ABSTRACT Aging and face sagging have many causes, and various techniques are used for treatment, including noninvasive procedures, such as focused ultrasound, which uses the principle of collagen regeneration by coagulative necrosis of the dermis layers using radiofrequency, but this procedure has complications. We reported a case of a 54-year-old female patient who complained of poor visual acuity in her right eye three days after a focused ultrasound facial aesthetic procedure, with the best visual acuity of 20/60. Biomicroscopy of the right eye revealed an acute cataract with three points of fibrosis extending from the posterior to the anterior capsule. The patient underwent phacoemulsification surgery with visual rehabilitation and improved vision of 20/20. We hypothesized that the occurrence of acute cataract was related to the inappropriate use of focused ultrasound. causes treatment procedures radiofrequency complications 54yearold yearold 54 year old 2060 20 60 20/60 capsule 2020 20/20 5 206 2 6 20/6 202 20/2 20/

An investigation into moving electromagnetic near-field hotspots inside a resonant cavity is presented. The investigation focused on simulating an alternative approach to microwave thermal ablation of tumours by manipulating the interaction between electromagnetic near fields instead of utilising an interstitial antenna. The methodology comprised comparing various electromagnetic field solvers, verifying the simulation techniques, characterising a rectangular resonant cavity, and attempting to manipulate the position of its hotspots by introducing a feed phase shift. The effects of dielectric media were also investigated. Progressive hotspot movement was achieved using input phase manipulation between 2.55 and 2.7 GHz with the feeds on opposite walls. No pattern change was evident at the system's eigenfrequencies, indicating a constant field pattern at its resonant peaks. Furthermore, it was determined that the characteristic modes of the system were narrowband, such that the addition of dielectric material altered the system's resonance. Therefore, the application of this method to thermal ablation, which requires high precision, accuracy and control, was deemed impractical. Future recommendations include using adjustable geometry to design field patterns, comparing dielectric media with significant thermal mass, and investigating the 'inverse problem' to create a specific current distribution around the resonant cavity and induce the desired hotspot patterns.

Abstract Objective Intraoral thyroglossal duct cyst is a relatively rare clinical disease. This article reviews the diagnosis and treatment process of 7 patients and explores the clinical characteristics of diagnosis and treatment of intraoral thyroglossal duct cyst in combination with past literature reports. Method A retrospective analysis was conducted on 7 cases of intraoral thyroglossal duct cyst admitted to the Otolaryngology ward of Dalian Municipal Central Hospital from January 2017 to January 2024. The cases were recorded in terms of gender, age, symptoms, physical signs, radiological examinations, surgical methods, and postoperative complications. All cases were followed up, and the latest follow-up results were recorded. Results Among the 7 cases, 6 patients underwent laryngoscopic and radiological examinations before surgery, and 1 child was found to have a cyst during surgery. All cases were diagnosed with intraoral thyroglossal duct cyst and treated with plasma radiofrequency surgery. None of the patients had postoperative complications, and no recurrence was found in the six-month follow-up after discharge. Conclusion Intraoral thyroglossal duct cyst is rare in clinical practice. It is important to pay attention to its differential diagnosis clinically, and careful review of images is required before surgery. Cryoablation with low-temperature plasma radiofrequency is not only minimally invasive and has a quick recovery but also has few complications and a low recurrence rate. It is a safe and effective treatment method that is worthy of clinical promotion. Level of Evidence: Level 3. disease reports 201 2024 gender age symptoms signs methods up followup follow surgery sixmonth six month discharge practice clinically lowtemperature temperature rate promotion Evidence 3 20 202 2

