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At least 235 records · Page 13Linked to original sources

Laparoscopic pomeroy tubal ligation: a comparison with tubal cauterization in a teaching hospital.

OBJECTIVE: To compare laparoscopic Pomeroy tubal ligation to standard bipolar tubal cauterization for the outcome measures of failure rate, complication rate and procedure duration, with an analysis of the effect of resident experience on procedure duration. STUDY DESIGN: Retrospective study of patients presenting for interval sterilization between August 1998 and June 2000. RESULTS: The characteristics of the laparoscopic Pomeroy (n = 99) and bipolar cautery (n = 62) patients were comparable. The mean procedure duration was 40.8 +/- 14.6 minutes for laparoscopic Pomeroy and 39.6 +/- 18.8 minutes for bipolar cautery (p < 0.68). Multiple regression analysis revealed that procedure duration was a function of both months in residency (R2 = .098, p < 0.007) and number of laparoscopic Pomeroy procedures performed (R2 = .082, p < 0.01). One complication occurred with each procedure (p < 0.576). Two sterilization failures occurred after bipolar cautery and 1 after laparoscopic Pomeroy (p < 0.33). The laparoscopic Pomeroy failure occurred in the shortest tubal segment obtained, 0.7 cm, versus the average segment length, 2.07 +/- .79 cm. CONCLUSION: Laparoscopic Pomeroy did not differ from bipolar cautery for the outcome measures studied. Both time in residency and procedure-specific experience affect the duration of laparoscopic Pomeroy. A tubal segment length of 1 cm should be removed to limit sterilization failures.

Clinical Competence↗

[Model of inflammatory angiogenesis in rabbit cornea induced by punctual alkaline cauterization].

PURPOSE: To establish a model of angiogenesis in rabbit cornea induced by punctual alkaline cauterization. METHODS: Six rabbits were submitted to punctual cauterization in right cornea. It was used a circular piece (3 mm) of filter paper, that was previously soaked in 1 M NaOH and placed 1 mm from the superior limbus for 2 minutes. The animals were evaluated at 3, 6, 9, 12, 15, 18 and 21 days after cauterization. Quantification of angiogenesis was performed according to 4 methods: radial vessel length (V), angiogenic index (I), area of the triangle (T) and area of the circular band sector (S), which provide an approximation of the area of neovascularization. RESULTS: The analysis of the quantitative data of angiogenesis showed that neovascular response progressed in a biphasic manner: rising between days 0 and 12 (proliferation), stable between days 12 and 21 (maturation). This pattern was observed on the values of the vascular growth mean rate. Between days 0 and 12, it was 16 times greater than that verified between days 12 and 21. It was found a statiscally significant positive linear correlation among the 4 methods of measurement of angiogenesis. CONCLUSION: The punctual alkaline cauterization of the rabbit cornea induces and sustains corneal neovascularization, so that, it can be used as model of angiogenesis.

Animals↗

Cellular events associated with inflammatory angiogenesis in the mouse cornea.

The aim of this study was to establish an angiogenesis model in the mouse and to define immunohistochemically the cellular events that precede angiogenesis. After chemical cauterization of the murine cornea, neovascularization was observed within 36 hours. The cellular infiltrate was analyzed by using antibodies on cryostat and paraffin sections and by histochemical staining for mast cells. It was found that neither T lymphocytes nor mast cells nor macrophages in a more mature stage of development were part of the infiltrate that preceded the ingrowth of new blood vessels. Instead, the infiltrating cells appearing from 3 hours on were granulocytes and inflammatory monocytes, as detected by an antibody against the calcium-binding protein MRP14. The authors conclude that the induction of angiogenesis during nonspecific inflammation is associated with the early influx of myelomonocytic cells, but not with the infiltration of mature macrophages, T lymphocytes, or mast cells. This study shows that immunohistochemical analysis of cauterized murine corneas presents a useful tool for further studies on cells and cell products involved in the angiogenic process.

Animals↗

[Urethrostenosis from Dupuytren to Guyon: "the tools and the men"].

