August 1997 Cryosurgical Publications
A weekly updated compilation of cryosurgery related publications
| August 5th | August 12th | August 19th | August 26th |
| BIOSYS |  | | | |
| MEDLINE | | | | |
BIOSYS Database:
1. BOOK
Daly, J M.
Metastatic cancer to the liver.
De Vita, V. T. Jr., S. Hellman and S. A. Rosenberg (Ed.). Cancer:
Principles and practice of oncology, 5th edition, Vols. 1 and 2.
lxix+1539p.(vol. 1); li+1585p.(vol. 2) Lippincott-Raven Publishers:
Philadelphia, Pennsylvania, USA. ISBN 0-397-51574-X(set); ISBN
0-397-51575-8(Vol. 1); ISBN 0-397-51576-6(Vol. 2). 1997. p. 2551-2570.
Medline Database:
BIOSYS Database:
Medline Database:
1. Shumway SJ; Johnson EM; Svendsen CA; Kriett JM; Ring WS.
Surgical management of ventricular tachycardia.
Annals of Thoracic Surgery, 1997 Jun, 63(6):1589-91.
(UI: 97349150)
Abstract: BACKGROUND: Ventricular tachyarrhythmias are the leading cause of
death from coronary artery disease. A small percentage of these arrhythmias
originate in chronically ischemic myocardium, rather than acutely ischemic
myocardium, and can be refractory to medical management. Epicardial mapping
and focal cryoablation of foci demonstrating early activation may provide
definitive therapy when pharmacologic management fails. We report a series
of 42 consecutive patients with refractory ventricular tachycardia (VT) who
were treated with open epicardial mapping and focal cryoablation after
pharmacologic management failed. METHODS: We retrospectively reviewed the
records of patients who underwent surgical treatment of malignant VT. For
patients not recently seen in the clinic, we conducted telephone
interviews. At the time of operation, epicardial mapping was performed to
locate foci of early electrical activation. These foci were then
cryoablated, using 2-minute applications of liquid nitrogen-cooled probes.
All patients underwent postoperative electrophysiologic studies to test for
inducible VT. RESULTS: Of these 42 patients, 34 (81%) were male, 8 (19%)
female. Average age was 62.9 +/- 10.6 years; ejection fraction, 0.20
(range, 0.04 to 0.50); and number of foci ablated, 2.1 +/- 1.1 (range, 1 to
6). At the time of cryoablation, all patients underwent additional
procedures, including aneurysmectomy, coronary artery bypass, or valve
replacement. The 30-day operative mortality was 9.5% (4 of 42). Of the 38
survivors, 36 (94.7%) were clinically free of VT; the remaining 2 had
spontaneous or inducible VT. CONCLUSIONS: Open cryoablation of foci
propagating VT appears to be safe and effective. It may be the most
definitive treatment for malignant VT.
2. Jester DM.
Office procedures. Cryotherapy of dermal abnormalities.
Primary Care; Clinics in Office Practice, 1997 Jun, 24(2):269-80.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97319011)
Abstract: Cryotherapy of dermal abnormalities is a commonly used technique in
the field of primary care. To perform cryotherapy effectively, one must
understand the principles of cryoablation and how they apply to specific
skin disorders. One also must be familiar with the various types of
equipment that are used to perform cryotherapy. With this understanding
cryotherapy easily can be integrated into outpatient primary care.
3. Zhou XD; Tang ZY.
Management of hepatocellular carcinoma: long-term outcome in 2639 cases.
