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At least 1,027 records · Page 57Linked to original sources
PubMed1991

Colposcopically directed punch biopsy: a potentially misleading investigation.

OBJECTIVE: To determine the relation between the histology of an initial colposcopically directed punch biopsy and a subsequent diathermy loop excision biopsy of the transformation zone, and the effect of lesion size on this relation. DESIGN: Prospective observational study of loop diathermy excision biopsies of the cervical transformation zone. SETTING: Academic unit colposcopy clinics at The Birmingham and Midland Hospital for Women and Dudley Road Hospital, Birmingham. SUBJECTS: 243 women managed by colposcopy and directed punch biopsy followed by loop diathermy excision. OUTCOME MEASURES: The histology of the punch biopsy and the excised transformation zone and the size of the abnormal lesion. RESULTS: In 132 (54%) of the 243 women the histology of the punch biopsy and loop excision specimen did not agree. In 62 (47%) of these 132 women a more severe lesion was found in the excised transformation zone, including three unsuspected adenocarcinoma in situ and one stage Ia1 cancer. In 39 (41%) of the 96 women in whom a lesion of CIN 3, or greater severity, was found in the loop excision specimen, the paired punch biopsy had suggested a lesion of lesser severity. In small area lesions, the punch biopsy was more likely to show more severe disease than the loop excision specimen (P = 0.0014). CONCLUSIONS: The results suggest that directed punch biopsy is an inadequate endpoint by which to judge the severity of an epithelial lesion. The findings have important implications for patient management and the design of trials and cast doubt on the results of studies using punch biopsy as an endpoint.

Biopsy↗
PubMed1998

Factors affecting the outcome of laparoscopic ovarian drilling for polycystic ovarian syndrome in women with anovulatory infertility.

OBJECTIVE: To describe and analyse the factors affecting the pregnancy rate of laparoscopic ovarian drilling for polycystic ovarian syndrome in women with anovulatory infertility. DESIGN: A retrospective study. SETTING: A specialist infertility clinic based at a teaching hospital in England. POPULATION: One hundred and eighteen women, for whom hospital records and follow up data were available, with polycystic ovarian syndrome who underwent laparoscopic ovarian surgery for anovulatory infertility over a five year period, between January 1991 and December 1995. MAIN OUTCOME MEASURES: Ovulation and pregnancy rate. RESULTS: The cumulative conception rate 12 months after the treatment was 54%. Women who conceived following the surgery had a shorter duration of infertility, were treated with diathermy (rather than laser), had higher pre-operative luteinising hormone levels, were younger and were more likely to have ultrasonographic evidence of polycystic ovarian disease. Logistic multiple regression analysis showed that the duration of infertility, modality used in treatment (laser or diathermy) and the pre-operative levels were the main determinants of the outcome. CONCLUSION: Women with polycystic ovarian syndrome respond favourably to laparoscopic ovarian drilling. The success rate in women with infertility duration of less than three years, treated with diathermy, in whom the pre-operative level was more than 10 IU/L reached 79%.

Adult↗
PubMed2006

Systematic review of the safety of electrosurgery for tonsillectomy.

In the meta-analysis models, compared with cold steel dissection with ties/packs haemostasis (reference technique): * Bipolar diathermy dissection and haemostasis was associated with statistically significant lower odds of primary haemorrhage (OR 0.13, 95% CrI 0.03 to 0.51), including primary haemorrhage requiring return to theatre (OR 0.002, 95% CrI <0.001 to 0.26). * Coblation was associated with statistically significant higher odds of secondary haemorrhage requiring return to theatre (OR 33.82, 95% CrI 1.25 to 5676.00). * Monopolar and bipolar diathermy dissection and haemostasis (OR 4.12, 95% CrI 1.12 to 14.67; OR 2.86, 95% CrI 1.12 to 8.02, respectively), coblation (OR 3.75, 95% CrI 1.29 to 12.12), and cold steel dissection with monopolar or bipolar diathermy haemostasis (OR 4.83, 95% CrI 1.56 to 15.95; OR 9.18, 95% CrI 3.09 to 30.53, respectively) were all associated with statistically significant higher odds of secondary haemorrhage. * In deciding which technique to employ, factors to consider include patient characteristics, the underlying risk of primary or secondary haemorrhage, which is regarded as likely to be more serious, and the clinical significance of the observed differences in haemorrhage rates across techniques.

