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At least 703 records · Page 39Linked to original sources

PubMed1989

Endoscopic Nd:YAG laser therapy in upper gastrointestinal bleeding.

Between 1983 and 1986 thirty-seven patients with upper gastrointestinal bleeding or stigmata of acute bleeding were treated at the Second Department of Surgery with endoscopic laser therapy. The non-contact method was used. The cause of bleeding was gastric ulcer in 13 cases and duodenal ulcer in 5. Two patients had anastomotic ulcer, 6 had a simple ulcer, 7 had telangiectases (Mb. Osler), 2 had Mallory Weiss tears and 2 bled after gastric biopsy. Twenty-one patients bled during endoscopy and 16 had signs of recent bleeding. During acute bleeding laser treatment was effective in 95% (1, 3). However, 41% of all patients (15/37) rebled within a week after laser therapy and in 30% (11/37) an emergency operation was necessary. The overall mortality rate was 10.8% (4/37). Endoscopic laser coagulation is successful in the initial treatment of acute upper GI-bleeding. However, there is a considerable risk of rebleeding. Acute laser therapy may change an emergency operation into an elective one, provided that the group at risk of rebleeding can be anticipated at first endoscopy.

Duodenal Ulcer↗

PubMed1977

[Indications, technics and results of cataract surgery on an eye effected with healed or present retinal detachment or predisposed to detachment].

This communication is a survey of 53 cataract operations followed up during a period of 1-6 years, with an average of 4 years, and performed on patients who had a high risk of subsequent retinal detachment because of a preceding detachment on the fellow eye or on the cataractous eye, because of peripheral retinal degenerations, or a history of hereditary retinal detachment. Most of the operations were performed under general anesthesia and ocular hypotony. In all the cases, a limbal-based conjonctival flap with a double line of sutures (scleral and conjonctival), an iridectomy in segment, a zonulolysis and a cryoextraction, were done. As for the retina, 18 eyes received a coagulation before the cataract extraction by galvano- or cryocoagulation or even by xenon photocoagulation. Among them 3 had a detachment after the cataract extraction, but 2 of them were cured by a new operation. 15 eyes had peripheral retinal lesions which were coagulated after the cataract extraction by cryo-, laser or xenon coagulation. Nevertheless 2 had a detachment. 13 patients with a detachment on the fellow eye or in the family, had no peripheral lesion and were not coagulated. None of them had a retinal detachment after the cataract extraction. Finally the eyes operated upon a short time after the cataract extraction suffered severe complications: reopening of the cataract incision, loss of vitreous and finally loss of 2 eyes out of 3.

Cataract↗

PubMed1991

Gamma-aminobutyric acid (GABA) immunocytochemistry of laser coagulations in the rabbit retina.

Rabbit retinas were treated with laser coagulations of low intensity, using five different wavelengths. After coagulation (1, 4 and 28 days), the retinas were stained for GABA, using a direct biotin-avidin-horseradish peroxidase immunocytochemical method. These time intervals were chosen with regard to the existing knowledge of retinal repair. The staining for GABA was increased in the inner plexiform layer at the centre of the lesions at days 1 and 4 after coagulation. At the margins of the lesions, cells in the ganglion cell layer showed strong staining and cells in the amacrine cell layer showed cuffing, independent of the wavelength used. On day 28, a regression of the hyperstaining was noted. Some possible pathophysiological mechanisms are discussed.

Animals↗

PubMed1999

The efficacy and safety of argon plasma coagulation therapy in Barrett's esophagus.

BACKGROUND: Thermoablation is being used to eliminate the metaplastic epithelium of Barrett's esophagus and allow its reversal into squamous epithelium in an acid-controlled environment. This study assessed the efficacy and safety of a new thermoablation technique, argon plasma coagulation. METHODS: Patients with circumferential Barrett's esophagus 2 to 5 cm long were enrolled. Acid suppression was accomplished with lansoprazole. One-half the circumference of Barrett's mucosa was treated with argon plasma coagulation, and the other half served as an internal control. After macroscopic squamous re-epithelialization occurred, biopsy specimens were obtained from both areas systematically. RESULTS: Nine patients, all men with a mean age of 51.1 years, completed the study. During 24-hour esophageal pH monitoring a pH less than 4 occurred on average 2.8% of the time with a mean dose of lansoprazole of 70 mg/day. Squamous re-epithelialization developed in treated areas in all 9 patients. Biopsy showed that 7 of 9 patients (77.8%) had squamous re-epithelialization without intestinal metaplasia. Biopsy showed that 2 of 9 patients (22.2%) had squamous re-epithelialization with evidence of underlying intestinal metaplasia. There were no serious complications. CONCLUSIONS: Argon plasma coagulation in an acid-controlled environment was both efficacious and safe in the treatment of Barrett's esophagus. However, the reappearance of squamous epithelium after therapy did not exclude the presence of underlying intestinal metaplasia.