Gan To Kagaku Ryoho Japanese Journal of Cancer and Chemotherapy, 1997 May,
24 Suppl 1:9-16.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97354656)
Abstract: This paper reports the progress of management in 2639 patients with
pathologically proven primary liver cancer (PLC) over the past three
decades, and the factors improving long-term outcome. The 5-, and 10-year
survival after resection of PLC was 45.9% and 34.8%, respectively, for the
whole series (n = 1826), and 61.3% and 45.7%, respectively, for patients
with small PLC (< = 5 cm, n = 645). The 5-year survival after cryosurgery
was 37.9% for the whole series (n = 191), and 53.1% for patients with small
PLC (n = 56). The 5-year survival of 73 patients receiving sequential
resection after cytoreduction therapy was 67.8%. The 5-year survival after
re-resection for recurrence tumor (n = 148) was 34.5%; 239 patients
survived more than 5 years; 124 of these patients (51.9%) were small PLC,
and 63 patients survived more than 10 years. Encouraging changes in the
prognostic pattern were observed when the PLC data of 1958-1970 (n = 178),
1971-1982 (n = 582) and 1983-1994 (n = 1879) were compared; the 5-year
survival being 4.8%, 11.2% and 45.4%, respectively, and the 10-year
survival being 4.2%, 7.5% and 34.6%, respectively. Some aspects to prolong
survival further were discussed.
4. Tang ZY; Yu YQ; Zhou XD; Yang BH; Lin ZY; Lu JZ; Ma ZC; Ye SL; Liu KD.
Three decades' experience in surgery of hepatocellular carcinoma.
Gan To Kagaku Ryoho Japanese Journal of Cancer and Chemotherapy, 1997 May,
24 Suppl 1:126-33.
(UI: 97354668)
Abstract: In the author's institution, 2254 patients with hepatocellular
carcinoma (HCC) have been treated during 1958-1994. The overall 5-year
survival increased from 5.4% (1958-1970), to 11.9% (1971-1982), to 46.2%
(1983-1984), which correlated well with the increasing proportion of small
HCC in the series (2.6%, 12.1%, and 33.4%, respectively); with the
increasing percentage of limited resection (3.1%, 32.2%, and 58.3%); with
the increasing number of re-resections for recurrence (0, 27, and 114
patients); and with the increasing number of second stage resections (0, 5,
and 67 patients). In our institution, surgical approaches that resulted in
significantly prolonging survival included: small HCC resection,
re-resection, and cytoreduction followed by sequential resection for
initially unresectable HCC. Experience in these 3 aspects suggests: (a)
Small HCCs are mainly found by screening using AFP and ultrasonography (US)
in a high risk population, and limited resection is the best treatment in
patients with compensated liver cirrhosis, the 5-year survival after
resection being 62.9% (n = 549). (b) Postoperative monitoring using AFP/US
every 2-3 months for 5-10 years after curative resection is needed to
detect subclinical recurrence. Limited re-resection is indicated for liver
recurrence less than 3 nodules, and lung lobectomy is of proven merit to
prolong survival for solitary lung metastasis. Re-resection of subclinical
recurrence has resulted in a 10-20% further increase in 5-year survival
after curative resection. (c) Palliative surgery other than resection such
as hepatic artery ligation (HAL) and cannulation with arterial infusion
(HAI), cryosurgery, etc. are superior to palliative resection with residual
cancer. (d) Cytoreduction and sequential resection have provided hope for
localized unresectable HCC, particularly in the right cirrhotic liver.
Multimodality combination treatments such as
HAL+HAI+radioimmunotherapy/regional radiotherapy are acceptable
cytoreductive therapies. Repeated transcatheter hepatic arterial
chemoembolization (TACE) is an alternative nonsurgical approach. Sequential
resection is important to eradicate residual cancer after cytoreduction.
The 5-year survival of 72 patients with cytoreduction and sequential
resection for initially unresectable HCC was 62.1% and resulted in
improving 5-year survival in the entire series of unresectable HCC over the
3 periods from 0% to 7.4% to 25.7%, respectively. However, multicentric
origin and tumor invasiveness are two major targets to be studied in the
control of recurrence and metastasis.
5. Rabin Y; Shitzer A.
Combined solution of the inverse Stefan problem for successive
freezing/thawing in nonideal biological tissues.
Journal of Biomechanical Engineering, 1997 May, 119(2):146-52.
