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PubMed1983

Urothelial susceptibility to tumor cell implantation: comparison of cauterization with N-methyl-N-nitrosourea.

To determine whether or not transitional cell carcinoma cells will preferentially implant and grow on an altered urothelial surface, cauterization and instillation of N-methyl-N-nitrosourea (MNU) were used to alter the murine bladder urothelium. Transplantable tumor cells (2.09 X 10(6) ) were placed into the bladders of 53 mice. Tumor cell implantation occurred in only 6 per cent of the mice with a normal bladder, whereas tumors were present in 28 per cent of mice pretreated with intravesical MNU and in 67 per cent of mice which had a portion of the bladder cauterized prior to insertion of tumor cells (p less than 0.005). This study not only establishes the optimal technique for implantation in this experimental model, but also suggests that seeding may be a contributory factor in the high recurrence rate following endoscopic treatment of bladder tumors in man.

Animals↗

PubMed1961

Fatal epistaxis.

The instances in which nosebleed is potentially fatal are those in which there is a history of recent head injury, severe arteriosclerotic cardiovascular disease or an underlying vascular tumor in the nasal chambers. Fatal nasal bleeding has not been reported in children. An awareness on the part of the physician of the potentially fatal significance of his patient's nosebleed is the very best insurance against such an event. Intelligent history-taking, careful physical and x-ray examination, generous sedation, precise local cauterization and packing, estimation of hemoglobin mass and a search for bleeding and clotting disorders are the best weapons of the physician called to treat epistaxis. These procedures, coupled with adequate blood replacement and an informed attitude toward surgical interruption of the blood supply to the bleeding region should forestall death from fatal nosebleed.

Blood Coagulation Disorders↗

PubMed1980

Comparison of avitene, topical thrombin, and gelfoam as sole hemostatic agent in tuboplasties.

Forty-eight virgin guinea pigs were subjected to bilateral sectioning of the uterine horn and cuff type salpingostomy. Avitene, Topical Thrombin, or Gelfoam was used as the sole hemostatic agent in each of three study groups. Bipolar cauterization was used in a control series. These agents were compared with regard to ease of application, degree of adhesion formation, net surface area, and microscopic evaluation of degree of fibrosis and inflammatory reaction. The results revealed no statistically significant differences among the various methods of hemostasis. Data were evaluated by uni- and multivariate analyses. Several trends in the data were noted: the greatest amount of fibrosis was associated with Topical Thrombin and Avitene, and the greatest inflammatory response was associated with Avitene. These agents show no superiority to currently used cautery methods of obtaining hemostasis.

Animals↗

PubMed2000

Role of the vomeronasal organ in neonatal offspring recognition in sheep.

Twenty-five pregnant Dorsett ewes were randomly divided into three groups to test if ewes use their vomeronasal organs for offspring recognition during nursing. One group of eight ewes (procaine) were made anosmic by irrigation of the nasal olfactory apparatus with a zinc sulphate procaine solution. The second group of nine ewes (cauterized) had their vomeronasal organs rendered nonfunctional by cauterization of the nasoincisive duct. The third group of eight ewes were the controls. Parturition was synchronized in all ewes with betamethasone on Day 145 of gestation. Maternal responsiveness was tested two separate times with 1- to 2-day-old alien lambs. Each alien lamb trial was conducted 24 h apart. Cauterized ewes allowed alien lambs to suckle and they were unable to distinguish alien lambs from their own lambs, whereas the ewes in both groups with functional vomeronasal organs (procaine and control) violently rejected any alien lamb's attempt to suckle. Thus, female sheep use their vomeronasal organs for neonatal offspring recognition.

Animals↗

PubMed1992

Streptococcus salivarius bacteremia and meningitis following upper gastrointestinal endoscopy and cauterization for gastric bleeding.

Streptococcus salivarius is a normal inhabitant of the oral cavity. When isolated from blood cultures, this viridans streptococcus is often disregarded as a contaminant. Viridans streptococci, although a common cause of endocarditis, are rarely associated with bacterial meningitis and account for less than 1% of all cases of purulent meningitis. We report a case of bacteremia and meningitis due to S. salivarius that occurred in a patient who underwent upper gastrointestinal endoscopy and cauterization for control of gastric bleeding. Although bacteremia following gastrointestinal procedures has been well documented, its incidence is low (ranging from 2% to 10%), and its course is usually transient without major clinical sequelae. This case is unique with respect to the pathogen isolated, the length of bacteremia, and the meningitis that subsequently developed following a gastroesophageal procedure.