ABSTRACT Objective: This study assessed the cost-effectiveness of radiofrequency ablation compared with percutaneous ethanol injection in patients with early hepatocellular carcinoma in relation to the objective response rate and costs related to the procedure. Methods: This was a prospective single-center randomized trial. The primary outcome was cost-effectiveness. Secondary outcomes were the complete response rate according to the modified response evaluation criteria in solid tumors 60 days after randomization and the complication rate within 180 60 days. Results: Fifty patients were placed into the following groups: percutaneous ethanol injection (n=23) and radiofrequency ablation (n=27). Fifty-four nodules were randomized (mean follow-up: 205.37 days). The estimated mean hospital cost was US$ 1854.11 and US$ 2770.96 for the Radiofrequency Ablation and Percutaneous Ethanol Injection Groups, respectively. The incremental cost-effectiveness ratio was US$ -2674.59, which is advantageous for radiofrequency ablation. After 60 d, 28 of 29 nodules in the Radiofrequency Ablation Group achieved complete response versus 12 of 22 in the Percutaneous Ethanol Injection Group (RD, 42.01 [95%CI= 20.55–63.24]; p<0.001). Only four early complications were observed among patients treated by percutaneous ethanol injection (p<0.05). Late complications occurred in two and one patient(s) in the Radiofrequency Ablation and Percutaneous Ethanol Injection Groups (p>0.05), respectively. Conclusion: Radiofrequency ablation was more cost-effective and achieved higher complete response and lower complication rates than the Percutaneous Ethanol Injection Group within this cohort. Registry of Clinical Trials: NCT06450613 Objective costeffectiveness effectiveness procedure Methods singlecenter single center trial costeffectiveness. effectiveness. 6 18 Results groups n=23 n23 n 23 (n=23 n=27. n27 n=27 . 27 (n=27) Fiftyfour followup follow up follow-up 20537 205 37 205.3 days) US 185411 1854 11 1854.1 277096 2770 96 2770.9 respectively 2674.59, 267459 2674 59 -2674.59 d 2 1 RD, RD (RD 4201 42 01 42.0 95%CI= 95CI CI 95 [95%CI 20.55–63.24 20556324 20 55 63 24 20.55–63.24] p<0.001. p0001 p p<0.001 0 001 p<0.001) p<0.05. p005 p<0.05 05 (p<0.05) patient s patient(s p>0.05, p>0.05 , (p>0.05) Conclusion costeffective effective cohort Trials NCT NCT0645061 n=2 n2 (n=2 (n=27 2053 3 205. 18541 185 1854. 27709 277 9 2770. 2674.59 26745 267 5 -2674.5 420 4 42. 95%CI 20.55–63.2 2055632 p000 p<0.00 00 p00 p<0.0 (p<0.05 p>0.0 (p>0.05 NCT064506 n= (n= 2674.5 26 -2674. 20.55–63. 205563 p0 p<0. (p<0.0 p>0. (p>0.0 NCT06450 (n 2674. -2674 20.55–63 20556 p<0 (p<0. p>0 (p>0. NCT0645 -267 20.55–6 2055 p< (p<0 p> (p>0 NCT064 -26 20.55– (p< (p> NCT06 -2 20.55 (p NCT0 - 20.5 20.

ABSTRACT There is increasing interest in ultrasound-guided ablation treatments for thyroid diseases, including benign and malignant ones. Surgeons, radiologists, and endocrinologists carry out these treatments, and various organizations within these specialties have recently released multiple international consensus statements and clinical practice standards. The aim of the present consensus statement is to provide guidance, cohesion, and standardization of best practices for thermal ablation procedures of thyroid nodules. The statement includes the indications for these procedures, preprocedural evaluations, technical aspects of the procedures, posttreatment care, follow-up, complications, and training recommendations. This document was written by a panel of specialists from the Brazilian Society of Interventional Radiology and Endovascular Surgery (SOBRICE), the Brazilian Society of Head and Neck Surgery (SBCCP), and the Brazilian Society of Endocrinology and Metabolism (SBEM). The statement does not aim to provide criteria for assessing the capability of specialists to perform the procedure. Instead, it aims to promote the standardization of best practices to reduce potential adverse outcomes. Additionally, it strives to enhance the delivery of high-quality care and the widespread adoption of these technologies on a national level. The recommendations collectively serve as a guidebook for applying best practices in thyroid ablation. ultrasoundguided ultrasound guided diseases ones Surgeons radiologists standards guidance cohesion nodules evaluations followup, followup follow up, up follow-up complications SOBRICE, SOBRICE , (SOBRICE) SBCCP, SBCCP (SBCCP) SBEM. SBEM . (SBEM) procedure Instead outcomes Additionally highquality high quality level (SOBRICE (SBCCP (SBEM

