| September 2nd | September 9th | September 16th | September 23d | September 30th | |
| BIOSYS | | | | | |
| MEDLINE | | | | | |
1. Kuflik, E G; Gage, A A.
Recurrent basal cell carcinoma treated with cryosurgery.
Journal of the American Academy of Dermatology, v.37, n.1, (1997): 82-84.
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.
1. Borgatta L; Lopatinsky I; Shaw FM.
Overcoming unsatisfactory colposcopy. Use of osmotic dilators.
Journal of Reproductive Medicine, 1997 May, 42(5):271-5.
(UI: 97316144)
Abstract: OBJECTIVE: To evaluate the usefulness of osmotic dilators as an
alternative to diagnostic cone biopsy. STUDY DESIGN: Women who had an
unsatisfactory colposcopic examination were offered repeat examination
after use of osmotic dilators as part of an interventional, nonrandomized
study. The physician selected the type, size and duration of use of the
dilator. RESULTS: Twenty-nine of 32 women (91%) underwent a satisfactory
repeat examination. Diagnostic cone biopsy was avoided in all women.
Twenty-one women did not require further treatment, and four women had the
lesion removed by the colposcopically directed biopsy. Six women underwent
electrosurgery, and one woman underwent cryotherapy. CONCLUSION: The use of
osmotic dilators can decrease the need for diagnostic cone biopsy.
2. Lacroix D.
[An update of surgery for ventricular tachycardia].
Archives des Maladies du Coeur et des Vaisseaux, 1997 Apr, 90 Spec No
1:19-26.
Language: French.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97381097)
Abstract: The implantable defibrillator has, to a certain degree, taken over
some of the indications of antiarrhythmic surgery in ventricular
tachycardia resistant to drug therapy. Initially reserved for patient with
ventricular aneurysms, this form of surgery may also be proposed for
patients with localised infarction. The multiplicity of forms of
tachycardia, the variability of their mechanism which is not always limited
to the subendocardial layers requires mapping procedure to guide the
surgical intervention on the arrhytmogenic substrate. The so-called
regional procedures which, for most workers, combine resection and
cryo-ablation, is a good compromise between risk and efficacy. This surgery
used to be associated with a high mortality but this has been considerably
reduced by technical advances in myocardial protection. Similarly, the
failure rate has also been reduced by the identification of "atypical"
mechanisms. These improvements have been obtained thanks to systems of
mapping which allow investigation of the epicardium/endocardium
relationship and activation of the deep septal regions. Although the two
techniques are not designed for the same type of patient, global mortality
of surgically treated patients in the long term is not different to that of
patients with an implantable defibrillator. Clinical efficacy of
antiarrhythmic surgery is over 90% at 5 years in the majority of large
scale trials. This type of surgery is the only really radical approach
because of the limitations of catheter ablation and should be considered to
be complementary to the implantable defibrillator in the management of
post-infarction ventricular tachycardia.
3. Maturanza M; Maritato F; Costanzo A; Pavero R; Battistini G.
[Combined outpatient surgical-cryotherapeutic treatment of anal fissures.
Our experience].
Minerva Chirurgica, 1997 Apr, 52(4):393-5.
Language: Italian.
(UI: 97367129)
Abstract: The authors describe their technique and their experience of
ambulatory surgical-cryotherapeutic combined, treatment of anal fissure.
The data were observed in 35 patients (medium age 37.5); in 16 cases,
previous treatments gave no benefit. The surgical treatment was the lateral
internal close sphincterotomy according to Notaras, with local anesthesia
(personal technique), followed by a fissure curettage with a N protosside
cryosound. The results confirm the well known effectiveness of lateral
internal sphincterotomy and the validity of ambulatory treatment and of
cryotherapy.
4. Mallon E; Dawber R.
Cryosurgery in the treatment of basal cell carcinoma. Assessment of one
and two freeze-thaw cycle schedules.
Dermatologic Surgery, 1996 Oct, 22(10):854-8.
Pub type: Clinical Trial; Journal Article; Randomized Controlled Trial.
