Expert consensus on microwave ablation for benign breast nodules / 中华内科杂志

Because mammary glands are regulated by endocrine factors, they are prone to various abnormalities and disorders. Breast nodules are common and occur frequently in clinical practice. The clinical management of breast nodules mainly includes follow-up observation, lesion biopsy, and surgical intervention, and surgical intervention is an effective treatment. Ultrasound-guided percutaneous microwave ablation is a new minimally invasive treatment technology developed in recent years. It has the advantages of short operation time, no scarring, less damage to the lactiferous duct, quick recovery, and good curative effects without bleeding. The establishment of an expert consensus on microwave ablation for benign breast nodules aims to provide a reliable clinical basis for microwave ablation of benign breast nodules, standardize the treatment process, and improve treatment efficacy, so as to serve as a reference for physicians in clinical practice.

"Leverage pry-off method" for effective prevention of thermal injury during microwave ablation of benign thyroid nodules / 南方医科大学学报

OBJECTIVE@#To assess the safety and efficacy of"leverage pry-off method"for preventing thermal injury during microwave ablation of benign thyroid nodules.@*METHODS@#From July, 2017 to September, 2019, a total of 348 patients with benign thyroid nodules underwent ultrasound-guided microwave ablation. For protecting from thermal injury during the ablation, "hydrodissection technique" was used in 174 of the patients (admitted from July, 2017 to August, 2018) and "leverage pry-off method" in the other 174 patients (admitted from September, 2018 to September, 2019). All the patients were followed up for 1 to 12 months after the operation for observation of severe complications and nodular residues.@*RESULTS@#Ultrasound-guided microwave ablation was completed in all the 348 patients. The most common severe complication associated with the ablation was voice change, occurring in 3 cases (1.7%) in "hydrodissection technique" group and in 4 (2.3%) in the "leverage pry-off method" group, showing no significant difference between the two groups (P>0.05). During the follow-up, no significant difference was found in the rate of nodular residues between the "hydrodissection technique" group and "hydrodissection technique" group (9.8% vs 10.9% (P>0.05).@*CONCLUSIONS@#The "leverage pry-off method" is simple and effective for preventing thermal injury during microwave ablation of benign thyroid nodules.

Ultrasound-guided anhydrous ethanol and microwave ablation for functional parathyroid cyst: a case report / 南方医科大学学报

We report a case of functional parathyroid cyst treated by ultrasound-guided anhydrous ethanol sclerotherapy and microwave ablation. The 63-year-old female patient was diagnosed to have functional parathyroid cyst with hypercalcemia, high PTH and cystic space-occupying lesions in the neck by ultrasound, radionuclide scanning and PTH measurement of the cystic fluid. The patient refused to receive cyst resection, and anhydrous ethanol sclerotherapy with microwave ablation was performed under ultrasound guidance. The procedure was completed smoothly without any complications either during or after the operation. Follow-up examination of the patient at 18 months after the operation showed a significant reduction of the mass and normal blood calcium and iPTH levels, demonstrating a clinical cure of the patient. Ablative treatment of functional parathyroid cyst has not been documented so far. This approach provides a minimally invasive treatment modality for such cases where surgical resection is not an option, but its efficacy and safety need to be evaluated in more cases with longer follow-up time.

Rapid hemostasis: a novel and effective outpatient procedure using microwave ablation to control epistaxis of isolated mucosal bulge lesions / Hemostasia rápida: um procedimento ambulatorial novo e eficaz utilizando ablação por micro-ondas para controlar a epistaxe de lesões isoladas protuberantes da mucosa

