[Experimental cauterization and its effect on the amino acid content of cornea and aqueous humor].
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Amino Acids↗
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Endoscopic treatment of posterior epistaxis.
Posterior epistaxis management remains a challenge. Besides their traumatic character, the usual treatments may cause as much morbidity and even mortality as the underlying pathology. A technique of endoscopically guided monopolar selective cauterisation was introduced in Lausanne at the end of 1987. Since then, 163 patients with a posterior epistaxis have been treated in our department. For 139 of these, endoscopic monopolar cauterization was the first treatment applied. Haemostasis was achieved at the first attempt in 82% of cases. The total success rate, including early recurrences controlled by a new cauterization, was 92%. Endoscopic monopolar cauterization requires the ability to perform nasal endoscopy, but presents few disadvantages. This technique represents a selective, relatively atraumatic, rapid and effective treatment. Moreover, costs are much lower than those of other methods. In our opinion, endoscopic monopolar cauterization should be the treatment of choice for posterior epistaxis.
Adolescent↗
BDNF and trkB mRNA expression in neurons of the neonatal mouse barrel field cortex: normal development and plasticity after cauterizing facial vibrissae.
Development of the central somatosensory system is profoundly modulated by the sensory periphery. Cauterization of facial whiskers alters the segregation pattern of barrels in rodents only during a few days just after birth (critical period). Although a molecular basis of the segregation of barrel neurons and the critical period for the anatomical plasticity observed in layer IV barrel neuron is not clear yet, the accumulating evidence suggests that neurotrophins modulate synaptic connections including central nervous system. In this study, we showed by in situ hybridization that mouse barrel side neurons express brain-derived neurotrophic factor (BDNF) mRNA and both catalytic and non-catalytic forms of trkB mRNA. Cautery of row C vibrissae on the right side of the face within 24 h after birth (post natal day 0, PND0) reduced the expression of BDNF and trkB mRNA from the division region between the contralateral row C barrels at PND7. The vibrissae in row A, C, and E were cauterized at PND0 followed by quantitative RT-PCR for BDNF and trkB mRNA with total RNA isolated from the barrel region at PND7. The result showed that BDNF, but not trkB, mRNA was increased several-fold in the contralateral barrel region. These data suggest that the expression of BDNF mRNA is differentially regulated between injured barrels and actively innervated barrels. The differential expression of the mRNA encoding neurotrophins and their receptors may be important in regulating the injury-dependent re-segregation of barrels.
Animals↗
Inhibition of corneal neovascularization by recombinant adenovirus mediated antisense VEGF RNA.
The expression of vascular endothelial growth factor has been strongly implicated in the pathogenesis of conditions leading to inappropriate blood vessel growth in the eye. As such, vascular endothelial growth factor is an attractive target for anti-angiogenic therapies designed to treat neovascular eye diseases. One such therapy, antisense gene therapy, is a technique based on the ability of single-stranded DNA or RNA sequences to alter the expression of targeted genes. Recombinant adenoviruses have demonstrated efficient ocular cell transduction with a high level of transgene production. Cauterization of the normally avascular rat cornea results in a strong neovascular response, making it an ideal animal model for the testing of anti-angiogenic therapies. In this study, a recombinant adenovirus system was assessed for the ability to express biologically relevant antisense RNA to reduce vascular endothelial growth factor expression in a rat model of corneal neovascularization. Recombinant adenovirus constructs expressing short and long antisense and sense vascular endothelial growth factor cDNA, under the control of cytomegalovirus major immediate early promoter or the RNA polymerase III promoter, VA1, were constructed. The expression of short and long antisense RNAs was demonstrated by Northern blot hybridization. All constructs were capable of producing RNA, and the highest level of antisense RNA production was detected in retinal pigment epithelial cells which had been transduced with the longer antisense cDNA construct under the control of the VA1 promoter. This construct was also the most efficient in reducing in vitro vascular endothelial growth factor production (P<0.05) and human endothelial cell proliferation. This construct was subsequently injected into rat eyes 24hr prior to cauterization of the cornea and antisense vascular endothelial growth factor expression was demonstrated by in situ hybridization. The resulting neovascular response was clearly inhibited at 4, 7 and 14 days post-cautery, compared to the control injections which demonstrated an intense neovascular response. Only one out of six eyes injected with the long antisense cDNA construct under the control of the VA1 promoter demonstrated any vascular response to cautery. The reduction in the neovascular response was correlated, with significantly lower amounts of vascular endothelial growth factor protein in the corneas (P=0.006). These observations suggest that the specific down-regulation of vascular endothelial growth factor production is sufficient to reduce the corneal neovascular response and that recombinant adenovirus might be a useful vehicle to produce antisense RNA in situ to down-regulate ocular gene expression.
