ABSTRACT
Objective:To explore the effect of radiofrequency heating on the morphology of articular cartilage in the knee and the expression of interleukin-1β (IL-1β) and tumor necrosis factor-α (TNF-α) in the synovium using a rabbit model of knee osteoarthritis (OA).Methods:Fifty-four male rabbits had OA induced in their right hind limbs using the modified Hulth method. They were then randomly divided into a model group, a cervus and cucumis polypeptide (CCP) group and a radiofrequency thermotherapy (RT) group, each of 18. The CCP group was injected with deer melon peptide intramuscularly every day, while the RT group was given daily radiofrequency hyperthermia treatment at 36.5-38.5 ℃. The model group was not provided with any special treatment. On the 6th, 12th and 18th day of the treatment, 6 rabbits in each group were sacrificed to resect the right femur′s medial condyle cartilage. The morphological characteristics of the cartilage were evaluated using modified Mankins scoring, while the contents of lL-1B and TNF-a in the synovial membrane were detected using enzyme-linked immuno-sorbent assays.Results:The average Mankins scores and the levels of IL-1β and TNF-α decreased significantly at each time point, and significant differences were observed among the three groups. In the RT group the average Mankins score as well as the IL-1β and TNF-α levels decreased significantly with time throughout the experiment.Conclusions:Radiofrequency hyperthermia is superior to the injection of deer melon polypeptide in knee osteoarthritis, at least in rabbits. The therapeutic mechanism may be related to the control of IL-1β and TNF- α levels in the synovial membrane.
ABSTRACT
BACKGROUND: For the treatment of primary varicose vein of greater saphenous vein(GSV) due to reflux from incompetent saphenofemoral junction(SFJ), several methods such as ligation and stripping, or duplex-guided sclerotherapy have traditionally been introduced. As for sclerotherapy, the recurrence rate has been reported to be very high. In spite of higher success rate, traditional high ligation with stripping of GSV requires several days' admission with general anesthesia and several more days before returning to normal daily life. New modalities, which are less invasive and possibly have lower recurrence to rate with a chance for early ambulation, are being proposed. They are such as endovenous radiofrequency(RF) therapy, endovenous laser therapy, etc. OBJECTIVE: We tried to evaluate the efficacy and safety of endovenous RF therapy as an alternative to high ligation and stripping in case of GSV varicosity in mild to moderate degrees. METHODS: Both GSV varicosities and varicosed tributaries are marked by doppler and/or ultrasonic imaging. A catheter connected to RF generator is inserted proximally through the incision of vein wall percutaneously, usually above or below the knee. After confirming position of the SFJ using ultrasound, the catheter is progressed as far as to 1-2cm below the SFJ. Then, the generator is activated and the catheter withdrawn slowly for complete heating and occlusion of the target vein. Additional ambulatory phlebectomy or sclerotherapy is optional. We wrap the limbs with self-adhesive short stretch bandage for 2-3 days and encourage the patient to walk regularly and wear compressive stocking later. RESULTS: We performed endoluminal RF treatment on 10 legs of 9 patients(5 males and 4 females). Follow-up intervals varied from 2 to 10 months. Patients were generally satisfied with improvement of symptom. On the clinical evaluation with doppler and duplex examination, there were a few blood flows except only some segments of GSV in 7 patients CONCLUSION: Although endoluminal RF therapy may have a somewhat higher recurrence rate than that of traditional high ligation with stripping of GSV, endoluminal RF therapy is expected to have several advantages over traditional surgery, including less invasiveness, no need for admission or general / spinal anesthesia, earlier return to normal daily life, and finally easy performance, especially for the dermatologist.