Electrocoagulation↗
PubMed1980

Electrosurgery and wound healing: an experimental study in rats.

Many surgeons are hesitant in the use of electrocautery on the gastrointestinal tract. The aim of the present study is to compare wound healing following incisions made by scalpel and diathermy in the rat. Healing was assessed by bursting strength measurements and histology. This study revealed no difference in strength by bursting measurements between scalpel and diathermy incision. Histologically there is not a lag in healing in the gastrointestinal tract following electroincision. It is concluded that in abdominal surgery, diathermy can be used without detriment to the strength of any suture line and with no difference in its final healing.

Animals↗
PubMed1992

Surgical techniques and visual prognosis in retinal detachment due to macular hole.

In 250 eyes with retinal detachment due to macular hole, the visual prognosis of each surgical technique was evaluated. (1) Macular diathermy adversely affected the visual prognosis. (2) Macular buckling+macular diathermy produced a poorer visual prognosis than macular buckling alone. (3) The visual prognosis resulting from gas tamponade alone or vitrectomy+gas tamponade was better than that resulting from macular diathermy. It is not clear whether there is a significant difference in visual prognosis between gas tamponade alone and vitrectomy+gas tamponade. (4) Macular laser photocoagulation does not adversely affect the visual prognosis. Judging from these results, gas tamponade, which has the possibility of better visual prognosis and less operation stress, should be selected as the initial technique.

Electrocoagulation↗
PubMed2001

Swiftlase assisted CO2 laser ablation in the treatment of nasal obstruction due to hypertrophy of the inferior turbinates.

Hypertrophy of the inferior turbinates are the major cause of nasal obstruction. CO2 lasers have been used to reduce the size of the inferior turbinates over the last 20 years. However, the many techniques of delivery of the laser show that there is no one standard method reducing the size of the turbinates. We now describe how the laser can be applied directly to the turbinates using a handpiece with a special nasal tip, thus overcoming the disadvantages delivery via arthroscopic devices, microscopes and fibers. This technique is further enhanced by coupling it with Swiftlase which swirls the focused beam in a 3 mm spot thus ablating tissue more quickly. This procedure is done under local anaesthesia. The ablation of the anterior third of the inferior turbinates effectively overcomes nasal obstruction. This new method was compared to the more traditional submucus diathermy. 22 patients were subjected to laser treatment whilst 20 patients were subjected to diathermy. The outcome was evaluated subjectively by the patients themselves at 2 weeks, 3 months and 6 months. At the end of the study, the laser group reported a more significantly improved nasal airway (91% against 75%) and decreased rhinorrhea (72.7% against 35%) when compared to the diathermy group.

Adolescent↗
PubMed1978

[Drainage of subretinal fluid: technic and results].

The drainage of subretinal fluid (S.R.F.) after choroidal diathermy offers a distinct advantage: important reduction of massive haemorrhages from the drainage site (4% vs 48% in the non diathermy group in our series). According to us it is not a decisive factor for the anatomical prognosis because complications of drainage in themselves seem to be a quite infrequent cause of anatomical failure. On the other hand we think that visual outcome is better in the diathermy group because of a diminution of macular haemorrhages.

Choroid↗
PubMed1995

[A new surgical technique in congenital cataracts for prevention of regenerated cataract. Controlled central excision of capsular leaves with endodiathermy coagulation of the capsular sac periphery].

