Purpose: We used an impedance-controlled generator with an internally cooled electrode to perform radiofrequency ablation (RFA) in ex vivo bovine livers, with a single injection of either 38.5% sodium chloride (NaCl) or 10% hydrochloric acid (HCl), to determine the relative effects of these two solutions on tissue impedance, temperature and ablation volume.
Materials and methods: We performed 10 ablations each with injections of NaCl (NaCl-RFA), HCl (HCl-RFA) or nothing (RFA-alone), with a power setting of 200 W for 15?minutes. We recorded tissue impedance before and after injection. We logged temperatures obtained from thermocouple probes positioned 5, 10, 15 and 20?mm from the internally cooled RF electrode. After ablation, we measured ablation zone longitudinal and transverse diameters, and we calculated a spherical ratio (SR) for each ablation.
Results: Mean post-injection impedance of 30.3 (standard deviation [SD] 2.5) ohms for HCl was significantly lower than that of 55.4 (SD 3.5) ohms for NaCl (p?<?.001). Mean maximum temperatures recorded at each respective distance from the RFA electrode were all highest for HCl-RFA and lowest for RFA-alone (p?<?.001). Mean longitudinal and transverse diameters after HCl-RFA (5.50 [SD 0.25] cm and 5.28 [SD 0.22] cm, respectively) were significantly larger than those after NaCl-RFA (4.24 [SD 0.35] cm and 3.55 [SD 0.43] cm, respectively) and after RFA-alone (3.60 [SD 0.10] cm and 2.70 [SD 0.13] cm, respectively) (p?<?.001). Mean SR after HCl-RFA (0.93, SD 0.02) was significantly higher than mean SR after NaCl-RFA (0.76, SD 0.06) and RFA-alone (0.72, SD 0.04) (p?<?.001).
Conclusion: Monopolar, impedance-controlled RFA, with an internally cooled electrode and a single 10% HCl injection may allow larger tumors to be treated, potentially resulting in improved patient outcomes. 相似文献
This study was designed to evaluate the efficacy of low‐level laser therapy (LLLT) in the treatment of temporomandibular disorders (TMDs). We searched electronic databases and references lists of relevant articles, retrieved all of the published randomised controlled trials in regard to these issues and then performed a meta‐analysis. Fourteen highly qualified RCTs reporting on a total of 454 patients, which evaluated the effectiveness of LLLT for patients suffering from TMDs were retrieved. The results indicated that LLLT was not better than placebo in reducing chronic TMD pain (weighted mean difference = ?19·39; 95% confidence interval = ?40·80–2·03; P < 0·00001; I2 = 99%). However, the LLLT provided significant better functional outcomes in terms of maximum active vertical opening (MAVO) (weighted mean difference = 4·18; 95% confidence interval = 0·73–7·63; P = 0·006; I2 = 73%), maximum passive vertical opening (MPVO) (weighted mean difference = 6·73; 95% confidence interval = 01·34–12·13; P = 0·06; I2 = 73%), protrusion excursion (PE) (weighted mean difference = 1·81; 95% confidence interval = 0·79–2·83; P = 0·59; I2 = 0%) and right lateral excursion (RLE) (weighted mean difference = 2·86; 95% confidence interval = 1·27–4·45; P = 0·01; I2 = 73%). The results of our meta‐analysis have provided the best evidence on the efficacy of LLLT in the treatment of TMDs. This study indicates that using LLLT has limited efficacy in reducing pain in patients with TMDs. However, LLLT can significantly improve the functional outcomes of patients with TMDs. 相似文献
The aim of this study was to compare the use of a microvascular coupler device (MCD) for end-to-side venous anastomosis (ETS group) and phleboplasties combined with MCD for end-to-end venous anastomosis (ETE group) in free tissue transfer for oral and maxillofacial reconstruction, with regard to the anastomosis time and occurrence of postoperative vascular crisis. The ETS group included 22 patients and the ETE group included 40 patients. Patient demographic data, anastomotic time, coupler size, microvascular complications, and flap survival rates were collected and analyzed. In the ETS group, the most suitable donor vessel size was greater than 2 mm, varying from 2 mm to 4 mm. The average anastomosis time was 3.35 ± 0.89 min in the ETS group and 7.80 ± 2.93 min in the ETE group; the difference between the groups was statistically significant (p < 0.0001). There were no statistically significant differences in complications or outcomes between the two groups. The ETS venous anastomosis with MCD technique is a better choice for anastomosis when the donor vessel size is greater than 2 mm. In those cases with mismatched veins, ETS venous anastomosis with MCD could significantly reduce the anastomosis time compared to ETE venous anastomosis with MCD after phleboplasties. 相似文献
Objective To investigate the influence of earlier renal fibrosis on ischemia and reperfusion induced acute kidney injury. Methods Male C57BL/6 mice at eight to twelve weeks old age were divided into 4 groups randomly: (1)Sham (n=3); (2)Unilateral ureter obstruction (UUO, n=6): UUO for 3 days (UUO3d, n=3) and UUO for 5 days (UUO5d, n=3);(3)Ischemia and reperfusion (IR, n=7): bilateral kidney ischemia for 40 minutes followed by 24 hours of reperfusion; (4)UUO for 3 days plus IR (UUO3d+IR, n=6): bilateral kidney ischemia after UUO 2 days for 40 minutes followed by 24 hours of reperfusion, and the real time for UUO was 3 days. Pathologic analysis for acute or chronic injury was performed on paraffin embedded kidney sections with hematoxylin and eosin (HE) or Masson staining. Apoptosis was detected by immunohistochemistry(IHC) and Western blotting with anti-caspase-3 antibody, and proliferation was observed by IHC with anti-ki67 antibody. Results On kidney sections with HE or Masson staining, it showed that the chronic kidney lesions and fibrosis got more severe as time of UUO prolonged from 3 days to 5 days; the area of matrix deposition increased in UUO5d and UUO3d mice significantly compared to Sham mice (P<0.05) and was smaller in UUO3d mice compared with UUO5d mice obviously (P<0.05). Acute kidney injury could be observed in UUO3d+IR mice, such as massive inflammatory cells infiltration, tubules dilation, brush border disappearance, tubular epithelial cells vacuolar degeneration, necrosis, casting formation, coexisting with chronic lesions: thinner cortex, broadened interstitial space, and increased blue stained matrix. Acute kidney injury score in UUO3d+IR mice was higher than that in IR mice significantly (P<0.05), and serum creatinine level increased significantly in UUO3d+IR mice compared to Sham mice (P<0.05). Caspase-3 expression increased and ki67 positive tubular cells decreased in UUO3d+IR mice than those in IR mice obviously (P<0.05). Conclusion Earlier renal fibrosis aggravates acute kidney injury induced by ischemia reperfusion in mice through increasing apoptosis and decreasing proliferation of tubular epithelial cells. 相似文献