Abstract Introduction Recurrent epistaxis is commonly encountered in the rhinology outpatient clinic. Under endoscopic guidance, both bipolar cautery and monopolar forceps (combined with suction) have been employed to control the bleeding. However, the use of monopolar forceps requires the placement of grounding pads. Most procedures are currently performed in operating rooms. Objective We investigated outcomes after the use of Microwave Ablation (MWA) to control epistaxis in adults with isolated mucosal bulge lesions. All procedures were performed with patients under local anesthesia in our outpatient clinic. Methods This is a retrospective cohort study. We included 83 adults with epistaxis of isolated mucosal bulge lesions. Microwave ablation was performed in the outpatient clinic to control bleeding, after induction of local anesthesia. The primary outcome was successful hemostasis. The secondary outcomes were the rebleeding rates at weeks 1 and 4 and month 6, and complications (crust or synechiae formation, septal perforation, and/or orbit or brain complications). Results All bleeding points were successfully ablated; hemostasis was achieved within 1-2 min. The mean pain score was 1.83 intra-operatively and 0.95 1 h postoperatively. No patient re-bled, and no severe MWA-related complication (septal perforation, synechiae formation, or orbit or brain complication) was recorded to 6 months of follow-up. Conclusions Endoscopic microwave ablation with patients under local anesthesia is a novel, safe, effective, rapid, well-tolerated, outpatient treatment for adults with epistaxis of isolated mucosal bulge lesions, especially those for whom general anesthesia might be risky, those with electrical implants, and those exhibiting contraindications for arterial embolization.

Resumo Introdução Epistaxe recorrente é comumente encontrada no ambulatório de rinologia. Sob orientação endoscópica, foram empregados tanto o cautério bipolar quanto a pinça monopolar (combinados à sucção) para controlar a condição. No entanto, o uso de pinças monopolares requer a colocação de placas de aterramento. Atualmente, a maioria dos procedimentos é feita em salas de cirurgia. Objetivo Investigamos os resultados após o uso da ablação por micro-ondas (MWA, do inglês Microwave Ablation) no controle da epistaxe em adultos com lesões isoladas protuberantes da mucosa. Todos os procedimentos foram feitos em nosso ambulatório com os pacientes sob anestesia local. Métodos Estudo de coorte retrospectivo. Foram incluídos 83 adultos com epistaxe de lesões isoladas protuberantes da mucosa. A ablação por micro-ondas foi feita no ambulatório para controlar o sangramento, após a administração de anestesia local. O desfecho primário foi uma hemostasia bem-sucedida. Os desfechos secundários foram as taxas de ressangramento, nas semanas 1 e 4 e no mês 6, e complicações (formação de crostas ou sinéquias, perfuração septal e/ou complicações orbitais ou cerebrais). Resultados Todos os pontos de sangramento foram contidos com sucesso; a hemostasia foi alcançada em 1-2 minutos. O escore médio de dor foi de 1,83 no intraoperatório e de 0,95 1 h no pós-operatório. Nenhum paciente apresentou ressangramento e nenhuma complicação grave relacionada à MWA (perfuração septal, formação de sinéquias ou complicações orbitais ou cerebrais) foi registrada em 6 meses de seguimento. Conclusões A ablação endoscópica por micro-ondas com pacientes sob anestesia local é um tratamento ambulatorial novo, seguro, eficaz, rápido e bem tolerado para adultos com epistaxe de lesões isoladas protuberantes da mucosa, especialmente aqueles para os quais a anestesia geral pode ser arriscada, indivíduos com implantes elétricos e aqueles com contraindicações para embolização arterial.

Microwave hyperthermia in conjunction with radiotherapy in superficial tumours: correlation of thermal parameters with tumour regression / Hipertermia de microonda de conjunto con radioterapia en los tumores superficiales: correlación de los parámetros térmicos con la regresión del tumor

OBJECTIVE: The aim of the present study is to evaluate the correlation between the thermal parameters of hyperthermia and the clinical outcome in patients with superficial tumours. METHODS: In this study, 20 patients were included with either submandibular lymph nodes from head and neck cancer, or breast cancer relapses post-mastectomy. They were treated with radiation in combination with one session of433 MHz microwave hyperthermia (1 hour, 42.5 ºC-46 ºC). The dose of irradiation ranged from 54 to 60 Gy. The thermal parameters calculated were the minimum volume temperature, the maximum volume temperature and the time interval where the volume temperature was greater than 44 ºC. RESULTS: All patients responded positively to the combined treatment and 60% of the patients showed a complete response. Of the three parameters tested, the only parameter that was found to correlate with the reduction of the tumour diameter was the time with volume temperatures greater than 44 ºC (p < 0.001, Spearman rho). No moderate toxicity was observed. CONCLUSION: Microwave heating should be over 44 ºC for favourable treatment response, when combined with radiotherapy. More patients are needed to confirm the above results.