Inherent in all operative methods of congenital cataract surgery with the aim of preserving the posterior leaf of the capsule is the risk of recurrence. Even after phakectomy of the pars plicata, secondary cataract can occur in the peripheral remains of the capsule, and this method also entails the risk of retinal detachment and loss of the capsule diaphragm, which would otherwise allow subsequent IOL implantation. We developed a new surgical technique to preserve the peripheral capsular sac and to avoid secondary cataract within the optical axis. Unipolar diathermy coagulation was applied to the anterior peripheral leaf of the capsule, provided that both leaves of the capsule were touching when slight pressure was applied to the probe. In preliminary studies of autopsy eyes, fusion of the capsular leaves was clearly apparent, even if the lens epithelium was not morphologically destroyed by diathermy coagulation. These were 42 eyes with congenital cataract (12 children with bilateral cataract, 9 eyes with mild anterior PHPV syndrome). Their ages were between 4 weeks and 8.5 years and the period from April 1988 to December 1992; follow-up was 1 to 4.5 years: 36 eyes, 6 eyes with PHPV. The following operation was undertaken in the children. After central anterior capsulectomy and aspiration of the lens, the anterior and posterior leaves of the capsular sac were fused circularly at the periphery by unipolar endodiathermy coagulation. The posterior chamber was deepened by viscoelastic substance allowing diathermy application at the anterior capsule with risk.(ABSTRACT TRUNCATED AT 250 WORDS)

Cataract↗
PubMed1989

Use of the carbon dioxide laser in the drainage of subretinal fluid.

Hemorrhage and retinal perforation are two sight-threatening complications associated with techniques employed to drain subretinal fluid in rhegmatogenous retinal detachment. We hypothesized that the carbon dioxide (CO2) laser would reduce these complications because of its cauterizing action and high absorption in water. The CO2 laser was compared with a conventional technique of using a penetrating diathermy electrode to drain subretinal fluid in rabbits with experimentally detached retinas. No hemorrhage occurred in 223 drainage trials using the CO2 laser, whereas hemorrhage occurred in 21 (4.8%) of 434 trials using the penetrating diathermy electrode. Furthermore, a depth of saline of only 45 microns protected the retina from perforation at CO2 laser dose adequate for drainage. These results indicate that further evaluation of the CO2 laser in treating human retinal detachment is warranted.

Animals↗
PubMed1990

Surgical techniques and reattachment rates in retinal detachment due to macular hole.

We evaluated reattachment rates of the transvitreal and transscleral techniques for treating 250 eyes with retinal detachment due to macular hole. The initial success rate of the transvitreal approach was 56% (53/94). There was no difference between the results of gas tamponade alone and vitrectomy and gas tamponade. The initial success rate of the transscleral approach was 83% (130/156). Macular diathermy and macular buckling showed a higher reattachment rate than macular diathermy alone. The final success rates were the same (95%), regardless of which approach was selected as an initial technique. The patients whose initial transvitreal reattachment failed and who underwent additional transvitreal procedures (including macular laser photocoagulation) showed a success rate of 93%. We believe that gas tamponade, which has possibility of better visual prognosis, should be selected as an initial technique because the final success rate was found to be the same regardless of the initial surgical techniques.

Diathermy↗
PubMed1984

Electromagnetic heating of tissue-equivalent phantoms with thin, insulating partitions.

The electromagnetic power absorption in tissue-equivalent phantoms that are used for evaluation of diathermy and hyperthermia applicators is analyzed for the purpose of determining the effect of an insulating partition that is frequently used to facilitate separation of the phantom for thermographic analysis of heating distributions. An analysis that is based on the plane wave spectrum decomposition of the electromagnetic field is applied to a simplified model of the medium. The simplified model is valid whenever the insulating partition does not significantly alter the fields in the medium. The curves that are presented indicate that thin partitions do not significantly alter the power absorption for most situations of therapeutic interest. Data on the effects of partition thickness and electrical parameters are presented for microwave and radiofrequencies of interest for diathermy and hyperthermia.