Bacteremia↗

PubMed2004

Use of bipolar energy for transurethral resection of bladder tumors: pathologic considerations.

BACKGROUND AND PURPOSE: Bipolar electrocautery has recently been introduced as a modality for transurethral resection of bladder tumors (TURBT). The primary benefits of bipolar TURBT stem from the use of saline irrigant rather than glycine or water. TURBT should be conducted in a fashion such that the resected tissue can be used for proper grading and staging, so excessive cauterization of the tissue should be avoided. In this study, we compared the pathologic characteristics of bladder tumor specimens resected with bipolar versus standard monopolar energy to determine specimen quality. PATIENTS AND METHODS: Bipolar TURBT (Gyrus Medical Inc., Maple Grove, MN) was performed in 11 patients. Pathologic specimens were compared with the specimens from 11 patients who had previously undergone standard monopolar TURBT. Resected tissue was examined by a pathologist who recorded tumor size, grade, location, presence of muscularis propria, presence of muscle invasion, and final diagnosis. The pathologist also determined the degree of cautery artifact in each specimen. The pathologist was blinded to the form of electrocautery used and the clinical diagnosis. RESULTS: Transurethral resection with bipolar electrocautery was carried out without difficulty or complication in all cases. Similarly, there were no complications in resection by standard monopolar electrocautery. The bladder tumor chips obtained with bipolar TURBT were smaller because of the smaller size of the bipolar loop. However, this did not interfere with the pathologic assessment. There were no significant pathologic differences between specimens according to the type of cautery used. A large degree of cautery artifact was noted in the tissue of larger tumors resected using both monopolar and bipolar electrocautery. However, the incidence and degree of cautery artifact were similar in the two groups. No trends between tumor location and degree of cautery effect were noted. The pathologist had no difficulty reaching a full and proper diagnosis in all cases involving either form of electrocautery. CONCLUSIONS: Bipolar electrocautery is well suited for TURBT. Bladder tissue obtained from bipolar TURBT is of the same histologic quality as that obtained from standard monopolar TURBT and provides the urologist with a reliable and complete diagnosis.

Electrosurgery↗

PubMed1981

New laparoscopic sterilization with exteriorization of tubes (cauterization, ligation): a preliminary report.

The fallopian tube's remarkable mobility and inherent length makes possible its exteriorization from the abdominal cavity to perform any kind of tubal sterilization. We offer a new laparoscopic technique utilizing (1) exteriorization of the tube and the performance of either (a) tubal ligation (Pomeroy technique); or (b) unipolar cauterization, or (2) intraabdominal in-sleeve cauterization in case of failure to exteriorize the tube. Our approach, on the one hand, was to avoid laparotomy but still preserve the advantages of tubal ligation, and on the other hand, to avoid possible bowel burn but still retain the beneficiary effect of electrical cauterization. To accomplish this, a simple second puncture uninsulated trocar-sleeve and grasping forceps were designed. With this technique, 325 patients have had voluntary interval sterilization at Olive View Medical Center-UCLA Campus (1977-1980). No bowel burn or pregnancies have occurred. No laparotomies have been necessary. Complications were minor and compared favorably with those cases in which other techniques were used.

Adult↗

PubMed1995

The role of middle ear effusions and epidermal growth factor in cholesteatoma formation in the gerbilline temporal bone.

To study the process of aural cholesteatoma formation, we used gerbilline temporal bones to examine histologically the early stages of spontaneous cholesteatomas associated with experimentally induced otitis media with effusion (OME) following electric cauterizations of the eustachian tube. Epidermal growth factor (EGF) was then localized immunohistochemically in the pars flaccida of normal ears and the forming spontaneous cholesteatomas. Findings in the ears with the early spontaneous cholesteatomas were effusion inside the pars flaccida and hypertrophy and hyperkeratosis of the pars flaccida. Findings in the ears with experimental OME involved an effusion in the whole middle ear cavity as well as hypertrophy and hyperkeratosis in both the pars flaccida and pars tensa. The incidence of ear drum changes was higher in the experimental OME group than in control animals without cauterization. EGF was localized in the mucous layer of normal drums, the mucous layer and lamina propria of drums with hypertrophy alone, and all layers in drums with hypertrophy and hyperkeratosis. EGF was especially positive in the cytoplasms of transformed cuboidal cells. These findings suggest that EGF within the transformed mucous layer may play an important role as a biochemical factor in developing cholesteatomas.

