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PubMedDate not supplied

A minimally invasive vasectomy with the no suture, inline method for vas occlusion.

OBJECTIVE: The current vasectomy methods, including the no scalpel vasectomy (NSV), have received considerable attention in recent years, because they are minimally invasive and utilize special instruments to expose the vas. However, at least 28 different methods for vas occlusion have been utilized with these procedures, and some postoperative complications have been attributed to the method of vas occlusion. Therefore, in this report we will critique the existing methods for vas occlusion and introduce a new and rapid method. PATIENTS AND METHODS: The NSV instruments were used to expose the vas, but, in addition, a fine skin hook, a short-bladed tenotomy scissors, and a hand-held, hotwire cautery were used for the new no suture, inline method of vas occlusion. No ligatures were placed around the vas, no portion of the vas was removed, and the mesentery behind the vas was not disturbed. The vas sheath was disrupted, there was luminal cautery on both the abdominal and testicular sides, a section of vas was detubularized and trimmed, and its epithelium was destroyed by cautery. This technique has been performed in 158 consecutive cases. RESULTS: All patients have demonstrated complete azoospermia on two follow-up semen analyses, with no pregnancies reported. CONCLUSION: This new method of vas occlusion seems to be rapid and compatible with the NSV instruments.

Evaluation Studies as Topic↗
PubMed2003

[Neuroprotection with carotenoids in glaucoma].

PURPOSE: The aim of the paper was to assess the place of the natural carotenoids (lutein, zeaxanthin) in glaucoma optic neuropathy. METHODS: For this purpose, we carried out an experimental and prospective study, during 3 months, on 8 laboratory animals (Guinea pigs), which we increased the IOP, in both eyes, by cautery of two episcleral vessels. The animals were divided into treatment in two groups: the group I (5 Guinea pigs) which we modified their usual diets by adding 2 cps/day of IcapsL (6 mg lutein/zeaxanthin) and the group II (3 Guinea pigs)--control group, without increasing the diet with lutein and zeaxanthin. The statistical analysis was performed by Student's t test. RESULTS: Before the cautery of episcleral vessels, the mean IOP was 16.8 mm Hg in group I and 16.5 mm Hg in the group II; after the cautery of episcleral vessels, the mean IOP was 26.2 mm Hg in group I and 25.9 mm Hg in the group II (p = 0.004). At the end of the study, the levels of serum lutein were 0.64 mumol/L in group I and 0.22 mumol/L in group II. The loss of retinal ganglion cells was 18.9% in group I and 29.7% in martor group, in correlation with the cup/disc ratio: 0.37, respectively 0.51. Also, in the group II, the increase of IOP was associated at the myelin portion of optic nerve head with axonal degeneration in peripheral regions. CONCLUSIONS: Glaucoma optic neuropathy has a multifactorial pathogenesis, including the oxidative stress. Lutein and zeaxanthin, with its strong antioxidative effects, can represent a viable solution in the complex treatment of glaucoma.

Animals↗
PubMed2006

[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↗
PubMedDate not supplied

[Florid vulvar condylomatosis. Comparison of therapeutic schedules].

The problem of warts' therapy is of great interest for the diffusion of this pathology, for its high rate of recurrence and for its relation to CIN. So we evaluated the efficacy of different therapeutic methods for vulvar condylomata, used in 254 patients treated in our center from January '86 to July '90. 55 women underwent hot cautery, 31 laser-therapy, 42 excisional biopsy, 62 were treated with alpha interferon, 11 with beta interferon, 13 with thymopentin in association with electro-cautery or laser and in 40 cases no treatment was performed. The follow up, from 6 to 36 months, showed a remission of 88.1% in excisional biopsy, of 77.4% in laser-therapy, of 70.9% in electro-cautery, of 45.4% in beta interferon, of 45.2% in alpha interferon, of 76.9% in thymopentin and of 65% in the not treated group. No one therapy yielded optimal results, although surgical methods appeared to allow complete removal of the wart lesion with one application only, and to be better accepted by the patients because of the psychologic benefit of immediate remission notwithstanding the possibility of recurrencies. The results of the studied medical therapies appeared scanty. We conclude that, being the tissues around florid lesion purely affected by HPV, medical therapy needs further research in the hope of a more radical treatment.

Adult↗
PubMedDate not supplied

Experimental corneal neovascularization: biomicroscopic, angiographic, and morphologic correlation.