Adipose Tissue↗
PubMed1986

Monitoring middle cerebral artery blood velocity during carotid endarterectomy.

Transcranial pulsed Doppler ultrasound and spectral analysis were used to monitor blood velocities in the middle cerebral artery of nineteen patients (mean age 61 +/- 9 years) during carotid endarterectomy. A Javid shunt was used in all patients. The intensity weighted mean Doppler frequency for each spectral sweep (at 5 ms intervals) was time-averaged over the cardiac cycle to obtain a mean value for blood velocity in the middle cerebral artery. The range of such values found in the 19 patients was: 12-38 cm s-1 after anaesthesia (baseline); 12-69 cm s-1 during diathermy; 0-30 cm s-1 during carotid clamping; 16-32 cm s-1 during shunting and 18-60 cm s-1 in the recovery room. The average change in middle cerebral artery blood velocity from baseline values showed significant increases during diathermy (P less than 0.005), shunting (P less than 0.05) and in the recovery room (P less than 0.005). Clamping of the internal carotid artery showed a significant decrease in middle cerebral artery blood velocities of all patients (P less than 0.005), three of whom showed no flow in the middle cerebral artery during clamping. Abnormally high amplitude Doppler signals at the commencement of shunting were detected in 17 of the 19 patients. Such Doppler signals are consistent with turbulent blood flow or the introduction of micro-air bubbles by the shunt. Backbleeding in the internal carotid artery before insertion of the shunt was associated with diminished flow in the ipsilateral middle cerebral artery of ten patients, oscillatory forward/reverse flow in three patients and cessation of flow in the remaining six patients.

Adult↗
PubMed1979

Long-term effects of interval laparoscopic sterilization by bipolar electrocoagulation on menstruation.

We studied the menstrual patterns of 258 patients before and after laparoscopic sterilization by bipolar diathermy. The observed changes were obtained were mainly related to the kind of contraception used before sterilization. The frequency of menstrual disorders after sterilization were compared to those in a control group of non-sterilized women matched for age and parity: 12--42 months after the operation, the sterilized women did not have more irregular cycles, menorrhagia, metrorrhagia, hysmenorrhea or dyspareunia than the control group but the sterilized women did have a slightly higher incidence of polymenorrhea (p less than 0.05) and menses lasting less than 3 days (p less than 0.01). We conclude that interval laparoscopic sterilization by bipolar diathermy can be recommended for patients with normal menstrual cycles.

Adult↗
PubMed2006

Attenuation of muscle damage by preconditioning with muscle hyperthermia 1-day prior to eccentric exercise.

This study investigated the hypothesis that muscle damage would be attenuated in muscles subjected to passive hyperthermia 1 day prior to exercise. Fifteen male students performed 24 maximal eccentric actions of the elbow flexors with one arm; the opposite arm performed the same exercise 2-4 weeks later. The elbow flexors of one arm received a microwave diathermy treatment that increased muscle temperature to over 40 degrees C, 16-20 h prior to the exercise. The contralateral arm acted as an untreated control. Maximal voluntary isometric contraction strength (MVC), range of motion (ROM), upper arm circumference, muscle soreness, plasma creatine kinase activity and myoglobin concentration were measured 1 day prior to exercise, immediately before and after exercise, and daily for 4 days following exercise. Changes in the criterion measures were compared between conditions (treatment vs. control) using a two-way repeated measures ANOVA with a significance level of P < 0.05. All measures changed significantly following exercise, but the treatment arm showed a significantly faster recovery of MVC, a smaller change in ROM, and less muscle soreness compared with the control arm. However, the protective effect conferred by the diathermy treatment was significantly less effective compared with that seen in the second bout performed 4-6 weeks after the initial bout by a subgroup of the subjects (n = 11) using the control arm. These results suggest that passive hyperthermia treatment 1 day prior to eccentric exercise-induced muscle damage has a prophylactic effect, but the effect is not as strong as the repeated bout effect.