RESUMO A ablação guiada por topografia foi projetada para melhorar a regularidade da córnea durante a correção de aberrações de alta ordem da córnea. O presente relato descreveu três casos com diferentes indicações de ablação guiada por topografia para correção de astigmatismo irregular. Os pacientes foram monitorados no pós-operatório imediato e tardio para avaliar a estabilização corneana em longo prazo. As indicações cirúrgicas basearam-se na queixa do paciente de má qualidade de visão associada a ceratotomia radial prévia, transplante de córnea ou ceratocone. Nos três casos, os pacientes relataram melhora na qualidade da visão e manifestaram satisfação com o procedimento; entretanto, o paciente que já havia sido submetido ao crosslinking apresentou progressão do ceratocone no pós-operatório tardio. Finalmente, a ablação personalizada guiada por topografia parece representar uma técnica segura e eficaz para reduzir irregularidades da córnea em córneas não ectásicas. irregular pósoperatório pós operatório prazo basearamse basearam se prévia procedimento entretanto Finalmente ectásicas

ABSTRACT Topography-guided ablation was designed to improve corneal regularity throughout the correction of corneal high order aberrations. The present report described three cases with different indications for topography-guided ablation to correct irregular astigmatism. The patients were monitored in the immediate and late postoperative periods to evaluate long-term corneal stabilization. Surgery indications were based on the patient's complaint of poor quality of vision associated with previous radial keratotomy, corneal transplant, or keratoconus. In all three cases, the patients reported an improvement in the quality of their vision and expressed satisfaction with the procedure; however, the patient who had previously been submitted to crosslinking presented with keratoconus progression in the late postoperative period. Finally, topography-guided customized ablation appears to represent a safe and effective technique for reducing corneal irregularities. Topographyguided Topography guided aberrations topographyguided topography astigmatism longterm long term stabilization s keratotomy transplant procedure however period Finally irregularities

ABSTRACT Introduction: Human aortic tissues in vitro are tools to clarify the pathophysiological mechanisms of the cardiovascular system, cell culture, and transplants. Therefore, this study aims to analyze and compare the preservation of human aneurysmatic aortic tissues in three different solutions. Methods: Six human abdominal aortic aneurysms were obtained from patients after surgical ablation. The aorta samples were incubated in different solutions - 0.9% normal physiological saline solution, Ringer’s lactate solution, and histidine-tryptophan-ketoglutarate solution (Custodiol®). Segments were collected at 0, 6, 24, and 48 hours. Creatine kinase and nitrate/nitrite were quantified for each incubation time. The tissue’s alpha-smooth muscle actin was analyzed by immunofluorescence. Results: There was a significant increase in creatine kinase formation in the normal saline group at 0 and 48 hours and in the Ringer’s lactate group at 0 and 48 hours (P=0.018 and P=0.028). The lower levels of creatine kinase and nitrate/nitrite and the aortic tissues’ morphological integrity show that histidine-tryptophan-ketoglutarate has better tissue protection. These data suggest that histidine-tryptophan-ketoglutarate induces a protective effect on smooth muscle cells, with less tissue depletion in the aortic aneurysm. Conclusion: This study compared three preservation solutions with the potential for human abdominal aortic aneurysm tissue preservation. The histidine-tryptophan-ketoglutarate solution reduced tissue injury and improved tissue preservation in human abdominal aortic aneurysm tissue samples. Introduction system culture transplants Therefore Methods ablation 09 9 0.9 Ringers Ringer s histidinetryptophanketoglutarate histidine tryptophan ketoglutarate Custodiol®. Custodiol Custodiol® . (Custodiol®) 6 24 4 nitratenitrite nitrate nitrite time alphasmooth alpha immunofluorescence Results P=0.018 P0018 P 018 (P=0.01 P=0.028. P0028 P=0.028 028 P=0.028) protection cells Conclusion 0. (Custodiol® 2 P=0.01 P001 01 (P=0.0 P002 P=0.02 02 (Custodiol P=0.0 P00 (P=0. P=0. P0 (P=0 P=0 (P= P= (P

