Percutaneous treatment of non-contained lumbar disc herniation by injection of oxygen-ozone combined with collagenase.

PURPOSE: To evaluate the therapeutic results of oxygen-ozone combined collagenase injection for the treatment of lumbar disc herniation compared to the surgery. And to explore the role of this minimally invasive treatment as an alternative to disc surgery. MATERIALS AND METHODS: Two groups of patients (n=108) were treated with different ways respectively. Minimally invasive group of patients was treated with the injection of oxygen-ozone combined with collagenase into the lumbar disc or the epidural space; the other group was treated with traditional surgery. After the treatment, the patients were followed-up and the therapeutic effect was assessed at 2 weeks, 3 and 12 months by the modified Macnab criteria. RESULTS: The success rate was 86.11% and 88.89% in minimally invasive group at 3 and 12 months respectively, while 92.59% and 95.37% in surgical group. There was no statistically significant difference between two groups at 3 and 12 months (P=0.123, P=0.08). However, the surgical group produced a statistically significant greater improvement for back pain and disability in the first few weeks (P=0.0001). The success rate was 51.86% and 85.18% at 2 weeks in minimally invasive group and surgical group respectively. No serious complication occurred in this group. CONCLUSIONS: The combination of the oxygen-ozone with collagenase shows significant reductions in pain and improvements in function at 3 and 12 months, it can be considered as an option for the treatment of non-contained lumbar disc herniation instead of surgery.

[Effects of intermittent and continuous thermochemotherapeutic intra artery infusion on adriamycin concentration in rabbit VX-2 tumor].

BACKGROUND & OBJECTIVE: It has been proved that vital signs of organism can be influenced by heat infusion and the thermochemotherapy with Adriamycin (ADM) is more effective than the general chemotherapy in inhibiting extraneous rabbit VX-2 cells. Intermittent thermochemotherapeutic infusion and continuous thermochemotherapeutic infusion with ADM were performed respectively on the rabbits to evaluate the effectiveness and safety of intermittent thermochemotherapeutic intra artery infusion by comparing their respiration rate, heart rate, body temperature, and the ADM concentration in VX-2 carcinoma. METHODS: VX-2 tumor models were established in the hind legs of 30 New Zealand rabbits, and then they were divided into three groups (10 in each group) randomly. 100 ml saline and ADM in room temperature were infused, 100 ml saline and ADM in 60 degrees C were intermittently infused, and 100 ml saline and ADM in 60 degrees C were continuously infused into the tumor nutrient arteries, which were confirmed by DSA, of the rabbits in each group respectively. During the infusion, the 43-45 degrees C lasting time of the tumor tissues in the two 60 degrees C infusion groups was measured. After the infusion,the respiratory rate,heart rate,body temperature,and the concentration of ADM within the tumors were determined. RESULTS: The concentration of ADM was 7.115+/-2.180 microg/ml in the room temperature infusion group,17.213+/-1.657 microg/ml in the 60 degrees C continuous infusion group, and 16.545+/-3.426 microg/ml in the 60 degrees C intermittent infusion group. There was no significant difference between the 60 degrees C intermittent infusion group and the 60 degrees C continuous infusion group (P >0.05), while there was significant difference between the 60 degrees C intermittent infusion groups and the room temperature infusion group,so was between 60 degrees C continuous infusion groups and the room temperature group (P< 0.05). The 43-45 degrees C lasting time was 22.53+/-1.44 minutes in the continuous infusion group and 24.31+/-2.45 minutes in the intermittent infusion group. There was no significant difference between these two groups (P >0.05). There was no significant difference in the respiration rate, heart rate, and body temperature between the 60 degrees C intermittent infusion group and the room temperature infusion group (P >0.05). CONCLUSION: Compared with continuous infusion, intermittent thermochemotherapy intra artery infusion is a more effective and safer interventional thermochemotherapy.

[Adriamycin thermotherapy through hepatic artery for model of VX2 carcinoma in rabbit liver].

BACKGROUND & OBJECTIVE: It was reported that heating can enhance sensitivity of rabbit VX2 cell to adriamycin and increase intracellular concentration of adriamycin. This study was designed to evaluate the anti-tumor effects of interventional hyperthermia and interventional chemotheramotherapy on VX2 carcinoma in rabbit liver. METHODS: VX2 carcinoma cells were surgically implanted into the right liver lobe of 60 male New Zealand white rabbits, which were randomly divided into 4 groups(15 rabbits per group). To inject physiological saline(37 degrees C), adriamycin (37 degrees C), physiological saline(60 degrees C), and adriamycin (60 degrees C) in different groups via hepatic artery of the rabbits with liver cancer. One week later, to observe the volume of tumor, the serum level of aspartate transaminase(AST), and observe the survival period of VX2 rabbits. RESULTS: In group of ADM(60 degrees C), the tumor growth rate (0.53 +/- 0.21)% was significantly lower than group 2(1.09 +/- 0.26)%, group 3(3.32 +/- 1.28)%, and group 4(3.48 +/- 1.17)% (P < 0.05, P < 0.05, P < 0.01, respectively). The survival period of adriamycin (60 degrees C) group (50.0 +/- 2.0)d was significantly higher than the untreated control group (40.5 +/- 3.0)d, (P < 0.05). The serum level of AST of TNP-470 with lipiodol group was not higher than the other treated groups(P > 0.05), but being significantly higher than the untreated control group after treated(P < 0.05). CONCLUSION: Adriamycin (60 degrees C) greatly decreases the tumour growth rate, and prolongs the survival period.

[Effect of interventional chemothermotherapy on vascular permeability of tumor liver tissue and normal liver tissue in VX-2 tumor-bearing rabbits].

BACKGROUND & OBJECTIVE: It was reported that heating could enhance the sensitivity of chemotherapy with Adriamycin and increase the intracellular content of Adriamycin. The aim of this study was to investigate the effect of interventional chemothermotherapy on vascular permeability of tumor liver tissue and normal liver tissue in VX-2 tumor-bearing rabbits. METHODS: Thirty rabbits used as implanted hepatocarcinoma model were randomly divided into 3 groups: non-perfusion group (injected only with 1% Evans blue after catheterization), normothermic perfusion group (the perfusion fluid was 25 degrees C normal solution), and hyperthermic perfusion group(the perfusion fluid was 60 degrees C normal solution). The contents of Evans blue in the tissues of three groups, which were used as the indices of vascular permeability, were calculated by the standard curve and spectrophotometry. RESULTS: The Evans blue contents in tumor liver tissue and normal liver tissue is statistically different (P < 0.05). There was no over difference of the Evans blue contents in two kinds of tissue between normal perfusion group and non-perfusion group. There was overt difference of the Evans blue contents in two kinds of tissue between hyperthermic perfusion group and normothermic perfusion group. CONCLUSION: Interventional chemothermotherapy could increase the vascular permeability of normal liver tissue and tumor liver tissue.