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Biomedical subjects

N Jetha

Publications and source records attributed to N Jetha.

15 recordsLinked to original sources

A new type of CO2 laser avoids power density loss due to absorption and the blooming effect by the CO2 gas environment.

The aim of this study was to compare the acute tissue effects of a standard CO2 laser (Ultrapulse 5000) with a new design (Ultrapulse 5000L) that utilizes a different carbon isotope (C13) in the rat uterine horn model. Following laparotomy, measured laser injuries were effected with the Ultrapulse 5000 or Ultrapulse 5000L lasers via a laparoscope using CO2 or air for insufflation. Serial sections of the lesions were, thereafter, obtained to evaluate depth and width of total injury, width of defect and thermal damage zone. When CO2 was used as the insufflating gas, Ultrapulse 5000L laser was associated with significantly deeper lesions compared to the Ultrapulse 5000 system for the two tested pulsed energy levels (P < 0.0001). The width of total injury and thermal damage zone were significantly less with the former laser compared to the latter. The width of the defect was, however, significantly larger with the Ultrapulse 5000L laser for the 200 millijoule pulsed energy level, whereas it was comparable for the 75 millijoule level. When air was used as the insufflation gas, all four parameters of tissue injury were comparable between the two types of laser (P > 0.05). The adverse effects on the CO2 laser beam and the resultant altered tissue effects that occur in a regular CO2 environment are avoided by the use of the Ultrapulse 5000L or an air environment.

Air↗

Removal of the ovarian surface epithelium from the rabbit ovary--a cause of adhesions following a standard injury.

To assess the effect of the removal of ovarian surface epithelium on repair, a standard injury was induced in the ovaries of 10 rabbits. In one ovary the surface cells were denuded, and in the other they were left intact. The effect on adhesion formation was assessed at 12 days. Adhesions were assessed by visual inspection at laparotomy and histological examination of adhesion formation, including a stereological assessment of scar volume. On visual assessment the overall adhesion scores for the denuded ovaries were greater than for the intact ovaries. Histology showed the adhesions were attached only to the site of injury. The Fallopian tube was adherent to 35 and 4% of the denuded and intact ovarian segments respectively (P = 0.003). The scar volumes for each side were similar. After 12 days there was only partial re-epithelialization on the denuded ovaries. Electron microscopy confirmed the slow healing, with much of the surface still covered by a fibrinous-like exudate. The findings of this small study lend further weight to the importance of the surface epithelium in the control of adhesion formation. Standard surgical procedures may generate adhesions by the inadvertent denuding of surface epithelium from adjacent healthy tissues, possibly by the loss of plasminogen activator activity that is found in the mesothelium of the peritoneum. This study highlights the importance of controlling for inadvertent cell loss whilst investigating methods for adhesion prevention.

Animals↗

Renal microangiopathy in the primary antiphospholipid syndrome: a case report with literature review.

We report the case of a 52-year-old male patient with recurrent thrombosis from 'primary antiphospholipid syndrome' who developed renal microangiopathy. Despite anticoagulant therapy with coumadin, serum creatinine progressively increased from 398 to 592 mumol/l and platelets decreased to 43,000. The patient responded to high-dose methylprednisolone and aspirin and the renal function improved. A review of the literature disclosed 4 other cases of association between primary antiphospholipid syndrome and renal microangiopathy. The clinical characteristics of these cases are discussed.

Adult↗

Effect of hyaluronic acid on postoperative intraperitoneal adhesion formation in the rat model.

