The response of the rat tail to hyperthermia

Temperature, heat shock proteins and growth regulation of the bone tissue

Ambient heat modulates the elongation of bones in mammals, and the mechanism of such a plasticity has not been studied completely. The influence of heat on growth and development of bone depends on its values. Five zones of temperature influence on the bone tissue with different biological effects have been distinguished : a) under-threshold thermal zone < 36.6 ºС, insufficient amount of heat is a limiting factor for osteogenesis; b) normal temperature zone 36.6‒37.5 ºС, the processes of breakdown and development of bone in this temperature range is balanced; b) zone of mild thermal shock 39‒41 ºС, the processes of functioning of osteoblasts, osteocytes and formation of the bone tissue intensify; d) the zone of sublethal thermal shock > 42 ºС, growth of bone slows; e) zone of non-critical shock > 50 ºС, bone tissue cells die. We propose a model of the mechanism of influence of heat shock on bone growth. Mild heat shock is a type of stress to which membrane enzymes adenylyl cyclase and cAMP-protein kinase react. Protein kinase A phosphorylates the gene factors of thermal shock proteins, stress proteins and enzymes of energy-generating processes – glycolysis and lipolysis. Heat shock protein HSP70 activates alkaline phosphatase and promotes the process of mineralization of the bone tissue. In the cells, there is intensification in syntheses of insulin-like growth factor-I, factors of mitogenic action, signals of intensification of blood circulation (NO) and synthesis of somatotropin. The affinity between insulin-like growth factor I and its acid-labile subunit decreases, leading to increased free and active insulin-like growth factor I. Against the background of acceleration of the capillarization process, energy generation and the level of stimulators of growth of bone tissue, mitotic and functional activities of producer cells of the bone – osteoblasts and osteocytes – activate. The generally known Allen’s rule has been developed and expanded: “Warm-blooded animals of different species have longer distal body parts (tails) if after birth the young have developed in the conditions of higher temperature”. The indicated tendency is realized through increased biosynthesis of heat shock proteins and other stimulators of growth processes in the bone tissue.

THERMAL DOSE REQUIREMENT FOR TISSUE EFFECT: EXPERIMENTAL AND CLINICAL FINDINGS

In this review we have summarized the basic principles that govern the relationships between thermal exposure (Temperature and time of exposure) and thermal damage, with an emphasis on normal tissue effects. We have also attempted to identify specific thermal dose information (for safety and injury) for a variety of tissues in a variety of species. We address the use, accuracy and difficulty of conversion of an individual time and temperature (thermal doses) to a standardized value (eg equivalent minutes at 43 degrees C) for comparison of thermal treatments. Although, the conversion algorithm appears to work well within a range of moderately elevated temperatures (2-15 deg C) above normal physiologic baseline (37-39 deg C) there is concern that conversion accuracy does not hold up for temperatures which are minimally or significantly above baseline. An extensive review of the literature suggests a comprehensive assessment of the "thermal does-to-tissue effect" has not previously been assembled for most individual tissues and never been viewed in a semi-comprehensive (tissues and species) manner. Finally, we have addressed the relationship of thermal does-to-effect vs. baseline temperature. This issues is important since much of the thermal dose-to-effect information has been accrued in animal models with baseline temperatures 1-2 deg higher than that of humans.

Apoptosis induced by hyperthermia in Dunn osteosarcoma cell line in vitro

The effect of hyperthermia at 43.5 degrees C for 1 h on Dunn osteosarcoma cells was studied. With sham-heated cells (37 degrees C, 1 h) as the control, the hyperthermia treated cells were divided into five groups. Time 0 group was the cells that were harvested immediately after heated at 43.5 degrees C for 1 h. Whereas time 3, 6, 12, and 24 h groups were the cells that were collected respectively after reincubation at 37 degrees C for the above different time periods. The appearance of hyperthermia-induced apoptosis of Dunn osteosarcoma cells was demonstrated to be time dependent. With the confocal microscopic study and TUNEL staining, the morphological characteristics of apoptosis, condensed nuclei and fragmented nuclei were obvious when reincubated at 37 degrees C for 6 h after hyperthermic treatment. This hyperthermia-induced apoptosis was further confirmed by flow cytometric analysis on DNA contents. The sub-G1 region that was proposed as a marker of apoptotic cells was most significantly elevated at 6 h after hyperthermic treatment and, thereafter, decreased to the levels of control values by 24 h, as the apoptotic cells underwent secondary necrosis and degraded to debris. The DNA strand breaks, considered as the key biochemical event of apoptosis, were detected by the TUNEL assay. This study indicated that hyperthermia (43.5 degrees C for 1 h) can induce apoptotic changes on osteosarcoma cells in vitro very rapidly (within 6 h after treatment), and its occurrence might not be detected if the samples are not taken at several early time points after hyperthermia.

