Liver cancer: increased microwave delivery to ablation zone with cooled-shaft antenna--experimental and clinical studies.

PURPOSE: To prospectively investigate whether the ablation zone induced with microwaves could be increased by delivering greater energy with a cooled-shaft antenna. MATERIALS AND METHODS: All studies were animal care and ethics committee approved. Written informed consent was obtained from all patients. Microwave ablation was performed by using a cooled-shaft antenna in 48 ex vivo and 12 in vivo experiments with porcine livers. The coagulation diameters achieved in different microwave ablation parameter groups (60-90 W for 5-25 minutes) were compared. Ninety patients (78 men, 12 women; mean age, 53 years; age range, 20-82 years) with 133 0.8-8.0-cm (mean, 2.7 cm +/- 1.5 [standard deviation]) primary or metastatic liver cancers were treated with the same microwave ablation technique. Complete ablation (CA) and local tumor progression (LTP) rates were determined. Generalized estimating equations were used to compare differences in tumor size, ablation zone diameter, and CA and LTP rates between different patient subgroups. RESULTS: In the ex vivo livers, in vivo livers, and liver cancers, one application of microwave energy with 80 W for 25 minutes produced mean coagulation diameters of 5.6 x 7.4 cm, 3.5 x 5.9 cm, and 3.6 x 5.0 cm, respectively. Skin burn was not observed. CA rates in small (

Human fecal metabolism of soyasaponin I.

The metabolism of soyasaponin I (3-O-[alpha-L-rhamnopyranosyl-beta-D-galactopyranosyl-beta-D-glucuronopyranosyl]olean-12-ene-3beta,22beta,24-triol) by human fecal microorganisms was investigated. Fresh feces were collected from 15 healthy women and incubated anaerobically with 10 mmol soyasaponin I/g feces at 37 degrees C for 48 h. The disappearance of soyasaponin I in this in vitro fermentation system displayed apparent first-order rate loss kinetics. Two distinct soyasaponin I degradation phenotypes were observed among the subjects: rapid soyasaponin degraders with a rate constant k = 0.24 +/- 0.04 h(-)(1) and slow degraders with a k = 0.07 +/- 0.02 h(-)(1). There were no significant differences in the body mass index, fecal moisture, gut transit time, and soy consumption frequency between the two soyasaponin degradation phenotypes. Two primary gut microbial metabolites of soyasaponin I were identified as soyasaponin III (3-O-[beta-D-galactopyranosyl-beta-D-glucuronopyranosyl]olean-12-ene-3beta,22beta,24-triol) and soyasapogenol B (olean-12-ene-3beta,22beta,24-triol) by NMR and electrospray ionized mass spectroscopy. Soyasaponin III appeared within the first 24 h and disappeared by 48 h. Soyasapogenol B seemed to be the final metabolic product during the 48 h anaerobic incubation. These results indicate that dietary soyasaponins can be metabolized by human gut microorganisms. The sugar moieties of soyasaponins seem to be hydrolyzed sequentially to yield smaller and more hydrophobic metabolites.