Animals↗

PubMedDate not supplied

Timing, dosing and duration of antimicrobial prophylaxis in urology: a study in guinea pigs with special reference to high-risk conditions.

A study in guinea pigs was performed to investigate the importance of timing, dosage and duration of antimicrobial prophylaxis in urologic surgery. To simulate high-risk conditions, in one group a foreign body was implanted subcutaneously. The prostate and one kidney were cauterized and bacteremia was induced by intravenous injection of an Escherichia coli suspension. Various ciprofloxacin regimens were tested. The results indicate that antimicrobial prophylaxis is beneficial only if administered before or shortly after surgery. Full therapeutic dosage may not be necessary for prophylactic efficacy. Single-dose prophylaxis was as effective as multiple doses. Foreign body infection could be prevented by single-dose prophylaxis.

Animals↗

PubMed1983

Corneal neovascularization as studied by scanning electron microscopy of vascular casts.

Rat corneas were cauterized chemically, and the induced neovascularization was studied by scanning electron microscopy of vascular casts. Casts were prepared by filling the pericorneal and intracorneal vessels with an acrylic monomer by an intracardiac injection. The initial response to injury was a vasodilation of pericorneal vessels and the appearance of impressions in the walls of veins and venules consistent with those of marginating leukocytes. The first new vascular buds emerged from the pericorneal venules and capillaries at 27 hours after injury. These sprouts lengthened and multiplied by 72 hours to produce a rich anastomosing plexus. New vessels were not seen arising from arteries and arterioles. By 7 days, numerous channels reached the cautery site and, by 13 days, many of the redundant intracorneal vessels had regressed leaving large looping channels connecting either with a pericorneal artery or a vein. The casts of those continuous with the artery had surface features suggesting arterial or arteriolar differentiation, whereas the smooth surfaces of the remaining channels were consistent with those of veins or capillaries. Transmission electron microscopy confirmed this differentiation by documenting intracorneal vessels with the smooth muscle and prominent endothelial cell nuclei which characterize arteries and arterioles. Vascular casts have several advantages in the study of neovascularization. They depict the three-dimensional characteristics of new vessel formation and reflect the vascular and cellular events in the accompanying acute inflammatory response; define more readily than histologic sections the time that the first new buds appear; emphasize capillaries and venules as the predominant source of new vessels; and suggest that certain new intracorneal vessels assume morphologic features of arteries or arterioles, whereas others retain capillary or venous characteristics.

Animals↗

PubMed2006

Bilateral epistaxis in children: efficacy of bilateral septal cauterization with silver nitrate.

OBJECTIVE: To evaluate the rate of control of epistaxis in patients with bilateral complaints using silver nitrate and to assess short-term complications from this therapy. STUDY DESIGN AND SETTING: Retrospective chart review with prospective incident case identification in a tertiary referral pediatric otolaryngology practice. SUBJECTS AND INTERVENTIONS: Forty-six consecutive patients presenting to a single pediatric otolaryngologist with complaints of bilateral epistaxis received bilateral silver nitrate cauterization to the anterior septum and were seen in follow-up 2 months later to assess for control of epistaxis and complications from this therapy. RESULTS: Ninety-three percent (43/46) of patients followed-up at 2 months after therapy. About 93% (40/43) had total or near-total resolution of their epistaxis. Five percent (2/43) of patients returned to the clinic after initial successful control for a second cauterization during the period of study. No significant complications of infection, perforation, long-term crusting, tattooing or mucocutaneous or allergic reactions were identified. CONCLUSIONS: Bilateral epistaxis can be treated at a single visit with bilateral silver nitrate therapy in children. This treatment is highly effective, well-tolerated, and appears to have a low rate of complications.

Adolescent↗

PubMed2004

A model of intrinsic sphincteric deficiency in the rat: electrocauterization.