OJETIVO: El objetivo del presente estudio es evaluar la correlación entre los parámetros térmicos de la hipertermia y el resultado clínico en pacientes con tumores superficiales. MÉTODO: En este estudio, se incluyeron 20 pacientes con ganglios linfáticos submandibulares de cáncer de cabeza y cuello, o post-mastectomía por recidivas de cáncer de mama. Los pacientes fueron tratados con radiación en combinación con una sesión de hipertermia de microondas de 433 MHz (1 hora, 42.5 ºC-46 ºC). La dosis de irradiación osciló entre 54 y 60 Gy. Los parámetros térmicos calculados fueron la temperatura de volumen mínimo, la temperatura de volumen máximo y el intervalo de tiempo donde el volumen de la temperatura fue superior a 44 ºC. RESULTADOS: Todos los pacientes respondieron positivamente al tratamiento combinado y el 60% de los pacientes demostrados una respuesta completa. De los tres parámetros probados, el único parámetro que se comprobó que se correlaciona con la reducción del diámetro del tumor fue el tiempo con temperaturas de volumen superiores a 44 ºC (p < 0.001, rho de Spearman). No se observó ninguna toxicidad moderada. CONCLUSIÓN: Calentamiento por microondas debe estar por encima de 44 ºC para que la respuesta sea favorable al tratamiento en combinación con radioterapia. Se requieren más pacientes para confirmar los resultados anteriores.

Eficiencia del método de polimerización con microondas en la rehabilitación por prótesis oculares individuales / Effectiveness of microwaves polymerization method in individual ocular prostheses rehabilitation

La polimerización con microondas es una nueva forma de llevar a cabo la confección de prótesis oculares individuales, sin embargo son aún insuficientes los estudios que exploren la eficiencia de este método. Se realizó una investigación para determinar el efecto de la polimerización con microondas en la eficiencia de la rehabilitación por prótesis oculares individuales. Se llevó a cabo un estudio de evaluación económica del tipo minimización de costos. Se comparó la polimerización tradicional simplificada con la polimerización por el método de microondas. Se consideraron para la efectividad el monómero residual, la deflexión transversal, la contracción lineal, la porosidad, la estabilidad del color, la resistencia al impacto, la dureza, la absorción de agua y la resistencia transversal. Se calcularon los costos médicos directos sobre la base de un modelo teórico para un paciente que requirió una prótesis ocular individual en el año 2006. Se documentó la igualdad de efectividad entre ambos métodos de polimerización. El costo teórico para un paciente que requirió una prótesis ocular individual fue de $ 79,85 USD y $ 70,07 USD por los métodos tradicionales y por microondas respectivamente. El método de polimerización con microondas ahorró en consumo de energía eléctrica y favoreció una mayor productividad de los recursos humanos, a la vez que incrementó la eficiencia(AU)

Microwaves polymerization is a new method to design individual ocular prostheses; however, there is a lack of studies exploring the effectiveness of present method to determine the effect of the microwaves polymerization in relation to effectiveness of individual ocular prostheses rehabilitation. An economic evaluation study was conducted to minimize costs. The simplified traditional polymerization was compared with microwaves polymerization method. For residual monomer the effectiveness transverse deflection, linear contraction, porosity, color stability, impaction resistance, hardness, water absorption and transverse resistance were took into account. The direct medical costs were estimated on the base of a theoretical model for a patient required an individual ocular prosthesis expressed in currency of 2006. Equality effectiveness of both polymerization methods was documented. Theoretical cost for a patient required an individual ocular prosthesis was of $ 79,85 USD and of $ 70,07 USD for the traditional and microwaves methods, respectively. The microwave polymerization method saves electric power consumption and favors a greater productivity of human resources while to increase the effectiveness(AU)

