CAREER: Establishing the Efficacy of Cryomyolysis - Cryosurgery of Uterine Fibroids

9703326 Bischof子宫肌瘤是妇科最常见的器官疾病，也是女性大手术的最常见原因。 目前的治疗方法包括子宫切除术（手术切除子宫）、肌瘤切除术（手术切除肌瘤）和最近的肌溶解术（破坏体内的肌瘤）。 拟议的工作将调查冷冻手术的肌瘤或冷冻肌溶解术的潜力，作为一个保守的替代妇女谁患有肌瘤，但不希望接受手术切除肌瘤或子宫。 研究假设为：1.冷冻肌溶解术的有效性主要是由于血管损伤（对滋养肌瘤的血管网络的损伤），而不是直接的细胞损伤（对肌瘤细胞本身的损伤），以及2.细胞破坏的程度可以预测的基础上，在冷冻肌溶解过程中施加在组织上的热历史。 通过测试这些假设的具体目标的建议，我们将能够回答以下问题：如何保持低的温度多长时间是必要的破坏单个纤维瘤细胞和组织？ 当细胞和组织在体内（体内）与体外（体外）时，冷冻手术破坏细胞和组织的能力是否有差异？ 如果存在差异，是否可归因于体内（体内）血管损伤机制？ 最后，在手术过程中形成的冰球的大小如何与该技术造成的组织破坏量相关联？ 这些问题的答案是至关重要的冷冻手术破坏的机制的透彻理解，因此，谨慎和有效地应用这种手术技术在子宫肌瘤。 ***

9703326 Bischof Uterine fibroids are the most common organ disease in gynecology and the most common reason for major surgery in women. Current treatments include hysterectomy (surgical removal of the uterus), myomectomy (surgical removal of the fibroid), and most recently myolysis (destruction of the fibroid in the body). The proposed work will investigate the potential of cryosurgery of the fibroid or cryomyolysis as a conservative alternative for women who suffer from fibroids but do not wish to undergo a surgical operation to remove either the fibroid or their uterus. The hypotheses are: 1. The effectiveness of cryomyolysis is due primarily to vascular injury (damage to the vascular network nourishing the fibroid) as opposed to direct cellular injury (damage to the fibroid cells themselves), and 2. The extent of cellular destruction can be predicted based on the thermal history imposed on the tissue during cryomyolysis. By testing these hypothesis in the specific aims of the proposal, we will be able to answer the following questions: How low a temperature held for what length of time is necessary to destroy single fibroid cells and tissues? Is there a difference in the ability of cryosurgery to destroy the cells and tissues when they are in the body (in vivo) vs. when they are outside of the body (in vitro)? If a difference exists, can it be attributed to a vascular in injury mechanism inside the body (in vivo)? And finally, how does the size of the ice ball that is formed during the surgery correlate to the amount of tissue destroyed as a result of the technique? The answers to these questions are critical to a thorough understanding of the mechanism of cryosurgical destruction and, consequently, to the prudent and effective application of this surgical technique in uterine fibroids. ***