2-Pyridinylmethylsulfinylbenzimidazoles↗

PubMed1991

[Use of laser scalpel in the surgical treatment of injuries of the liver].

An analysis of the 10-years clinical use of CO2-laser scalpel in surgery of traumas of the liver in 41 patients was performed. In 55 patients wounds of the liver were treated by the routine surgical method. Laser coagulation is especially effective for treatment of great area flat wounds. A pronounced hemo- and cholestatic effect of the defocused laser radiation was noted which allowed 3, 5 times more often performing the radical treatment of wounds of the liver. Lethality was reduced from 31% to 24%.

Adult↗

PubMedDate not supplied

Infrared-photo-coagulation for hemorrhoids treatment.

The treatment of bleeding and prolapsing hemorrhoids at stage I and II using infrared-coagulation is technically simple, therapeutically effective and complication-free. Comparative examinations of their efficacy compared with sclerosing injections and rubber band ligature have shown that the method of sclerosing injections is equal, opposite to the rubber band ligature, especially in stage II a little less effective, but without any complications as pain or secondary bleeding.

Hemorrhoids↗

PubMed1976

[Diabetic retinopathy, problems of documentation and evaluation (author's transl)].

Follow-up studies of diabetic retinopathy cause difficulties through the altering numbers and figures of the retinal changes. If the various pictures of retinopathy are changed furthermore by coagulation, we have to distinguish, between spontaneous improvements or deteriorations and changes which are due to therapy. Follow-up studies with various evaluation methods have shown that the chosen criteria do not lead to corresponding judgements. The visual acuity seems to be the only criteria with decisive and relatively objective statements.

Diabetic Retinopathy↗

PubMed1989

Nd:YAG laser pleurodesis through thoracoscopy: new curative therapy in spontaneous pneumothorax.

From January 1986 to May 1987, 14 patients with spontaneous pneumothorax were treated in our department with a new endoscopic method using neodymium:yttrium-aluminum-garnet laser photocoagulation through thoracoscopy. The 10 male and 4 female patients ranged in age from 14 to 59 years (mean age, 29 years). In all patients, the procedure was performed under general anesthesia. The thoracoscope was introduced through a 1- to 1.5-cm incision in the anterior axillary line of the fourth intercostal space. The fiber of the laser was advanced through the operative channel of the thoracoscope. In all patients, the bleb (or blebs) detected in the apex of the upper lobe was successfully coagulated with low-power laser pulses. Then the parietal pleura of the first five ribs was partially scarified to achieve pleurodesis. There were no side effects. Thirteen patients were successfully treated without recurrence (maximum follow-up, 29 months). We conclude that this new therapy can play an important role in select patients with spontaneous pneumothorax.

Adult↗

PubMed1990

[Krypton laser coagulation in idiopathic macular holes].

Twenty-six eyes with acute idiopathic senile macular holes and visual acuity of between 0.02 and 0.5 were treated by laser coagulation with krypton red. The laser burns were placed in a ring around the hole, at the border of the retinal detachment. A few weeks after treatment marked regression of the detachment was seen. During the follow-up period (3-18 months) visual acuity improved in 18 eyes, deteriorated in 1 and was unchanged in 7.

Aged↗

PubMed1993

Comparison between efficacy of full- and mild-scatter (panretinal) photocoagulation on the course of diabetic rubeosis iridis.

The study enrolled 59 eyes with rubeosis iridis and proliferative diabetic retinopathy. The efficacies of two types of panretinal photocoagulation ('full' and 'mild' scatter) on the course of diabetic rubeosis iridis were compared. The mean posttreatment follow-up period was 22 +/- 4.8 months. After application of full-scatter photocoagulation (1,200-1,600 spots) in 27 eyes, rubeosis iridis regressed in 70.4% cases, remained unchanged in 14.8% and deteriorated in 14.8%. After mild-scatter photo-coagulation (400-650 spots) in 32 treated eyes, rubeosis iridis regressed in 37.5% cases, 34.4% was unchanged, while deterioration was found in 28.1%. A better therapeutic effect of panretinal photocoagulation in regression of diabetic rubeosis iridis was obtained, if the total dose of the applied laser spots was higher.

