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Biomedical subjects

R M Soderstrom

Publications and source records attributed to R M Soderstrom.

At least 19 recordsLinked to original sources
PubMed1997

Retreatment with nafarelin for recurrent endometriosis symptoms: efficacy, safety, and bone mineral density.

OBJECTIVE: To assess the efficacy, safety, and effect on bone mineral density of a 3-month course of retreatment with intranasal nafarelin acetate for recurrent symptoms of endometriosis. DESIGN: Multicenter, open-label, nonrandomized clinical trial. SETTING: Eleven hospital-based and private practices. PATIENT(S): Thirty-six women with endometriosis symptoms recurring after 3 or 6 months of treatment with nafarelin. INTERVENTION(S): Nasal nafarelin 200 micrograms twice daily for 3 months. MAIN OUTCOME MEASURE(S): Assessments for dysmenorrhea, dyspareunia, pelvic pain, tenderness, and induration. Measurement of bone mineral density of the lumbar spine. RESULT(S): Improvements from admission to the end of retreatment were significant for dysmenorrhea, pelvic pain, tenderness, induration, and dyspareunia. Three months after retreatment ended, mean symptom scores for dysmenorrhea and pelvic tenderness, although worse than at the end of retreatment, were still significantly better than scores at admission. Mean bone mineral density 3 months after retreatment was 0.56% lower than before retreatment and 1.94% lower than before initial treatment. CONCLUSION(S): Three-month nafarelin retreatment for recurrent endometriosis symptoms was effective and safe.

Administration, Intranasal↗
PubMed1997

Injuries to major blood vessels during endoscopy.

Major blood vessel injury is a true emergency during endoscopic procedures. Too often, fear of litigation quashes the opportunity to assess the cause and learn from the experience of others. Frequently, only through a medicolegal review can such events be evaluated. A review of 47 such cases highlighted several key lessons. Proper technique for inserting the Veress needle, laparoscopic cannula, and open cannulas can prevent most accidents. If standard precautions during insertion are breached, safety shields on disposable cannula sleeves may not prevent or reduce the risk of major vessel injury. Distorted anatomy or steep Trendelenburg position may increase the risk. Retroperitoneal hematomas require exploratory laparotomy for proper assessment. Dissections around the great vessels of the pelvis require the same methods and precautions during laparoscopy as during laparotomy.

Blood Vessels↗
PubMed1996

Gynecologic endoscopic gas embolism.

OBJECTIVE: To alert gynecologic surgeons to the risk of room air embolism during endoscopy. DESIGN: Case reports. SETTING: Medico-legal consultations. PATIENTS: Five women having endoscopic procedures. INTERVENTIONS: Endoscopy followed by emergency resuscitative measures. RESULTS: Morbidity and mortality. CONCLUSIONS: The risk of room air embolism may be lessened by attention to the operative technique and by monitoring the end tidal carbon dioxide levels.

Adult↗
PubMed1996

Endometrial ablation using a distensible multielectrode balloon.

The VestaBlate system uses a multielectrode intrauterine balloon as a device to create effective and safe endometrial ablation (EA). The surface of the distensible balloon is impregnated with thermistors and thin, platelike electrodes. It is designed to deliver low-power electroenergy to the endometrium. Unlike the resectoscope techniques that require nonelectrolytic fluids for uterine distention, moving electrodes at high power outputs, and other variables that are operator dependent, the VestaBlate is computer controlled using a standard type electrosurgical generator. A respiratory enzyme stain, nitroblue tetrazoleum, was used to determine the extent and depth of tissue necrosis to a myometrial depth of 2 to 4 mm with uniform destruction of tissue with power setting at 45 W for a 4-minute application of energy. Sixty-nine patients have been treated, with 45 followed for at least 3 to 9 months. The amenorrhea rate is 40%; the oligomenorhea-hypomenorrhea rate is 49%.

Electrodes↗
PubMed1994

Electrosurgical injuries during laparoscopy: prevention and management.

