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At least 469 records · Page 26Linked to original sources
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

Sutureless vasectomy, an improved technique: 1300 cases performed without failure.

Thirteen hundred bilateral, partial vasectomies have been performed for sterilization, without a failure. The procedure utilizes (1) a small, single incision; (2) no sutures; (3) cautery of each vas deferens lumen with a hand-held, battery-operated, disposable, hot-wire cautery; and (4) sealing of the proximal vas deferens in its sheath with a single tantalum clip. No spermatic granulomas were noted using this technique.

California↗
PubMed1976

Role of Tenon's capsule in postoperative restrictions.

Management of all restricted strabismus cases is difficult and frequently will require two or more procedures. The prevention of these restrictions at the time of primary surgery is far more important. All tissue should be handled as gently as possible, with smooth or fine-tip forceps, avoiding large fixation devices. Sharp dissection is essential - tissue should not be torn but cut carefully and sharply with scissors under direct visualization. The conjunctival and Tenon's capsule incisions should not be made directly over the muscle; this will result in scarring of the muscle to Tenon's capsule or of Tenon's capsule to the muscle insertion stump, promoting restriction. The muscle should be isolated under direct visualization or inspected carefully after isolation, with great care taken not to incorporate any unnecessary Tenon's capsule in the muscle and to avoid the inferior oblique msucle on lateral rectus muscle surgery. A blind, deep sweep is completely contraindicated. The intermuscular membranes, check ligaments, and muscle foot plates must be completely severed, under direct visualization, well beyond the resection site in the course of a resection,and 5 to 8 mm. behind the insertion in the course of a recession. Complete hemostasis during the procedure and at its completion is essential; 2.5 percent phenylephrine and minimal cautery will help achieve this. Since cautery will result in a scar of Tenon's capsule to that area of the sclera, it should be used as little as possible. Phenylephrine 2.5 percent has been used safely with halothane anesthesia in many patients without significant arrhythmias. The secondary treatment of restriction is very difficult, whereas their prevention requires only good surgical technique and careful attention to detail.

Adult↗
PubMed2004

Preliminary report on surgical technique in hepatic parenchymal transection for liver tumors in the elderly: a lesson learned from living-related liver transplantation.

BACKGROUND AND OBJECTIVES: Availability of hi-tech surgical devices has elaborated the technique of parenchymal transection during hepatectomy from classic crushing clamp technique 1,2 to a combination of an ultrasonic dissection with special type of cautery 3,4. We have developed a new technique to resect hepatic parenchyma using an ultrasonic surgical aspirator in association with a monopolar floating ball. This combination has been utilized in 42 liver resections. METHODS: A retrospective analysis of perioperative mortality, length of hospitalization, and blood transfusion during surgery in two patient groups who underwent liver resection was carried out. We divided the patient population into Group A (42 patients), who underwent the new technique, and Group B (107 patients), who experienced the crushing clamp technique. A second analysis was performed, where we divided the same patient population group in Group 1 with age less than 65, and Group 2 including patients older than 65 years. RESULTS: We found that the new technique reduced length of stay, procedure length, and use of perioperative blood. We determined that the two age groups performed similarly in comparison to LOS, length of procedure, blood use, and complications. CONCLUSION: This enforces the fact that the elderly can receive such surgical treatment without hesitation.

Aged↗
PubMed1987

Mechanisms of healing in the injured lung treated with the Nd-YAG laser.

An experimental study was done to evaluate the pattern of healing after sealing an incision in the pulmonary parenchyma with the Nd-YAG laser. Gross and histologic examinations of healing were compared with those of lung cauterized or sutured with chronic catgut. The results indicate that the use of the Nd-YAG laser to seal small vessels and air leaks has distinct advantages over cautery or suture closure of incisions in pulmonary tissue.

Animals↗
PubMed1978

The importance of cauterization to maintain a healthy cervix. Long-term study from a private gynecologic practice.