(UI: 97311674)
Abstract: A new combined solution of the one-dimensional inverse Stefan problem
in biological tissues is presented. The tissue is assumed to be a nonideal
material in which phase transition occurs over a temperature range. The
solution includes the thermal effects of blood perfusion and metabolic heat
generation. The analysis combines a heat balance integral solution in the
frozen region and a numerical enthalpy-based solution approach in the
unfrozen region. The subregion of phase transition is included in the
unfrozen region. Thermal effects of blood perfusion and metabolic heat
generation are assumed to be temperature dependent and present in the
unfrozen region only. An arbitrary initial condition is assumed that
renders the solution useful for cryosurgical applications employing
repeated freezing/thawing cycles. Very good agreement is obtained between
the combined and an exact solution of a similar problem with constant
thermophysical properties and a uniform initial condition. The solution
indicated that blood perfusion does not appreciably affect either the shape
of the temperature forcing function on the cryoprobe or the location and
depth of penetration of the freezing front in peripheral tissues. It does,
however, have a major influence on the freezing/thawing cycle duration,
which is most pronounced during the thawing stage. The cooling rate imposed
at the freezing front also has a major inverse effect on the duration of
the freezing/thawing.
6. Maslova IV; Onufrieva EK.
[Treatment of children with congenital diseases of the larynx and
trachea].
Vestnik Otorinolaringologii, 1997(3):46-8.
Language: Russian.
(UI: 97339772)
Abstract: +33 cases of vascular tumors, 15 of congenital membranes, 12 of
papillomatosis, 5 of cysts, 12 of abnormal laryngeal cartilages, 3 of
tracheomalacia, 9 of stridor, 1 of fibrous polyp and 1 of mucous membrane
folding in the interarytenoid region are reported. Operative interventions
primarily endoscopic laser surgery were performed in children with
congenital vascular tumors, membranes, cysts. Removal of papillomas in
congenital papillomatosis conducted with the use of micro-instruments and
CO2-laser was combined with immunomodulation. Children with laryngeal
cartilage anomalies, tracheomalacia and stridor were subjected to prolonged
nasotracheal intubation of even tracheotomy only in case of severe
respiratory failure..
BIOSYS Database:
1. Diller, K R.
Engineering-based contributions in cryobiology.
Cryobiology, v.34, n.4, (1997): 304-314.
Abstract:
Over the past three decades there has been an increasing number of
engineering-trained researchers who have made the field of cryobiology a
primary focus of their work. In prior times the advances in cryobiology
were accomplished nearly exclusively by members of the life and medical
science communities. In general, the practice of engineering may be
distinguished by two features: an emphasis on rigorous quantitative
measurement and analysis of processes and the synthesis of an
understanding of fundamental principles of nature into the design of novel
devices and processes for specific applications. One area of focus in
cryobiology that engineers have emphasized is the design of new apparatus,
including both experimental instrumentation and clinical diagnostic and
therapeutic devices. There has been a broad spectrum of new apparatus
invented to enable the quantitative control and measurement of the
fundamental phenomena that govern processes in cryobiology. Among these
are low-temperature cryomicroscopy stages and mass diffusion chambers,
which now are often used in conjunction with digital image analysis
algorithms to quantify changes to individual cells and tissues elicited
during the process being studied. Other applications include the
development of novel measurement techniques for assessing system
properties and states during freezing and thawing. In cryosurgery and in
cryopreservation new probes and apparatus have been designed to provide
more accurate and effective processes to achieve clinical objectives.
Equally important and complementary to the design of hardware is the
development of analytical models which can be applied to understand and
interpret experimental data and to predict the behavior of systems for
operation in domains beyond those for which empirical data are available.
Perhaps the most critical role of these models is for inverse solution
techniques with experimental data to obtain values for the intrinsic
constitutive properties of tissues which govern their response to freezing
and thawing processes.
2. Smith, M D; Downie, J B; Dicostanzo, D.
Granuloma annulare.
International Journal of Dermatology, v.36, n.5, (1997): 326-333.
3. Baust, J; Gage, A A; Ma, H; Zhang, C-M.
Minimally invasive cryosurgery: Technological advances.
