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At least 991 records · Page 55Linked to original sources
PubMed1983

Adriamycin permeability of the rat bladder under different conditions.

Fifty female Sprague-Dawley rats were treated with 1.4 or 2.4 mg. adriamycin intravesically. Radioimmunological measurement of serum concentrations were performed up to 3 hours post-instillation in normal bladder mucosa, cystitis, and after electrocoagulation, under different filling conditions, as well as with the use of a detergent (Tween 80). The serum concentrations achieved were markedly higher after electrocoagulation or cystitis; altogether they reached only 1/6,000 of the instilled concentration. These studies on the rat bladder suggest that perioperative instillation of adriamycin to prevent recurrence is not contraindicated shortly before or after transurethral resection (TUR) of superficial bladder tumors.

Absorption↗
PubMed1999

An experimental model of bulbar urethral stricture in rabbits using endoscopic radiofrequency coagulation.

OBJECTIVES: To develop an experimental model of endoscopic urethral stricture mimicking the human clinical situation. METHODS: Twenty-four New Zealand male rabbits were included. Eighteen animals (study group) underwent videourethroscopy with a pediatric resectoscope, and a 3 to 5-mm-long circumferential electrocoagulation of the bulbar urethra was performed, without postoperative urinary diversion. Six animals underwent the same procedure without application of electrocautery (control group). Each animal was assessed for urethral stricture on day 15 and day 30 by videourethroscopy and voiding cystogram. Among the study group, 8 animals were killed on day 15 and 10 on day 30 for histologic evaluation. All the control animals were killed on day 30 for histologic examination. RESULTS: Nine animals (50%) in the study group developed a significant bulbar stricture (reducing the lumen by more than 50%) at day 15. Histologic examination confirmed the presence of hyalin fibrosis mutilating the urethral wall. No spontaneous improvement of the stricture was observed on day 30. None of the controls developed urethral stricture, and histologic examination showed a normal urethra in each case. CONCLUSIONS: Endoscopic electrocoagulation of the urethral wall provides a reproducible model of stricture in the rabbit.

Animals↗
PubMed2002

Uterine dehiscence in a nullipara, diagnosed by MRI, following use of unipolar electrocautery during laparoscopic myomectomy: Case report.

Uterine scar dehiscence following laparoscopic myomectomy (LM) is a rare event. We present a case of an magnetic resonance imaging-diagnosed uterine dehiscence in a primigravid patient at 29 weeks gestation, following a laparoscopic subserosal myomectomy, performed using unipolar electrocoagulation. Pregnant patients with a history of prior surgery where unipolar electrocoagulation is used on the uterus should be closely followed throughout pregnancy and uterine dehiscence or rupture should be part of the differential diagnosis when they present with abdominal pain.

Adult↗
PubMed1997

Argon plasma coagulation (APC) in gastroenterology: experimental and clinical experiences.

BACKGROUND: Diathermy procedures are indispensable in interventional endoscopy. Argon beam coagulation is an innovative no-touch electrocoagulation technique in which high-frequency alternating current is delivered to the tissue through ionized argon gas. METHOD AND PATIENTS: Before clinical application, we conducted in-vitro studies to investigate the depth and diameters of tissue coagulation in fresh operative specimens from the stomach, small intestine and colon. Five different power/gas flow settings between 40 and 155 W and 2 and 7 l/min were used. The impact time (1-10s) and the incident angle of the probe (45 degrees and 90 degrees) were also varied. The maximum depth of necrosis was 2.4 mm, the maximum diameter 1.1 cm. No perforation occurred even in critical areas such as the colon and duodenum. We therefore performed argon beam coagulation in 66 consecutive patients. Two power/gas flow settings of 40 and 70 W and 2 and 3 l/min, respectively, were used. The impact time and incident angle were varied individually. RESULTS: In 49 of the 50 patients with oozing haemorrhage from angiodysplastic lesions, polypectomy sites, erosions or ulcers or oozing of blood due to vascular penetration by tumours, definitive haemostasis was achieved in one to two sessions. In all 11 patients with residual sessile adenoma tissue, complete removal was possible. Oesophageal patency was restored in all five patients with stenosing tumours. In one patient with angiodysplasia of the caecal pole, an asymptomatic accumulation of gas in the submucosa was observed which resolved spontaneously. In two patients with extensive oesophageal carcinoma, there was a transitory--also asymptomatic--accumulation of gas in the mediastinum and peritoneal cavity but no evidence of perforation. CONCLUSION: Argon plasma electrocoagulation is an effective and relatively low-cost alternative to laser therapy in gastrointestinal endoscopy.

Adenoma↗
PubMed2003

The use of halofuginone in limiting urethral stricture formation and recurrence: an experimental study in rabbits.

