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Free Radical Biology & Medicine Jun 2024Osteomyelitis, a grave deep tissue infection primarily caused by Staphylococcus aureus, results in serious complications such as abscesses and sepsis. With the incidence...
Osteomyelitis, a grave deep tissue infection primarily caused by Staphylococcus aureus, results in serious complications such as abscesses and sepsis. With the incidence from open fractures exceeding 30 % and prevalent antibiotic resistance due to extensive treatment regimens, there's an urgent need for innovative, antibiotic-free strategies. Photothermal therapy (PTT) and photodynamic therapy (PDT) renowned for generating localized reactive oxygen species (ROS), face limitations in penetration depth. To overcome this, our method combines the deep penetration attributes of medical microwaves (MW) with the synergistic effects of the ZnO/ZrO solid solution. Comprehensive in vitro and in vivo evaluations showcased the solid-solution's potent antibacterial efficacy and biocompatibility. The ZnO/ZrO solid solution, especially in a 7:3 M ratio, manifests superior microstructural characteristics, optimizing MW-assisted therapy. Our findings highlight the potential of this integrated strategy as a promising avenue in osteomyelitis management.
PubMed: 38848785
DOI: 10.1016/j.freeradbiomed.2024.05.049 -
Langmuir : the ACS Journal of Surfaces... Jun 2024Herein, we constructed the branch-shaped SiO/nano GO (nGO)/FeO/selenium quantum dots (QDs) (SeQDs) nanoparticles (SGF/SeQDs) embodying magnetism, fluorescence, and...
Herein, we constructed the branch-shaped SiO/nano GO (nGO)/FeO/selenium quantum dots (QDs) (SeQDs) nanoparticles (SGF/SeQDs) embodying magnetism, fluorescence, and microwave stimulus response properties to enhance the performance of releasing drugs. The SGF/SeQDs composite was characterized by technologies including powder X-ray diffraction, transmission electron microscopy, infrared spectroscopy, etc. In the nanoparticles, the branch-shaped SiO provides a large specific surface area, nGO as the dielectric loss-style material promotes microwave-absorbing performance, and the FeO serves as a magnetic targeting agent and microwave absorber. Integrating nGO and FeO could further strengthen the microwave absorption of the entire composite; selenium features both fluorescence and anticancer effects. The synthesized nanoparticles as carriers exhibited a branch-like mesoporous sphere of ∼260 nm, a specific surface area of 258.57 m g, a saturation magnetization of 24.59 emu g, and good microwave thermal conversion performance that the temperature was elevated from 25 to 70 °C under microwave irradiation. These physical characteristics, including large pore volume (5.30 nm), high specific surface area, and fibrous morphology, are in favor of loading drugs. Meanwhile, the cumulative etoposide (VP16) loading rate of the nanoparticles reached to 21 wt % after 360 min. The noncovalent interaction between the VP16 and SGF/SeQDs was mainly the hydrogen-bonding effect during the loading process. Furthermore, the drug release rates at 180 min were up to 81.46, 61.92, and 56.84 wt % at pH 4, 5, and 7, respectively. At 25, 37, and 50 °C, the rates of drug release reach 25.40, 56.84, and 65.32 wt %, respectively. After microwave stimulation at pH 7, the rate of releasing drug increased distinctly from 56.84 to 71.74 wt % compared to that of nonmicrowave irradiation. Cytotoxicity tests manifested that the carrier had good biocompatibility. Therefore, the nanoparticles are looking forward to paving one platform for further applications in biomedicine and drug delivery systems.
Topics: Silicon Dioxide; Drug Carriers; Humans; Quantum Dots; Selenium; Microwaves; Drug Liberation; Nanoparticles; Cell Survival; Etoposide; Antineoplastic Agents; Particle Size; Surface Properties; Ferrosoferric Oxide
PubMed: 38848468
DOI: 10.1021/acs.langmuir.4c01376 -
International Journal of Hyperthermia :... 2024The objective was to describe the technique and clinical outcome of microwave thermal ablation (MWA) and perfusion combined with synthetic bone substitutes in treating...
PURPOSE
The objective was to describe the technique and clinical outcome of microwave thermal ablation (MWA) and perfusion combined with synthetic bone substitutes in treating unicameral bone cysts (UBCs) in adolescents.
MATERIALS AND METHODS
A total of 14 consecutive patients were enrolled by percutaneous MWA and saline irrigation combined with synthetic bone substitutes. Clinical follow-up included the assessment of pain, swelling, and functional mobility. Radiological parameters included tumor volume, physis-cyst distance, cortical thickness of the thinnest cortical bone, and the Modified Neer classification system.