AIMS: Intrinsic sphincteric deficiency (ISD) denotes a malfunction of the distal urethral sphincter. Our objective was to produce a durable model of ISD in the rat. METHODS: Surrounding tissues lateral to the mid-urethra were cauterized to produce sphincteric injury in 24 adult female Sprague-Dawley rats. The rats were divided into four groups of six rats each and followed for 2, 4, 6, and 16 weeks. Sphincteric function was studied by using the vertical tilt table/intravesical pressure clamp model to measure leak point pressures (LPPs). Muscle and nerve damage were assessed with hematoxylin and eosin (H&E) and anti-protein gene product (PGP) 9.5 staining, respectively. As a control, 12 rats underwent a sham operation and subsequent LPP testing at 2, 4, 6, and 16 weeks. RESULTS: The mean LPPs of the rats 2, 4, 6, and 16 weeks after cauterization were 18.7 +/- 0.8 cm H2O, 27.6 +/- 1.6 cm H2O, 24.3 +/- 1.7 cm H2O, and 19.1 +/- 2.2 cm H2O, respectively. The mean LPPs of the rats 2, 4, 6, and 16 weeks after the sham operation were 49.8 +/- 1.3 cm H2O, 51.2 +/- 1.5 cm H2O, 51.6 +/- 2.0 cm H2O, and 49.7 +/- 0.6 cm H2O, respectively. When compared to time-matched control groups, the decreased LPPs in each cauterized group were significantly lower (P < 0.001). Histological analysis showed muscle damage and fewer nerves in all cauterized groups. CONCLUSIONS: Cauterization of tissues lateral to the mid-urethra decreased LPP without affecting bladder function. This electrocauterization model produced low LPPs that, after 2 weeks, were maintained for up to 16 weeks. Histology suggests that damage to striated muscle and nerves might have contributed to the change in LPP in this model for ISD.

Animals↗

PubMed1999

Non-functioning pituitary tumour after long-term treatment with gonadotrophin-releasing hormone agonists in a patient with vaginal agenesis who underwent neovaginoplasty and cauterization of endometriosis under laparoscopy.

Vaginal agenesis combined with a functional uterus is a rare condition in which treatment modalities that preserve reproductive function are controversial. A 21 year old female presented with congenital vaginal agenesis combined with cervical atresia. She was treated with gonadotrophin-releasing hormone (GnRH) agonists for a total period of over 5 years when a non-functioning pituitary tumour was detected by brain magnetic resonance imaging (MRI). A laparoscopically assisted reconstruction of a neovagina and neoendocervical canal was performed utilizing lyophilized porcine dermal skin to line the neovagina. Endometriosis of the pelvis was revealed and adhesiolysis and cauterization were also carried out under laparoscopy. The GnRH agonist was discontinued and the patient resumed cyclic menses with no abdominal pain. The pituitary tumour decreased in size 6 months after the cessation of GnRH agonists. We raise the question as to whether pituitary MRI should be performed for patients who need long-term administration of GnRH agonists.

Adult↗

PubMed2000

Pyriform sinus fistula: management with chemocauterization of the internal opening.

A branchial remnant originating in the pyriform sinus causes a recurrent fistula or abscess in the neck. In spite of excision, recurrence may result from inadequate removal of the fistula tract. We attempted chemocauterization of the internal opening of the fistula tract with trichloroacetic acid (TCA) on direct endoscopy. This is a 6-year review of 18 patients with pyriform sinus fistula. Medical history, barium esophagography, computed tomography scans, operative findings, and treatment results were analyzed. By direct endoscopy, all patients were found to have a fistula opening in the pyriform sinus, exclusively on the left side. In only 9 patients, the fistula tract was identified by barium esophagography before operation. Computed tomography revealed a suspicious fistula tract originating from the pyriform sinus in 8 of 10 patients. Sixteen patients were initially managed by TCA chemocauterization. There were no serious intraoperative or postoperative complications. Four patients had recurrent masses, which were managed by simple excision in 2 patients and repeated TCA cauterization in the other 2 patients with unobliterated internal openings. We recommend barium swallow study and direct endoscopy for all patients presenting with a recurrent lateral neck abscess, especially on the left side. Our results suggest that initial chemocauterization of the internal opening can be a reasonable alternative procedure for the management of pyriform sinus fistula.