PURPOSE: We developed a reproducible animal model for the induction of urethral stricture in the rabbit and evaluated the role of halofuginone in limiting stricture formation. MATERIALS AND METHODS: A total of 20 New Zealand male rabbits were used in the first phase of the experiment. Bulbar urethral stricture was induced by electrocoagulation. The animals were then randomly assigned to 2 groups of 10 each, which received a diet containing halofuginone or a normal diet. In the second phase electrocoagulation induced stricture was treated with visual internal urethrotomy in 45 rabbits. These rabbits were randomly assigned to 2 groups, namely a halofuginone and a control group. RESULTS: In the first phase stricture developed in 2 study rabbits (20%) vs 10 controls (100%). In the second phase 37 rabbits were evaluable (8 died). Recurrent stricture was observed in 5 of the 18 study rabbits (27%) vs 14 of the 19 controls (73%). CONCLUSIONS: Halofuginone is effective in limiting the occurrence of de novo urethral stricture and recurrent stricture after visual internal urethrotomy. This antifibrotic molecule may become an important therapy to treat urethral stricture and/or recurrence following endoscopic manipulation of stricture in humans.

Administration, Oral↗
PubMed2005

Randomized trials in the treatment of Barrett's esophagus.

Treatment for Barrett's esophagus (BE) has consisted of medical treatment (acid suppression medications), surgery (fundoplication) and endoscopic ablative techniques (photodynamic therapy, argon plasma coagulation and multipolar electrocoagulation). Despite the large number of clinical trials of the efficacy of different therapeutic modalities, there is a paucity of published randomized controlled trials. The aim of this review is to evaluate the published randomized therapeutic trials in patients with BE. A comprehensive MEDLINE search was performed to review randomized clinical trials of different therapeutic modalities in BE. Only eight randomized studies have been published. The eight randomized studies reviewed include: two trials that evaluated medical and surgical therapy; two placebo controlled trials for photodynamic therapy (PDT); one placebo controlled trial comparing argon plasma coagulation (APC) versus surveillance; two trials comparing PDT versus APC; and one trial comparing APC versus multipolar electrocoagulation (MPEC). All the studies are prospective, however only one study is double-blinded. Each study has a small sample size, uses a different population of BE patients (dysplasia versus no dysplasia, short segment BE versus long segment BE), has different defined endpoints (endoscopic ablation of BE, number of treatments required for endoscopic ablation of BE, and elimination of high grade dysplasia) and the methodology for the treatment modalities is different among the studies. Though the data to support the use of endoscopic ablative techniques in the treatment of BE are promising, more rigorous double-blind and larger, well designed randomized studies are required to draw any definitive conclusions.

Barrett Esophagus↗
PubMed1983

Surgical treatment of recalcitrant warts.

Cryosurgery is the first choice for surgical treatment of viral warts. It is applied in two ways: with blister induction in extraplantar common warts and without blister induction in genital, filiform, and mosaic warts. Plantar and periungual warts are enucleated with a spoon or scraped off with a curet after preparatory focal electrocoagulation with a ball probe. Genital warts may be treated with "extracutaneous" electrosection and electrocoagulation.

Cryosurgery↗
PubMed1989

Blood vessel coagulation for incisional surgery.

Blood vessel electrocoagulation allows the cutaneous surgeon rapid and reliable bleeder control for incisional wounds. The following article discusses the various instruments and techniques used for blood vessel electrocoagulation.

Electrocoagulation↗
PubMed1990

Ablation of the cystic duct and gallbladder: clinical observations.

The cystic duct and gallbladder were ablated in eight patients with acute gallbladder disease who had been treated with minicholecystostomy instead of cholecystectomy because of multiple risk factors. First, endoluminal transcatheter radio-frequency electrocoagulation of the cystic duct was performed under fluoroscopic control, which resulted in complete occlusion in all eight patients. Next, the mucosa of the isolated gallbladder was sclerosed with 95% ethanol and 3% sodium tetradecyl sulfate in one to four sessions; no analgesics were required. The gallbladder volumes of all patients, estimated by means of ultrasound, were 1.5-22 cm3 (average, less than 10 cm3) after a mean follow-up period of 5 months. One patient died of a cerebrovascular accident 15 months after sclerotherapy. In all surviving patients, the gallbladder fistulas are dry and obliterated. These early clinical data indicate that electrocoagulation permits reliable, safe obliteration of the human cystic duct. The authors believe that sclerotherapy of the isolated gallbladder is feasible without toxic effects but that their treatment needs adjustment to achieve complete ablation of the gallbladder mucosa in a shorter period and in all patients.

Aged↗
PubMed1990

Development and progression of uremic changes in the mouse with surgically induced renal failure.

