Comparison between microwave ablation and bipolar radiofrequency ablation in benign thyroid nodules: differences in energy transmission, duration of application and applied shots.

PURPOSE: Comparison between different thermal ablation systems for thyroid nodules regarding their different procedural characteristics such as treatment-time, number of shots and energy transmission in the context of their clinical performance such as complication rate and volume reduction after three months. METHODS: A total of 60 patients with 65 nodules underwent thermal ablation of thyroid nodules with either microwave ablation (MWA) (9 male, 15 female and mean age 57 ± 13 years) or radiofrequency ablation (RFA) (12 male, 24 female and mean age 54 ± 12 years). RESULTS: Mean initial volume (MWA: 23.90 ± 17.35 ml; RFA: 29.44 ± 30.09 ml), energy transmission (MWA: 13.56 ± 10.17 kJ; RFA: 15.12 ± 13.45 kJ), energy transmission per ml (MWA: 0.85 ± 1.01 kJ/ml; RFA: 0.65 ± 0.32 kJ/ml), power (MWA: 22.69 ± 12.32 J/s; RFA: 20.97 ± 7.86 J/s) and duration of ablation (MWA: 618 ± 304 s; RFA: 695 ± 463 s) were not statistically different (p > .05). MWA required significantly less shots (MWA: 3 ± 1; RFA: 6 ± 3) than RFA (p < .05). At three-months follow-up a significant mean nodular volume reduction of 53.54 ± 15.40% after MWA and 51.21 ± 16.58% after RFA (p < .05) was measured. However, mean nodular volume reduction was not significantly different between both systems (p > .05). One patient treated by MWA reported a transient Horner's syndrome, which recovered without any further treatment. Major complications such as nodule rupture, infection or persisting nerve injuries did not occur. CONCLUSION: Both systems are suitable to treat thyroid nodules and show no significant difference in the duration of application, energy transmission and volume reduction. However, MWA requires less shots to treat the whole nodule.

Long term effects of tear gases on respiratory system: analysis of 93 cases.

AIM: This study aimed to assess the long-term respiratory effects of tear gases among the subjects with history of frequent exposure. MATERIALS AND METHODS: A questionnaire by NIOSH and pulmonary function tests was performed in 93 males exposed to the tear gases frequently and 55 nonexposed subjects. RESULTS: The mean numbers of total exposure and last 2 years exposure were 8.4 ± 6.4 times, 5.6 ± 5.8 times, respectively. Tear gas exposed subjects were presented with a higher rate for cough and phlegm more than 3 months (24.7% versus 11.3%, P > 0.05). Mean FEV1/FVC and % predicted MMFR in smoker exposed subjects are significantly lower than those in smoker controls (81.7% versus 84.1%, P = 0.046 and 89.9% versus 109.6%, P = 0.0004, resp.). % predicted MMFR in nonsmoker exposed subjects is significantly lower than that in nonsmoker controls (99.4% versus 113.1%, P = 0.05). Odds ratios for chest tightness, exercise dyspnea, dyspnea on level ground, winter morning cough, phlegm, and daily phlegm were increased almost 2 to 2.5 folds among tear gas exposed subjects. CONCLUSION: The rates for respiratory complaints were high in the case of the exposure to the tear gases previously. Tears gas exposed subjects were found to be under the risk for chronic bronchitis.