ABSTRACT: Odontogenic myxoma is a maxillofacial tumor that is benign in nature. It is characterized by a slow-growing, painless, and site-aggressive behavior. A main feature is that it is not encapsulated so it has high potential of invasiveness and penetration into peripheral tissues. Large lesions may cause extensive compromise of the region. Treatment strategy for Odontogenic Myxoma is still controversial. Radical resection with an appropriate surgical margin is recommended, but emerging evidence has suggested that a more conservative approach will result in less morbidity and adequate results. This report shows a remarkable result on a 16-year-old patient who had a Mandibular Odontogenic Myxoma treated with a conservative approach. Intra-lesional absolute alcohol irrigation was performed during a 5-month period. Considerable volume reduction of the lesion happened which allowed a minimal overall resection. No recurrence was found after a 3 year follow-up.

ABSTRACT Femtolasik is one of the most used techniques in refractive surgery due to good refractive results, predictability, reproducibility, and safety, achieving excellent results and a high degree of satisfaction. Although the complication rates are small, it is worth noting that there may be intercurrences. The objective of this work is to report a case of complication in the dissection of the lamella of laser in situ keratomileusis (Lasik) with Femtosecond laser, and subsequent lamella tear. Excimer Laser was applied with mitomycin 0.02% and re-approached with wavefront guided surgery, evolving with good final visual quality. predictability reproducibility safety satisfaction small intercurrences Lasik (Lasik tear 002 0 02 0.02 reapproached re approached quality 00 0.0 0.

RESUMO O FemtoLasik é uma das técnicas mais empregadas em cirurgia refrativa, por seus bons resultados refracionais, sua previsibilidade, sua reprodutibilidade e sua segurança. Tem alto grau de satisfação, com rápida recuperação visual. Apesar de as taxas de complicações do FemtoLasik serem pequenas, intercorrências podem existir. O objetivo deste trabalho foi relatar um caso de uma complicação na dissecção da lamela por Lasik com laser de femtossegundo com consequente rasgadura da lamela, sendo aplicado Excimer Laser com mitomicina C 0,02%. O retratamento foi realizado com ablação de superfície (ceratectomia fotorrefrativa) guiada por frente de onda, evoluindo com boa qualidade visual final. refrativa refracionais previsibilidade segurança satisfação pequenas existir 002 0 02 0,02% ceratectomia fotorrefrativa onda final 00 0,02 0,0 0,

ABSTRACT Introduction: The objective of this study was to develop a radiofrequency ablation technique to create a homogeneous scar tissue in the atrial myocardium. Methods: In the double-blinded morphological stage of the study, the left atrial appendage was used as an anatomical model to investigate the efficacy of one experimental and two conventional techniques to create ablation lines. Then, these lines were studied by morphologists. The clinical stage involved investigation of the outcomes of the developed technique for creation of ablation lines. During thoracoscopic radiofrequency fragmentation of the left atrium, all ablation lines were created using the experimental radiofrequency technique. Results: In all histological sections of ablation lines created using the criterion of “steady decrease in the time to transmurality”, there were no intact (viable) cells, in contrast to the other two conventional methods, i.e., a homogeneous scar of the atrial wall. Investigation of clinical efficacy of this developed technique revealed recurrent atrial fibrillation only in six of 137 patients (4.4%) at median follow-up time of 36 (10; 58) months. None of the patients developed specific complications (wall perforation or bleeding). According to intracardiac mapping performed after the end of the blind period, the sources of atrial fibrillation in these six patients were outside the radiofrequency ablation zone (perimitral or in the right atrium). Conclusion: A steady decrease in the time to transmurality should be considered as the priority intraoperative criterion for the formation of a homogeneous scar during radiofrequency ablation of the left atrium wall using a bipolar ablation clamp. Introduction myocardium Methods doubleblinded double blinded Then morphologists Results transmurality, , transmurality” viable (viable cells methods ie i e i.e. 13 4.4% 44 4 (4.4% followup follow up 3 10 (10 58 months bleeding. bleeding . bleeding) period perimitral atrium. atrium) Conclusion clamp i.e 1 4.4 (4.4 (1 5 4. (4. ( (4