Sequential slit-lamp examinations and fluorescein angiograms were performed on adult rabbits to define the morphological and functional maturation of new intracorneal vessels induced by chemical cautery. The vasoproliferation induced by this injury began as vascular sprouts from the preexisting pericorneal vessels and continued until there were well formed vascular loops carrying blood to and from the cautery site. Many vessels, particularly venules, then regressed. As defined by the fluorescein angiograms and microscopic examination of tissue sections, the final loops were formed by muscularized vessels (arterioles) bringing blood to the cautery site, and unmuscularized vessels (venules) carrying blood back to the vessels at the corneoscleral limbus. The angiograms recorded during the evolution of these vessels suggest that intracorneal arterioles form when blood flow or pressure from a preexisting pericorneal arteriole induces muscularization in a previously undifferentiated sprout arising from a capillary or venule.

Animals↗
PubMed1988

Scalpel versus electrocautery in modified radical mastectomy.

Forty nine consecutive mastectomy patients were randomized to one of two groups. Twenty four patients had skin flaps created with the cold scalpel and twenty five with the electrocautery. The two groups were similar with respect to age, stage of disease, size of tumor, and weight. Cautery patients had significantly less operative blood loss when compared with scalpel patients, 352 versus 507 milliliters, respectively, P less than 0.05. No cautery patient required transfusion compared with three transfused scalpel patients, P less than .005. Total postoperative hemovac drainage and hospital stay were not significantly different between the two groups. Although the number of fever days and wound complications were slightly higher in the cautery group, the difference was not statistically significant. The electrocautery may be superior to the scalpel for mastectomy.

Electrocoagulation↗
PubMed1979

Morphologic observations on experimental corneal vascularization in the rat.

The morphologic evolution of the early events of corneal vascularization in the rat cornea induced by silver nitrate cautery were followed by light and electron microscopy. An initial acute inflammatory response occurred within the first 6 hours after cautery as evidenced by vascular dilation, diapedesis of leukocytes, and an increased vascular permeability, as manifested by distended lymphatics and the presence of extravascular fibrin. At 24 hours after injury, the hypertrophy and the prominence of nucleoli and the presence of abundant polyribosomes were the initial suggestion that vascular endothelial cells and pericytes had entered the mitotic cycle. Nine hours later, at 33 hours after cautery, the first new vessels were observed as sprouts from the capillary arcade and postcapillary venules. The experiments reemphasize the association of acute inflammation and corneal vascularization in this model and underscore the early occurrence of vascular endothelial cell replication.

Animals↗
PubMed1982

Effect of diaphragmatic lymphatic contamination on caudal mediastinal node lymph flow in unanesthetized sheep.

Our purpose was to determine the effect of diaphragmatic lymphatics on steady state caudal mediastinal node (CMN) or lung lymph flow in the unanesthetized sheep. After standard lung lymph fistula preparation, in which the CMN efferent was cannulated, nine sheep had an additional extensive cautery procedure in the right chest along the esophagus and diaphragm to sever any systemic lymphatics entering the CMN. This was followed by a similar cautery procedure on the left side, one week later. There was no difference in steady state lymph flow, QL, or in the lymph-to-plasma, L/P protein ratio in any paired study when comparing the bilateral cautery procedure with the right side alone, nor was there any difference in these parameters when this data was compared with that from thirty standard lymph fistula preparations. In addition, diaphragmatic lymphatics were cannulated in five sheep. Mean QL immediately post-surgery was 1.6 +/- 0.4 ml/hr compared to a CMN QL of 6.1 +/- 0.4 ml/hr. By six hours after surgery, diaphragmatic QL decreased to 0.4 +/- 0.2 while CMN flow remained relatively steady. We conclude that residual diaphragmatic lymphatics, if any, entering the caudal mediastinal lymph node, not removed by the standard preparation do not appear to affect steady state CMN lymph flow or L/P ratio, in the normal unanesthetized sheep, especially if measurements are obtained at least 6 hours after surgery.

Animals↗
PubMed1996

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↗
PubMed1997

Treatment of colorectal and ileoanal anastomotic sinuses.

PURPOSE: This study is designed to describe a technique and report results for treating low anastomotic sinuses. METHODS: Restorative proctocolectomy and complicated low anterior resections were protected with diverting loop ileostomy. Contrast enemas identified anastomotic problems before ileostomy closure. Pouch-anal or colorectal anastomotic sinuses that failed to resolve with observation were treated before intestinal continuity was restored. With the patient receiving regional or general anesthesia, a rigid proctoscope or anoscope was used to identify the sinus opening. The common wall between the sinus and the bowel lumen was divided under direct vision with laparoscopic cautery scissors, and the sinus cavity was debrided with a suction cautery wand placed through the scope. RESULTS: Six patients with anastomotic sinuses have received outpatient treatment in the described manner during the past two years. Four patients had restorative proctocolectomies for ulcerative colitis, and two had low anastomosis for rectal cancer. Three patients presented with pelvic sepsis before the contrast study; the remainder were asymptomatic. Division of anastomotic sinus was performed one to eight months after diagnosis of the sinus. Following division, anastomotic cavities resolved in five patients by 1 month and in one patient by 12 months. In these six patients, there was one dilatable anastomotic stricture but no other anastomotic complications at follow-up 5 to 16 (mean, 9.2) months after sinus division. CONCLUSION: When used in conjunction with fecal diversion, sinus unroofing by division of the common wall between the sinus and bowel lumen treats low pelvic sinuses.