Adult C57BL/6 mice with surgically induced renal failure of 1-15 weeks' duration were examined for the presence of changes caused by the renal failure. Surgery consisted of the electrocoagulation of the entire surface of the right kidney followed 3 weeks later by contralateral nephrectomy. Control groups comprised normal mice as well as sham-operated mice subjected to the right kidney electrocoagulation followed by visualization of the left kidney rather than removal. Results indicate: (1) the surgical procedures to induce renal failure were free of local and systemic infectious complications, (2) moderate to severe degree of renal failure was consistently achieved and remained stable over the study period, (3) significant growth retardation of the renal failure mice was present throughout the study whereas sham-operated mice showed catch-up growth with normal controls by the 3rd week postsurgery, (4) anemia was a very early manifestation of the disease appearing by the 1st week after the induction of renal failure to reach its nadir by the 2nd week; a mild anemia was observed transiently postsurgery in sham-operated mice and ascribed to the renal injury, and (5) renal failure mice were free of visible changes of advanced uremia such as impaired wound healing, bleeding tendency and gross neurological deficits. This new experimental model is proposed as a tool for the study of the pathogenesis and treatment of chronic uremia. While developed to study the immunological disturbances of renal failure, this model could conceivably serve for the study of other abnormalities, anemia in particular.

Anemia↗
PubMed1982

Experimental investigations on the absorption of intravesically instilled mitomycin C in the urinary bladder of the rat.

After ligation of ureters and urethra, male Sprague-Dawley rats were treated over 3 h with either 2 mg mitomycin C (MMC) intravesically (group I), or in conjunction with pre-instillation bladder electrocoagulation (group II) or iatrogenic Escherichia coli/xylene-induced severe cystitis (group III). Vesical absorption of MMC was investigated by measuring serum MMC up to 180 min postinstillation on the basis of a thin agar plate method. There was no statistically significant different with regard to the total amount of MMC absorbed between groups I and II. However, when groups I and III or II and III were compared, a significant differing transvesical absorption was calculated, being higher for the electrocoagulation than for the cystitis group. The possible clinical implication of this finding is discussed in connection with the most recent literature.

Absorption↗
PubMed1996

Ultrastructural study of peripheral nerve injury induced by monopolar and bipolar diathermy.

The effect of unipolar and bipolar electrocoagulation on human and albino rat peripheral nerves was examined by transmission electron microscopy. The greater auricular nerve obtained from operated patients and the femoral nerve of an albino rat were chosen for this study. The nerves were divided into three groups: controls, segments of nerves spot-coagulated with unipolar instruments, and segments of nerves spot-coagulated with bipolar instruments. Significant cell injury, expressed by marked damage of the Schwann cells, was induced by unipolar coagulation in both myelinated and unmyelinated nerves, in humans as well as in the albino rat. However, in bipolar-treated nerves, the Schwann cell architecture remained well preserved in both types of nerves. The results are in favor of bipolar electrocoagulation when applied in areas rich in neurovascular supplies.

Animals↗
PubMed2006

Hot biopsy forceps in the diagnosis of endobronchial lesions.

Electrocoagulation bronchoscopy biopsy forceps may prevent bleeding, but could also impair the quality of the specimens obtained. Patients with endobronchial lesions during bronchoscopy underwent six endobronchial biopsies each with a hot biopsy forceps, alternating between with electrocoagulation ("hot") and without ("cold"). Bleeding was quantified on a scale of 1-4, with 1 being no bleeding. The generator was set on "soft coagulation" mode, with power settings of 40, 60, 80 and 100 W for each group of 10 patients in a sequential fashion. Clinical pathology results were recorded before samples were reviewed by a second, blinded, pulmonary pathologist. A total of 39 patients with 40 endobronchial lesions had six biopsies performed (one patient had only four samples taken), giving a total of 238 biopsy samples. Concordance between hot and cold samples was 92.5% for the clinical pathologist and 87% for the blinded pathologist. Paired analysis suggested lower average bleeding score with the use of hot forceps. Overall bleeding rates for cold and hot biopsies, respectively, were as follows: grade 1: 30.3 and 41.2%; grade 2: 62.2 and 49.6%; grade 3: 7.6 and 9.2%; and grade 4: 0 and 0%. In conclusion, the use of hot biopsy forceps for endobronchial biopsy does not appear to have a negative impact on the pathological samples. Hot biopsy forceps showed a statistically significant reduction in bleeding score, which is unlikely to be of clinical significance.

Adult↗
PubMed1991

Comparative studies using a rigid thoracoscope and fiberoptic bronchoscope to treat spontaneous pneumothorax.

