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Biomedical subjects

L Koltun

Publications and source records attributed to L Koltun.

8 recordsLinked to original sources
PubMed2001

Sutureless closed hemorrhoidectomy: a new technique.

OBJECTIVE: To compare a new technique of radical hemorrhoidectomy using an electrothermal device originally devised to seal vessels in abdominal operations, with the conventional open Milligan-Morgan procedure performed with diathermy. SUMMARY BACKGROUND DATA: Hemorrhoidectomy is one of the most commonly performed anorectal operations. Two well-established methods, the "open" Milligan-Morgan excision and the "closed" Ferguson technique, both carry risks of postoperative bleeding, urinary retention, and late anal stenosis. The convalescence is similarly long and difficult after both operations. The quest for an improved technique of radical excision of hemorrhoids is justified. METHODS: In this case-control study, two groups of patients were alternatively allocated into study and control groups. In the study group (n = 40), an electrothermal system was used. The tissue fusion produced by this device consists of melting of collagen and elastin. This technique essentially achieves a sutureless closed hemorrhoidectomy. The operative time, postoperative complications, and time off work were compared with the group undergoing conventional Milligan-Morgan hemorrhoidectomy (control group, n = 40). RESULTS: The operative time and time off work were significantly shorter in the study group. There were also fewer postoperative complications in this group. CONCLUSIONS: The "tissue-welding" properties of this device and the shape of the electrode handpiece may be successfully applied to the performance of an operation most appropriately described as a "modified sutureless closed hemorrhoidectomy." This pilot study shows that this new technique is simple and safe, significantly shortens the operation, and is followed by a significantly easier and shorter recovery.

Adult↗
PubMed2000

Effect of rectal stump washout on the presence of free malignant cells in the rectum during anterior resection for rectal cancer.

PURPOSE: It is possible that implantation of viable malignant cells is one of the mechanisms of anastomotic recurrence in rectosigmoid cancer. The viability of shed intraluminal cells was previously established and malignant cells were retrieved on circular staplers in unwashed rectal stumps. The aim of this study is to evaluate the effectiveness of a defined and uniform washout protocol in eradication of intraluminal malignant cells during anterior resection. METHODS: In 14 consecutive patients the closed rectal stump was washed before insertion of the circular stapler. The washout was performed uniformly by instillation of ten increments of 50 ml of saline through a rectal tube. Samples from the first, fifth, and tenth washings were collected for cytologic examination. The presence or absence of malignant cells was then correlated with rectal stump length, length of the tumor-free distal margin, and differentiation and Dukes staging of the tumor. RESULTS: In 11 patients the first washing was positive for free malignant cells, and the fifth washing was still positive in 7 patients; however, the last (tenth) samples were clear in 10 patients, and malignant cells were recovered in only 4 patients. The rectal stump and the tumor-free distal margin were shorter in patients who still had positive cytology for free intraluminal malignant cells after stump irrigation with 500 ml of saline. No correlation was found with tumor differentiation or staging. CONCLUSIONS: Free malignant cells are shed into the rectal stump during anterior resection. Mechanical lavage with saline effectively eradicates these cells; however, the completeness of cleansing is volume related. Incomplete cleansing with 500 ml of saline correlates with lower tumors. Technically more difficult surgery involves traumatic handling of the tumor and possibly induces shedding of more malignant cells. We suggest that rectal stump washout during anterior resection for carcinoma should be routine, and the volume of the lavage fluid should be larger than 500 ml.

Aged↗
PubMed2000

Abdominal stoma fashioned by a used circular stapler.

A method of application of a used circular stapler in abdominal stoma formation is described. The procedure is rapid, simple, carries less tissue trauma than the conventional methods and does not involve any additional cost. It allows for a precise circular aperture in the abdominal wall which may be optimally adjusted to the bowel diameter. This method seems to minimize the occurrence of stomal complications and particularly the incidence of troublesome parastomal hernias.

Abdomen↗
PubMed1997

Varicocele treatment in pubertal boys prevents testicular growth arrest.