Reducción de flora contaminante en alimentos mediante tratamiento con microondas / Flora of reduction in food contamination by treatment with microwave

La contaminación bacteriana de alimentos que se consumen en la calle servidas por expendedores ambulantes constituye una alternativa alimentaria para los trabajadores y estudiantes, pero a la vez es fuente de enfermedades trasmitidas por alimentos a los consumidores, para el estudio de la acción de hornos microondas sobre la contaminación de alimentos se tomaron setenta y siete (77) muestras de alimentos de la ciudad de Trujillo-Venezuela, colectadas en expendios (21 perros calientes, 32 empanadas y 24 arepas), tomadas en condiciones de asepsia se trasladaron en cadena de frío hasta el laboratorio para su estudio. De cada muestra se separaron dos partes, una para irradiarla con microondas durante un minuto para luego someterla al estudio bacteriológico y otra control sin el citado tratamiento. Se confirmó contaminación fecal en el 60% de las muestras examinadas, la exposición a microondas durante un minuto redujo en un 85,4% las cargas de bacterias coliformes. Los resultados demuestran la destrucción de bacterias en un 90% de perros calientes, 40% en empanadas y 66,6% de arepas que resultaron positivas. La acción del microondas sobre los alimentos resultó ser una técnica efectiva para reducir las cargas de bacterias contaminantes.

Food that is served by mobile stall and consumed on the street is a nutritional alternative for workers and students but, sometimes, the bacterial contamination of this “fast food” can be a diseasis transmitted by food to consumer. In this study of the effect of microwave ovens on the contamination of food, seventy-seven examples of “fast food” were collected from mobile stalls (twenty-one hot-dogs, thirty-two empanadas and twenty-for arepas). The sample were taken in aseptic conditions and transferred to the laboratory in cold storage. Each sample was divided into two parts. One part was irradiated with microwaves for one minute and the subjected to a bacteriological analysis. The other was not subjected to the radiation treatment. Fecal contamination was confirmed in 60% of the samples examined; the one minute exposure to microwaves reduced the levels of bacterial coliforms by 85.4%. The results revealed the destruction of bacteria in 90% of the hot-dogs, in 40% of the empanadas and in 66.6% of de arepas that were diagno-sed as positive. The effect of microwaves proved to be an effective technique in reducing the levels of bacterial conta-minants in food-stuffs.

Influence of microwave sterilization on the cutting capacity of carbide burs

OBJECTIVE: This study compared the cutting capacity of carbide burs sterilized with microwaves and traditional sterilization methods. MATERIAL AND METHODS: Sixty burs were divided into 5 groups according to the sterilization methods: dry heat (G1), autoclave (G2), microwave irradiation (G3), glutaraldehyde (G4) or control - no sterilization (G5). The burs were used to cut glass plates in a cutting machine set for twelve 2.5-min periods and, after each period, they were sterilized (except G5) following the protocol established for each group. The cutting capacity of the burs was determined by a weight-loss method. Data were analyzed statistically by Kruskal-Wallis and Dunn's test. RESULTS: The means of the cutting amount performed by each group after the 12 periods were G1 = 0.2167 ± 0.0627 g; G2 = 0.2077 ± 0.0231 g; G3 = 0.1980 ± 0.0326 g; G4 = 0.1203 ± 0.0459 g; G5 = 0.2642 ± 0.0359 g. There were statistically significant differences among the groups (p<0.05); only dry heat sterilization was similar to the control. CONCLUSION: Sterilization by dry heat was the method that least affected the cutting capacity of the carbide burs and microwave sterilization was not better than traditional sterilization methods.