Prior to 1978, the conventional treatment of pneumothorax generally consisted of conservative therapies such as rest, needle puncture, or thoracic cavity drainage; however, when conservative therapies were ineffective or relapse occurred therapeutic approach, 34 percent (11/32) of our patients required a thoracotomy. Consequently, in 1981, we began to use alternative therapies to reduce the need for thoracotomy. In this report, we describe the results of using a rigid thoracoscope and fiberoptic bronchoscope for the treatment of spontaneous pneumothorax. Initially, we treated 31 of 79 patients with a rigid thoracoscope and electrocoagulation therapy. Therapy was effective in 17 (55 percent) of the patients. Only 13 (16 percent) of the 79 patients required a thoracotomy, which represents a 50 percent reduction in incidence. Of the 14 cases in which therapy was ineffective, the major cause of failure was our inability to view a broad thoracic area and treat all blebs with a rigid thoracoscope. Subsequently, we developed a method using a fiberoptic bronchoscope (FB), which allows an unrestricted view of the thoracic area, in combination with electrocoagulation and fibrinogen or thrombin solution (or both) for the treatment of spontaneous pneumothorax. We treated 19 of 39 patients with the FB method. Treatment was effective in 15 (80 percent) of the patients. Only 4 (10 percent) of the 39 patients required a thoracotomy, which is a reduction of over 60 percent in our original incidence.

Adult↗
PubMed1985

Colposcopic, cytological and histological evaluation of the cervical stump 3 years after supravaginal uterine amputation.

Colposcopic, cytological and histological (endocervical curettage) evaluation of the remaining cervical stump was done 3 years after 99 supravaginal uterine amputations performed for benign condition. Peroperative electrocoagulation of the endocervical mucosa had been done in all the patients and postoperative ectocervical electrocoagulation in 39 (39.4%) cases. No active inflammatory, premalignant or malignant changes were detected at the 3-year examination of the cervix. Furthermore, normal adenomatous epithelium had been wholly or partly relaced by squamous epithelium in 89% of the cases.

Adult↗
PubMed1987

Endoscopic control of major ulcer bleeding.

Emergency surgery for bleeding ulcer still carries a significant risk. Moreover, most patients with major ulcer bleeding are poor surgical risks. Non-surgical methods that are safe and reliably control major bleeding are therefore much warranted. The most promising of various non-operative methods under investigation seems to be endoscopic application of heat delivered by laser, heater probe, or electrocoagulation. In the present study monopolar electrocoagulation with a wet probe reliably controlled major ulcer bleeding in 51 (66%) of 77 patients hemodynamically assessed as requiring emergency surgery. The endoscopic success rate in patients with gastric or duodenal ulcer was 76% and 56%, respectively. It was particularly high (87%) in 23 patients, 17 of whom fulfilled clinical criteria of having stress ulcers. The mortality rate in patients with endoscopically controlled bleeding did not differ from that in 190 patients with spontaneous cessation of ulcer bleeding (8% and 6%, respectively), none of which exsanguinated.

Duodenoscopy↗
PubMed2001

[Endoscopic treatment of bleeding gastroduodenal ulcers].

INTRODUCTION: The aim of this study was to assess the extent to which GI endoscopic treatment of bleeding gastroduodenal ulcers is effective and whether it could reduce the need for surgery. METHODS: A retrospective evaluation was carried out. Over a period of three years (1995-1997), 122 patients with bleeding caused by a gastroduodenal ulcer, defined as fresh haematemesis with or without melaena, old haematemesis with melaena or melaena accompanied by a systolic blood pressure below 80 mmHg, underwent emergency GI endoscopy. Endoscopic therapy consisted of either injection therapy or electrocoagulation. RESULTS: Altogether 72 patients received endoscopic treatment. Primary haemostasis was achieved in 94%. Definitive haemostasis after one endoscopic treatment with either injection therapy or electrocoagulation was achieved in 63% and 62%, respectively. Including repeated endoscopic treatment, definitive haemostasis was achieved in 79%. No direct complications of the treatment were observed. DISCUSSION: Endoscopic treatment of bleeding gastroduodenal ulcers is the only alternative to an operation. Endoscopic treatment can reduce the need for surgery, as it was effective in about 80% of the patients.

Adult↗
PubMed1975

[Conservative operations in malignant tumors of the rectum and the sigmoid colon].

The results of treatment in 230 patients with malignant transformation of polyps and villous tumors, carcinoid and cancer of the rectum and sigmoid are reported. The aforementioned tumors were removed by transanal excision, electrocoagulation adn posterior proctotomy. In 33 patients economic operations for rectal cancer were associated with radiotherapy. Late results indicated that after economic resections for rectal cancer in most cases a persistant cure is gained. In malignified polyps, villous tumors and rectal carcinoids electroexcision or electrocoagulation seems to be an adequate procedure. Patients subjected to economic resections need to be examined every month during the first postoperative year, and later once in six months.

Adenocarcinoma↗