Great progress has been made in the management of urethral narrowing during the second half of the 20th century owing to the appearance of urology as a specialty, to the spinoff of lithotripsy, to the motivation provided by the Argenteuil award and to the refinement of surgical tools. Progress was made in the exploration (impression dilatators, ball exploration) and treatment: permanent or progressive dilatation, cauterization, internal or external urethrotomy. Biographical notes are then given about the surgeons who made this progress possible: Amussat, Benique, Civiale, Desormeaux, Ducamp, Guillon, Heurteloup, Lallemand, Leroy D'Etioles, Maisonneuve, Reybard and Segalas.

Cautery↗

Preliminary study of electrocautery smoke particles produced in vitro and during laparoscopic procedures.

BACKGROUND: The objective of this preliminary study was to describe the particles contained in cautery smoke produced during five laparoscopic procedures and verify the collection method during three laboratory experiments on ex vivo animal tissue. METHODS: A cascade impactor collected the smoke according to particle size, and particle weights were calculated on an electronic microbalance. Electron microscopic analysis and energy dispersive X-ray evaluation were used to determine particle morphology and elemental composition. RESULTS: The particles, distributed according to size on the seven rotating trays of the impactor, had diameters ranging from 0.05 to >25 micro m, with most being 0.1-1 micro m. In vitro experiments yielded more particles, especially larger (>5 micro m) ones, than the surgical procedures, because the cauterized specimens could be placed much closer to the cascade impactor in the laboratory environment, eliminating most obstacles to particle recovery. In the laparoscopic surgery patients, larger particles, because of their physical properties, were more likely to remain trapped in the abdomen or to drop off in the collection apparatus. Uniformly, two populations of particles were demonstrated--either large, irregular fragments (2-25 micro m) rich in carbon and oxygen, suggesting structural cellular components, or small homogeneous spheres (0.1-0.5 micro m) composed of sodium, magnesium, calcium, and potassium salts. CONCLUSIONS: This study demonstrates the presence of breathable aerosols and cell-size fragments in the cautery smoke produced during laparoscopic procedures. Their exact chemical composition and potential adverse effects for patients and personnel are not known.

Cautery↗

A plasma scalpel: comparison of tissue damage and wound healing with electrosurgical and steel scalpels.

We have been evaluating a plasma scalpel (the term has no relation to blood plasma) for four years that, with the generation of a small, hot gas jet (3,000 C), can cut tissue and simultaneously cauterize blood vessels of 3 mm in diameter. Twenty-nine plasma scalpel hepatectomies in dogs and comparative skin wound healing (with steel and electrosurgical scalpels) in 90 mice showed that bleeding was reduced, and the thermal insult in liver tissue was limited to 2 mm from the incision; both liver and mouse skin incisions healed without complication. The completion of epithelization of mouse skin wounds occurred at 2 to 6, 6 to 14, and 6 to 18 days, and the average scar width was 0.8, 1.4, and 2.1 mm for the steel, electrosurgical, and plasma scalpels, respectively. The plasma scalpel effectively cauterizes blood vessels as it cuts, leaving limited damaged tissue. We have recently begun human trials, and the device shows promise as a clinical tool.

Animals↗

Comparative study of the effects of submucosal cauterization of the inferior turbinate with or without outfracture.

AIM: The objective of this study was to compare the effects of submucosal cauterization of the inferior turbinate with or without outfracture. STUDY DESIGN: Clinical prospective. METHOD: Twenty patients with inferior turbinate hypertrophy were randomized and divided into two groups. The first one was submitted to submucosal cauterization associated with outfracture, and the second one without fracture. Five items were assessed to compare both methods: pain, nasal bleeding, scarring--analyzed through anterior rhinoscopy, observing edema, hyperemia and seropurulent secretion; crust formation (seen through anterior rhinoscopy); and nasal airway patency. Follow-up was performed on days 7, 14, 30. RESULTS: In both groups crusting formation was similar. Scarring showed better results in the outfracture group in the first two weeks postoperative. The analysis of nasal airway patency showed good results in 80% of the patients submitted to submucosal cauterization with outfratcture on day 30 postoperatively. CONCLUSIONS: We concluded that submucosal cauterization of inferior turbinate with outfracture is better than the procedure without outfracture.

Adolescent↗

Effects of a dominant follicle on ovarian follicular dynamics during the oestrous cycle in heifers.