Effect of microwave disinfection on denture base adaptation and resin surface roughness

This study evaluated the effect of disinfection methods [chemical disinfection (immersion in 100 ppm chloride solution) or microwave disinfection (690 W for 6 min)] on the internal adaptation of denture bases and resin surface roughness. For the adaptation test, 18 maxillary denture bases were obtained from stone casts duplicated from a metallic master model and submitted to the following treatments: 1) control (no disinfection), 2) chemical disinfection or 3) microwave disinfection. Disinfection procedures were performed twice (T1, T2) with a 7-day interval between them. Internal adaptation was measured at baseline (T0) and after T1 and T2 by weighing a vinyl polysiloxane film reproducing the gap between the resin base and the master model. For surface roughness measurement, 60 rectangular (5x10x40 mm) resin specimens were either mechanically or chemically polished and then submitted to the disinfection treatments. Surface roughness (Ra) was recorded after polishing (T0) and after T1 and T2. Data were analyzed by ANOVA GLM for repeated measures and Bonferroni correction at 5 percent significance level. Bases submitted to microwave disinfection had gradual increase of misfit, while bases immersed in chloride solution did not differ from the control group. Surface roughness increased in the mechanical polishing groups with microwave disinfection and decreased in the chemical polishing groups.

Este estudo avaliou o efeito de métodos de desinfecção [desinfecção química (imersão em solução clorada 100 ppm) ou desinfecção por microondas (690 W por 6 min)] na adaptação interna de bases de próteses totais e na rugosidade superficial da resina. Para o teste de adaptação, 18 bases superiores foram duplicadas a partir de um modelo-mestre metálico e submetidas aos seguintes tratamentos: 1) controle (sem desinfecção), 2) desinfecção química ou 3) desinfecção por microondas. Os procedimentos de desinfecção foram realizados duas vezes (T1, T2) com intervalo de 7 dias. A adaptação interna foi medida no baseline (T0), após T1 e T2 por pesagem de um filme de silicona de adição que reproduzia o espaço entre base de resina e modelo-mestre. Para a rugosidade superficial, 60 espécimes retangulares (5x10x40 mm) receberam polimento mecânico ou químico e foram submetidos aos tratamentos de desinfecção. A rugosidade superficial (Ra) foi registrada após o polimento (T0) e após T1 e T2. Os dados foram analisados por ANOVA GLM para medições repetidas e teste de Bonferroni com nível de significância de 5 por cento. As bases submetidas à desinfecção por microondas tiveram aumento gradual de desadaptação, enquanto que as bases imersas em solução clorada não diferiram do grupo controle. A rugosidade superficial aumentou nos grupos de polimento mecânico e desinfecção por microondas e diminuiu nos grupos de polimento químico.

Epicardial Microwave Application in Chronic Atrial Fibrillation Surgery

The search for alternative epicardial energy sources in the treatment of nonvalvular atrial fibrillation (AF) is a relatively new aspect of the evolving spectrum of Maze operations. We tested the hypothesis that epicardial microwave ablation produces identical results to those of the standard cryosurgical Maze. Fourteen consecutive patients with chronic AF underwent on-pump epicardial Maze procedures after routine cardiac surgery. The results were compared with those of 14 control patients selected from our Maze database of 280 patients. There were no differences in age, sex, cardiothoracic ratio, duration of AF, pump time, intensive care unit or hospital stays. The aortic cross clamp time with epicardial microwave was, however, shortened from 110 to 65 minutes (p=0.011). The recurrence rate of AF after discharge showed no significant difference between the two groups (14% vs. 15%, p=0.841). Epicardial microwave ablation might be a valuable alternative to the conventional cryosurgical Maze procedure, especially for those patients without associated mitral valve disease.