Despite the fact that electrophysics and its application to surgery, in particular endoscopic surgery, is a discreet science, there is little attention paid to the applied principles of the physics involved when surgeons receive their formal training in the technical aspects of surgery. Most training programs consider the discipline of electrosurgery as a skill that is left to the 'hands on' exposure of the student, and that the skills and knowledge of the average professor have been awarded through a 'grandfather' process of credentials. As a result, many myths have been perpetuated over the past decades since William Bovie introduced the first electrosurgical diathermy machine using high frequency radio waves instead of heated instruments (cautery) to destroy human tissue. Electrogenerators, today, have become finely tuned instruments that offer many versatile variables for the contemporary surgeon to harness and deliver, in either a discreet or broad manner, to tissue to obtain a desired effect and outcome.

Electric Injuries↗
PubMed1994

Colposcopic documentation. An objective approach to assessing sexual abuse of girls.

Accurate measurements of the genital anatomy of victims of child sexual abuse can be documented with colposcopic photography. Most colposcopies available, however, do not have a built-in measuring grid for medicolegal documentation. Because of the unique optics designed for the colposcope, an accurate comparison can be provided if the measuring tool is photographed in the same focal plane and at the same magnification as the object of concern. Properly labeled slides may then be used as clear evidence in court.

Anthropometry↗
PubMed1992

Distending the uterus: what medium is best?

Because most diagnostic hysteroscopes take only a few minutes, the experienced hysteroscopist generally prefers to use CO2 distention. For extensive operative procedures, especially submucous myomectomy, glycine or sorbitol usually are chosen.

Carbon Dioxide↗
PubMed1992

Electricity inside the uterus.

Although electrosurgery has been employed for decades, few surgeons have received formal training in its proper use. The erroneous belief that electrosurgery techniques increase scar formation or impair healing processes led surgeons to use other methods to deliver energy to the living cell. At the cellular level, 1 watt is 1 watt. Knowing how to calculate and administer this amount of energy is the challenge. Laser technology fostered the development of improved electrogenerators and accessories that are easier to understand and control. The use of digital reader boards, displayed in watts rather than an arbitrary dial setting, is one example. A good electrosurgical system, with proper accessory electrodes, costs only 10% of the price of the average laser. For hysteroscopic resectoscopy procedures, a thorough knowledge and appreciation of the physics of electrosurgery is a basic requirement. In the future, I hope the power density and wattage delivered at the electrode tip will be displayed easily for surgeons using the resectoscope. One day, we may have a "laser-electrode" system to meet all our needs.

Electricity↗
PubMed1991

Glycine as an irrigant during microsurgical hemostasis. A microsurgeon's observations.

The "drip-stop-coagulate" technique used during microsurgery is tedious and, at times, frustrating when electrolyte-rich solutions are used as an irrigant. Glycine, a nonelectrolyte solution, allows the gynecologist to apply electrosurgical energy in a fluid medium; lactated Ringer's solution, the irrigant frequently used by microsurgeons, will not. When, during microsurgery, glycine is used in place of lactated Ringer's solution, the origin of the bleeding site can be easily isolated and coagulated during irrigation, assisting the surgeon in precise and complete hemostasis.

Electrocoagulation↗
PubMed1990

Electrosurgery: advantages and disadvantages.

Though electrosurgery has been with us for decades, few surgeons have received formal training in its potential uses. The erroneous belief that electrosurgery techniques increase scar formation or impair healing processes, has led surgeons to other methods to deliver energy to the living cell. A watt, is a watt, is a watt--knowing how to calculate and administer that energy is the challenge. Fig. 4. Laser technology has forced the bioelectrical engineers to develop improved electrogenerators and accessories that are easier to understand and control. The use of digital reader boards, displayed in watts rather than an arbitrary dial setting is one example. A current flow meter for bipolar forceps will now tell the surgeon when all of the tissue has been desiccated. Soon I hope the power density and wattage delivered at the electrode tip will be easily displayed for the gynecologic surgeons. Who knows, one day we may have a "laser-electrode" system to meet all of our needs.

Carbon Dioxide↗