The effects of artery occlusion on temperature homogeneity during hyperthermia in rabbit kidneys in vivo

To investigate the role of arterial occlusion on temperature homogeneity during hyperthermia for deep seated tissue, a renal hyperthermia animal model has been established using New Zealand white rabbits. The effects of ultrasound-induced renal hyperthermia, with or without continuous and intermittent renal artery occlusion, were compared and analysed. Both continuous and intermittent occlusion showed certain protection of surrounding tissue and demonstrated improved temperature homogeneity and heating efficiency. The benefits of continuous vs. intermittent occlusion are compared and discussed as well.

Acute tumor lysis syndrome in high grade lymphoblastic lymphoma after a prolonged episode of fever

Acute tumor lysis syndrome occurs in rapidly growing lymphoid malignancies, usually as a consequence of chemotherapy or corticosteroids. We present what appears to be the first reported case of tumor lysis occurring after a sustained episode of high fever of 42.0 degrees C in a patient with high grade lymphoblastic lymphoma and a high tumor burden.

Exercise-induced hyperthermia as a possible mechanism for tendon degeneration

Mathematical modelling of tendon thermodynamics predicted that the temperature of the central core of the equine superficial digital flexor tendon would plateau at 11 degrees C above the tendon surface temperature during a sustained gallop. A mean temperature differential (between tendon core and surface) of 5.4 (S.E. +/- 1.0) degrees C was demonstrated in vivo in four horses. Peak intra-tendinous temperatures in the range 43-45 degrees C were recorded. Temperatures above 42.5 degrees C are known to result in fibroblast death in vitro [Hall (1988) Radiobiology for the Radiologist, 3rd Edn., pp. 294-329]. These in vivo recordings provide a possible aetiology for the degenerative changes that are observed in the central core of tendons in both equine and human athletes.

Magnetic resonance imaging of burn injury in rats

In-vivo magnetic resonance imaging (MRI) studies have been performed to follow pathological changes induced by 3-sec and 10-second burns on eleven rat tails. T1-weighted, T2-weighted, density-weighted, and water-suppressed images were acquired immediately after and four days following thermal injury. MRI results were correlated with histology. For 3-sec burns, both edema and lipids contributed significantly to the hyperintensity seen on MRI at the site of injury. For 10-sec burns, edema was the major contributor to hyperintensity. Quantitative comparisons indicated the intensity and spatial extent of the edema signal to be most indicative of the degree of injury. MRI also demonstrated potential in determining coagulation necrosis and lipid accumulation at burn sites. These studies indicate the potential of MRI in diagnosing and monitoring burn injuries and therapies.

In vivo findings associated with heat generation during thermomechanical compaction of gutta-percha. 1. Temperature levels at the external surface of the root

Temperature elevations of 10 degrees C above body temperature, of duration greater than 1 minute, may be sufficient to cause bone tissue injury. Temperature rises on the root surface in excess of 10 degrees C have been shown in studies in vitro of thermoplasticized gutta-percha root filling techniques. To determine whether results in vitro at room temperature could be extrapolated to conditions in vivo, temperature elevations were recorded at the mid-point on the root surface of the canine tooth in the ferret during thermomechanical compaction of gutta-percha. The time taken for the temperature to return to normal was also measured. There was no statistically significant difference between temperature elevations recorded in vitro and those measured in vivo. A linear extrapolation may therefore be made from results recorded at room temperature. Temperature elevations dissipated more rapidly in vivo than in vitro; this may be due to the cooling effect of the microvasculature of the periodontal membrane.