A total of 13,897 patients from a private gynecologic practice were retrospectively analyzed with special regard to the benefits obtained from hot linear cautery. This has been performed as an office procedure since 1937, providing unique long-term follow-up. The exposed cervical transitional zone and mild, atypical, or dysplastic cervical cytology were so treated in 6,364 patients. A significantly higher percentage of carcinoma in situ and invasive disease was found in the noncauterized cervices. With the trend of cervical intraepithelial neoplasia (CIN) toward development at an earlier age in today's population, the importance of office cauterization in preventing cervical cancer becomes apparent.

Adolescent↗
PubMed1986

A comparison of three techniques for ovarian reconstruction.

We compared three methods of ovarian reconstruction in 23 mature female New Zealand White rabbits. Each animal was its own control. The right ovary in each rabbit was incised and repaired by placing three 8-0 nylon sutures through and through the base of the defect (method A). The left ovary was repaired without these through-and-through sutures. In 16, hemostasis was achieved by microbipolar cautery (method B); in seven, hemostasis was achieved with three sutures placed entirely inside the defect (method B1). The cortex of each ovary was repaired identically by continuous 8-0 nylon suture. Outcome was evaluated by laparoscopy 14 days after mating. Through-and-through sutures (right ovary) caused a significant increase in adhesion formation and decrease in nidation index. When these animals were put to death 14 weeks later, the right ovaries were significantly smaller. On the left, there was no difference in any outcome variable between methods B and B1. This study clearly shows the detrimental effect of through-and-through sutures for ovarian reconstruction.

Animals↗
PubMed1996

[Epistaxis in children].

Most epistaxis in children come from the anterior part of the nasal septum. The bleeding is usually under control by manual compression or vestibular packing with a piece of cotton or calcium alginate. In case of severe or recurrent epistaxis, one must look for a bleeding disorder or a nasal/nasopharyngeal tumour, especially juvenile nasopharyngeal angiofibroma in adolescent males. Chemical or electrical cautery of the septum should be suggested in case of recurrent idiopathic epistaxis. When bleeding continues despite such treatments, anterior nasal packing is recommended; life-threatening epistaxis usually requires posterior packing. Embolisation can be used to reduce blood supply before surgery in case of haemorragic tumours or vascular malformations.

Cautery↗
PubMedDate not supplied

Application of potassium-titanyl-phosphate (KTP) laser in the excision of pyriform fossa hemangioma.

Pyriform fossa hemangioma, especially of the cavernous type, is a rare case and very few such lesions have been encountered in general otolaryngological practice. We report such a lesion in a 36-year-old, middle-aged woman presenting with complaint of foreign body sensation in the throat. Examination revealed a hemangioma in the right pyriform fossa that was successfully managed using KTP-532 laser and bipolar cautery.

Adult↗
PubMed2004

Subchondral giant-cell tumor of the proximal tibia: arthroscopic treatment for accelerated articular cartilage and meniscal degeneration in two patients.

Giant-cell tumor most commonly occurs in the distal femur and proximal tibia and characteristically involves the subchondral bone. Incomplete resection leads to recurrence rates of up to 50%. Intralesional curettage, adjuvant treatments, and polymethyl methacralate (PMMA) reconstruction is the current mainstay of treatment and has produced recurrence rates of less than 10%. Achieving adequate curettage while preserving the articular cartilage of the tibial plateau poses a significant challenge, especially when the tumor involves the subchondral bone. We report on 2 cases, both with symptomatic full-thickness tibial articular cartilage loss and one with a meniscal tear, after curettage, phenol cautery, and PMMA reconstruction of giant-cell tumor of the proximal tibia. Arthroscopic chondroplasty and planing of the exposed cement was performed in both cases, theoretically reducing focal areas of stress concentration that could lead to further meniscal damage and injury to the femoral condyle articular surface in weight-bearing. Partial meniscectomy for a complex meniscal tear was performed in one case. Eighteen months postoperatively, both patients were asymptomatic, working full-time, and participating in light physical activity. Repetitive heavy loading of the knee, such as running, was prohibited, and long-term follow-up is warranted to assess for further joint degeneration and need for total knee arthroplasty.