Cryobiology, v.34, n.4, (1997): 373-384.
Abstract:
The technological advances which have caused renewed interest in
cryosurgery are the development of intraoperative ultrasound to monitor
the therapeutic process and the development of new cryosurgical equipment
designed to use supercooled liquid nitrogen. The thin, highly efficient
probes, available in several sizes, can be placed in diseased sites via
endoscopy or percutaneously in minimally invasive procedures. The manner
of use is to place the probe in the desired location in the diseased
tissue with ultrasound guidance. If required by the size or location of
the tumor, as many as five probes can be inserted and cooled to - 195
degree C simultaneously. The process of freezing is monitored by
ultrasound which displays a hypoechoic (dark) image when the tissue if
frozen. Rapid freezing, slow thawing, and repetition of the freeze/thaw
cycle are standard features of technique. Clinical applications which have
become common in the past 4 years include the treatment of prostatic
cancer and liver tumors. The cases selected for cryosurgery are generally
those for which no conventional treatment is possible. However, especially
in prostatic cancer, the operative morbidity is so low and the results of
therapy are sufficiently good in the short term to merit consideration of
use in earlier stages of the disease. Diverse tumors in other sites, such
as the brain, bronchus, bone, pancreas, kidney, and uterus, have also been
treated in small numbers by cryosurgery. Judging from this experience,
further expansion in the use of cryosurgical techniques seems certain.
4. Tezuka, T; Kohriyama, K; Tsujii, Y; Tatsuta, N; Sugiyama, Y; Yamada, H.
A case of giant strawberry mark with high risk of the occurrence of
deprivation amblyopia by the closure of eyelid with a bloody crust.
Hifu, v.39, n.2, (1997): 177-180.
Language: Japanese.
Abstract:
A two-month-old female baby with a giant strawberry mark on her left,
upper and lower eyelids is reported. Following ophthalmologic examination,
erosion occurred on her eyelid. Her left eyelid was closed by a bloody
crust for 3 weeks. As deprivation amblyopia was suspected, urgent surgery
to lift her left eyelid with a nylon suture was performed and epidermis
obtained by a suction blister was transplanted to the erosion. Eight years
later, the lesion had completely disappeared and skin with almost normal
texture was obtained by several cryosurgical and dye laser treatments.
5. Marcushamer, M; King, D L; Ruano, N S.
Cryosurgery in the management of mucoceles in children.
Pediatric Dentistry, v.19, n.4, (1997): 292-293.
6. Holman, M R; Rowland, S J.
Design and development of a new cryosurgical instrument utilizing the
Peltier thermoelectric effect.
Journal of Medical Engineering & Technology, v.21, n.3-4, (1997): 106-110.
Abstract:
Warts and some other dermatological conditions may be treated by the
application of intense cold. This freezing has to be so severe as to form
ice crystals which will rupture the cell membranes. The initial part of
this project was to investigate the feasibility of using Peltier
thermoelectric coolers (TECs) to cool down a suitable hand-held treatment
tip to a temperature of approximately - 50 degree C. The results of these
initial experiments showed how this could be accomplished and a prototype
cryosurgical instrument, suitable for clinical trials, was designed and
constructed. This new design is freestanding, self-contained and is
operated from a standard 230 V mains supply. Unlike existing systems it
does not use any disposable gases or liquids. A cryoprobe of this new
design would allow reliable cryosurgery to be performed in a GP's
treatment room where supplies of liquid nitrogen, nitrous oxide or carbon
dixoide are not readily available. The design also has a built-in
thermometer to measure the treatment tip temperature thus ensuring
consistency in treatment. Clinical trials are being conducted at a number
of GP practices to evaluate this new design.
7. Johnson, L B; Krebs, T S; Wong, J J; Daly, B; Kuo, P C; Plotkin, J S; Njoku,
M; Van Echo, D.
Preoperative mapping with MRI predicts complete ablation by cryosurgery in
patients with hepatic metastases. (Digestive Disease Week and the 97th
Annual Meeting of the American Gastroenterological Association,...