ABSTRACT Introduction: The objective of this study was to develop a radiofrequency ablation technique to create a homogeneous scar tissue in the atrial myocardium. Methods: In the double-blinded morphological stage of the study, the left atrial appendage was used as an anatomical model to investigate the efficacy of one experimental and two conventional techniques to create ablation lines. Then, these lines were studied by morphologists. The clinical stage involved investigation of the outcomes of the developed technique for creation of ablation lines. During thoracoscopic radiofrequency fragmentation of the left atrium, all ablation lines were created using the experimental radiofrequency technique. Results: In all histological sections of ablation lines created using the criterion of “steady decrease in the time to transmurality”, there were no intact (viable) cells, in contrast to the other two conventional methods, i.e., a homogeneous scar of the atrial wall. Investigation of clinical efficacy of this developed technique revealed recurrent atrial fibrillation only in six of 137 patients (4.4%) at median follow-up time of 36 (10; 58) months. None of the patients developed specific complications (wall perforation or bleeding). According to intracardiac mapping performed after the end of the blind period, the sources of atrial fibrillation in these six patients were outside the radiofrequency ablation zone (perimitral or in the right atrium). Conclusion: A steady decrease in the time to transmurality should be considered as the priority intraoperative criterion for the formation of a homogeneous scar during radiofrequency ablation of the left atrium wall using a bipolar ablation clamp. Introduction myocardium Methods doubleblinded double blinded Then morphologists Results transmurality, , transmurality” viable (viable cells methods ie i e i.e. 13 4.4% 44 4 (4.4% followup follow up 3 10 (10 58 months bleeding. bleeding . bleeding) period perimitral atrium. atrium) Conclusion clamp i.e 1 4.4 (4.4 (1 5 4. (4. ( (4

Resumen: La ablación de las venas pulmonares se ha convertido en un tratamiento clave para fibrilación auricular (FA). Sin embargo, pueden ocurrir recurrencias. La estrategia disponible para la ablación después de una recurrencia de FA es controvertida, compleja y desafiante, y la información es limitada. Mediante la presentación de una serie de casos se resumen y discuten elementos clave en la comprensión y tratamiento del paciente con FA recurrente sintomática después de un procedimiento inicial de ablación de venas pulmonares que requiere un nuevo procedimiento de ablación. En las últimas décadas se ha obtenido una mejor comprensión de los mecanismos fisiopatológicos implicados en la FA recurrente posterior a ablación de venas pulmonares, lo que permite identificar factores asociados, crear scores predictores e implementar técnicas de optimización o estrategias adicionales para mejorar la durabilidad y la eficacia del aislamiento de venas pulmonares. Debido a que la reconexión de venas pulmonares es un hallazgo típico durante los procedimientos repetidos, ésta debe ser considerada el objetivo principal de una nueva ablación. Las estrategias de ablación adicional (desencadenantes extrapulmonares o sustratos arritmogénicos) son controvertidas y requieren investigaciones futuras.