Adenoviridae↗
Push enteroscopic cauterization: long-term follow-up of 83 patients with bleeding small intestinal angiodysplasia.
BACKGROUND: This study assessed the long-term effectiveness of push enteroscopic cauterization of bleeding intestinal angiodysplasia. METHODS: We retrospectively reviewed the clinical course of patients who underwent push and sonde enteroscopy for obscure gastrointestinal bleeding and were diagnosed with intestinal angiodysplasias. RESULTS: One hundred twelve patients bleeding from small intestinal angiodysplasias were identified. After excluding those lost to follow-up (29), data were collected from 83 patients. Fifty-five patients (29 men; mean age, 73 years; mean units of packed red blood cells transfused, 21.4; average bleeding history, 22 months) were cauterized. Twenty-eight patients (12 men; mean age, 71; mean units of packed red blood cells transfused, 15.8; average bleeding history, 22 months) were not cauterized. The noncauterized group (follow-up, 26 +/- 14 months; mean +/- SD) continued to bleed, requiring 2.16 +/- 3.86 units of packed red blood cells transfused per month (units/month) before and 0.97 +/- 1.46 units/month after diagnosis (NS). The cauterized group (follow-up, 30 +/- 18 months) significantly improved, requiring 2.40 +/- 2.97 units/month before treatment and 0.32 +/- 0.91 units/month after cauterization (p < 0.0001, paired t test). CONCLUSION: Cauterization of endoscopically accessible small intestinal angiodysplasias may decrease rebleeding.
Aged↗
Cauterization of hydrosalpinges before in vitro fertilization is an effective surgical treatment associated with improved pregnancy rates.
OBJECTIVE: Our purpose was to determine whether proximal tubal cauterization is an effective method of reversing the decreased pregnancy rates seen in patients undergoing in vitro fertilization-embryo transfer with hydrosalpinges present. STUDY DESIGN: We studied a group of 94 patients with tubal factor infertility. Sixty patients had hydrosalpinges documented by either hysterosalpingography or laparoscopy, or both. Forty-five had surgical treatment of hydrosalpinges by salpingectomy or by proximal tubal cauterization. In vitro fertilization-embryo transfer was performed within 3 months after surgery. Pregnancy and implantation rates were compared. RESULTS: Patients with hydrosalpinx had significantly decreased clinical pregnancy and implantation rates per cycle (14% and 8%, respectively) compared with those of patients undergoing proximal tubal cauterization before the in vitro fertilization cycle (73% and 36%, respectively). These pregnancy and implantation rates are comparable with those found in patients with tubal factor infertility without hydrosalpinges (53% and 22%, respectively), as well as in salpingectomy-treated patients (46% and 24%, respectively). CONCLUSIONS: Proximal tubal cauterization is effective in reversing the adverse effects of hydrosalpinges.
Cautery↗
Menstrual pattern change 1 year after sterilization: results of a controlled, prospective study.
