Antioxidants; Molecular Structure; Enzyme Inhibitors; Molecular Docking Simulation; Computer Simulation; Skin Neoplasms; Azoles; Pyrazoles
PubMed: 37184042
DOI: 10.1080/14756366.2023.2205042