PURPOSE: There is evidence that varicocele damage, as reflected by loss of testicular mass, is most striking in the pubertal age group. We attempted to evaluate the long-term effect of early varicocele treatment on testicular growth and sperm count and, thus, determine its prophylactic value. MATERIALS AND METHODS: We compared testicular mass and sperm count in 32 men (mean age 28 years) who underwent surgery for varicocele at 11 to 15 years old (mean age 13) to those in 26 untreated, age matched men (mean age 30 years) with varicocele and 27 male controls (mean age 25 years). Mean followup in the treated group was 14.5 years (range 12 to 20). Testicular volumes were measured by ultrasonography. RESULTS: There was no significant difference between left and right testicular volumes in the treated or control group, in contrast to the untreated group, in which the left testicles were significantly smaller. Comparison of testicular mass showed a striking similarity between the treated and control groups, while there was a significant difference when the untreated group was compared to the control and operated groups. Total sperm counts were significantly less in the untreated than the treated and control groups. CONCLUSIONS: These data support the notion that testicular hypotrophy related to varicocele may be reversed by early intervention and they further strengthen the indication for varicocelectomy in children.

Adolescent↗
PubMed1980

Colony stimulating activity in sera of erythroleukemic mice (RLV-A).

RLV-A serum activity was measured by the agar colony assay to determine the effect of this erythroid dyscrasia on the granulopoietic humoral regulator, colony stimulating factor (CSF). In general, the sera of early, midstage and terminal animals not given endotoxin had high cluster forming properties compared to normal sera. The sera of early, midstage, and terminal mice treated with endotoxin had only a fraction of the colony forming ability of serum obtained from normal endotoxin-treated mice (EMS) with the earliest stages of the disease showing least activity followed by a rise in activity paralleling normal EMS, as the disease progressed. Sera from RLV-A endotoxin treated mice retained ability to stimulate cluster growth especially when compared to the slight activity displayed by normal endotoxin treated mouse sera.

Animals↗
PubMed1975

Granulopoiesis in "preleukemic" mice with anemia induced by Rauscher leukemia virus, variant a.

To understand further the hematopoietic dyscrasias induced by a variant (a) of Rauscher leukemia virus (RLV), we used Escherichia coli endotoxin to stress the hematopoietic system of control and RLV/a-infected BALB/c mice. During the preleukemic stages of virus infection, there was slight splenomegaly without peripheral blood erythroblastosis. Granulocyte release and tissue mobilization mechanisms appeared unaffected by the RLV/a infection. Both RLV/a-infected and control mice reacted to endotoxin with peripheral granulocytosis and peritoneal granulocyte mobilization, though the circulating granulocyte levels in RLV/a-treated mice initially were lower than those in controls. Spleen of RLV/a-infected animals were larger than those of controls, but both responded to endotoxin with elevated numbers of granulocytes and erythroblasts. Since numbers of bone marrow erythroblasts in both groups of mice were decreased after endotoxin, stem cell competition and/or shunting of stem cells from marrow to spleen may have been involved. Endotoxin also induced rapid falls in hematocrit levels in both groups. These studies suggested that RLV/a-infected mice can be a model to study 1) erythropoietic dysfunction uncomplicated by defective granulopoietic release and tissue mobilization control mechanisms, and 2) progression of evolving granulocytic leukemia.

Anemia↗
PubMedDate not supplied

A microprocessor temperature-controlled air delivery system for dentinal hypersensitivity testing.

A new microprocessor temperature controlled air delivery system for determining cold and warm temperature thresholds of dentinal hypersensitivity has been designed and built. The temperature range of the unit is -5 degrees to + 85 degrees C. Air is delivered from a typical dental unit air syringe nozzle at a relatively gentle flow rate of 0.2 cu ft/min at operator selected temperatures, with an accuracy of +/- 0.2 degrees C. Within seconds, 1 degree to 5 degrees temperature increments or decrements are accomplished. Larger, i.e., 20 degree increments or decrements, require approximately 15 seconds. The unit can operate from standard 110 V/60 Hz or 230 V/50 Hz outlets and requires a source of compressed air at 60 psig, equivalent to that provided by dental operatory-type air compressors. This report provides a description of the unit, its operation, and data from two clinical studies in which it was used successfully to determine temperature thresholds of dentinal hypersensitivity.

Dentin Sensitivity↗