Two hypotheses were tested: (1) a dominant follicle causes regression of its subordinate follicles, and (2) a dominant follicle during its growing phase suppresses the emergence of the next wave. Cyclic heifers were randomly assigned to one of four groups (6 heifers/group): cauterization of the dominant follicle of Wave 1 or sham surgery (control) on Day 3 or Day 5 (day of ovulation = Day 0). Ultrasonic monitoring of individually identified follicles was done once daily throughout the interovulatory interval. The onset of regression (decreasing diameter) of the largest subordinate follicle of Wave 1 was delayed (P less than 0.01) by cauterization of the dominant follicle of Wave 1 on Day 3 compared to controls (mean onset of regression, Days 10.8 +/- 2.1 vs 4.3 +/- 0.4). Cauterization of the dominant follicle of Wave 1 on Days 3 or 5 caused early emergence (P less than 0.01) of Wave 2 when compared to controls (Day-3 groups: Days 5.5 +/- 0.4 vs 9.6 +/- 0.7; Day-5 groups: Days 7.0 +/- 0.3 vs 9.1 +/- 0.4). The results supported the two hypotheses. In addition, cauterization of the dominant follicle of Wave 1 on Days 3 or 5 increased the incidence of 3-wave interovulatory intervals.

Animals↗

Transurethral vaporization-resection of the prostate versus standard transurethral prostatectomy: comparative changes in histopathological features of the resected specimens.

OBJECTIVES: Transurethral vaporization resection of the prostate (TUVRP) is a recent modification of the standard transurethral resection of the prostate (TURP). TUVRP uses a band electrode coupled to a high electrocuting energy to achieve simultaneous resection, vaporization and coagulation of the prostate. We evaluated the histopathological resection specimens of patients treated with TUVRP to see whether the higher energy used will result in thermal artifacts that will interfere with the pathological evaluation of the prostate, and compared the results to TURP specimens. MATERIAL AND METHODS: The histopathological specimens of 50 patients that underwent TUVRP or TURP were reviewed. Artifactual pathological patterns that were identified in the specimens included: abnormal cellular orientation and spindling, artifactual cellular detachment from the underlying basement membrane, atypical cytological changes or areas of stromal coagulative necrosis. Each identified pattern was awarded 1 point. The severity of cautery artifact was graded into mild, moderate or severe according to the sum of points in each specimen. RESULTS: Mild cautery artifact changes were noted in 1 patient who underwent TURP. Moderate changes were noted in 21 patients in each TURP and TUVRP groups while severe changes were noted in 4 and 3 patients undergoing TUVRP and TURP respectively. There were no statistically significant differences between the groups with regard to the severity of the cauterization- induced changes. CONCLUSIONS: The quality of histopathological specimens produced by TUVRP is similar to the standard TURP. It seems that the higher energy use in electrovaporization technique does not result in greater thermal injury to the tissues possibly because of the cooling effect of the irrigation fluids used intraoperatively.

Artifacts↗

Treatment of acquired chronic esophagopleural fistula by endoscopic cauterization.

Successful treatment of an eight-year-old esophagopleural fistula by means of endoscopic cauterization with an alkaline solution is reported. Previous therapeutic attempts with other more conventional measures had failed. The technique of the successful treatment is described. No complications could be attributed to its use.

Cautery↗

Electrodissection tonsillectomy.

A prospective, double-blind study was undertaken to compare the technique of removing tonsils using cold dissection with selective cauterization vs electrocautery dissection. The length of the procedure, blood loss, degree of pharyngeal pain, otalgia, and incidence of postoperative hemorrhage was recorded for 106 consecutive patients. In addition, our experience in performing the electrodissection tonsillectomy in 2431 patients is reviewed. Electrodissection tonsillectomy is a safe and effective procedure that offers several advantages over that of cold dissection using selective cautery.

Double-Blind Method↗

Intramural coronary collateral flow in dogs.