Adult↗
PubMed2006

QT dispersion in non-apneic simple snoring patients and the effect of surgical therapy on QT dispersion.

AIM: Increased QT dispersion in cases of obstructive sleep apnea, which may induce serious arrhythmias, is a well-known process. However, there is little information about the QT dispersion in patients with simple snoring without apnea. We investigated QT dispersion in snoring and the effect of surgical therapy on QT dispersion. METHODS: One hundred and sixty two patients with simple snoring without apnea were included in this study. Patients had polysomnography and surface electrocardiography (ECG) on the pre-operative 1st week and post-operative 4th week. The patients underwent one of the three surgical procedures, which include uvulopalatopharyngoplasty, laser assisted uvulopalatoplasty, and cautery assisted uvulopalatoplasty. QT dispersion was calculated in each patient from pre-operative and post-operative surface ECG. Pre-operative and post-operative values were compared using the student's t test. P<0.05 was considered statistically significant. RESULTS: One hundred and fourteen of the patients were male, 48 were female, and the mean age was 35.2+/-14.1 years (range: 21-51). No improvements were observed in 9 of the patients. Surgical interventions were successful in 153 patients (94%). Post-operative QTc max and QTc dispersion values were significantly shortened, and QTc min was increased compared to the pre-operative values (449.6+/-6.2 vs. 440.9+/-20.8, and 68.2+/-8.4 vs. 43.8+/-6.2, and 381.3+/-7.8 vs. 397.0+/-5.9 respectively; P=0.001). CONCLUSION: This study shows that QT dispersion is increased in simple snoring patients without apnea and that QT dispersion decreases after surgical interventions.

Adult↗
PubMed1977

A two-year experience with the Falope ring sterilization procedure.

The use of cautery laparoscopic sterilization procedures has two major disadvantages: (1) occasional inadvertent thermal injury to organ structures other than the Fallopian tube and (2) the inability to limit the injury to the Fallopian tube in a manner that might allow subsequent reconstructive surgery. In an effort to avoid the use of thermal energy to effect female sterilization, the Falope ring laparoscope was developed. From October, 1973, through September, 1975, 4,390 sterilization procedures were completed employing this approach; 902 cases have been completed at the Woman's Clinic of the Johns Hopkins Hospital, 1,741 cases were completed by gynecologists in various cities in the United States, and 1,747 procedures were completed by physicians in various locations throughout the world sponsored by the International Fertility Research Program.

Cautery↗
PubMed1997

Lacrimal punctal occlusion for the treatment of superior limbic keratoconjunctivitis.

PURPOSE: To test the hypothesis that superior limbic keratoconjunctivitis is caused by insufficient tear supply to the superior keratoconjunctiva. METHODS: We used cautery and sutures to permanently occlude the lacrimal puncta of 11 patients (22 eyes) with superior limbic keratoconjunctivitis for whom topical treatment was ineffective. RESULTS: All 11 patients (22 eyes) responded favorably to lacrimal punctal occlusion. After lacrimal punctal occlusion, rose bengal and fluorescein staining (both on a scale of 0 [no staining] to 9 [complete staining]) were reduced (mean +/- SD, 2.7 +/- 1.6 to 1.1 +/- 1.8 and 1.4 +/- 1.2 to 0.4 +/- 0.8, respectively). Impression cytology disclosed improvement of squamous metaplasia in the superior conjunctiva as well as increased goblet cells in nine of 13 eyes (69%) examined. Subjective symptoms improved in all 22 eyes (100%). CONCLUSIONS: Improvement of local tear deficiency to the superior limbic portion by punctal occlusion was an effective treatment in this small series. Superior limbic keratoconjunctivitis might be caused by the insufficient local tear supply.

