Recently, we reported on the occurrence of DNA double-strand breaks in different human cell lines exposed to ultrasound in vitro with some insight into the subsequent DNA damage response and repair pathways. The impact of these observed effects again sways between extremes. It could be advantageous if employed in gene therapy, wound and bone fracture-accelerated healing to promote cell proliferation, or in cancer eradication if the DNA lesions would culminate in cell death. Here, an overview of the rationale for therapeutic ultrasound and the salient knowledge on ultrasound-induced effects on the nucleus and genomic DNA is presented. The implications of the findings are discussed, hopefully to provide guidance to future ultrasound research.
Purpose: Fusion imaging methods are essential in local therapies for hepatocellular carcinoma. Fusion imaging using markers is a method that constantly tracks and displays points marked on the image by calculating the position of the sensor attached to the probe in real time. By applying this method, we have established a fusion marker two-point method that allows identification of hepatocellular carcinomas that are otherwise difficult to visualize by B-mode imaging, and have applied it to treatment. In this study, we examined whether ablation margins could be visualized in percutaneous radiofrequency ablation (RFA)/microwave ablation (MWA) for hepatocellular carcinoma using the fusion marker two-point method. Subjects and Methods: Fusion markers were set on both sides of the hepatocellular carcinoma using our fusion marker two-point method. Next, a fusion marker was set on the noncancerous side of the border between the cancerous and noncancerous portions on the ventral side of the hepatocellular carcinoma lesion. The same procedure was performed on the dorsal side. After the surgery, the coagulation area became hyperechoic, and if the fusion marker set in that area was located, it was possible to evaluate whether the ablative margin was secured during the surgery. Results: RFA/MWA was performed for hepatocellular carcinoma. Moreover, after the surgery, the reference image and echo sections were matched, and using the fusion marker margin method, it was confirmed that the hepatocellular carcinoma was located within the ablative margin. Conclusion: It was possible to visualize the ablative margin in RFA/MWA during the perioperative period using fusion markers.
Video-assisted thoracoscopic surgery (VATS) is becoming more common for lobectomy in lung cancer cases. There are several reports concerning the risks of thrombus formation in the left atrium on the resected pulmonary vein (PV) stump, because the residual PV stump is longer after VATS than after open lobectomy, especially in the case of left upper lobectomy. We report three cases of left atrium (LA) thrombus in the PV stump after right upper, left upper, and left lower lobectomy with VATS for lung cancer. Electrocardiography in the three cases showed atrial fibrillation. In the first and second cases, the thrombi were first detected by enhanced CT scan, and then we further examined them by transthoracic echocardiography (TTE) and transesophageal echocardiography (TEE). In the third case, the thrombus was first detected by TTE. TTE was useful for finding PV stump thrombosis after lobectomy with VATS, especially in patients at high risk of thrombosis, such as those with atrial fibrillation, large LA volume, and receiving steroid therapy. We report that we could detect PV stump thrombosis with careful examination of the PV inflow point by TTE, and that the LA thrombi in the three cases were treated by direct oral anticoagulants (DOAC) and disappeared.