The objective of this study was to determine whether intramural collaterals contribute significantly to total retrograde flow (index of collateral flow). The left circumflex, left anterior descending, right, and septal coronary arteries were separately cannulated, and blood flows through these vessels were monitored on an isolated, blood-perfused beating heart preparation. Epicardial collaterals between the borders of the circumflex and right coronary perfusion territories were cauterized, and retrograde flow from the circumflex coronary artery was determined before and after cauterization. This procedure unmasked the intramural collateral flow component to retrograde flow. By occluding and unoccluding the coronary flows from the right, septal, and left anterior descending coronary arteries during these measurements, we were able to determine their contribution to epicardial and intramural collateral flow. We found that, after cauterization, an average of 58 +/- 3.6% of the total retrograde flow remained. The septal and left anterior descending coronary arteries contributed almost equally to this retrograde flow. We concluded that, because the epicardial collaterals were cauterized, the source of retrograde flow was from intramural collaterals and constituted about one-half of the measured retrograde flow in dogs with a native collateral circulation.

Animals↗

[Treatment of the ingrown toenail by phenol cauterization (ASLUF)].

BACKGROUND: The aim of this study was to evaluate the clinical and the ethiopatogenetic aspects of the ingrown toenail, treated by usual surgical technique versus phenol wedge cauterization (ASLUF). METHODS: From June 1990 to June 1999, 388 patients (218 male and 170 female patients, age range 9-90 years) were treated by 413 wedge ablation, surgical or chemical. After the operation, patients were controlled after 2 days, 1 week, 1 month, 6 months and 1 year. 109 patients were treated by usual surgical treatment, 260 patients by phenol cauterization (ASLUF), 19 by total ablation. RESULTS: 23 patients presented again ingrown toenail in the same place after few months, 20 patients after surgical treatment and 3 patients after phenol cauterization. All 23 patients were treated again without problems. CONCLUSIONS: In our personal opinion, the treatment of ingrown toenail is necessary soon, without the routine use of antibiotic therapy and the total ablation of the nail is not necessary. On this basis phenol wedge cauterization is the most suitable treatment for ingrown toenail with good cosmetic results, lower recurrence rate and from the functional point of view.

Adolescent↗

Nitric oxide synthase inhibition by N(G)-nitro-L-arginine methyl ester retards vascular sprouting in angiogenesis.

The present study was designed to evaluate the role of nitric oxide (NO) for angiogenesis. Angiogenesis was elicited upon mouse cornea by chemical cautery with silver nitrate. Angiogenic activity was evaluated by measuring the length of vascular sprout with or without administration of NO synthase (NOS) inhibitor, N((G))-nitro-L-arginine-methyl ester (L-NAME). In the pericorneal plexus, a circulatory loop situated in the same topological situation for all individuals was selected to observe vascular sprouting. At 72 h after cauterization, the length of the longest vascular sprout was measured using the perfused whole-mount cornea. The length of nontreated mice (83 +/- 83 microm) was significantly longer than that of L-NAME treated mice (33 +/- 24.6 microm). To address the possible contribution of production of vascular endothelial growth factor (VEGF) and NO, we measured mRNAs of VEGF and inducible NOS. The mRNA level of VEGF increased to 170% of the nontreated level at 12 h after cauterization and returned to the nontreated level by 24 h after cauterization. mRNA of inducible NOS remained elevated 24 h after cauterization. These results suggest that the response of preexisting vessels to angiogenic stimulus via NO is of importance in the process of angiogenesis, i.e., vascular sprouting is promoted by NO production. This might be attributable to enhancement of an increase in vascular permeability and /or vasodilation via NO.

Animals↗

Segmental phenolization for the treatment of ingrowing toenails: a review of 6 years experience.

BACKGROUND: Ingrowing toenails are a common problem causing significant morbidity. Many of the procedures used for treating this painful condition cause considerable discomfort and have high failure rates. In recent years, phenol cauterization of the nail bed has been used increasingly. METHODS: A retrospective study was carried out of all patients treated by this method in the authors' clinic during the period January 1996 to December 2001. In this study, phenol cauterization is the standard form of treatment and 948 phenol cauterizations were carried out in 764 patients. RESULTS: There was no significant morbidity and the procedure was tolerated well by all patients. Overall recurrence was 4.3% (33 patients) after 18 months. All symptomatic recurrences were successfully treated by repeating phenol cauterization. CONCLUSIONS: Phenol cauterization compares favourably with other surgical ablation techniques for ingrowing toenails and may be the ablation procedure of choice of an ingrowing toenail.

