Safety and Efficacy Outcomes From a Single-Center Study of Image-Guided Percutaneous Microwave Ablation for Primary and Metastatic Lung Malignancy.

Introduction: Image-guided percutaneous microwave ablation (MWA) is becoming a more common treatment option for patients with primary and metastatic lung malignancies. Nevertheless, there is limited literature on the safety and efficacy of MWA compared with standard-of-care therapy, including surgical resection and radiation. This study will report the long-term outcomes after MWA for pulmonary malignancies and investigate the factors related to efficacy, including lesion size, location, and ablation power. Methods: Retrospective single-center study analyzing 93 patients who underwent percutaneous MWA for primary or metastatic lung malignancies. Outcomes included immediate technical success, local tumor recurrence, overall survival, disease-specific survival, and complications. Results: At a single institution, 190 lesions (81 primary and 109 metastatic) were treated in 93 patients. Immediate technical success was achieved in all cases. Freedom from local recurrence was 87.6%, 75.3%, and 69.2% and overall survival was 87.7%, 76.2%, and 74.3% at 1 year, 2 years, and 3 years, respectively. Disease-specific survival was 92.6%, 81.8%, and 81.8%. The most common complication was pneumothorax, which occurred in 54.7% (104 of 190) of procedures, with 35.2% (67 of 190) requiring a chest tube. No life-threatening complications occurred. Conclusions: Percutaneous MWA seems safe and effective for treatment of primary and metastatic lung malignancies and should be considered for patients with limited metastatic burden and lesions less than 3 cm in size.

Intracranial Hypotension and Cerebrospinal Fluid Leak.

Review of the clinical presentation, imaging findings, and management of headache secondary to intracranial hypotension.

Effects of various irrigation solutions on microleakage of Class V composite restorations.

STATEMENT OF THE PROBLEM: Irrigation solutions used in the preparation of composite restorations have been reported to contain potential contaminants that may interfere with, and compromise, composite bonding. PURPOSE: The purpose of this in vitro study was to evaluate microleakage of Class V composite restorations after irrigation of acid conditioner with various solutions. MATERIAL AND MENTODS: Standardized Class V preparations (5 mm wide, 4 mm high and 2 mm deep) were made at the cemento-enamel junction on available buccal, lingual, mesial, and distal surfaces of extracted human posterior teeth. The prepared teeth, separated into 7 groups (n=10), were etched for 10 seconds with a 37% phosphoric acid gel. Each group was irrigated with 1 of the following solutions: (1) tap water, (2) sterile water, (3) sodium chloride solution, (4) filtered water, (5) chlorhexidine, (6) sodium hypochlorite, and (7) distilled water. Each preparation was treated with a bonding agent (Opti-Bond Solo) and then restored with a hybrid composite (Herculite XRV). The restorations were polished with Soflex polishing disks and then thermal cycled for 1000 cycles between 5 degrees C and 55 degrees C with a 20-second dwell time. Assessment of microleakage was performed by application of a dye penetrant, sectioning of the teeth, and examination at original magnification x 20. The nonparametric Kruskal-Wallis test (alpha=.05) was used for statistical analysis. RESULTS: Microleakage ranging from 10% to 30% was observed in all groups tested. Tap water exhibited the highest incidence of leakage, sterile water the least, with the other irrigation solutions leading to intermediate leakage. However, there was no significant difference in microleakage resulting from any of the irrigation solutions tested. CONCLUSION: The effect of irrigation solutions used in this in vitro study was not significant.

Osteonecrosis of the maxilla as a complication to chemotherapy: a case report.

Numerous oral complications have been documented as a consequence of chemotherapy for the treatment of cancer. One not so well documented consequence of this treatment is avascular necrosis or osteonecrosis of the underlying bone. In this case report, osteonecrosis of the maxilla in a 48-year-old female patient who was treated for acute myelogenous leukemia is presented. The patient had successfully completed both induction and consolidation chemotherapy without steroid administration. Possible causes and difficulties in diagnosis were reviewed.