Abstract: Objective To summarize the method and effective result of thoracoscopic intrapleural perfusion hyperthermochemotherapy(TIPHC) for treating malignant pleural effusion caused by lung cancer. Methods Fiftyeight patients with malignant pleural effusion caused by lung cancer were randomly divided into therapeutic group(30 cases) and control group(28 cases) between February 1999 and March 2005. Pleural biopsy and TIPHC under general ansthesia with unilateral ventilation were performed in the therapeutic group, and intrapleural injection of cisplatin was administered in control group after drainage of pleural effusion. The effect on malignant pleural effusion， the change for the concentration of carcinoembryonic antigen(CEA)， cytokeratin-19 fragments (CYFRA21-1)， neuronspecific enolase (NSE) and the side effect were compared before and after the treatment. Results The therapeutic group achieved total response rate of 100.0%, but only 53.6% in control group, with significant difference(χ 2=3.863, Plt;0.05). Furthermore, the concentration of CEA， CYFRA21-1， NSE in therapeutic group dramatically descended than control group(t=2.562,Plt;0.05). But there was no significant difference in side effect (Pgt;0.05). The pathological diagnosis of all the patients were determined in the therapeutic group. Conclusion TIPHC has the advantage of both diagnosis and treatment of malignant pleural effusions. It is safe and effective, and also able to determine the diagnosis. Furthermore, it offers the superiority of small wound， best visualization and convenient pleural biopsy.
Objective To assess the effectiveness of transpupillary thermotherapy (TTT) for the treatment of central exudative chorioretinopathy. Methods Tweenty-nine eyes with central exudative chorioretinopathy were treated with Iris 810 nm diode laser TTT. The laser beam size was 1.0, 2.0 or 3.0 mm with power settings between 80-300 mW and treatment time 60 sec. The follow up periods were wihzin 4-40 weeks. The therapeutic effect was accessed by visual acuity examination,dinect ophthalmoscopy and fluorescein or indocyanine green angiography. Results The visual acuity improved in 8 eyes (28%), remained no change in 19 eyes (65%) and decreased in 2 eyes (7%). Choroidal neovascularization were closed in 12 eyes in fundus angiography. The symptoms alleviated in 10 patients. Conclusion Transpupillary thermotherapy is a potential treatment for the central exudative chorioretinopathy. (Chin J Ocul Fundus Dis, 2002, 18: 184-186)
The Influence of microwave and hot water immersion hyperthermia on the lymphedematous skin of lower extremity on 12 patients was studied by using immunohistochemical and lymphoscintigraphic methods. We assumed that the subsidence of inflammatory changes in the lymphedematous limb and/or local absorption of tissue fluid protein following local microwave heating, but not the augmented lymph How seemed to be responsible for the reduction of edema.
Objective To conduct a systematic review on the Electrocardiogram (ECG) changes in the workers exposed to high temperatures by means of meta-analysis.Methods The retrospective cohort studies on the relationship between high temperature and ECG abnormalities published from 1990 to May 2009 were searched in CNKI, VIP, WanFang database and CBM database. The literatures meeting the inclusive criteria were selected, the quality was assessed, the data were extracted, and the meta-analyses were conducted with RevMan 4.2.2 software. Results A total of 20 studies were included. The results of meta-analyses showed: the ECG abnormality rate of the high-temperature group was obviously superior to that of the control group with significant difference (OR=2.76, 95%CI 2.37 to 3.20, Plt;0.000 01). The high-temperature severely affected left ventricular hypertrophy (OR=3.49, 95%CI 2.83 to 4.31, Plt;0.000 01), sinus bradycardia (OR=2.83, 95%CI 2.33 to 3.43, Plt;0.000 01), and changes in ST-T segment (OR=2.63, 95%CI 1.48 to 4.68, P=0.000 10), which indicated that the abnormal changes of ECG, such as left ventricular hypertrophy, sinus tachycardia, sinus bradycardia, and changes in ST-T segment could be the sensitive indexes to monitor cardiovascular disease of workers exposed to high-temperature. Conclusion The incidence of ECG abnormalities caused by high-temperature operation is obviously superior to that of the control group, so it is required to strengthen the health monitoring and labor protection for the workers exposed to high temperature.