Adolescent↗
PubMed1995

Inhibition of bladder tumor cell implantation in cauterized urothelium, without inhibition of healing, by a fibronectin-related peptide (GRGDS).

BACKGROUND: Local recurrence after transurethral resection of bladder tumors (TURB) is common and might be diminished if free tumor cells within the bladder are prevented from reattaching. METHODS: In vitro inhibition of murine bladder tumor cells to an approximation of urothelial matrix with agents that might block attachment to components of the extracellular matrix, and in vivo inhibition of attachment in cautery-injured murine bladder. RESULTS: GRGDS, (0.1-2.5 mg/ml), a fibronectin-related peptide, mannose-6-phosphate, (0.1-20 mg/ml), a carbohydrate, and heparin (1-625 units/ml) all inhibited attachment in vitro in a dose-dependent fashion. YIGSR (0.1-2 mg/ml), a laminin-related peptide, did not. Mannose (10 mg/ml) did not significantly inhibit attachment of tumor cells to cauterized urothelium in vivo, whereas there was a 77% reduction of attachment in bladders irrigated with GRGDS (6.25 mg/ml) (p < 0.05), and the appearance of subsequent tumors in the bladder was inhibited. Finally, GRGDS (6.25 mg/ml) did not inhibit healing of the cautery ulcer. CONCLUSIONS: RGD-containing peptides may be useful as adjuvant therapy to decrease local recurrence after TURB and perhaps in other circumstances in which tumor cells spilled into a wound or body cavity threaten surgical success.

Animals↗
PubMed1976

Experimental iridectomy with bipolar microcautery.

Peripheral iridectomy was performed in pigmented rabbits after the application of bipolar microcautery to the iris surface. At low doses of cautery, no increase in postoperative inflammation or complications was noted clinically or pathologically in control eyes. High doses of cautery resulted in an increased incidence of postoperative inflammation, corneal opacity, hyphema, iris prolapse, lens changes, and poor wound healing.

Animals↗
PubMed1979

Microsurgical tubal anastomosis in the rabbit following three types of sterilisation procedure.

The reversibility of Falope ring, Pomeroy and unipolar cautery methods of sterilisation was examined in 30 rabbits. Using microsurgical techniques, an overall pregnancy rate of 56.6% was attained. Reversibility was more readily achieved and resulted in a higher pregnancy rate after Falope ring than Pomeroy or cautery sterilisation. The pregnancy rate after each method of sterilisation seems to correlate with the results obtained for reversal of sterilisation in the human.

Animals↗
PubMed1991

Management of epistaxis in children.

A randomised clinical trial of antiseptic nasal carrier cream (Naseptin) and silver nitrate cautery in the treatment of epistaxis in children was carried out. Fifty-four percent responded to cautery with silver nitrate and 50% to treatment with Naseptin antiseptic carrier cream. There were 24 patients in each group. No statistically significant difference was observed between the groups when tested with the chi 2 test. We believe that the first line treatment of epistaxis in children should be the use of antiseptic nasal cream.

Adolescent↗
PubMed2006

Hormone levels before and after tubal sterilization.

OBJECTIVE: The aim of this study was to determine whether women experience significant luteal phase hormonal changes following interval tubal sterilization. DESIGN: This is a partly randomized, prospective clinical study. SETTING: This study involved healthy volunteers in an academic research environment. PATIENTS: This study involved 118 fertile women seeking tubal sterilization and 57 fertile controls with at least three normal cyclic menstrual periods before entry into the study. INTERVENTIONS: The patients were randomized to bipolar cautery or Hulka clip as sterilization methods. Barrier contraception or abstinence was used by controls. MAIN OUTCOME MEASURES: The main outcome measures are serum estradiol and progesterone levels and urinary estradiol and pregnanediol levels obtained during the luteal phase before, 1 year and 2 years after sterilization. RESULTS: The women randomized to the bipolar cautery group had higher midluteal progesterone levels measured between Days 5 and 11 postovulation (15.5 ng/mL before sterilization, 14.5 ng/mL at 1 year and 14.5 ng/mL at 2 years) than did the other two groups. The clip group had progesterone levels of 14.1, 12.0 and 12.5 ng/mL at baseline, 1 year and 2 years, respectively, and the control group had levels of 12.0, 11.9 and 11.3 ng/mL for the same periods. Serum estradiol and progesterone and urinary pregnanediol and estradiol were not significantly changed over the 2-year period, nor were there significant differences between the two groups. CONCLUSIONS: There were no significant hormonal changes in sterilized women over a period of 2 years when compared with their baseline levels or when compared with unsterilized age-matched controls.