Summary: Pulmonary vein ablation has become a key treatment for atrial fibrillation (AF). However, recurrences can occur. The ideal strategy for ablation after AF recurrence is controversial, complex, and challenging, with limited data available. By presenting a series of cases, we summarize and discuss key elements in the understanding and treatment of patients with symptomatic recurrent AF after an initial pulmonary vein ablation procedure who are subjected to a new ablation procedure. In recent decades, there has been a better understanding of the pathophysiological mechanisms involved in recurrent AF after pulmonary vein ablation, making it possible to identify associated factors, create predictive scores and implement optimization techniques or additional strategies to improve the durability and efficacy of pulmonary veins isolation. Because pulmonary vein reconnection is a typical finding during repeat procedures, it should be considered the primary goal for a repeat ablation procedure. Additional ablation strategies (extrapulmonary triggers or arrhythmogenic substrates) are controversial and require further investigation.

Resumo: A ablação das veias pulmonares tornou-se um tratamento chave para fibrilação atrial (FA). No entanto, podem ocorrer recorrências. A estratégia ideal para a ablação após uma recorrência da FA é controversa, complexa e desafiadora e existem dados limitados. Através da apresentação de uma série de casos resumimos e discutimos elementos chave no entendimento e tratamento do paciente com FA recorrente sintomática após um procedimento inicial de ablação de veias pulmonares, que são submetidos a um novo procedimento de ablação. Nas últimas décadas obteve-se uma melhor compressão dos mecanismos fisiopatológicos envolvidos na FA recorrente pós-ablação de veias pulmonares, isso permite identificar fatores associados, criar scores preditores, implementar técnicas de otimização ou estratégias adicionais para melhorar a durabilidade e eficácia do isolamento de veias pulmonares. Dado que a reconexão de veias pulmonares é um achado típico durante os procedimentos repetidos deve ser considerado o objetivo principal para uma nova ablação. As estratégias de ablação adicional (desencadeadores extrapulmonares ou substratos arritmogénicos) são controversas e requerem investigação futura.

Abstract The Alfeu-I lamproite is one of the few alkaline rock occurrences in the South of Brazil that represents the alkaline event related to the South Atlantic opening and the enormous magmatic activity that formed the Paraná basalts. Alfeu-I lamproite is a diatreme facies and exhibits an inequigranular texture with macrocrysts of mica, spinel, garnet, and ilmenite and microcrysts of mica, pyroxene, and rare olivine, all immersed in a groundmass of pyroxene, spinel, perovskite, rutile, ilmenite, and, more rarely, olivine. Major element compositions of Alfeu-I pyroxene, garnet, ilmenite, mica, and olivine were determined by electron microprobe analyses, and trace element concentrations of clinopyroxene, garnet, ilmenite, and mica were measured using laser-ablation inductively coupled plasma mass spectrometry techniques. Temperature, pressure, and oxygen fugacity (fO2) conditions during the crystallization of Alfeu-I lamproite were calculated with the geothermobarometers and olivine, spinel, garnet, and orthopyroxene. The resulting mean equilibrium temperature ranges from 1375°C at 4 GPa to 1395°C at 5 GPa, whereas the fO2 points to ΔFMQ = +2.4 (at 4 GPa) and ΔFMQ = +2.2 (at 5 GPa). Rb-Sr and Sm-Nd isotopic data together with the trace element concentrations of minerals suggest that melting of a mantle source enriched in incompatible elements and volatiles due to previous subduction events occurred during the Gondwana breakup around 125 Ma ago. Fluids that may have originated from subducting slabs in the old subduction zone are probably the cause of the high fO2 conditions in Alfeu-I lamproite. AlfeuI Alfeu I basalts spinel garnet pyroxene perovskite rutile rarely analyses clinopyroxene laserablation laser ablation techniques Temperature pressure fO (fO2 orthopyroxene 1375C C 1375 1395C 1395 24 2 +2. 22 GPa. . RbSr Rb Sr SmNd Sm Nd 12 ago (fO 137 139 +2 1 13 +