To determine if female sterilization is associated with adverse menstrual change, we compared prospectively collected menstrual data from women who underwent sterilization via bipolar cauterization, banding, and Pomeroy ligation with data from women whose husbands obtained a vasectomy and from women who were not planning sterilization. At first-year follow-up, sterilization via banding with Falope rings was not associated with adverse change. After excluding initially abnormal cases: (1) cauterization women were bleeding more heavily than all other groups excepting Pomeroy; (2) cauterization and Pomeroy women experienced more dysmenorrhea than women not planning sterilization; and (3) more cauterization and Pomeroy women (collapsed samples) developed abnormal length cycles than did the two control groups. There were no group differences regarding development of beneficial/neutral change (e.g., decreased dysmenorrhea). However, cauterization and Pomeroy groups experienced a significantly higher average number of adverse changes than did the other groups and were at significantly greater risk of developing one or more adverse changes than were women not planning sterilization. The only pattern of association among adverse menstrual changes occurred significantly more often in the cauterization and next in the Pomeroy groups.
Adult↗
Laparoscopic cautery in the treatment of endometriosis-related infertility.
Life table analysis and the two-parameter exponential method have been applied to pregnancy rates in 72 patients undergoing laparoscopic cautery exclusively. Patients with male factor infertility were excluded. Estimated cure rates for patients with stage I and II disease were 98.2% and 76.6%, respectively (not significantly different). No significant difference was seen when anovulation complicated the endometriosis (68.6%). When greater than one infertility factor was present, a significant difference was observed (50.6%). Patients with stage I disease had an average fecundity of 10.30% with decreasing values observed in stage II (7.59%), anovulation (6.67%), and more than one infertility factor (3.33%). We conclude that laparoscopic cauterization is an effective mode of therapy for the treatment of stage I and II endometriosis associated with infertility.
Adult↗
Cauterization of the external endolymphatic duct in elasmobranchs. The Portmann experiment revisited.
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Animals↗
[Therapeutic cauterization of the skin in Saudi Arabia].
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Cautery↗
In vivo measurement of corneal angiogenesis with video data acquisition and computerized image analysis.
BACKGROUND: Measurement of corneal angiogenesis is useful for quantitating the effects of angiogenic stimuli and for evaluating the efficacy of potential inhibitors of neovascularization. Because accurate methods to record the entire pattern of corneal neovascularization over time in individual living animals do not exist, we have developed a noninvasive method to achieve this goal. EXPERIMENTAL DESIGN: The technique couples video data acquisition methods with computerized analysis of the video images. A stereotactic holding and positioning device allows alignment of the cornea such that it is viewed in a known and repeatable way. Contrast between blood vessels and corneal stroma in the images is enhanced by illuminating the cornea with monochromatic light centered on the peak absorption of hemoglobin. For each observation, multiple overlapping images of the peripheral cornea are recorded on videotape and subsequently digitized with a computer image analysis system. Overlapping regions are found by either statistical cross-correlation or common object identification methods. A montage of nonoverlapping adjacent images is made. Background electronic signals are reduced and contrast is enhanced in each montage with the aid of image processing. Finally, vessel area is calculated by pixel counting after establishing the density range for vessel identification. To demonstrate the utility of the method, we measured over the course of 18 days, the total area of neovascularization in rabbit corneas cauterized with silver/potassium nitrate, and treated topically with either normal saline (control) or 1% prednisolone acetate (100 microliters four times daily for 10 days). The corneal angiogenic response was measured at the time of cautery and at selected intervals thereafter. RESULTS: The amount of angiogenesis in each control cornea increased progressively during the entire observation period. In contrast, the prednisolone-treated corneas manifested less neovascularization than controls during the treatment interval. After treatment ended, the amount of corneal angiogenesis increased slightly in this experimental group. This method provided multiple data points from each animal. CONCLUSIONS: To date, accurate measurement of corneal neovascularization has been a time-consuming process yielding few data points for each animal studied. The new method described, accurately measures even small changes in the area of corneal neovascularization, and allows for multiple observations of the same animal. The technique as currently developed, however, is not applicable to corneas that are markedly opaque or associated with intracorneal hemorrhage.
Animals↗
Association between surges of follicle-stimulating hormone and the emergence of follicular waves in heifers.