Thermal enhancement of radiation-induced leg contracture

Early and late damage in the normal tissues of the legs of mice was compared following treatment with radiation alone or radiation followed immediately by hyperthermia. Hyperthermia was given by immersing the hind leg in a water bath at 43.0 degrees, 43.3 degrees, or 43.5 degrees C for 1 hr. Damage was assayed by measuring leg contracture at various intervals from 5 to 365 days after treatment. At 5 days after treatment, only hyperthermia-induced contracture was observed. At 10 and 20 days, contracture increased with radiation dose in heated legs, but little contracture had developed in mice treated with radiation alone. By 45 through 365 days, however, contracture correlated with radiation dose both in mice treated with radiation alone as well as in those treated with radiation and hyperthermia. The greatest differential in the slopes of the dose response curves, suggesting hyperthermic radiosensitization, was seen 20 days after treatment. Nevertheless, at 365 days, contracture was still significantly greater in the mice treated with radiation and hyperthermia (43.5 degrees bath) than in the irradiated controls. Thermal enhancement ratios (TERs) were calculated from LCD50 values (LCD50 = radiation dose that would give a stated level of leg contracture in 50% of the mice). For greater than or equal to 3 mm contracture, TERs were 4.1 to 7.9 at 30 days, depending on bath temperature, but only 1.1 to 1.5 at 365 days. For an isoeffect of greater than or equal to 7 mm contracture, TERs were 1.9 to 5.3 at 30 days, and 0.8 to 1.8 at 365 days. Thus, contracture was enhanced more at 20 to 30 days after treatment with radiation and hyperthermia than at 120 through 365 days. Radiation damage not only appeared earlier in mice treated with hyperthermia than in those treated with radiation alone, but after the highest temperature tested (43.5 degrees bath), contracture was greater from 5 through 365 days after treatment than in controls treated with radiation alone.

Radiofrequency hyperthermia and topical retinoic acid therapy in murine melanoma

Malignant cells are known to be sensitive to increased temperature. The effects of hyperthermia (HT) on intradermally implanted S91 melanoma cells in syngeneic mice were investigated with a hand-held radiofrequency generator. The possible additive effects of topical retinoic acid (RA) in this system also were studied. Five millimeter diameter melanomas were treated with either HT alone, RA alone, or a combination of HT and RA and were then evaluated after 43 days and 59 days. Eighteen of 20 tumors treated with HT alone and all 20 melanomas treated with HT/RA were eradicated. RA alone caused complete regression in 11 of 19 treated tumors. It is concluded that radiofrequency HT is an effective treatment in intradermal murine melanoma and that the addition of RA does not significantly alter the outcome because of the extreme effectiveness of HT alone.

Periodontal tissue reactions following root canal obturation with an injection-thermoplasticized gutta-percha technique

The thermoplasticized gutta-percha obturation technique is a relatively recent development in endodontics. In this study we evaluated the possible effects of heat transmitted to the periodontal tissues when the Obtura root canal filling device was used in dog teeth. Two 8-month-old beagle dogs were used; 56 root canals of 36 teeth (maxillary incisors and first, second and third premolars of both jaws) were divided into two groups. In Group A 26 root canals were obturated with the lateral condensation technique, while in Group B 30 root canals were obturated using the Obtura device, without sealer. Observation periods were 1, 3, 7, 28 and 56 days. After routine laboratory procedures, hematoxylin-eosin stained sections were examined under a light microscope. In this experimental model the thermoplasticized gutta-percha obturation technique caused a periapical inflammatory reaction at all observation periods. Inflammatory reaction and destruction of collagen fibers were localized in the area around the apical delta, while the alveolar founding bone, the roots of the teeth and the periodontal ligament at the side of the root surfaces remained normal.

Capacitive radiofrequency hyperthermia in the treatment of cutaneous murine melanoma

We have evaluated localized capacitive radiofrequency hyperthermia in the treatment of murine S91 melanoma. Two hundred and ten DBA/2J male mice were implanted with 1 X 10(6) S91 murine melanoma cells innoculated into a noninflammatory upper dermal suction blister cavity. Two tumors were implanted per animal, so that each animal served as its own control in evaluating the effects of temperature, treatment duration, and tumor size on tumor growth following radiofrequency hyperthermia treatment. The data supported the following conclusions: (1) capacitive radiofrequency hyperthermia is effective in the treatment of murine S91 melanoma; (2) duration of treatment between 10 and 60 seconds at 52 degrees C does not influence effectiveness; and (3) treatment temperatures greater than 49 degrees C are needed for maximal effectiveness in the treatment of these tumors. Based on these preliminary findings, high temperature, short duration capacitive radiofrequency hyperthermia may prove to be a useful modality in the treatment of certain cutaneous malignancies.