Gastroenterology, v.112, n.4 SUPPL., (1997): A1452.
8. Korpan, N N; Hochwarter, G.
Pancreatic cryosurgery: A new surgical procedure for pancreatic cancer.
(31st Annual Scientific Meeting of the European Society for Clinical
Investigation, Kiel, Germany, March 19-22, 1997. )
European Journal of Clinical Investigation, v.27, n.SUPPL. 1, (1997): A33.
9. Rabin, Y; Julian, T B; Wolmark, N.
A compact cryosurgical apparatus for minimally invasive procedures.
Biomedical Instrumentation & Technology, v.31, n.3, (1997): 251-258.
Abstract:
A new liquid-nitrogen-based apparatus for minimally invasive cryosurgery
is presented. The cryoprobe was designed for application to breast tumors;
however, it can be used for the treatment of other tumors. The cryoprobe
has three major components, a cryoneedle, a thermal insulation shell, and
a protective tube, which may be assembled as part of the operation. This
special assembly keeps destruction to surrounding tissues due to cryoprobe
penetration minimal, and allows accurate localization of the cryoprobe tip
by means of stereotactic or needle-localization techniques. An alternative
cryoprobe consists of a cryoneedle and a thermal insulation shell, which
are rigidly connected. The liquid nitrogen supply system has two major
components, an air-pressure source and a liquid nitrogen container, which
are physically separated. This special configuration allows placement of
the liquid nitrogen container adjacent to the cryotreated tissue and
decreases the length of the cryoprobe feeding tube. In turn, heat losses
to the surroundings are reduced, and therefore coolant consumption is
reduced. The short feeding tube allows safe operation at low pressures.
The small size of the apparatus makes it attractive for cryosurgical
operations. It has been evaluated in gelatin solutions and in porcine
skeletal muscle and liver. In-vivo results do not differ significantly
from those obtained in gelatin solutions with regard to the dimensions of
frozen regions. Using a three cryoprobe configuration, a frozen region
with an average diameter of 50 mm and a length of 75 mm was obtained
within 11 minutes. The thermal efficiency of that procedure was found to
be 43%.
10. Shields, J A; Shields, C L; De Potter, P.
Surgical management of conjunctival tumors: The 1994 Lynn B. McMahan
lecture.
Archives of Ophthalmology, v.115, n.6, (1997): 808-815.
Abstract:
To our knowledge, there are no articles that describe the specific
step-by-step details of the surgical removal of premalignant and
malignant conjunctival tumors. We describe our current approach to the
surgical management of squamous cell carcinoma (intraepithelial or
invasive), localized melanoma, and primary acquired melanosis of the
conjunctiva. The surgical method differs with limbal tumors, extralimbal
tumors, and primary acquired melanosis. Limbal lesions are managed by
localized alcohol corneal epitheliectomy, removal of the main mass by a
partial lamellar scleroconjunctivectomy, and supplemental cryotherapy.
Tumors located in the extralimbal conjunctiva are managed by alcohol
application, wide circumferential surgical resection, and cryotherapy.
Primary acquired melanosis is managed by alcohol epitheliectomy, removal
of suspicious foci, quadrantic staging biopsies, and cryotherapy from the
underside of the conjunctiva. In all cases, a" no touch" method is used
and direct manipulation of the tumor is avoided to Prevent tumor cell
seeding into a new area. We have employed this technique on 109 patients
with conjunctival squamous neoplasms and 137 patients with conjunctival
melanoma, about 80 of which neoplasms were associated with primary
acquired melanosis. Our observations suggest that well-planned initial
surgical management using this technique decreases the chance of tumor
recurrence for conjunctival melanoma and squamous cell carcinoma. We
describe a detailed stepwise approach to the surgical management of
conjunctival neoplasms. It requires meticulous clinical evaluation and
complete removal of the tumor in one operation using a specific
technique.
11. Lee, F; Bahn, D K; McHugh, T A; Kumar, A A; Badalament, R A.
Cryosurgery of prostate cancer. Use of adjuvant hormonal therapy and
temperature monitoring: A one year follow-up.
