Cryoablation has been used for many years as a surgical ablation technique in the prostate and kidney. However, since the introduction of high-intensity focused ultrasound (HIFU) and robotic surgery for prostate tumours, its popularity in the urologic community has declined. In the early 2000s, innovations in cryoablation technology allowed the use of thinner probes, which were suitable for percutaneous application. As a result, radiologists began using cryoablation, first in the liver, and then in other organs or tissues such as the kidney, lung, breast, pancreas, bone, and soft tissue. In most of these locations, cryoablation has great potential given its inherent advantages, including the use of local anaesthesia, little or no pain during and after the procedure, real-time monitoring of the ablation area on US, CT or MRI, the potential for ablation of large tumours with multiple probes, and the ability to change the shape of the ablation in non-spherical tumours. Yet despite these advantages, the use of percutaneous cryoablation among radiologists appears to be far lower than that of heat-based ablation techniques. The aim of this article is to outline specific aspects of cryoablation and to illustrate its potential clinical applications with case presentations.Key Points• Recent advances have made cryoablation suitable for percutaneous use by radiologists with image guidance.• Cryoablation has distinct advantages over heat-based ablation techniques.• Cryoablation is becoming increasingly popular for lung, breast, kidney, bone, and soft tissue tumours.
BackgroundColorectal cancer is the third most common cancer and the third leading cause of cancer-related death. Bevacizumab is a humanized monoclonal antibody developed against vascular endothelial growth factor (VEGF) for the treatment of metastatic cancer. The parameters of RECIST (Response Evaluation Criteria for Solid Tumors) are not adequate to detect important treatment effects and response. Our goal was to evaluate the possibility of using sTRAIL (serum-soluble TNF-related apoptosis-inducing ligand) and VEGF as markers of treatment efficacy and prognosis in patients with metastatic colon cancer.MethodssTRAIL and VEGF levels were measured by ELISA in the sera of 16 bevacizumab-treated metastatic colon cancer patients and 10 presumably healthy age-matched controls. The measurements were taken before and after treatment for comparison purposes.ResultsElevated levels of sTRAIL were found in seven out of 16 patients after bevacizumab treatment. Although these patients had a median survival time of 20.6 months, the remaining bevacizumab-treated patients who did not show an increase in sTRAIL had a median survival time of 9.4 months. As expected, serum VEGF levels were decreased in all patients who received bevacizumab therapy and showed no correlation between serum VEGF levels and patient survival (data not shown).ConclusionsSerum sTRAIL levels might be a useful predictor of prognosis in metastatic colon cancer, in the early evaluation stages following bevacizumab treatment.
BackgroundThere is no data available to adequately explain the alterations in total antioxidant capacity, hydrogen peroxide, malondialdehyde and total nitric oxide concentrations in severe persistent asthma and newly diagnosed allergic asthma patients. In the study below we have examined changes in total antioxidant capacity, hydrogen peroxide, malondialdehyde and total nitric oxide levels in severe persistent asthma and newly diagnosed allergic asthma patients and the association(s) between these variables.MethodsThe first group of patients included 6 male and 8 female subjects with severe persistent asthma, having a mean age of 42.4 years. A second group of subjects consisted of 14 newly diagnosed allergic asthma patients with a mean age of 43.8 years. All patients were followed in our clinic, and were evaluated by clinical status. A third group of 14 age-sex matched healthy controls were also included. Serum samples were collected and stored at –70 until use for the determination of total antioxidant capacity, hydrogen peroxide, malondialdehyde and total nitric oxide concentrations. Serum IgE levels, ANA, RF, hepatitis markers, C3, C4 and eosinophil levels were evaluated in all patients. All assays were carried out in duplicate.ResultsTotal antioxidant capacity levels of Group IB, group II and group III were lower than the IA group. Total antioxidant capacity levels of groups II and III were higher than in group IB. Hydrogen peroxide concentrations in group IB were lower than in group IA, while concentrations in group II were higher than in group IB. The malondialdehyde concentration of group IB was lower than in all other groups. The malondialdehyde concentration of group III was higher than all other groups. The malondialdehyde concentration of group II was lower than in group III. The total nitric oxide level of group IB was lower than all other groups. The total nitric oxide level of group III was higher than all other groups, while that of group II was higher than for both groups IA/IB.ConclusionsTo monitor the omalizumab treatment efficacy in the severe allergic asthma patients; total antioxidant capacity, hydrogen peroxide, malondialdehyde and total nitric oxide concentrations might be new markers.
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