Stromal sensitivity to radiation and hyperthermia

The influence on stroma of heat alone, X-rays alone or the combined treatment, has been studied using the tumour bed effect (TBE) as an assay. Ca NT cells have been implanted into previously treated subcutaneous sites as an angiogenic stimulus. The vascular damage is then assessed by the reduced tumour growth rate, which results from inadequate vascular proliferation. A range of X-ray doses was used and large alterations in latent period for growth to 2 mm diameter were followed by smaller alterations in the growth rate of established tumours. A dose response relationship was seen for latency (0-20 Gy) and for growth rate (0-16 Gy). A range of subcutaneous temperatures was obtained by immersion in a water bath for 60 minutes at 40 degrees, 41.5 degrees, 43 degrees or 44.5 degrees C. A slight retardation of tumour growth was seen after 41.5 degrees C, but an unexpected acceleration resulted from the highest heat treatment. Combined heat and X-ray treatments showed thermal sensitization of the X-ray induced TBE at 41.5 degrees C, with a reversal at higher temperatures. At 43 degrees C and 44.5 degrees C a mild thermal burn was induced and this appeared to elicit neovascularisation that could be utilized by the implanted tumour cells. Delayed implantation of tumour cells (at 4 weeks instead of 1 day) abolished this effect.

1985 Douglas Lea memorial lecture. Hyperthermia in the treatment of cancer

There are sound biological reasons for using hyperthermia in the treatment of malignant disease. This review includes a discussion of this rationale and describes effects of hyperthermia either given alone or in combination with ionising radiation to cells in vitro, tumours or normal tissues. Topics discussed include thermotolerance, step-down sensitisation, fractionation, re-treatment of previously irradiated sites, thermal enhancement ratio and thermal dose. Problems of heat delivery and temperature measurement are considered and the current status of clinical studies is stated briefly.

Reversible injury after mild hyperthermia

Skin contraction and leg contracture resulted from immersion of mice legs in a water bath at temperatures of 42.5 degrees to 43.7 degrees C for 45 to 90 minutes. The maximum contracture was observed between 5 and 15 days after treatment, but little damage remained after about 30 days. After healing of the early tissue damage, there was no progression of residual damage in skin up to 490 days after treatment. In contrast, radiation-induced contracture develops rapidly after 14 days, and may continue to progress for 100 days or more. In the present studies, leg contracture could be attributed primarily to injury in the skin, because skinning the legs before measuring eliminated most of the contracture. Temperature differences between subcutaneous tissue and deep muscle were not consistently observed or statistically significant, and probably made little or no contribution to the difference in thermal response of these tissues.

Dose-response relationships for photodynamic injury to murine skin

Oedema and necrosis of murine tail skin have been measured after intravenous injection of haematoporphyrin derivative ("Photofrin", or PhI) followed 24 h later by graded exposures of the tail to full-spectrum visible light from a quartz-halogen lamp. End-points were degree of oedema and the proportion of mice in a dose-group that developed skin necrosis and tail atrophy. Oedema developed within 24 h of illumination and was a function of PhI dose and duration of light exposure. Onset of necrosis occurred after a minimum of 5 days and onset time was an inverse function of exposure time. Probit plots of proportion of necroses versus light exposure yielded values for ND50 (exposure corresponding to 50% incidence of necrosis) and l/slope. At the high but non-toxic dose of 2 mg PhI/mouse, ND50 was 18 min, l/slope 4 min, for pigmented BDF1 mice. Halving the PhI dose increased ND50 by a factor of 1.9. Albino BALB/c mice were markedly more sensitive to 2 mg PhI plus light than BDF1 mice: the ND50 was 7 min. Temporary occlusion of the blood supply to the tail (10 min before and during illumination) abrogated totally the oedematous and necrotic reactions to photodynamic therapy.