Efecto de microondas sobre staphylococcus aureus y salmonella spp. inoculados en carne molida congelada / Effect of microwaves over staphylococcus aureus and salmonella spp. innoculated into frozen minced meat

Se estudió la eficiencia del horno de microondas en la destrucción de algunos microorganismos patógenos inoculados en tortas de carne de res. Las otras carnes fueron inoculadas con Salmonella ssp. o Staphylococcus aureus, mantenidas en congelación por 2-3 días a -4ºC y posteriormente descongeladas en un horno de microondas Amana de 2450 Hz, según su peso. Fueron sometidas a niveles de potencia de 60 por ciento, 70 por ciento y 80 por ciento y 90 por ciento por períodos de 15,45,60,90 y 105 segundos. se determinó en cada muestra la tasa de sobrevivencia de las bacterias inoculadas según la metodología descrita por Vanderzant y Splittstoesser; así como la actividad de la enzima fosfatasa ácida como parámetro de cocimiento. Los recuentos de los microorganismos inoculados demuestran que, independientemente del nivel de cocción utilizado, se requiere de un tiempo mayor a aquel en que la carne se considera cocida desde el punto de vista enzimático y organoléptico para obtener la eliminación de ambas bacterias

O uso de microondas para descalcificaçäo de tecidos mineralizados da mandíbula de ratos / Using microwaves for the decalcification of mineralized tissues of the rat mandible

Neste trabalho, compararam-se a preservaçäo tecidual e o tempo de descalcificaçäo através de E.D.T.A. a 7 por cento, pH 7,3, hemimandíbulas de ratos fixadas em etanol 70 por cento, associado ou näo às microondas. Houve o mesmo grau de preservaçäo histológica em ambos os grupos estudados, com uma acentuada reduçäo do tempo de desmineralizaçäo na ordem de 83 por cento quando se associou o microondas

Termoterapia transuretral por microondas en el tratamiento de la hiperplasia benigna de la próstata: 3 años de seguimiento / Transurethral thermotherapy by microwaves in the treatment of benign prostatic hyperplasia: 3 years follow up

Durante un periódo de 53 meses hemos tratado 890 pacientes portadores de una hiperplasia prostática benigna de la Próstata a través de la Termoterapia transuretral mediante microondas. 365 pacientes completaron 3 años de seguimiento, incluyendo 35 que presentaban retención urinaria al momento de ser tratados. El tratamiento consistió en 1 sesión ambulatoria de 1 hora de duración bajo anestesia local. El score de Madsen-Iversen disminuyó de 11.7 (pretratamiento) a 4.1 después de 3 años de seguimiento (p = 0.01). El flujo máximo aumento desde 11.7 (antes del tratamiento) hasta los 14.9 después de 3 años (p = 0.01). El tratamiento fue bien tolerado excepto por tansitorias retenciones de orina en 101 pacientes, 2 enfermos relataron además ausencia de eyaculación post-tratamiento y ningún paciente ha referido impotencia. De los 35 pacientes en retención urinaria, 22 permanecen sin sonda después de 3 años de seguimiento (residuo postmiccional: 105 cc). Nuestros resultados indican que la Termoterapia transuretral es un tratamiento efectivo y seguro, el cual mejora los parámetros subjetivos y objetivos. Experiencias adicionales y un mayor tiempo de seguimiento determinaron el rol definitivo de esta terapia en el manejo de la hiperplasia prostática benigna de la Próstata

Resinas acrílicas dentais polimerizadas por energia de microondas, método convencional de banho de água e quimicamente ativada: propriedades físicas / Acrylic resins polymerized by microwave energy, conventional water bath curing and self-curing systems: physical properties

Avaliaram-se as propriedades físicas de sorçäo e solubilidade em água, resistência transversal e flexäo máxima antes da fratura e resistência ao impacto de quatro marcas comerciais de resinas acrílicas dentais, sendo duas polimerizadas de modo convencional em banho de água aquecida, uma curada por microonda e a última resina, autopolimerizada. Verificou-se que as resinas diferiram entre si em relaçäo às propriedades estudadas, e provavelmente essas diferenças estäo relacionadas ao tipo de polimerizaçäo a que foram submetidas e à composiçäo das mesmas

Técnica para la polimerización de resina acrílica para dentaduras con irradiación de microondas / Acrylic resin poliymerization technique for dentures with microwaven radiation

Se describe detalladamente la técnica para la polimerización de resina de acrílico para dentaduras con irradiación de microondas, así como las precauciones que deben tomarse y el equipo recomendado