Adult↗
PubMed1997

Epistaxis: a retrospective review of hospitalized patients.

A 2-year retrospective study (August 1, 1992, to July 31, 1994) reviews medical records of 249 hospitalized epistaxis patients at seven Baltimore-area hospitals. This review represents the first multihospital study of patients hospitalized with epistaxis. The study evaluates multiple factors associated with epistaxis: demographics, underlying medical diseases, use of anticoagulation medication, site of epistaxis, and month of hospital admission. Blood transfusion requirement, hematocrit level, length of stay, treatment, and local/systemic complications are studied as well. The month of hospital admission was evenly distributed without a wintertime predominance, and the mean length of stay was 4 days. Treatment and outcome were similar in all hospitals, and more than 83% of patients responded to packing, balloon placement, local cautery, or a combination thereof. Of the 249 patients reviewed, 30 underwent surgical endoscopic cautery, 3 required formal surgical arterial ligation, and 1 underwent arterial embolization. All 30 endoscopic cauterizations successfully stopped the epistaxis, and this technique proved to be a useful adjunct for patients who required multiple interventions. The review identified a 3% complication rate of epistaxis and its treatment, including synechiae, aspiration, angina, myocardial infarction, and hypovolemia. No deaths were directly attributable to epistaxis or its treatment.

Adolescent↗
PubMed2006

Eruptive vellus hair cysts: an effective extraction technique for treatment and diagnosis.

BACKGROUND: Eruptive vellus hair cysts are uncommon developmental anomalies of vellus hair follicles that are observed in young patients. Two patients were evaluated for asymptomatic flesh-coloured papules appearing on the chest, abdomen and axillae. Lesions of both patients were diagnosed histologically as eruptive vellus hair cyst, which is a disorder with no standard treatment option. OBJECTIVE: To introduce an alternative treatment and diagnostic technique for eruptive vellus hair cysts and to evaluate this technique's effectiveness histopathologically. MATERIALS AND METHODS: We treated the lesions by using cautery and a standard dissecting forceps under topical anaesthesia. After puncturing the overlying skin in the centre using the sharp-tipped cautery point, we grasped the base of the cyst using a standard dissecting forceps and we extracted the cysts out. In patient 1, extracted cysts were sent for histopathological examination; in patient 2, microscopic examination of the extracted material was performed in potassium hydroxide preparations. RESULTS: Over 150 cysts were extracted with this technique in two patients. The technique was simple, quick and tolerated well. No lesion recurrence was observed after 4 months. On histopathological examination, extracted cysts were observed to have cyst walls. In patient 2, the diagnosis was made within minutes by microscopic examination of the potassium hydroxide preparations of the extracted material. CONCLUSION: Our extraction technique is a simple and effective treatment option for these cysts. It can be regarded as curative since the cyst walls were also extracted. Microscopic examination of the potassium hydroxide preparation of the extracted cysts suggests that this technique can also be used as a simple diagnostic procedure.

Adolescent↗
PubMed2004

A comparison of the clinical usefulness of three different electroencephalogram monitors: Bispectral Index, processed electroencephalogram, and Alaris auditory evoked potentials.

UNLABELLED: We compared the usefulness of the Bispectral Index (BIS), Processed electroencephalogram (pEEG), and Alaris auditory evoked potentials (A-AEP). Ninety females scheduled for mastectomy were divided into three groups. Anesthesia was induced with propofol and fentanyl to insert a laryngeal mask airway (LMA) and was maintained by adding nitrous oxide. EEG was monitored by either BIS, spectral edge frequency by pEEG, or A-AEP index by A-AEP. We recorded the number of patients with impedance low enough to extract good EEG signals at the first electrodes application (success rate), the number with an index outside of the range considered appropriate for general anesthesia (inappropriateness rate), changes of the index by LMA insertion or surgical incision (responsiveness), and time to return to good EEG signals after signal disturbance by electric cautery (recovery time). The success rate was larger in BIS > or = A-AEP > pEEG. The inappropriateness rate was smaller in A-AEP < or = BIS , or = pEEG. The A-AEP group showed the largest responsiveness. The recovery time was shorter in pEEG < A-AEP < BIS. In summary, the BIS had the largest success rate, the A-AEP had the least inappropriateness rate and the largest responsiveness, and the pEEG had the fastest recovery time. IMPLICATIONS: We compared the usefulness of three electroencephalogram monitors. The Bispectral Index was the easiest for obtaining low impedance, the auditory evoked potential index had the least inappropriateness rate for general anesthesia and had the largest responsiveness, and the spectral edge frequency was the fastest in stabilizing measurement after electric cautery.

Adult↗