The relationship between heating time and temperature for rat tail necrosis with and without occlusion of the blood supply

The relationship between time of heating and temperature has been investigated for necrosis resulting in the loss of distal vertebrae in the rat tail. The study was made in both normal conditions and with the blood supply to the tail occluded. In normal conditions there was a transition in the isoeffect relationship close to 42.5 degrees C. Above this temperature a 1 degree C change was equivalent to a change in heating time by a factor of 1.95 +/- 0.01; below 42.5 degrees C the factor increased to 8.1 +/- 0.3. When the tail blood supply was occluded by a clamp the factor was 1.86 +/- 0.01 at temperatures above 42 degrees C and the tissue was considerably more sensitive to hyperthermia. The factor decreased to 1.3 +/- 0.01 at lower temperatures so that the difference in sensitivity between normal and clamped tissue markedly increased with increasing heating time. The results are interpreted in terms of decreased pH resulting from occlusion of the blood supply which renders the tissue more sensitive. The transition in the isoeffect relationship for normal tails is thought to result from the induction of thermal tolerance and is eliminated when the blood supply is occluded. The result is clearly relevant to the heat treatment of regions of tumours with poor blood supply.

Time-temperature relationship for hyperthermia induced stoppage of the microcirculation in tumors

The time-temperature dependence for microcirculation stoppage was investigated for the Rhabdomyosarcoma BA1112 growing in observation chambers ("sandwich chambers"). The tumor microcirculation could be observed continuously during the treatment, and the condition of the microcirculation was recorded every 15 minutes as "flowing" or "stoppage". By using large numbers of tumors, the 50% stoppage time (ST50) could be derived for the four temperatures investigated: 42 degrees, 42.5 degrees, 43 degrees and 43.5 degrees C. The respective ST50 values were 226, 152, 101 and 70 minutes. The results can be expressed as a log-linear relationship with a slope value of 0.4551 +/- 0.03 (SD) per degree centigrade. This value probably does not differ significantly from the "t 1/2 for every degree C" rule that has been found for the thermal response of many biological systems.

Hyperthermia in the treatment of prostate cancer

Hyperthermia-the sustained heating of tissues to temperatures of 42 degrees C to 43.5 degrees C--increasingly is being studied by scientists as a new tool to destroy cancer cells, either alone or in conjunction with other well established forms of treatment, such as radiotherapy and chemotherapy. Many studies on tissue cultures, on animals and also on humans, have established the fact that this new nonconventional adjuvant form of treatment is actually effective. Progress is being made in the development of the necessary technology for delivering the desired and controlled form of heat to the diseased site, while protecting the surrounding healthy tissues from irreversible damage. Initial clinical trials in this direction are very promising and seem to offer new avenues in the methods of treatment for cancer of the prostate.

The relationship between heating time and temperature: its relevance to clinical hyperthermia

It is well known that for a given level of damage to either cells in vitro or tissues in situ the relationship between temperature and time of application undergoes a transition in the range 42-43 degrees C and that above this temperature a change of 1 degree C is equivalent to a change in heating time by a factor of two. The present study has concentrated on establishing the relationship between time and temperature over a wide range. The investigation is in two parts, i.e. a review of the literature and an experimental study in which the endpoint used was necrosis in the tail of the baby rat. The aim is to provide information which might help solve a major clinical problem, namely the lack of a satisfactory means of relating treatments given with different temperatures for different lengths of time. The difficulty arises because there is no satisfactory definition of heat dose, in this context. The results confirm the relationship given above for temperatures above the transition. However, below the transition a change of 1 degree C is equivalent to a change in heating time by a factor of six. It is suggested that these relationships provide a means of monitoring a treatment in which the temperature does not remain constant and may vary within a heated volume. The method may also be used to compare treatments from different centres. An indication of the considerable uncertainties of the procedure is given.(ABSTRACT TRUNCATED AT 250 WORDS)

Microwave-induced hyperthermia and ionizing radiation. Preliminary clinical results

The combination of microwave-induced (2450 MHz) hyperthermia and ionizing radiation was used in 7 patients with superficial malignant tumours, which were considered refractory to other therapy. A newly developed heating system was used, allowing for a maintained temperature at the master probe of 42.5 degrees C +/- 0.5 degrees C during 45 min, but temperature measurements at multiple sites showed a marked variation. This preliminary series indicates that the combination of hyperthermia and ionizing radiation may be useful, the response rate (complete or partial) being 8 of 8 evaluable lesions. Even previously heavily irradiated sites responded. Technical improvements are highly needed to allow for controlled heating of any tissue volume.

