Like other tumors, chondrosarcoma must induce neovascularity as they grow. Recent studies have demonstrated that chondrosarcoma are vascular. Since normal cartilage is a hypoxic, yet avascular tissue and since chondrosarcoma bears some phenotypic relation to cartilage, it is not clear if hypoxic pathways remain intact in these tissues. Hypoxia-inducible factor l a (HIF-la) is the inducible subunit of the HIF-1 transcription factor that regulates genes involved in the response to hypoxia, some of which promote neovascularity. Vascular endothelial growth factor (VEGF) is one of the genes upregulated by HIF-1 and is the primary cytokine related to angiogenesis. In this study we examined the response of chondrocytes and chondrosarcoma cell lines to hypoxia. We found that both normal and malignant chondrocytes increased HIF-1 a protein expression in an oxygen concentration dependent manner and also increased VEGF mRNA expression in response to hypoxia. HIF-la protein and VEGF mRNA decreased when chondrosarcoma cells were transfected with siRNA targeting HIF-la prior to hypoxia exposure, suggesting that HIF-la expression resulted in increased VEGF expression. The role of the HIF-1cLNEGF pathway in angiogenesis in chondrosarcoma in vivo and its usefulness as a target for antiangiogenic treatment strategies for this tumor requires further investigation.

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This study shows the feasibility of using multiple microwave antennas simultaneously in the treatment of liver tumors intraoperatively. Additional percutaneous studies are currently under way to investigate the safety and efficacy in treating nonsurgical candidates.

Eosinophilic colitis (EC) is a rare form of primary eosinophilic gastrointestinal disease with a bimodal peak of prevalence in neonates and young adults. EC remains a little understood condition in contrast to the increasingly recognized eosinophilic esophagitis. Clinical presentation of EC is highly variable according to mucosal, transmural, or serosal predominance of inflammation. EC has a broad differential diagnosis because colon tissue eosinophilia often occurs in parasitic infection, drug-induced allergic reactions, inflammatory bowel disease, and various connective tissue disorders, which require thorough searching for secondary causes that may be specifically treated with antibiotics or dietary and drug elimination. Like eosinophilic gastrointestinal disease involving other segments of the gastrointestinal tract, EC responds very well to steroids that may be spared by using antihistamines, leukotriene inhibitors and biologics.

The purpose of this study was to evaluate the clinical implementation of triangular and spherical designs for simultaneous multiple-antenna ablation of human hepatocellular carcinoma (HCC) with a recently engineered microwave coagulation system. Institutional review board approval and informed consent were obtained, and the study was compliant with HIPAA requirements. Nine patients (five men, four women; age range, 53-79 years; mean age, 66.2 years) with resectable HCC (diameter, 2.9-6.0 cm; mean, 4.2 cm) underwent intraoperative ultrasonography-guided tumor ablation followed by resection and pathologic examination. Standard single-straight (n = 2), triangular triple-straight (n = 4), and spherical triple-loop (n = 3) antenna configurations produced mean estimated coagulation volumes of 16.7, 51.7, and 54.3 cm(3), respectively, during a single concurrent 5-10-minute ablation cycle. The triple-loop configuration yielded the most uniformly round ablation shape. Simultaneous activation of multiple straight or loop antennae is a potentially promising technique for rapid and effective treatment of large HCCs.

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