Anticancer Research, v.17, n.3A, (1997): 1511-1516.
Abstract:
Objective: To determine the clinical outcomes at one year of Stages T2-T3
prostate cancer by cryosurgery utilizing pretreatment with total androgen
ablation therapy and temperature monitoring to control the freezing
process. Study Group: To date, 347 patients have had 356 cryosurgical
procedures. 280 have reached one year post treatment. Of these, 131 had
re-evaluation with prostatic biopsy and serum PSA. Methods: Transrectal
ultrasound (TRUS) measurement of tumor size and biopsy of extraprostatic
space was used to stage patients into two main groups: confined (66.6%)
versus nonconfined (19.3%). Radiation failures (14.1%) formed a separate
group. Failure rates for the 131 men include all cancer diagnosed during
the one year period following cryosurgery. Results: The one year failure
rate for the study group was 19.8% (26/131). For stages T2a, T2b C, T3
and radiation failures, the rates ofpositive biopsies were 13.9%, 12.9%,
33.3% and 35%, respectively. For those with local control of cancer
(negative biopsy), 80% had prostate specific antigen (PSA) levels of lt
0.5 ng/Ml The statistical variables for persistent cancer with prostate
specific antigen gt 0.5 ng/ml were: sensitivity of 66.7%, PPV of 16.7%,
NPV of 98% and specificity of 83.7%. A statistically significant
difference exists between stages T2 vs T3 and radiation failures (p= lt
0.5). Major complications of rectal fistula and total incontinence for
previously non-treated cancer versus radiation failures were 0.33% and
8.7% respectively, a 26 times greater risk Conclusion: Results of
cryosurgery for all stages of prostate cancer at one year are
encouraging, being 80% free of disease (biopsy and prostate specific
antigen). The morbidity of the previously non-treated cancers from this
procedure for us was minimal with high patient acceptance. For radiation
failures a local control rate of 65% was achieved. However, early in our
experience significant morbidity did occur and our enthusiasm for
attempted salvage was initially tempered.
12. Schreuder, H W B; Van Egmond, J; Van Beem, H B H; Veth, R P H.
Monitoring during cryosurgery of bone tumors.
Journal of Surgical Oncology, v.65, n.1, (1997): 40-45.
Abstract:
Background: Cryosurgery is used in orthopaedic oncology as adjuvant
treatment after intralesional excision of bone tumors to induce cell
death at and beyond the surgical margin. Monitoring freeze/thaw cycles
during cryosurgery is beneficial in controlling a cryosurgical procedure
and in preventing an unwarranted local extent of the freeze. Method: We
conducted a study of 15 cryosurgical procedures with the use of a
protocolized temperature measuring system with peroperative graphic
visualization. Results: Using a liquid nitrogen spray, intralesional
temperatures of -150 degree C were achieved, which are, according to the
literature, associated with cell death. Extralesional temperature
measurements showed no subzero temperatures of surrounding important
tissues. Conclusions: Temperature recordings in and outside the lesion
during cryosurgery in orthopaedic oncology are of importance to monitor
the freeze/thaw cycles and are helpful in facilitating an effective
cryosurgical procedure and in controlling the extent of the freeze,
avoiding local complications.
Medline Database:
1. Schmidt JD.
Transperineal ultrasound-guided prostate cryosurgery.
Journal of Surgical Oncology, 1997 Jul, 65(3):228-9.
(UI: 97380134)
2. Kuflik EG; Gage AA.
Recurrent basal cell carcinoma treated with cryosurgery.
Journal of the American Academy of Dermatology, 1997 Jul, 37(1):82-4.
(UI: 97359611)
Abstract: BACKGROUND: Although there are reports of cure rates achieved by
cryosurgery for primary basal cell carcinomas (BCCs), there are few data on
the cryosurgical treatment of recurrent BCCs. OBJECTIVE: Our purpose was to
discuss case selection, cryosurgical management, and results of therapy.