The response of mouse intestine to combined hyperthermia and radiation: the contribution of direct thermal damage in assessment of the thermal enhancement ratio

The thermal enhancement of X-ray damage to mouse jejunum has been assessed when heating was achieved by immersion of an exteriorized loop of intestine in Krebs-Ringer solution. The results have been compared with those previously obtained following heating in situ. The primary effect of 1 hour of mild hyperthermia was to reduce the should of the crypt survival curve obtained following X-rays given alone. Thermal enhancement ratio (TER) values increased with increasing temperature, up to 42.3 degrees C, and were within the range reported for other normal tissues. However, when hyperthermia itself caused crypt loss and the contribution of hyperthermal killing to the overall tissue response was taken into account, there was little enhancement of radiation damage. There was no evidence of a large increase in TER at high temperatures, as is seen in some tumours and has been reported by Merino, Peters, Mason and Withers (1978) for intestine. It is possible that very high TER values which have previously been reported mainly reflect the heat-alone component of damage. Some of the implications of these results are discussed in relation to the combination of heat and radiation in therapy.

The relationship between heating time and temperature for inhibition of growth in baby rat cartilage by combined hyperthermia and X-rays

The relationship between the Thermal Enhancement Ratio (TER) for X-ray damage and time of heating has been investigated in epiphyseal rat cartilage. The TER at each temperature rises steeply with increasing heating time. Data obtained using various heat treatments with 8 Gy of X-rays have been analysed in terms of stunting "rate' as measured by the slope of the dose-effect curve obtained for each temperature. The "rate' of stunting per unit heating time, induced by thermally enhanced X-ray damage is compared with the "rate' of stunting induced by heat alone. The two are similar each having an activation energy of approximately 550kJ mole-1, as determined using the Arrhenius equation. Halving the heating time requires at 1 degrees C temperature increase to achieve the same degree of thermal enhancement of X-ray damage. Similar results have been reported previously for damage caused by heat alone. Over a range 42 degrees C-45 degrees C, the threshold heating time to cause direct thermal injury falls within the range of times used to enhance X-ray damage. It is suggested that a component of damage due to direct thermal injury, indistinguishable from radiation damage and thermally enhanced radiation damage, will contribute to TER assessments in some experimental systems.

Ultrasonic irradiation of mammalian cells in vitro at hyperthermic temperatures

Suspensions of V79 cells and HeLa cells have been irradiated with continuous 3 MHz ultrasound at a spatial average intensity of 3W cm-2. This irradiation condition did not give rise to cell lysis. When the cells were irradiated with ultrasound for up to six hours at 37 degrees C no cell killing was observed. However, at temperatures in the hyperthermia range 42--45 degrees C the increase in cell killing that resulted from the irradiation was greater than that which could be attributed to its heating effect alone.

Effects of hyperthermia on a neurogenic rat cell line (BT4C) in culture. Development of thermal tolerance during continuous heating

The malignant neurogenic rat cell line BT4C developed tolerance to further heat injury after continuous heating in culture at 41.0 and 42.0 degrees C for 8 and 2 hours, respectively. Survival was evaluated by colony forming ability. The proliferative capacity of the surviving cells was reduced after heating as shown by a decrease in size of the colonies.

Influence of hyperthermia on the oxygen enhancement ratio for x-rays, measured in vivo

The skin of mouse tail has been used to study the effect of hyperthermia on the oxygen enhancement ratio (OER). Heating was by immersion of a portion of the tail in hot water. Radiation was given either immediately before or after hyperthermia. The average skin reaction between 15 and 50 days after treatment was taken as the end-point. The OER in the absence of hyperthermia was 1.77, suggesting significant hypoxia of the skin. When hyperthermia was given after irradiation the measured value for the OER was not significantly different, but with prior hyperthermia the OER was increased to an average value of 2.3. This increase in OER is probably due to a transient increase in blood circulation following hyperthermia and causing improved tissue oxygenation during irradiation. As a consequence we would expect a greater thermal enhancement ratio for heat given before irradiation than afterwards, and this has frequently been observed with other normal tissues. There was no evidence that heat reduces OER, as has been reported by some authors on the basis of experiments performed on cells in vitro.