Adult↗
PubMed1980

Thermal wedge with penetrating keratoplasty to reduce high corneal cylinder.

I devised a new technique using a thermal wedge resection at the time of keratoplasty to reduce excessive amounts of corneal astigmatism. Surface cautery was used to draw this thermal wedge of corneal tissue into the area to be trephined, and removed at surgery from the patient's cornea. The final result was the same as combining a surgical tissue wedge resection with keratoplasty. This new technique has resulted in reduction of the astigmatic error by as much as 8.5 diopters.

Adult↗
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↗
PubMed1996

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↗
PubMed1999

Computer-controlled bipolar endotubal sterilization is successful in a rabbit model.

OBJECTIVE: To determine the efficacy of a computer-controlled bipolar endotubal catheter system designed to accomplish safe, effective, and inexpensive female sterilization in preventing pregnancy in a rabbit model. DESIGN: Prospective controlled study. SETTING: University animal care facility. ANIMAL(S): Sixty healthy virginal female New Zealand white rabbits. INTERVENTION(S): Rabbits were assigned to the following groups: [1] endotubal radiofrequency minimal energy (95 degrees C) treatment; [2] endotubal radiofrequency maximal energy (105 degrees C) treatment; [3] endouterine radiofrequency (105 degrees C) treatment; [4] nonsurgical control; [5] laparotomy-only control; [6] endotubal radio-frequency sham control; and [7] external Kleppinger forceps bipolar cautery control. Rabbits were mated at 4 or 12 weeks after treatment. MAIN OUTCOME MEASURE(S): Pregnancy outcomes in treated animals and nontreated controls. RESULT(S): No pregnancies were observed in any of the uterine horns in which minimal or maximal energy was delivered to the fallopian tubes or uterus, although pregnancy occurred in one horn as a result of the delivery of energy below the radiofrequency minimum of 95 degrees C. The outcomes of the treatment groups were significantly different from those of the nonsurgical and sham surgical control groups. CONCLUSION(S): With adequate tissue heating, 100% sterilization efficacy was achieved with a new, computer-controlled bipolar catheter, whereas pregnancies occurred in all untreated control groups. If human studies support these results, the goal of a safe, effective means of transcervical sterilization may be realized.

Animals↗
PubMed1998

Major hemorrhage in children with idiopathic thrombocytopenic purpura: immediate response to therapy and long-term outcome.

OBJECTIVES: We retrospectively characterized children with idiopathic thrombocytopenic purpura (ITP) who had major hemorrhage to determine response to therapy and long-term outcome. STUDY DESIGN: We reviewed the medical records of 332 children with ITP diagnosed at our center during the last 10 years for occurrence of major hemorrhage, defined as (1) intracranial hemorrhage, (2) epistaxis requiring cautery or nasal packing, (3) gross hematuria, or (4) other bleeding causing a decline in hemoglobin concentration. RESULTS: Of 332 patients with ITP, 58 (17%) had 68 episodes of major hemorrhage; 56 of these episodes were treated with corticosteroids, intravenous immunoglobulin, or both. The platelet count rose to > or =20,000/mm3 within 24 hours after presentation after only 18% of evaluated events, and 28% of patients with major hemorrhage still had a platelet count <20,000/mm3 after 7 days. Twenty-seven of 49 patients available for evaluation had resolution of ITP within 6 months, 21 had chronic ITP, and 1 died of sepsis. CONCLUSIONS: We observed that 17% of children with ITP had major hemorrhage. Only a minority of these patients had an immediate rise in platelet count after receiving intravenous immunoglobulin, corticosteroid treatment, or both. Prospective studies of childhood ITP focusing on short-term outcome variables in addition to platelet count should be performed to better define optimal treatment for each affected child.

Adolescent↗