RESULTS
The mean follow-up was 28.9 months (26-52 months). All UBCs were primary, and all patients underwent the MWA, saline perfusion, and reconstruction combined with a synthetic bone substitute session, except for one patient (7.1%) who required a second session. All patients had good clinical results at the final follow-up. Satisfactory cyst healing was achieved in 13 cases according to radiological parameters. Tumor volume decreased from a mean of 49.7 cm before surgery treatment to 13.9 cm at the final follow-up ( < 0.01). The physis-cyst distance increased from a mean of 3.17-4.83 cm at the final follow-up ( < 0.01). Cortical thickness improved from a mean of 1.1 mm to 2.0 mm at the final follow-up ( < 0.01). According to the proposed radiological criteria, our results were considered successful (Grading I and II) in 13 patients (92.9%) at the final follow-up.
CONCLUSION
Percutaneous microwave ablation combined with a bone graft substitute is a minimally invasive, effective, safe, and cost-effective approach to treating primary bone cysts in the limbs of adolescents.
Topics: Humans; Male; Female; Adolescent; Bone Cysts; Bone Substitutes; Microwaves; Follow-Up Studies; Child; Plastic Surgery Procedures; Young Adult; Ablation Techniques
PubMed: 38843894
DOI: 10.1080/02656736.2024.2345382 -
Current Opinion in Obstetrics &... Aug 2024Adenomyosis is a common cause of abnormal uterine bleeding (AUB), dysmenorrhea, and pelvic pain. Definitive diagnosis and treatment have historically been by uterine... (Review)
Review
PURPOSE OF REVIEW
Adenomyosis is a common cause of abnormal uterine bleeding (AUB), dysmenorrhea, and pelvic pain. Definitive diagnosis and treatment have historically been by uterine histopathology at time of hysterectomy; however, advances in imaging have supported earlier diagnosis and subsequent conservative treatment. This review aims to update the evidence supporting the uterine-sparing, procedural management options with a focus on clinical outcomes.
RECENT FINDINGS
Uterine artery embolization (UAE), radiofrequency ablation (RFA), high-intensity focused ultrasound (HIFU), percutaneous microwave ablation (PMWA), and adenomyomectomy are minimally invasive interventions proven to be effective in reducing AUB and dysmenorrhea due to adenomyosis. Symptom improvement is associated with a decrease in uterine volume. Studies support the use of alternative treatment options given the overall low rates of symptom recurrence and reintervention. Combination therapy may be more effective than monotherapy.
SUMMARY
This review provides the current evidence for use of alternative treatment options for adenomyosis. Access to ablative therapies in the USA is limited and primarily off label, given lack of FDA approval. High-quality prospective and randomized controlled trials are needed in order to further delineate treatment comparisons, efficacy, safety, and ideal patient selection for these treatments. More data are needed to assess safety and utility in those desiring future fertility.
Topics: Humans; Female; Adenomyosis; Uterine Artery Embolization; Treatment Outcome; High-Intensity Focused Ultrasound Ablation; Dysmenorrhea; Radiofrequency Ablation; Uterine Hemorrhage; Pelvic Pain
PubMed: 38837727
DOI: 10.1097/GCO.0000000000000972 -
Cancer Immunology, Immunotherapy : CII Jun 2024Despite the success of immune checkpoint inhibitors (ICIs) in treating solid tumors, lots of patients remain unresponsive to this therapy. Microwave ablation (MWA)...
Despite the success of immune checkpoint inhibitors (ICIs) in treating solid tumors, lots of patients remain unresponsive to this therapy. Microwave ablation (MWA) stimulates systemic adaptive immunity against tumor cells by releasing tumor antigens. Additionally, IL-21 has demonstrated importance in stimulating T-cell effector function. The combination of these three therapies-MWA, IL-21, and anti-PD-1 monoclonal antibodies (mAbs)-has yet to be explored in the context of cancer treatment.In this study, we explored the impact of thermal ablation on IL-21R expression in tumor-infiltrating lymphocytes (TILs). Subsequently, we assessed alterations in the tumor microenvironment (TME) and peripheral lymphoid organs. Additionally, we conducted a thorough examination of tumor-infiltrating CD45 immune cells across various treatment groups using single-cell RNA sequencing (scRNA-seq). Moreover, we determined the potential anti-tumor effects of the triple combination involving MWA, IL-21, and anti-PD-1 mAbs.Our findings revealed that MWA upregulated the expression of IL-21R on various immune cells in the untreated tumors. The combination of MWA with IL-21 exhibited a robust abscopal anti-tumor effect, enhancing the effector function of CD8 T cells and facilitating dendritic cells' maturation and antigen presentation in the untreated tumor. Notably, the observed abscopal anti-tumor effect resulting from the combination is contingent upon T-cell recirculation, indicating the reliance of systemic adaptive immunity for this treatment regimen. Additionally, the combination of MWA, IL-21, and PD-1 mAbs demonstrated profound abscopal anti-tumor efficacy. Our findings provide support for further clinical investigation into a triple combination therapy involving MWA, IL-21, and ICIs for the treatment of metastatic cancer.