The effects of ablation of a dominant follicle and treatment with follicular fluid on circulating concentrations of follicle-stimulating hormone (FSH) were studied and the temporal relationships between surges of FSH and follicular waves were studied in heifers with two or three follicular waves/interovulatory interval. Cauterization of the dominant follicle on Day 3 or Day 5 (ovulation on Day 0) (six control and six treated heifers/day) resulted in a surge (P less than 0.05) in FSH beginning the day after cautery. The FSH surge prior to wave 2 (first post-treatment follicular wave) occurred 4 days (Day 3 cautery) and 2 days (Day 5 cautery) before the surge in control groups, corresponding to a 4-day and a 2-day advance in emergence of wave 2 compared with controls. It was concluded that the dominant follicle on Day 3 and Day 5 was associated with the suppression of circulating FSH concentrations. Heifers (n = 4/group) were untreated or treated intravenously with a proteinaceous fraction of bovine follicular fluid on Days 0-3, 3-6, or 6-11. Concentrations of FSH were suppressed (P less than 0.05) for the duration of treatment, regardless of the days of treatment. Cessation of treatment was followed within 1 day by the start of a surge in FSH. The FSH surge prior to wave 2 occurred 2 days earlier (treatment on Days 0-3), 1 day later (treatment on Days 3-6), and 6 days later (treatment on Days 6-11) than in controls, corresponding to an equivalent advance or delay, respectively, in the emergence of wave 2 compared with controls. The results suggest that the effects of exogenous follicular fluid on follicular development were mediated, in whole or in part, by altering plasma FSH concentrations. Control heifers combined for the two experiments were separated into those with 2-wave (n = 11) or 3-wave (n = 5) interovulatory intervals. Two-wave heifers had two FSH surges and 3-wave heifers had three apparent FSH surges during the interovulatory interval. Results of the cautery and follicular fluid experiments indicated that a surge in FSH necessarily preceded the emergence of a wave. The FSH surges in treated and control heifers began 2-4 days before the detectable (ultrasound) emergence of a follicular wave (follicles of 4 and 5 mm), peaked 1 or 2 days before emergence and began to decrease approximately when the follicles of a wave begin to diverge into a dominant follicle and subordinate follicles (follicles 6-7 mm).
Animals↗
Retrobulbar anesthesia and eyelid closure--effect on corneal angiogenesis.
We evaluated the effect of corneal anesthesia produced by retrobulbar injections of bupivicaine and epinephrine on corneal neovascularization in the rat. The eyelids were sutured closed to prevent dessication and ulceration of the insensitive corneas. The amount of corneal neovascularization induced in animals receiving a retrobulbar anesthetic did not differ from those receiving control solutions. However, rats receiving retrobulbar injections exhibited greater corneal neovascularization than those that did not. Rats that had their eyelids sutured or patched closed also had more neovascularization than animals that did not. Likewise, rats that had sutures placed in the upper and lower eyelids, without palpebral immobilization, manifested more neovascularization than rats without sutures. These studies suggest that corneal anesthesia does not affect neovascularization induced by silver/potassium nitrate cauterization and that retrobulbar injections and eyelid closure enhance corneal neovascularization.
Anesthesia, Local↗
Endoscopic thoracic sympathectomy for hyperhidrosis: experience with both cauterization and clamping methods.
The goal was to review results of sympathectomy, performed with use of either cauterization or clamping, in patients with hyperhidrosis (n = 1,312): 653 early patients undergoing electrocautery sympathectomy, 305 later patients undergoing cauterization, and 354 patients treated with a clamping procedure. Patients were interviewed by telephone about the status of symptoms, adverse outcomes, and satisfaction. Palmar hyperhidrosis was cured in all but one patient, with a 98% satisfaction rate in the clamping group and 94.3% and 95.1% in the two cauterization groups ( < or = 0.025, clamping > cauterization). Facial sweating or blushing was cured in the majority (88%) of the 301 patients reporting this symptom. Severe compensatory hidrosis occurred in less than 6% (3% of the clamping group; < or = 0.001, clamping < cauterization). Recurrence rate was 3.0%. A number of factors were related to outcome. Endoscopic thoracic sympathectomy with clamping appears to be at least as safe and effective as earlier cauterization techniques, with the potential advantage of reversibility in those patients unhappy with the outcome.