Abscess↗

PubMed1998

Interleukin-1 receptor antagonist suppresses Langerhans cell activity and promotes ocular immune privilege.

PURPOSE: To determine whether the capacity of Langerhans cells (LCs) to abrogate ocular immune privilege can be suppressed by the topical application of interleukin-1 receptor antagonist (IL-1ra). METHODS: Cautery was applied to corneas of BALB/c mice on day 0 to induce centripetal migration of LCs. Immune privilege was tested by the ability to induce anterior chamber-associated immune deviation (ACAID) to intracamerally injected soluble antigen 1 to 2 weeks after cautery application. The number of LCs was enumerated by immunofluorescent staining. In other experiments, freshly procured Thy-1-depleted epidermal cells, with or without LC depletion, were injected directly into virgin murine corneas before testing for ACAID. All test animals were randomized for treatment with either topical IL-1ra or placebo in a masked fashion for 1 to 2 weeks after induction of LC migration and before intracameral injection of antigen. RESULTS: Intracorneal injection of freshly procured LC-depleted epidermal cells into normal eyes failed to abrogate ACAID, whereas LC-containing cell populations uniformly led to loss of immune privilege (P < 0.01). Topical treatment with IL-1ra led to retention of the cauterized eyes' capacity for ACAID induction (P < 0.01) and to a profound (>80%) suppression of LC migration compared with untreated controls (P < 0.01). Additionally, topical IL-1ra treatment of eyes with intracorneally injected LCs preserved immune privilege and ACAID induction (P < 0.001). CONCLUSIONS: IL-1 mediates mechanisms of immunity in corneal inflammation that subvert the normal eye's immune privileged state. However, its antagonism with topical administration of IL-1ra preserves ocular immune privilege and ACAID through suppression of LC function.

Administration, Topical↗

PubMed1976

The plasma scalpel.

The plasma scalpel simultaneously cuts tissue and cauterizes blood vessels measuring 3 mm in diameter with a small, hot (3000 C) gas jet. In animal studies, the amount of hemorrhage has been shown to be less with the plasma scalpel than with steel or electrosurgical scalpels, and incisions have healed without complications. Amount of damaged tissue is limited. Human trials are under way, and the device shows promise as a clinical tool.

Absorption↗

PubMed1975

Bilateral transnasal cauterization of the vidian nerve in vasomotor rhinitis.

A brief report of twenty cases of bilateral cauterization of the Vidian Nerve Canals in intractable non-atopic chronic Vasomotor Rhinitis by a Trans-Nasal approach not previously described is given. The authors find this approach to be a much safer and simpler procedure than either the Trans-Septal or the Trans-Antral routes. The advantages of this approach to the Vidian Nerve Canal over the Trans-Septal and Trans-Antral routes are discussed.

Anesthesia, Local↗

PubMed1997

Assessment of cardiomyocyte DNA synthesis in normal and injured adult mouse hearts.

Cardiomyocyte DNA synthesis was examined in normal and injured adult mouse hearts. In preliminary studied DNA synthesis was monitored by [3H]thymidine incorporation, followed by autoradiographic analysis of dispersed cell preparations. No synthetic cells were identified when 20,000 ventricular cardiomyocytes from normal adult hearts were examined. A high throughput assay was developed to establish the actual labeling index for the adult mouse heart. The assay utilized [3H]thymidine incorporation in transgenic mice which expressed a nuclear-localized beta-galactosidase (beta-Gal) reporter gene exclusively in cardiac myocytes. Cardiomyocyte DNA synthesis was evidenced by colocalization of beta-Gal activity and silver grains in autoradiograms of histological sections. Examination of 180,000 ventricular cardiomyocyte nuclei from normal adult transgenic mice identified a single synthetic nucleus, suggesting a maximum labeling index of 0.0005%. Cardiomyocyte DNA synthesis was next examined in hearts injured by focal cauterization of the left ventricular free wall. Only three synthetic nuclei were identified when 36,000 cardiomyocyte nuclei in the perinecrotic zone of the injured heart were examined. No additional synthetic nuclei were identified when 180,000 nuclei in regions distal to the necrotic zone were examined. These data confirm that cardiomyocyte DNA synthesis in the adult mouse heart is extremely rare and provide baseline data for analyses in genetically modified animals.

Animals↗