OBJECTIVE: The aim of this study was to determine the effectiveness of hyaluronic acid solution in preventing intraperitoneal (IP) adhesions. DESIGN AND SETTING: The study design was prospective, randomized and blinded and involved 83 rats. INTERVENTIONS: Measured serosal injury was inflicted using a CO2 laser on the right uterine horn of the rat. Animals randomized to groups 1 and 2 received either 0.4% hyaluronic acid or its diluent phosphate-buffered saline (PBS) intraperitoneally before and after the injury. In groups 3 and 4, the same solutions were used only after the injury. Postoperative adhesions were assessed at second-look laparotomy. Histologic assessment of the fresh laser injury was carried out on uteri pretreated with hyaluronic acid, PBS, or nothing. MAIN OUTCOME: Pretreatment with hyaluronic acid was associated with a significant reduction in postoperative adhesions and a significantly decreased crater depth. CONCLUSIONS: Hyaluronic acid appears to reduce postoperative IP adhesion formation by coating the serosal surfaces and decreasing the extent of initial tissue injury.

Animals↗

Percutaneous suction aspiration for osteomyelitis. Report of two cases.

The nucleotome, a recently developed instrument for percutaneous disc excision, was used for suction aspiration in two cases of osteomyelitis of the spine. The technique obtained significant amounts of pus, serosanguinous material, and tissue, which provided adequate samples for histologic examination and culture. Both patients obtained immediate relief of pain after a significant amount of pus and infected material was removed. Appropriate antibiotics were used for subsequent control of the infections. The risk and morbidity of this technique are no greater than with conventional needle biopsy.

Adult↗

A comparative histologic study on the healing process after tissue transection. I. Carbon dioxide laser and electromicrosurgery.

The present study was undertaken to evaluate and compare histologic parameters of wound healing subsequent to a standard uterine incision with carbon dioxide laser and electromicrosurgery in the rat model. The following histologic parameters were assessed and scored: scar width; amount of particulate carbon and necrotic debris; number of polymorphonuclear leukocytes, lymphocytes, histiocytes, and giant cells; and extent of edema, exudate, and collagen in the scar. The incisions were evaluated on postoperative days 0, 4, 7, 14, and 21. The ensuing scars were similar with respect to scar width and the amount of collagen in the scar. Foreign body reaction, denoted by histiocytes and giant cells, was significantly more pronounced in the electromicrosurgery group. Carbon particles, along with necrotic debris, appear to induce a foreign body tissue reaction. The particulate carbon in the electromicrosurgical incisions was significantly more extensive and was associated with the pronounced and longer lasting foreign body reaction in this group.

Animals↗

A comparative histologic study on the healing process after tissue transection. II. Carbon dioxide laser and surgical microscissors.

In a previous study we have demonstrated that tissue transection with a carbon dioxide laser produces less carbon and less foreign body reaction than electromicrosurgery. The purpose of this study was to compare the healing process subsequent to transection of the rat uterine horn with carbon dioxide laser and microscissors. Incisions were histologically examined on postoperative days 0, 4, 10, 14, and 21. The following histologic parameters were assessed: scar width; amount of carbon and necrotic debris; number of polymorphonuclear leukocytes, lymphocytes, histiocytes, and giant cells; and extent of edema, exudate, and collagen in the scar. The results show that cutting with a carbon dioxide laser causes significantly more necrosis and hence more extensive foreign body reaction than cutting with microscissors.

Animals↗

Histologic reaction to four synthetic microsutures in the rabbit.

Histologic reaction to nylon, polypropylene, polyglactin-910, and polydioxanone microsutures was assessed in the uterine horn of the rabbit. At 24 days after insertion of the microsuture, a marked infiltration of histiocytes was seen around the nylon, polypropylene, and polydioxanone microsutures, whereas the reaction to polyglactin-910 was characterized by the presence of giant cells. At 80 days after insertion of the microsutures, the polydioxanone was almost entirely absorbed and the reaction to polyglactin-910 was minimal. Moderate histiocytic infiltration persisted around the nylon and polypropylene sutures. Fibrosis was also detected around the nylon and polypropylene sutures at 80 days, but not at all around the polydioxanone and polyglactin-910 sutures. We conclude that polydioxanone leaves little or no tissue reaction at 80 days in the uterine horn of the rabbit.

Animals↗