Adult↗

PubMed1994

The infra-red coagulator in the treatment of AIDS-related Kaposi's sarcoma and a comparison with radiotherapy.

Experience with 1 s pulses of the infra-red coagulator is reported for the treatment of 10 cutaneous AIDS-related Kaposi's sarcoma lesions in seven patients. The infra-red coagulator may be a useful addition in the palliative cosmetic treatment of Kaposi's sarcoma, producing an acceptable result in small (less than 2 cm in diameter) Kaposi's sarcoma lesions of the arms and trunk, but not in those situated on the legs.

Acquired Immunodeficiency Syndrome↗

PubMed2003

Percutaneous sonographically guided microwave coagulation therapy for hepatocellular carcinoma: results in 234 patients.

OBJECTIVE: The objective of our study was to evaluate the long-term results of percutaneous microwave coagulation therapy for the treatment of hepatocellular carcinoma in a large patient population. SUBJECTS AND METHODS: Survival rates were determined in 234 patients with 339 nodules of hepatocellular carcinoma who had undergone percutaneous microwave coagulation therapy (208 men, 26 women; mean age, 54.8 years; mean tumor size, 4.1 +/- 1.9 cm; range, 1.2-8.0 cm; mean follow-up period, 27.9 months). Patients were those who had been rejected as candidates for surgery by the surgery department, who fit our study's criteria, and who agreed to participate. After baseline imaging studies were performed, the patients were followed up using the same combination of imaging (sonography, CT, or MR imaging) and posttreatment biopsy. RESULTS: After percutaneous microwave coagulation therapy, color Doppler flow signals disappeared in 92.0% (263/286) of the lesions. No enhancement was apparent in 89.2% (190/213) and 89.1% (41/46) of the lesions on contrast-enhanced CT and MR imaging, respectively. Posttreatment biopsies of 194 nodules showed no evidence of surviving tumor tissue in 180 nodules (92.8%). Resections of six lesions revealed complete tumor necrosis in five. The 1-, 2-, 3-, 4-, and 5-year cumulative survival rates were 92.70%, 81.60%, 72.85%, 66.37%, and 56.70%, respectively. The relationships between survival curves and the degree of hepatocellular carcinoma tumor differentiation and between survival curves and tumor size were statistically significant (p = 0.021). No severe complications were seen. CONCLUSION: Sonographically guided microwave coagulation proved to be safe and effective for the treatment of hepatocellular carcinoma. This therapy resulted in a high percentage of cases without evidence of residual tumor and satisfactory long-term results.

Administration, Cutaneous↗

PubMed1989

Percutaneous Nd:YAG laser coagulation of ventricular myocardium in dogs using a special electrode laser catheter.

A novel catheter system was used for intracardiac electrogram recordings, ventricular pacing and continuous-wave Nd:YAG laser (1,064 nm) irradiation of ventricular myocardium in eight dogs. Radiation at a power of 10 W for 3, 5, and 10 seconds was delivered through a 400 microns optical fiber. Power density was 15 W/mm2. A total of 96 laser injuries (12 per dog) were produced in selected sites in both the right and the left normal canine ventricle. Ventricular arrhythmias were noted during 12 of 96 (12.5%) laser pulses. Programmed electrical stimulation performed during control study immediately (all dogs) at 2 days (two dogs), and 4 months (4 dogs) following the experiments showed no episodes of sustained or nonsustained ventricular tachycardia. Radiation energies up to 50 J (10 W over 5 s) caused focal injuries of homogeneous coagulation/fibrosis localized to the target area, without vaporizing tissue and forming craters. Morphometrically and histologically there was a direct relationship between the energy of radiation delivered, and the extent and severity of the injury produced. The maximum size of lesions measured 7/11 mm (diameter/depth). Using a special catheter system laser coagulation of myocardium can be accomplished percutaneously. This method can create controlled subendocardial injuries without major side effects and appears to overcome most disadvantages of transcatheter high energy direct-current shocks when used as a regular course of procedure in ablation of arrhythmogenic tissue in the heart.

Animals↗

PubMed1982

Photocoagulation of cerebral arteriovenous malformations and arterial aneurysms with the neodymium: yttrium-aluminum-garnet or argon laser: preliminary results in twelve patients.