Topics: Interleukins; Animals; Mice; Immune Checkpoint Inhibitors; Programmed Cell Death 1 Receptor; Humans; Tumor Microenvironment; Combined Modality Therapy; Lymphocytes, Tumor-Infiltrating; Female; Neoplasms; Mice, Inbred C57BL; Cell Line, Tumor
PubMed: 38833177
DOI: 10.1007/s00262-024-03718-1 -
Journal of Liver Cancer Jun 2024Atezolizumab/bevacizumab is the recommended first-line systemic therapy for unresectable hepatocellular carcinoma (uHCC) and may facilitate curative conversion through...
INTRODUCTION
Atezolizumab/bevacizumab is the recommended first-line systemic therapy for unresectable hepatocellular carcinoma (uHCC) and may facilitate curative conversion through resection and locoregional therapies. However, there have been very few reports on curative conversion using microwave ablation (MWA). This study aimed to determine the curative conversion rate with MWA using atezolizumab-bevacizumab as the first-line treatment in patients with uHCC, and to compare the characteristics and survival of patients with and without curative conversion.
METHODS
Consecutive patients with uHCC who were started on atezolizumab-bevacizumab from May 2021 and December 2023 in a single tertiary center were included. Objective response (ORR) and disease control rate (DCR) were based on the RECIST 1.1 and mRECIST criteria.
RESULTS
Twenty consecutive patients with uHCC (60% advanced-stage) were included, 90% exceeding the up-to-7 criteria. The ORR and DCR were 35% and 60%, and 35% and 55% using RECIST and mRECIST, respectively. Five (25%) patients underwent successful curative conversion with MWA (4 advanced and 1 intermediate stage) despite a median HCC size of 6.1 (range: 2.4-7.3) cm. Two of these patients were tumor and drug-free 132-133 weeks from the 1st atezolizumab-bevacizumab dose. Patients who underwent curative conversion had significantly longer survival than those who did not. (p=0.024) Other factors associated with survival were male sex, Child-Pugh class A, and an objective response.
CONCLUSIONS
Despite the relatively large tumor size, successful curative conversion with MWA was achieved with first-line atezolizumab-bevacizumab in uHCC. However, data from prospective multicenter trials are required to determine whether this strategy is universally applicable.
PubMed: 38825875
DOI: 10.17998/jlc.2024.05.23 -
Carbohydrate Polymers Sep 2024The influence of locust bean gum (LBG) galactomannans (GMs) molecular weight (Mw) to assemble microparticulate systems was evaluated, and carriers for deep lung delivery...
The influence of locust bean gum (LBG) galactomannans (GMs) molecular weight (Mw) to assemble microparticulate systems was evaluated, and carriers for deep lung delivery were developed. A commercial batch of LBG with a mannose/galactose (M/G) ratio of 2.4 (batch 1) was used to study the influence of different microwave partial acid hydrolysis conditions on carbohydrate composition, glycosidic linkages, and aqueous solutions viscosity. The microwave treatment did not affect the composition, presenting 4-Man (36-42 %), 4,6-Man (27-35 %), and T-Gal (24-25 %) as the main glycosidic linkages. Depolymerization led to a viscosity reduction (≤0.005 Pa·s) with no major impact on polysaccharide debranching. The structural composition of the LBG galactomannans were further elucidated with sequence-specific proteins using carbohydrate microarray technologies. A second batch of LBG (M/G 3.3) was used to study the impact of GMs with different Mw on microparticle assembling, characteristics, and insulin release kinetics. The low-Mw GMs microparticles led to a faster release (20 min) than the higher-Mw (40 min) ones, impacting the release kinetics. All microparticles exhibited a safety profile to cells of the respiratory tract. However, only the higher-Mw GMs allowed the assembly of microparticles with sizes suitable for this type of administration.