METHODS: Cryosurgery was performed in 54 patients with 56 recurrent BCCs.
The treatment consisted of aggressive freezing including an adequate margin
of surrounding tissue. RESULTS: Wound healing was favorable and the
cosmetic results were excellent. Two recurrences were found and were
referred for Mohs micrographic surgery. CONCLUSION: We conclude that
cryosurgical treatment of selected recurrent BCCs yields results that
compare favorably with other methods of treatment.
3. Ma L; Zhao B; Di Y.
[Treatment of neovascular glaucoma by anterior retinal cryotherapy and
trabeculectomy].
Chung-Hua Yen Ko Tsa Chih Chinese Journal of Ophthalmology, 1996 Mar,
32(2):118-22.
Language: Chinese.
(UI: 97350460)
Abstract: OBJECTIVE: To investigate the efficacy of anterior retinal
cryotherapy (ARC) for treatment of neovascular glaucoma (NVG). METHODS: 12
eyes (11 patients) with open angle NVG were treated by ARC only, 22 eyes
(22 patients) with closed angle NVG were treated by ARC combined with
trabeculectomy, and 32 eyes (31 patients) with closed angle NVG were
treated by either ARC or cyclocryotherapy as controls. The follow-up period
were 6-26 months. RESULTS: Iris new vessels (INV) regressed or disappeared
with normal intraocular pressure (IOP) in 92% (11/12) of the eyes with open
angle NVG treated simply by ARC. In comparison with closed angle NVG
treated by the same method, there was a significant difference in IOP (P <
0.05). The combination of ARC and trabeculectomy showed markedly better
results than either ARC or cyclocryotherapy for treatment of closed angle
NVG (P < 0.01). In the eyes with closed angle NVG, INV regressed or
disappeared with normal IOP in 86% (19/22), 90% (18/20) achieved a marked
relief from pain and the visual acuity was better or unchanged in 67%
(8/12) that was significantly different from the eyes treated by
cyclocryotherapy (P < 0.05). CONCLUSION: The results indicate that ARC is
suitable for treatment of NVG at early stage, and ARC combined with
trabeculectomy, at later stage.
4. Ablin RJ.
What of the clinical significance of the cryoimmune response? [letter].
Dermatologic Surgery, 1997 Jun, 23(6):499-500.
Pub type: Letter.
(UI: 97360845)
5. Conejo-Mir JS; Moreno JC; Camacho F.
Cryosurgical treatment of professional chronic radiodermatitis.
Dermatologic Surgery, 1997 Jun, 23(6):483-6.
(UI: 97360838)
Abstract: BACKGROUND: Chronic x-ray dermatitis in professionals is a frequent
problem for doctors in our country due to the fact that many of them widely
used radiotherapy without any protection 15-20 years ago. Surgery has been
the most accepted treatment, though it generally decreases hand function.
OBJECTIVE: Up to now, cryosurgery was not usually considered as a possible
treatment if the lesions were located on fingers. In this study, the
advantages of cryosurgery for the treatment of professional chronic
radiodermatitis with incipient pretumoral lesions are emphasized. METHODS:
Cryosurgery was performed on six patients affected with chronic
professional radiodermatitis that showed keratomas and ulcerations, using
both spray (keratomas) and a probe 0.5 cm in diameter (ulcerations, in situ
squamous cell carcinoma). Nerve block anesthesia with mepivacaine 1% was
used in all cases. Before the treatment, all suspected lesions were
biopsied; if invasive squamous cell carcinoma was revealed in the
dermatopathological study, the patient was rejected. Variables such as
blister and necrosis formation, pain, and achromatic, sensibility, and
mobility disorders were studied. The follow-up period was 2 years. RESULTS:
Immediate postoperative results showed great pain and blistering in all
cases. Residual achromias were observed early postoperatively in all cases,
but were repigmented 1 year after therapy in four cases (66%). Sensory
alterations (hypo- and hyperthesias) were found in four cases (66%) 1 month
after treatment, although this complication was not observed 6 months after
treatment. Finger mobility was perfect in all cases 2 months after
treatment, and there was no recurrence in any case after 2 years of
follow-up. CONCLUSIONS: We believe cryosurgery must be considered as an
excellent treatment for professional chronic radiodermatitis with
keratomas, ulcerations, and incipient squamous cell carcinomas. Its use may
prevent further dramatic surgical treatment, like amputations, allowing the
preservation of finger function.