The effect of local hyperthermia on the small intestine of the mouse

Small loops of mouse jejunum were exteriorized and heated by immersion in a bath of Krebs-Ringer salt solution. Crypts were lost in the heated regions with a half-time of approximately six hours and reached a steady level of damage by 10--16 hours. There was no recovery in crypt number for one week after hyperthermia. Using a 24 hour assay, crypt survival curves were obtained using various heating times in the temperature range 37.5 degrees C--44.5 degrees C. These curves were qualitatively similar to those resulting from radiation damage, showing a shoulder followed by exponential killing. As the temperature was increased, progressive changes in shape of the curves indicated a proportional inhibition of accumulation of sublethal heat damage combined with increased rate of expression of lethal damage. Over the temperature range 42.3 degrees C--44.5 degrees C, a linear relationship was found between the rate of crypt loss and the reciprocal of the absolute temperature. An activation energy of 600 +/- 70 kJ mole-1 was calculated using the Arrhenius equation. In this temperature range, doubling the heating time had the same effect as increasing the temperature by 1 degree C. At temperatures below about 42.3 degrees C, the tissue became relatively less sensitive to increasing the treatment time.

Effects of hyperthermia on the mouse testis and its response to X-rays, as assayed by weight loss

The effects of both hyperthermia alone and X-rays combined with hyperthermia on mouse testis have been investigated. Testis weight on heating time was observed for temperatures in the range 39.5 to 43.75 degrees C. The relationship between the reaction rate and the reciprocal of absolute temperature indicated that, over the temperature range considered, the activation energy associated with such thermal damage was (646 +/- 45) x 10(3) J mol-1. No evidence was obtained to indicate a change in slope of the Arrhenius plot over this temperature range. Finally, despite the high sensitivity of the testis to heat and X-rays, no thermal enhancement of the weight loss after irradiation was observed when thermal treatments which, if given alone would produce some observable damage, were administered immediately after irradiation.

Two qualitatively different effects of hyperthermia on acid phosphatase staining in mouse spleen, dependent on the severity of the treatment

Heating the lower body of the mouse for up to 1.5 hours at temperatures above 41.0 degrees C causes an increase in splenic lysosomal acid phosphatase activity. For mouse temperatures up to 42.3 degrees C the change is probably due to enzyme activation, which reaches a maximum 1.5 hours after heating and then decays in a way which may be related to the transient ability of moderate hyperthermia to potentiate X-ray damage. At temperatures above about 42.5 degrees C hyperthermia results in a qualitatively different lysomal response, probably due to an increased lysosomal membrane permeability. The change is observed immediately after heating and remains high for at least 4 hours. The resultant release of hydrolases into the cytoplasm may be involved in the irreversible cell damage caused by severe hyperthermia.

The therapeutic advantage of combined heat and X rays on a mouse fibrosarcoma

The response of an experimental fibrosarcoma to combined heat and X rays has been assessed using delay in tumour regrowth. No thermal sensitization was observed for one hour of heating at 41.5 degrees C. A thermal enhancement ratio of 1.4 to 1.5 was seen for one hour of heating at 42.5 or 43.5 degrees C immediately after irradiation. The importance of the sequence and time interval between the two modalities was tested using a constant heat treatment of 42.5 degrees C for one hour. Heating was most effective when given after irradiation, with little change in TER for an interval of a half to six hours. When heat preceded the irradiation the pattern was more complex, with no sensitization at half, one, and six hours, but with a significant effect at two and three hours. The degree of sensitization often depended upon the X-ray dose, being lower below X-ray doses of about 20 Gy. The therapeutic advantage of the combined treatment was assessed by comparison with previously published results for skin reactions. No therapeutic benefit was found for treatments when heat and X-rays were separated by one hour or less. A therapeutic gain factor of about 1.3 was observed for heat given two to six hours after irradiation of this fibrosarcoma.

The response of the rat tail to combined heat and x rays

Moderate heat doses which, alone, cause no measurable response in the cartilage of the tail of the baby rat, may potentiate the effects of X-irradiation. The magnitude of the enhancement (the Thermal Enhancement Ratio, or TER) depends upon the heat dose in a similar way to that observed in other normal tissues. The thermal enhancement in the rat tail was also dependent on the dose of X rays, increasing with increasing dose. Potentiation was always greater when heat was applied before irradiation although the difference in TER between heating immediately before or after irradiation was less than 10%. Potentiation of X ray damage decreased steadily to zero as the heat and X-ray treatments were separated by increasing intervals of time. The loss of potentiation was more complete and more rapid when X rays were given before heating, but was also dependent on both the degree of heating and the dose of X rays.