Radiofrequency Ablation in Metastatic Disease

Abstract The liver is the most common site of metastas from colorectal cancer. Hepatic metastases are the major cause of morbidity and mortality in those patients. Surgical resection provides the greatest potential for cure in patients with secondary liver tumors but can be offered to only a small number of patients (5%-20%). In selected patients image-guided radiofrequency ablation (RFA) takes over the role as curative treatment option, especially in patients who are technically not eligible for surgery. Technical aspects, criteria for patient selection, aspects concerning follow-up imaging and results of percutaneous radiofrequency ablation in liver metastases from colorectal cancer are discussed

Electrochemical Treatment: An Investigation of Dose-Response Relationships Using an Isolated Liver Perfusion Model

Background/Aim: Ablative techniques such as radiofrequency ablation or non-thermal electrochemical treatment (ECT) are used to manage unresectable liver metastases. Although ECT is not affected by the cooling effect from adjacent vessels, there is a paucity of data available on ECT. Materials and Methods: We used porcine livers to establish an organ model with portal venous and hepatic arterial blood flow for a standardized analysis of the relationship between dose (electric charge) and response (volume of necrosis). Results: This model allowed us to study pressure-controlled perfusion of portal venous and hepatic arterial circulation in the absence of a capillary leak. A specially designed guiding template helped us place platinum electrodes at reproducible locations. With two electrodes, there was a linear relationship between charges of no more than 200 C and necrosis. The relationship was logarithmic at charges of 400-600 C. Larger electrode spacing led to a significant increase in necrosis. We measured pH values of 0.9 (range: 0.6-1.3) at the anode and 12.6 (range: 11.6-13.4) at the cathode. Conclusions: Using a perfusion model, we established an experimental design that allowed us to study ECT in the liver of large animals without experiments on living animals. An electrode template helped us improve the standardized analysis of dose-response relationships. ECT created reproducible and sharply demarcated areas of necrosis, the size of which depended on the charge delivered as well as on the number and spacing of electrodes. Doses higher than 600 C require longer treatment times but do not increase the area of necrosis (logarithmic dose-response relationship)

Policy of suspiciousness – mobilization of educational reforms in Sweden

In this article, we explore the processes of transfer and translation ofeducation policy in a study focusing on the relationship betweenthe Organisation for Economic Co-operation and Development(OECD) and Sweden. The purpose of the study is to investigatehow selective borrowing occurs both in terms of references todifferent types of knowledge sources underpinning the argumentsand shared discourse formations. The data were obtained fromtwo policy reports: an OECD review report of the Swedish schoolsystem and a Swedish follow-up report proposing actual schoolreforms. The method was twofold: first, mapping, categorizing,and counting all the textual references in the two documents;second, critically analyzing the discourses emerging in the twopolicy texts. The results show that international references play asignificant role in substantiating arguments for Swedish educationpolicy. Both policy texts share a policy discourse characterized bysuspiciousness toward the professionalism exercised by teachersand local education authorities.Bibliografiskt granskad</p