Topics: Mannans; Galactose; Molecular Weight; Plant Gums; Humans; Lung; Drug Carriers; Particle Size; Viscosity; Insulin; Drug Liberation; Galactans; Mannose; Animals
PubMed: 38823931
DOI: 10.1016/j.carbpol.2024.122268 -
Current Problems in Surgery Jun 2024
Review
Topics: Humans; Breast Neoplasms; Microwaves; Female; Nipples; Ablation Techniques; Treatment Outcome
PubMed: 38823890
DOI: 10.1016/j.cpsurg.2024.101483 -
The French Journal of Urology May 2024The incidence of localized renal cell carcinoma (RCC) is on the rise among individuals aged 70 and older. While the gold standard for treatment remains surgical...
INTRODUCTION
The incidence of localized renal cell carcinoma (RCC) is on the rise among individuals aged 70 and older. While the gold standard for treatment remains surgical resection, some elderly and frail patients with comorbidities are not eligible for this procedure. In selected cases, percutaneous thermal ablation, such as cryotherapy, microwave and radiofrequency, offers less invasive options. General anesthesia is sometimes necessary for such treatments, but most of the procedures can be conducted using mild or deep conscious sedation. This approach is preferably recommended for small cT1a tumors situated at a distance from the renal hilum and/or ureter. Active surveillance remains an alternative in the case of small low grade RCC although it may induce anxiety in certain patients. Recent research has highlighted the potentials of stereotactic ablative body radiotherapy (SABR) as a noninvasive, well-tolerated, and effective treatment for small renal tumors. This narrative review aims to explore recent advances in SABR for localized RCC, including appropriate patient selection, treatment modalities and administration, as well as efficacy and tolerance assessment.
MATERIAL AND METHODS
We conducted a literature review using the terms [kidney cancer], [renal cell carcinoma], [stereotactic radiotherapy], [SBRT], and [SABR] in the Medline, PubMed, and Embase databases, focusing on prospective and relevant retrospective studies published in English.
RESULTS
Studies report local control rates ranging from 70% to 100% with SABR, highlighting its efficacy in treating RCC. The decline in glomerular filtration rate (GFR) is approximately -5 to -17mL/min over the years following SABR. Common toxicities are rare, primarily CTCAE grade 1, include fatigue, nausea, chest or back pain, diarrhea, or gastritis.
CONCLUSION
Stereotactic ablative body radiotherapy (SABR) may be considered as a viable option for patients with localized RCC who are not suitable candidates for surgery with a high local control rate and a favorable safety profile. This approach should be discussed in a multidisciplinary meeting and results from ongoing clinical trials are awaited.
PubMed: 38823486
DOI: 10.1016/j.fjurol.2024.102660 -
European Journal of Medicinal Chemistry Aug 2024Cyclodextrin-based metal-organic frameworks (CD-MOFs) are gaining traction in the realm of drug delivery due to their inherent versatility and potential to amplify drug... (Review)
Review
Cyclodextrin-based metal-organic frameworks (CD-MOFs) are gaining traction in the realm of drug delivery due to their inherent versatility and potential to amplify drug efficacy, specificity, and safety. This article explores the predominant preparation techniques for CD-MOFs, encompassing methods like vapor diffusion, microwave-assisted, and ultrasound hydrothermal approaches. Native CD-MOFs present compelling advantages in drug delivery applications. They can enhance drug loading capacity, stability, solubility, and bioavailability by engaging in diverse interactions with drugs, including host-guest, hydrogen bonding, and electrostatic interactions. Beyond their inherent properties, CD-MOFs can be customized as drug carriers through two primary strategies: co-crystallization with functional components and surface post-modifications. These tailored modifications pave the way for controlled release manners. They allow for slow and sustained drug release, as well as responsive releases triggered by various factors such as pH levels, glutathione concentrations, or specific cations. Furthermore, CD-MOFs facilitate targeted delivery strategies, like pulmonary or laryngeal delivery, enhancing drug delivery precision. Overall, the adaptability and modifiability of CD-MOFs underscore their potential as a versatile platform for drug delivery, presenting tailored solutions that cater to diverse biomedical and industrial needs.
Topics: Metal-Organic Frameworks; Cyclodextrins; Humans; Drug Carriers; Drug Delivery Systems; Drug Liberation; Animals
PubMed: 38823266
DOI: 10.1016/j.ejmech.2024.116546