Percutaneous cementoplasty of osteolytic metastases induces immediate and long-lasting pain relief in oncological patients.

OBJECTIVE: To evaluate the clinical efficacy of percutaneous cementoplasty with respect to pain relief in patients with refractory painful bone metastases. DESIGN: Case series. SETTING: Regional hospital, Hong Kong. PATIENTS: All oncological patients with painful bone metastases despite conventional treatment seen between October 2006 and May 2010 were recruited. INTERVENTIONS: Cementoplasty with or without radiofrequency ablation. MAIN OUTCOME MEASURES: Pain score before and after the procedure. RESULTS: In all, 12 patients with 13 lesions received cementoplasty. Two patients were excluded from the analysis because of inadequate documentation of pain score due to rapid disease progression. For the remaining 10 patients with 11 metastases, the primary sites were the lung (n=3), renal cell carcinoma (n=2), rectum (n=2), pancreas (n=1), multiple myeloma (n=1), and soft tissue sarcoma (n=1). The locations of the metastatic lesions were scapula (n=1), thoracic vertebrae (n=1), lumbar vertebrae (n=3), and pelvic bones (n=6). Eight lesions were treated by cementoplasty alone, whereas the other three associated with large soft tissue components had radiofrequency ablation followed by cementoplasty in a single setting. Immediate or near-immediate pain relief after treatment was achieved in 10 out of 11 lesions; the median pain score was 5 before treatment and decreased to 2 a week after treatment (P=0.039). In all lesions for which the pain was successfully controlled in the first week, the palliation effect persisted at subsequent follow-ups. The median follow-up period for these patients was 16 weeks, and the longest pain-relieving effect was at least 9 months. CONCLUSION: In our experience, cementoplasty with or without radiofrequency ablation achieves satisfactory and long-lasting pain control in oncological patients with bone metastases. This is the first local study to describe the effect of cementoplasty for pain relief. Patients with painful bone metastases that are refractory to conventional treatments can benefit from cementoplasty, which should therefore be considered when conservative treatments fail.

Nutrition and growth of the moderately halophilic bacteria Micrococcus morrhuae K-17 and Micrococcus luteus K-15.

Chemically defined media have been developed for the growth of two moderately halophilic bacteria, Micrococcus morrhuae K-17 and Micrococcus luteus K-15. M. morrhuae K-17 grows well in a synthetic medium (SM-1) which contains a number of salts, 0.21 M KCl, 2 M NaCl, D-mannose, five vitamins and ten amino acids. The synthetic medium (SM-2) for M. luteus K-15 contains a number of salts, 0.21 M KCl, 1 M NaCl, D-fructose, nine vitamins and nine amino acids. Nutritional studies show that M. morrhuae K-17 can utilize a large number of organic compounds as carbon and energy source while the ability of M. luteus K-15 in utilizing the organic compounds is rather limited. The minimum salt requirement is 0.5 M NaCl for both strains when growth at the optimum temperature of 30 degrees C. However, this requirement can be lowered to 0.2 M in M. luteus K-15 when grown at a lower temperature of 25 degrees C. It is concluded that the ability to grow in a wider range of salt concentrations in response to temperature is species specific in moderate halophiles. The salt range for growth to occur can be extended when cells of both strains are grown in complex medium which might provide the amino acids and growth factors that cannot be synthesized by these strains at high salt concentrations.

Influence of temperature on ionic sparing effect and cell-associated cations in the moderate halophile, Micrococcus varians var. halophilus.

Cells of the moderately halophilic Micrococcus varians var. halophilus grew well in a chemically defined medium containing 1 to 3 M NaCl and 0.0103 M K+. The requirement for NaCl could be partially replaced by K+,:Li+ and Cs+. The efficiency of the sparing effect of these cations for NaCl was in order of K+ GReater than Li+ greater than Cs+. Increase in growth temperature was found to enchance the sparing effect of Li+ and Cs+ but not that of K+. Over the range of NaCl concentrations in which the cells grew well, cell-Na+ concentrations were similar to the medium NaCl concentrations while cellK+ concentrations were several-fold that in the medium. Cell-bound Na+ and K+ concentrations increased proportionally with medium NaCl concentration and growth temperature. The temperature-dependent cation accumulation was more obvious with K+ than Na+. The cell-associated Na+ + K+ concentrations were almost as high as or slightly higher than the external media which contained appropriate levels of NaCl regardless of the growth temperature.