Adult↗
PubMed1986

The effect of treatment on experimentally produced endometrial peritoneal implants.

Endometriosis was induced surgically by implanting pieces of endometrium in the uterine mesenteries of 50 rats. Their fertility was then assessed after various treatments. Ten rats with endometriosis were treated with microsurgical excision of implants, 10 with high-frequency diathermy, 10 with danazol, and 10 with intraperitoneal indomethacin. Ten more rats had implants that were left untreated. The results were compared with those of ten rats that had sham surgery with implantation of fat in the uterine mesenteries. Reproductive performance was better in control animals with sham surgery than in animals with endometrial implants. Maximum restoration of fertility was achieved with indomethacin. Microsurgery and danazol therapy both were effective in preventing residual endometriosis, but the animals tended to be less fertile after treatment. Adhesions were most pronounced after diathermy and least pronounced after microsurgery or indomethacin therapy. In rats treated with indomethacin, persistent endometriotic cysts were invariably smaller near the site of intraperitoneal injection: this suggests a local antiprostaglandin effect.

Animals↗
PubMed1975

Late complications of sterilisation by laparoscopy and tubal ligation. A controlled study.

The frequency of late sequelae in 454 patients sterilised by laparoscopy and diathermy or by abdominal tubal ligation was compared with that in 154 controls whose husbands had had a vasectomy. Results showed an increase in menstrual loss and pain with menstruation in the sterilised groups, especially if this had been done by diathermy and division under laparoscopic control.

Adult↗
PubMed1991

Epilation of upper lip hirsutism with a eutectic mixture of lidocaine and prilocaine used as a topical anesthetic.

Twenty-one patients were included in a double-blind, placebo-controlled, cross-over study with a eutectic mixture of lidocaine and prilocaine (EMLA). EMLA or placebo was placed on the upper lip for 1 hour; diathermy was then performed for 10 minutes. The pain caused by diathermy was evaluated by the patients and the cosmetologist on a four-point scale. The results of the investigation showed that there was significantly less pain after application of 5 gm of EMLA cream on the upper lip than after application of placebo, assessed both by the patient and by the cosmetologist. Eighteen of 20 patients preferred EMLA (p less than 0.0001). Local reactions were few and mild.

Adult↗
PubMed1983

The performance of a new 915-MHz direct contact applicator with reduced leakage.

The technical feasibility of commercially developing a safe and effective direct contact diathermy applicator operating at the industrial, scientific, medical (ISM) frequency of 915 MHz is demonstrated. The basic design consists of a circular waveguide which is internally loaded with two orthogonal pairs of forward ridges to obtain circular polarization and two rear ridges with a probe to excite the guide. Two prototype designs are considered: the small applicator (15 cm diameter) has one annular choke covered with a 2.5-cm thick microwave absorber, and the large applicator (25 cm diameter) has two additional concentric chokes to limit leakage radiation. The performance of the applicators was evaluated in terms of the requirements of a ORH microwave diathermy test protocol to control stray radiation and deliver a thermally effective absorbed dose rate to simulated muscle tissue of a phantom with a 1-cm or 2-cm fat layer. The net power required to deliver a thermally effective 235-W/kg specific absorption rate (SAR) to such a planar phantom was determined. For this net power, leakage levels considerably less than 5 mW/cm2 (at 5 cm from applicator-phantom boundary) were obtained for the applicators in direct contact with the phantom. If a small spacing (1 cm) between these applicators and planar phantoms is introduced, the net power required to deliver an effective SAR to a phantom and the associated leakage can become excessive. For the small applicator, the required net power for inducing an SAR of 235 W/kg in muscle tissue of a 1-cm fat layer phantom is about 330 W and the leakage is about 120 mW/cm2. For a 2-cm fat layer phantom, these values are somewhat higher. For the large applicator, using a 1-cm fat layer phantom, the values are about 200 W and about 17 mW/cm2. Again, for a 2-cm fat layer phantom, these values are somewhat higher.

Diathermy↗