Adolescent↗

Inhibition of inflammatory angiogenesis in rats by loco-regional administration of hydrocortisone and protamine.

We have studied the antiangiogenetic effects of hydrocortisone and protamine given intra-arterially. The cornea of male, Sprague-Dawley rats were cauterized with silver nitrate. The following treatments were given: 30 micrograms hydrocortisone topical (t.p.), b.i.d., 50 mg/kg/day intraperitoneally (i.p.) or intra-arterially (i.a.), 10 mg/kg/day protamine i.p. or i.a. Saline was administered to the control groups. In separate experiments we also evaluated the anti-inflammatory effects of hydrocortisone, i.p., on the cauterized corneas. Five days after cauterization, the animals were killed, exsanguinated and India ink was injected to show the network of neovessels. The percentage area of the cornea covered by neovessels was measured morphometrically and evaluated statistically. Hydrocortisone t.p. (-84%), i.a. (-60%) and protamine i.a. (-44%) significantly inhibited angiogenesis in the cauterized cornea. Either drugs, i.p., had any antiangiogenetic effects, but hydrocortisone significantly reduced cell infiltration of the corneas. The results suggest that locoregional administration of antiangiogenetic drugs might be clinically useful.

Animals↗

Removal of abdominal sources of caudal mediastinal node lymph in anesthetized sheep.

We investigated the conditions for and the quantity of abdominal contributions to caudal mediastinal node (CMN) efferent lymph in 15 anesthetized sheep with open thorax and lung lymph fistulas. Contractions of the diaphragm by phrenic nerve stimulation increased lymph flow by 29%. Adding large volumes (10 ml/kg) of 5% albumin solution to the peritoneal cavity increased lymph flow by 19 and 28% during diaphragm contraction. Tracer albumin specific activity in lymph indicated that about half the lymph flow increment came from the peritoneal liquid. Raising hepatic vein pressure 19 cmH2O increased CMN lymph flow 178%. Lymph protein concentration also increased markedly, from 0.72 to 0.91 of the plasma concentration. We devised a simple procedure to cauterize across the pleural surface of the diaphragm to destroy the aberrant lymphatics. This procedure markedly diminished both abdominal cavity and portal system contributions.

Abdomen↗

[Antisense vascular endothelial growth factor suppressed corneal neovascularization in rats].

OBJECTIVE: To explore whether recombinant adeno-associated virus mediated antisense vascular endothelial growth factor (rAAV-aVEGF) gene transfer inhibits the development of corneal neovascularization (CNV) in a rat model. METHODS: rAAV-aVEGF(165) and recombinant adeno-associated virus mediated Lacz (rAAV-Lacz) were constructed by three-plasmid cotransfection methods. Forty-eight Sprague-Dawley (SD) rats were divided into two groups randomly. CNV were induced in vivo by alkaline cauterization of the central cornea. Twenty-four rats were injected with rAAV-aVEGF(165) (10(10) pfu/ml) into conjunctiva; another rats were injected with rAAV-Lacz (10(10) pfu/ml) into conjunctiva as controls. The Lacz gene expression was evaluated by 5-bromo-4-chloro-3-indolyl-beta-D-galactoside (X-gal) immunohistochemical staining. 1 to 30 days post-cautery, CNV was evaluated by morphometric analysis, and expression of VEGF was evaluated by immunohistochemistry. RESULTS: Two days later, 21.36% +/- 1.07% Lacz gene expression was detected in conjunctival sac in control group. 30 d later, 28.02% +/- 1.16% Lacz gene remained expression. Morphometric analysis and immunohistochemistry demonstrated rAAV-mediated antisense VEGF(165) significantly inhibited CNV. The VEGF(165) protein was decreased post-cautery compared to control group injected with. rAAV-Lacz (F = 1639.22, F = 2187.16, F = 719.17, P < 0.01). CONCLUSIONS: This study suggests that rAAV-aVEGF(165) can sufficiently inhibit the cautery-induced CNV, and the effect is associated with the inhibition of VEGF production.

Animals↗