Adolescent↗
Simple device for chemical cauterization of posterior bleeding points in the nose.
Epistaxis in adults often arises from a posteriorly-placed bleeding point. This paper describes a method of cauterizing these vessels under endoscopic control using simple materials found in most ENT departments, thus avoiding the need for more specialist equipment.
Cautery↗
A simple technique for wedge biopsy of the liver.
A technique for wedge biopsy of the liver is presented. By applying pressure on the liver, biopsy is performed. Cauterization of the bleeding surfaces in small areas provides hemostasis without need for sutures and hemostatic agents.
Biopsy↗
Wound breaking strength and healing after suturing noninjured tissues.
BACKGROUND: Many operative procedures involve suturing healthy, previously nontraumatized tissues. The present study was done to investigate the wound breaking strength and healing after suturing noninjured tissues. STUDY DESIGN: A new experimental model of muscluloaponeurotic suture in the mouse is described and used to investigate the scar breaking strength, the concentration of 5-hydroxyproline, the extrusion of suture material, and the histological characteristics of the repair process. Scar quality was compared at three weeks between a group of mice in which suture was done without prior tissue injury (n = 24) and three groups of mice (n = 24 each) with prior tissue injury (tight-ischemic suture, incision, and cautery). Silk (n = 8), polyglactin 910 (n = 8), and polypropylene (n = 8) sutures were used within each group. RESULTS: Scars resulting from the suturing of healthy tissues had less breaking strength than those with ischemic, incised, or cauterized wound edges (507 g compared to 590, 730, and 732 g, respectively; p < 0.001) and had a lower 5-hydroxyproline concentration (5.1 ng/mg compared to 6.09, 6.77, and 7.49 ng/mg, respectively; p < 0.01). Polypropylene sutured scars had a higher breaking strength than silk (690 compared to 608 g, p < 0.01) or polyglactin 910 (690 compared to 626 g, p < 0.01). Most of the stitches were extruded from the scar independent of the suture material. CONCLUSIONS: The quality of a scar does not seem to be as good when wound edges are healthy than when they have been previously injured.
Animals↗
Comparison of the effects of ovarian cauterization and gonadotropin-releasing hormone agonist and oral contraceptive therapy combination on endocrine changes in women with polycystic ovary disease.
OBJECTIVE: To study the effects of laparoscopic ovarian cauterization and combination of long-acting GnRH agonist (GnRH-a) and oral contraceptive (OC) therapy on endocrine changes in women with clomiphene citrate (CC)- resistant polycystic ovary disease (PCOD). DESIGN: Prospective, randomized. SETTING: University-based infertility clinic. PATIENTS: Seventeen women with CC-resistant PCOD were included randomly in the study to either laparoscopic ovarian cautery or GnRH-a and OC therapy for 3 months. MAIN OUTCOME MEASURES: Serum concentrations of LH, FSH, androstenedione (A), T, and sex hormone-binding globulin (SHBG) were determined before each therapeutic approach and during the follicular phase of first menstrual cycle after the cessation of each treatment. RESULTS: The mean serum concentrations and the clinical profiles were similar in both groups. Both groups showed significant changes in LH, FSH, A, T, and SHBG compared with pretreatment levels. There were no significant differences in the final concentrations of LH, FSH, and A between the two study groups after each treatment, whereas T and SHBG levels were significantly different in the goserelin and OC group. The decrease in LH and increase in SHBG serum concentrations were greater in the goserelin and OC-treated women [-59% and + 5.9% versus - 70% and + 13.5%, respectively]. Although the SHBG concentration increased in both groups, the serum SHBG concentration of the goserelin and OC group was significantly higher than the other group. CONCLUSION: Both therapeutic modalities revealed similar effects on the endocrine profiles in women with CC-resistant PCOD. Considering the invasiveness, cost, and potential complications of laparoscopic ovarian cauterization, noninvasive medical treatment with GnRH-a and OC combination may be more effective in restoring the optimal follicular environment in women with PCOD.
Adult↗