Six arteriovenous malformations (AVMs) and five arterial aneurysms (AAs) were treated with either argon or neodymium:yttrium-aluminum-garnet laser irradiation; one AVM was treated with both. All AVMs were occluded completely, leaving adjacent tissue untouched and preserving the regional vascularization. Photocoagulation produced varying effects on AAs: in one case an intraoperative rupture was sealed, in two cases the volume of an ectasia was reduced when the bleeding and thinner areas were coagulated, and in one case a saccular aneurysm was progressively and completely obliterated while the patency of the parent artery was preserved. These preliminary results are satisfactory; more experience will indicate how and when these new techniques can replace traditional ones or be used in combination with them.

Adolescent↗

PubMed1990

[The application of laser rays in gastroenterology].

After reminding the difference between the surface electro-coagulation-section and the photo-coagulation "at distance" by Laser-ray, the author underlines that the most interesting indications of the Laser-ray introduced into the digestive endoscopes are the destruction of esophageal and colonic tumors for inoperable patients or patients with operative risks. The palliative destructions avoid mutilating operations which won't increase the survival time of the patients.

Esophageal Neoplasms↗

PubMed1997

Comparison of hemorrhoidal treatments: a meta-analysis.

OBJECTIVE: To determine whether any method of hemorrhoid therapy has been shown to be superior in randomized trials. METHOD: A meta-analysis of all randomized controlled trials assessing two or more treatment modalities for symptomatic hemorrhoids. MAIN OUTCOME MEASURES: Response to therapy, the need for further therapy, complications and pain. RESULTS: Eighteen trials were available for analysis. Hemorrhoidectomy was found to be significantly more effective than manual dilatation of the anus (p = 0.0017) and associated with less need for further therapy (p = 0.034), no significant difference in complications (p = 0.60) but more pain (p < 0.001). Patients who underwent hemorrhoidectomy had a better response to treatment than did patients who were treated with rubber-band ligation (p = 0.001), although complications were greater (p = 0.02), as was pain (p < 0.0001). Rubber-band ligation was better than sclerotherapy in response to treatment for all hemorrhoids (p = 0.005) and for hemorrhoids stratified by grade (grades 1 and 2, p = 0.007, grade 3, p = 0.042), with no difference in the complication rate (p = 0.35). Patients treated with sclerotherapy (p = 0.031) or infrared coagulation (p = 0.0014) were more likely to require further therapy than those treated with rubber-band ligation, although pain was greater after rubber-band ligation (p = 0.03 for sclerotherapy, p < 0.0001 for infrared coagulation). CONCLUSIONS: Rubber-band ligation is recommended as the initial mode of therapy for grades 1 to 3 hemorrhoids. Although hemorrhoidectomy showed better response, it is associated with more complications and pain than rubber-band ligation. Thus, it should be reserved for patients whose hemorrhoids fail to respond to rubber-band ligation.

Diathermy↗

PubMed1977

Controversial aspects of ablative photocoagulation in diabetic retinopathy (d.r).

In recent years ablative treatment of advanced diabetic retinopathy has gained more and more adherents. However, most cases of proliferative retinopathy, even if they are advanced, can be treated successfully by restricting xenon-or laser-coagulation to pathologic areas, while sparing healthy-looking parts of the retina. It is felt that destruction of large parts of the retinal periphery should be reserved for special cases only. In those cases where the fundus is clouded by abundant hemorrhages and vitrectomy does not seem advisable, ablative treatment should be tried ab externo by means of diathermy or cryoapplication.

Diabetic Retinopathy↗

PubMed1975

[Influence of occlusion of retinal vessels on the transport of 22Na and 131J-iodo-o-hippurate out of the subretinal space (experiments performed on cats) (author's transl)].

By means of microsurgical technique and under the control of the ophthalmoscope 300 mul of isotone solution of NaCl with 22Na or o-131J-iodo-hippuric acid were injected into the space between the retina and pigment epithelium of 28 narcotized tomcats after having closed the inferior retina vessels by photocoagulation about 1 hr before in an umber of the animals. With 22Na we could demonstrate that the retinal vessels influence the speed of the transport of substances out of the space between retina and pigment epithelium: When the retina vessels are closed, the transport is decelerated. The same experiments with o-131J-iodo-hippuric acid did not show any difference between the eyes with coagulated vessels and those with open ones. We cannot answer the question, whether sodium is transported in a mono-directional flux out of the space between retina and pigment epithelium (probably followed by water), or if there is simply an exchange between 22Na out of this space with 22Na of the blood.

Animals↗