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Hepatocellular carcinoma is a common liver cancer with poor prognosis. With symptoms not discovered until later stages, it is considered the most fatal malignant liver cancer worldwide, according to a Tulane University news release.
But a research team in the Tulane University Department of Biomedical Engineering is developing a novel cancer treatment that is able to shrink tumors to an average of less than 3% of their initial size in a mouse model.
The work of Jonah S. Harmon, Foad Kabin-ejadian and Joseph Bull, the John and Elsie Martinez Biomedical Engineering chair, is being featured in the September issue of APL Bioengineering and in a release by the American Institute of Physics.
Harmon, the lead author, is a former PhD student of Bull’s and a recent graduate of Tulane’s Biomedical Engineering Ph.D. program, and Kabinejadian is a recent post-doctoral Fellow in Bull’s lab.
The paper is titled “Combined gas embolization and chemotherapy can result in complete tumor regression in a murine hepatocellular carcinoma model.”
The typical treatment for this type of liver tumor is called transarterial chemoembolization, but researchers say it is invasive and too imprecise to be a local drug delivery method, the news release stated.
To increase the precision, the Tulane team created a combination treatment that involves vaporizing tiny droplets of perfluorocarbon, a common organic material comprised of carbon and fluorine that is used in pharmaceuticals, anesthetics and industrial fluids. The method is called gas embolization, and while relatively new, it is the particular research area of the authors.
“By changing the treatment parameters in this paper, we were able to achieve tumor regression, and by combining our method with chemotherapy we were able to reduce regrowth following treatment,” Bull said. “Gas embolization has never been used in patients. Demonstrating that it can induce tumor regression is really new. We’re very excited about the work in this paper.”
Their study tested gas embolization alone and in combination with two common cancer drugs — doxorubicin and tirapazamine. Gas embolization stops blood flow to the tumor, and it was highly effective when used in combination with DOX, Bull said.
The combination of gas embolization and DOX was so effective that, on average, tumors shrank to 2.9% of their initial size. When DOX was used alone, tumors grew to 300% of their initial size.
In the gas embolization method, perfluorocarbon liquid is administered intravenously, interacting with the DOX that has been administered in the body. DOX binds to the surface of the droplets of liquid, which are small enough to travel through capillaries and do not cause blood vessel blockage until they are vaporized. Thus, treatment can be applied locally at the specific site of the tumor.
To turn these tiny liquid droplets into microbubbles and cut off the blood flow to the tumor, ultrasound is applied from outside the body. When exposed to ultrasound waves, the shell of the liquid droplets “focuses the ultrasound to produce a region of low pressure inside the droplet, the nucleation site at which the liquid first transitions to gas, and then the gas bubbles inside the liquid droplet grow,” Bull said, until the droplet turns completely into microbubbles.
The drug DOX binds to the shell of the droplet, and the medicine becomes available to diffuse into the tumor, while the microbubbles cut off blood supply.
The combination of gas embolization and DOX was so effective that, on average, tumors shrank to 2.9% of their initial size. When DOX was used alone, tumors grew to 300% of their initial size, the news release said.

DEAR ABBY: I have been married for 14 years to a man a lot of people in our town think has no flaws. He helps a lot of people, and he is also a pastor, but he ignores me and takes me for granted, personally, emotionally and sexually. He’d rather watch TV until he falls asleep on the couch.
He looks at pornography online, and I catch him often. Even if he’s busy at work, he finds time for everybody but me. He always has excuses.
Since I married him, I have supported him and have gone the extra mile in all aspects — his work, church activities. I have waited on him and made sure all his needs were met. Now I have reached the end of the line, and I want to leave. But if I do, people who know him will make me the villain.
Although we still live under one roof for financial reasons, now I separate myself from him, look after him less and sleep in another room with my dog. Please, Abby, give me your views.
DONE WITH IT IN MAINE

DEAR DONE: It appears your husband has already checked out of this marriage-in-name-only.
Stop being afraid of being labelled a villain and offer your husband the option of couples counseling to see if the two of you can reconnect. Take into consideration that there may be more involved than you are aware of (ED problems, another woman).
If your husband refuses, and you haven’t already done so, confide what has been happening in two or three close female friends. They can then spread the word that there is more than one side to the story. Then talk to an attorney.

DEAR ABBY: Two years ago, my mother-in-law moved into a nursing home and was very sad to be leaving the house she had lived in for 50 years. My husband, devastated at the thought of someone else owning his childhood home, convinced me to sell our house and buy the house from my mother-in-law. We moved in and began renovating it with the intention that it would become our forever home.
The problem is, everyone regards it as THEIR home, not ours. His adult children, his brother and his nieces all come and go as they please. I have talked to my husband about locking the front door, but he often forgets.
His family members come into our house and make a mess or eat our food or sit out on our deck. Then they act like I need to accept it, as it’s their family house. I could maybe understand if we had inherited the house, but we pay the mortgage on it.
I’m out of patience. How do I get my in-laws to once and for all see that this house is not theirs but ours?
DESPERATE IN THE MIDWEST

DEAR DESPERATE: I assume you have been hesitant to tell these in-laws that the names on the deed to the house are yours and your husband’s. If you haven’t said it plainly, the time to do it is now. You don’t have to be nasty, but you do have to convey that you would like guests to call before coming over to be sure it’s convenient. This is not too much to ask.
It goes without saying (I sincerely hope) that they shouldn’t mess the place up or help themselves to your food uninvited. Your husband should back you up on this. Because he sometimes forgets to lock the door, that responsibility is one you will have to assume. You have my sympathy.
***
To receive a collection of Abby’s most memorable — and most frequently requested — poems and essays, send your name and mailing address, plus check or money order for $8 to: Dear Abby — Keepers Booklet, P.O. Box 447, Mount Morris, IL 61054-0447.