Objective To evaluate the efficacy of transpupillary thermotherapy（TTT）on three kinds of intraocular benign tumors. Methods Seventeen patients with 3 kinds of intraocular tumors，3 eyes of 3 patients with papillary hemangioma，9 eyes of 9 patients with choroidal hemangioma and 8 eyes of 5 patients with choroidal osteoma were treated with transpupillary thermotherapy.All patients underwent pretreatment ocular examination，including visual acuity，biomicroscopy for anterior segment and fundus examination，fundus fluorescein and indocyanine green angiography，optic coherence tomography，perimetry test，ultrasonography，and CT.TTT was conducted with infrared diode laser at810nm.with power of 360-1200 mW;beam diameter of 3 mm or combined 2-5 spots according to the tumor size;the exposure time was 60-80 seconds.The treatment was completed in one session，and another treatment was given 1-3 month later if active leakage demonstrated.The follow-up period was 6-36 months（mean 14.5 month）. Results The best corrected visual acuity with Snellen chart on average for papillary hemangioma was 0.17 before TTT and 0.27 after;for choroidal hemangioma was 0.39 before TTT and 0.46 after;for choroidal osteoma was 0.20 before TTT and 0.31 after.Three eyes with papillary hemangioma had operation to release subretinal fluid and intraocular laser coagulation;the tumor remained reddish color with dilated vessels and patches of hemorrhages on the surface.After TTT the color appeared pale yellowish，hemorrhages absorbed，subretinal fluid subsided，and choroidal retinal atrophy disclosed along the lower border of the tumor.In 9 eyes with choroidal hemangioma, the red-light area disappeared, subretinal fluid subsided, and the pigment proliferation in the treatment area was found.Eight eyes with choroidal osteoma had choroidal neovessels and macular hemorrhages;after TTT blood disappeared，subretinal fluid absorbed，and the color of tumor showed pale yellow with dark pigment and thin scar tissue.There was no significant complication associated with TTT. Conclusions Transpupillary thermotherapy is effective on papillary hemangioma，circumscribed choroidal hemangioma and choroidal osteoma either as preliminary or supplementary treatment. (Chin J Ocul Fundus Dis, 2006, 22:181-184)
Objective To observe the therapeutic effect of photodynamic therapy (PDT) and transpupillary thermotherapy (TTT) on circumscribed choroid hemangioma (CCH).Methods Clinical data of 32 patients (33 eyes) with CCH diagnosed by ocular fundus examination, fundus fluorescein angiography (FFA),indocyanine green angiography (ICGA),optical coherence tomography (OCT) and Bultrasound examination were retrospectively analyzed.Before the therapy the selected cases had best corrected visual acuity (BCVA) of fingercounting/15 cm-0.2,the sizes of 2-10 disc diameter (DD) and serous retinal detachment.Twentyone patients (22 eyes) whose tumor located at the posterior pole except for the papillomacular bundle and arch ring area underwent TTT.The parameters of TTT included: Iris 810 nm infra red diode laser，7001200 mW,60 s,and 1-3 spots. Eleven patients (11 eyes) with tumor located at the posterior pole except for the papillomacular bundle and arch ring area underwent. After 15 minutes of intravenous injection with Visudyne, laser irradiation with the wavelength of 689 nm was performed with the time of 83-123 s. The followup period was 12-48 months with the mean of 25.6 months.BCVA and results of indirect ophthalmoscopy,fundus photogrphy,FFA,ICGA,OCT and B ultrasound examination were exanmined and anlyzed.Results In the 22 eyes in TTT group, the BCVA improved in 15 and kept unchanged in 7;the results of fundus examinations showed healed retina and atrophy tumor with greywhite organized scar;the results of FFA revealed no fluorescence leakage and scar fluorescence dyeing of the lesion in later period；the results of OCT indicated disappeared retinal detachment, completely absorbed subretinal liquid and increased reflection of choroid tumor with scar；the results of Bultrasound examination showed no retinal detachment and atrophy tumor.In 11 eyes in PDT group,the BCVA improved in 9, unchanged in 2;the results of fundus examinations showed atrophy tumor with pigmentation；the results of FFA revealed disappeared fluorescence leakage；the results of OCT indicated completely absorbed subretinal liquid；the results of B-ultrasound examination showed atrophy tumor.Conclusions Both TTT and PDT can make the tumor atrophy,improve BCVA or keep it still;but apply to different area.