6. Goncalves JC.
Fractional cryosurgery. A new technique for basal cell carcinoma of the
eyelids and periorbital area.
Dermatologic Surgery, 1997 Jun, 23(6):475-81.
Pub type: Journal Article; Review; Review of Reported Cases.
(UI: 97360837)
Abstract: BACKGROUND: Cryosurgery is an established method to treat malignant
tumors of the eyelids and periorbital area. Nevertheless, it has been
abandoned for tumors greater than 10 mm, because it gives irregular
esthetic results and, in some cases, lagophthalmos. OBJECTIVE: To devise a
new method for the treatment of such tumors. METHOD: Fractional cryosurgery
is performed in stages: the center of the lesion is frozen, resulting in a
reduction of the tumor; this procedure is repeated, as necessary, until the
lesion's diameter is smaller than 10 mm; the standard cryosurgical
procedure is then carried out. RESULTS: The treatment of the first 20 basal
cell carcinomas with diameters between 10 and 24 mm is described, with
excellent clinical and cosmetic results. CONCLUSION: With fractional
cryosurgery, the final scar bears no relation to the size of the original
tumor but, instead, corresponds to the size of the lesion preceding the
final cryosurgical procedure.
7. Ohtake H; Misaki T; Iwa T; Matsunaga Y; Watanabe G; Takahashi M; Kawasuji M;
Watanabe Y.
Postoperative influences of surgical cryoablation for
Wolff-Parkinson-White syndrome--a analysis of myocardial enzymes and
function.
Japanese Circulation Journal, 1997 May, 61(5):396-401.
Pub type: Clinical Trial; Journal Article.
(UI: 97335573)
Abstract: We evaluated postoperative myocardial enzymes and function associated
with cryoablation in 20 patients with Wolff-Parkinson-White syndrome
undergoing surgical treatment for a single left-sided accessory conduction
pathway. Ten patients underwent endocardial atrial incision with
cryoablation using CO2 at -60 degrees C for 120 sec (group A), while the
remaining 10 patients did not receive cryoablation (group B). Levels of
aspartate aminotransferase (GOT), lactate dehydrogenase (LDH), and creatine
kinase (CK-MB) on postoperative days 1, 2, and 3 were higher in patients in
group A than in group B (p < 0.05). However, mean values remained low (GOT,
120.5 IU/L; LDH, 1105.1 IU/L; CK-MB, 76.3 IU/L). No electrocardiographic
changes were detected. Parameters of cardiac function, including cardiac
index, stroke volume index, systemic vascular resistance, and ejection
fraction, remained unchanged during the postoperative period in both
groups. Furthermore, 201Tl cardiac scintigraphy demonstrated no evidence of
myocardial perfusion defects due to cryoablation in group A. In conclusion,
myocardial damage induced by cryoablation is very minor and is not
associated with any clinical impairment of cardiac function.
8. Iodice F; Tramontana S; Casella G; Tramontana R; Fortuna G; Germano A.
Conization of the uterine cervix: two different surgical techniques.
Journal of Chemotherapy, 1997 Apr, 9(2):133-4.
(UI: 97319872)
9. Weinberger D; Fink-Cohen S; Axer-Siegel R.
Rhegmatogenous retinal detachment operation after radial keratotomy.
Acta Ophthalmologica Scandinavica, 1997 Apr, 75(2):214-5.
(UI: 97341102)
Abstract: Radial keratotomy has recently been introduced for the correction of
myopia. This procedure does not hinder progression of the
pathophysiological changes in the myopic eye. We hereby describe a case of
rhegmatogenous retinal detachment operation after radial keratotomy and
present the operative considerations and refractive results.
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