Seven new COVID-19 cases and a death in St. Martin were reported in three local parishes in Monday's Louisiana Office of Public Health update.

Two new cases raised the total in St. Mary since the pandemic began to 1,891. The death toll remained at 77.

St. Martin also had two new cases for a pandemic total of 2,058. The death reported Monday raised the number of parish fatalities to 61.

Assumption had three new cases for a total of 753. Twenty-four Assumption people have died.

Statewide:

--249 new cases raised the pandemic total to 161,462.

--9 new deaths raised the statewide toll to 5,207.

--9 fewer COVID-positive people are in hospitals, lowering the total to 587.

--7 fewer people are on ventilators for a total of 93.

The OPH said Monday that 145,570 people are presumed to have recovered from COVID-19. Subtracting the number of recoveries and the number of deaths from the total case count leaves nearly 11,000 active cases across the state.

The rate of new COVID-19 cases in St. Mary Parish has slowed, and while that is a good thing, one of the reasons behind it could be a bit misleading.
St. Mary Parish Coroner Dr. Eric Melancon said Friday that in addition to a lot of people having the disease already, others may contract the virus but are not reporting it because of pressure from family or employers.
“There’s a lot of pushback so that we don’t increase our numbers, which there’s no right or wrong answer there,” he said Friday. “It does hurt the parish in a way when we don’t have an accurate reply of what our true numbers are because later if we ever experience another global pandemic, our resources may be limited compared to what they would have been if we had the accurate numbers.”
According to the state Office of Public Heath’s figures as of noon Sunday, St. Mary Parish had 1,889 confirmed cases and 77 confirmed deaths. St. Mary has the number of deaths at 78, with two possible pending for up to 80, Melancon said.
The case increase is up from 1,600 a month ago.
While infection rate has slowed, Melancon said there is no way to stop it at the moment.
“Typically, what we’re finding is the only way we can stop it is to either get the disease or have a vaccine, and we know we don’t have a vaccine as of yet,” Melancon said.
While Melancon said any death is too many and the death toll for St. Mary is a “huge number,” he said that the death toll is low in the parish compared to what people could experience due to the illness. Medical practitioners are doing a better job of treating patients, he said.
That treatment among physicians in St. Mary Parish is not uniform, though, Melancon said, as each medical practitioner treats the virus how they see fit.
The majority of deaths in St. Mary Parish were among those older than 50, with the oldest being 101 and the youngest 31.
“People are so focused on the exact numbers,” Melancon said. “It really doesn’t matter. We have had almost 1,900 cases and say 80 deaths, so they’ll say ‘oh, but that’s such a low number.’ Well, I don’t want to be one of those 80 people who died.”
While Melancon said the virus is similar to the flu in many ways, COVID-19 can have such an effect on some people that it can kill them.
In St. Mary Parish, Melancon said one flu-related death was recorded last season.
While there is a perception that COVID-19 only can affect the elderly and those with medical illnesses, Melancon said that is false.
“If you look at the Department of Health website and data, 24% of the people who have died in our region did not have any comorbid conditions,” he said Friday. “Now, is that because it wasn’t reported on their death certificates by the physicians that were signing it out that they had these other comorbidities or is it that they’re just otherwise healthy people?”
However, he noted that younger people typically handle COVID, like other illnesses, better.
Despite the state recently entering Phase Three, Melancon said people should continue to do what they have to in order to safeguard themselves.
“When you walk in a mine field, you certainly want to walk lightly,” he said. “Again, the virus isn’t gone. It’s still there. Most people are not going to have much of an issue if they catch the virus. Some people will die. That’s as simple as you can make it.”
As for a vaccine, Melancon said that even if one comes out in the next month or two, it likely will not be available widespread to the public until next spring or early next summer.
He said the pecking order for vaccine distribution will be first-line responders first, then nursing home patients, while general population is far down the list.
Melancon, who has practiced medicine for 27 years, said that COVID-19 has been the biggest learning curve for him.
“I think that’s the hardest part,” he said. “The last time we had a pandemic was 100 years ago, so probably the biggest dilemma is that I think the medical field was too quick to latch onto ideologies or treatments that ‘may have shown benefit’ and use that as gospel. Medicine is never like that.”
There is still learning to be done, too.
“I don’t think we’ve learned nearly what we will know,” he said. “Probably this time next year, we’ll have a pretty good grasp of all the nuances of what transpired with COVID-19, and I think we’ll have a better playbook to go by the next time something like this happens.
“Now, the responses we use may not be applicable to the next disease,” Melancon added. “We don’t know, but I’d like to say I’m sure we’ll have a better collaboration or at least an understanding where the physicians who are managing patients and corporate medicine and politics and all of this, we don’t get into all these contests of who’s right and who’s wrong. Actually, everybody’s been wrong. We’ve all been wrong, and we’re learning.”