Objective To compare the clinical results of photodynamic therapy(PDT) and transpupillary thermotherapy (TTT) for patients with choroidal neovascu larization caused by exudative age-related macular degeneration. Methods Seventy cases (82 eyes) with exudative AMD were divided into PDT and TTT groups. Thirty-five cases (42 eyes) were treated with PDT. Nineteen eyes had occult or predominantly occult CNV. Twenty-three eyes had classic or predominantly classic CNV. Thirty-five cases (40 eyes) were treated with TTT. Twenty-five eyes had occult or predominantly occult CNV. Fifteen eyes had classic or predominantly classic CNV . Visual acuity, FFA, ICGA and OCT were evaluated before and after treatment. All cases were subfoveal or juxtafoveal CNV. The follow-up was 3-6 months. Results Visual acuity in 3 eyes (15.8％) of PDT group and 1 eye (4.0％) in TTT group increased at least 2 lines. The difference was no significant(P=0.1778), FFA showed cessation or reduction of fluorescein leakage from CNV in 15 eyes(78.9％) in PDT group and 13 eyes(52.0％) in TTT group. The difference was not significant (P=0 .0657). Three months after treatment, The visual acuity of 2 eyes(10.5％) in PDT group and 2 eyes (8.0％) in TTT group increased at least 2 lines. The difference was not significant (P=0.7728). FFA showed cessation or reduction of fluorescein leakage from CNV in 8 eyes(42.1％) in PDT group and 21 eyes(84.0％) in TTT group. The difference was significant (P=0.0037). Conclusion For classic CNV, the short-term effect of PDT is better than TTT concerning visual acuity. The effect of PDT is apparently better than TTT in cessation or reduction of fluorescein leakage one month after treatment. But there was no significant difference between PDT and TTT in cessation or reduction of fluorescein leakage three month after treatment. For occult CNV, there is no significant short-term difference between PDT and TTT concerning visual acuity. There was no significant difference between PDT and TTT in cessatin or reduction of fluorescein leakage one month after treatment. But three month after treatment TTT is apparently better than PDT in cessation or reduction of fluorescein leakage. We need more cases and longer follow-up to evaluate these two kinds of treatments in treating exudative age-related macular degeneration.(Chin J Ocul Fundus Dis，2004，20：285-288)
Objective To observe the vascular endthelial cellular apoptosis induced by transpupillary thermotherapy (TTT). Methods Vascular endothelial cells (VEC) cultured in vitro were treated with TTT, hyperthermia and TTT combined with indocyanine green (ICG) pretreatment. The cellular apoptosis was detected by doublelabelled flow cytometer (annexin Vfluroescein isothiocyanate and propidium iodide) analysis, fluorescent microscopy, nucleolus stainned with DNA dye hoechst 33258, DNA ladder detection and electron microscopy. Results Without significant rising of the temperature, TTT couldnprime;t increase the apoptosis of VEC. Pure hyperthermia and TTT combined with ICG pretreatment could increase apoptosis of VEC significantly, and the effect of the latter method was more obvious. The higher power of TTT was used and the longer duration the cells were cultured, the higher apoptosis rate of VEC was. Conclusion The induction of apoptosis of VEC might play an important role in the mechanism of the occlusion of CNV by TTT, and combining with ICG may obviously enhance the apoptosis rate at the same temperature, which may supply a theoretical basis for promoting the clinical effect of TTT.