(UI: 97388951)
Abstract: BACKGROUND: It has become routine practice in many centers to use two
successive freeze-thaw cycles in the treatment of the common types of basal
cell carcinoma. Because of the potential morbidity caused by this, we have
investigated the cure rate achieved with one freeze-thaw cycle compared
with that achieved with two freeze-thaw cycles in the treatment of facial
basal cell carcinomas of a uniform type and clinically in the best
prognostic group. Superficial truncal basal cell carcinomas are reported to
respond to less aggressive cryosurgery, and we have investigated the cure
rate achieved with one freeze-thaw cycle. OBJECTIVE: To compare the
efficacy of one freeze-thaw cycle versus two freeze-thaw cycles in the
treatment of facial basal cell carcinomas. Second, to investigate the
efficacy of one freeze-thaw cycle in the treatment of superficial truncal
basal cell carcinomas. This was investigated in a prospective randomized
post-treatment follow-up study. METHODS: Over the past 7 years, we have
treated 84 facial basal cell carcinomas with either a single 30-second
freeze-thaw cycle or a double 30-second freeze-thaw cycle. Patients were
allocated randomly into one of the two treatment schedules, and the cure
rates achieved were compared. Second, 29 superficial truncal basal cell
carcinomas were treated with a single 30-second freeze-thaw cycle. Patients
were followed up to assess response to therapy. RESULTS: A 95.3% cure rate
was achieved in the treatment of facial basal cell carcinomas with a double
freeze-thaw cycle. This compared with a cure rate of only 79.4% when facial
lesions were treated with a single freeze-thaw cycle. Treatment of
superficial truncal basal cell carcinomas with a single freeze-thaw cycle
achieved a cure rate of 95.5%. CONCLUSION: We recommend that, in order to
achieve high cure rates that are equivalent to many reports of formal
excision or radiotherapy, facial basal cell carcinomas require a double
freeze-thaw cycle with liquid nitrogen. One freeze-thaw cycle to truncal
basal cell carcinomas achieves high cure rates, equal to that achieved with
a double freeze-thaw cycle to facial basal cell carcinomas.
5. Rees RT; Rowson JE.
Two new retractors for use in cryotherapy.
British Journal of Oral and Maxillofacial Surgery, 1997 Jun, 35(3):199-200.
(UI: 97355819)
Abstract: Two new instruments are described for use in the cryotherapy of
peripheral nerves. They are designed to give good vision and access,
protect surrounding tissues and be comfortable to hold.
6. Marcushamer M; King DL; Ruano NS.
Cryosurgery in the management of mucoceles in children.
Pediatric Dentistry, 1997 May-Jun, 19(4):292-3.
(UI: 97343683)
7. Rabin Y; Julian TB; Wolmark N.
A compact cryosurgical apparatus for minimally invasive procedures.
Biomedical Instrumentation and Technology, 1997 May-Jun, 31(3):251-8.
(UI: 97325191)
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%.
8. Shalimov SO; Keisevich LV; Litvinenko OO; Koval'chuk OV.
[Analgesia in pancreatic cancer. Achievements and perspectives].
Klinicheskaia Khirurgiia, 1997(1):38-42.
Language: Ukrainian.
Pub type: Journal Article; Review; Review, Tutorial.
(UI: 97370688)
(none)
1. Limmer BL; Clark DP.
Cutaneous micrographic surgery for atypical fibroxanthoma.
Dermatologic Surgery, 1997 Jul, 23(7):553-7; discussion 557-8.
(UI: 97380074)
Abstract: BACKGROUND: Atypical fibroxanthoma is a locally aggressive cutaneous
tumor of the head and neck. Reported treatments include simple excision,
cryosurgery, radiation, and cutaneous micrographic surgery. OBJECTIVE: We
wish to further document the use of cutaneous micrographic surgery for
local control of atypical fibroxanthoma. METHODS: A retrospective study of
six cases from the University of Missouri-Columbia and a review of the
literature. RESULTS: Five (84%) of our cases were on the heads of elderly
patients with strong evidence of photodamage. Subclinical extension of
atypical fibroxanthoma required surgical margins averaging 9 mm. Cutaneous
micrographic surgery has been associated with no recurrences. CONCLUSION:
The results of our data demonstrate cutaneous micrographic surgery to be an
excellent modality to address this locally aggressive tumor. Cutaneous
micrographic surgery is an advantageous therapy for this tumor because of
its meticulous tissue removal, tissue mapping, and tissue sparing
qualities.
2. Holman MR; Rowland SJ.
Design and development of a new cryosurgical instrument utilizing the
Peltier thermoelectric effect.
Journal of Medical Engineering and Technology, 1997 May-Aug, 21(3-4):106-10.
(UI: 97366141)
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 degrees 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 dioxide 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.
1. Al-Majali, O; Routh, H B; Abuloham, O; Bhowmik, K R; Muhsen, M; Hebeheba, H.
A 2-year study of liquid nitrogen therapy in cutaneous leishmaniasis.
International Journal of Dermatology, v.36, n.6, (1997): 460-462.
Abstract:
Background: Among the different modalities for treatment of cutaneous
leishmaniasis, liquid nitrogen is considered an effective therapy with
very mild side-effects. Methods: A study was conducted using liquid
nitrogen topically for the treatment of cutaneous leishmaniasis in the
King Hussain Medical Centre, Amman-Jordan. Among 468 patients of cutaneous
leishmaniasis, 293 were treated with liquid nitrogen and the rest were
treated with other known treatment modalities. Results: Of the patients
treated with cryo surgery liquid nitrogen, 215 of 293 permitted
appropriate follow-up; the clinical response was significant and
effective. No systemic adverse effects were noted. Mild cutaneous
complications were infrequent, and included hypopigmentation,
hyperpigmentation, and scar formation. Conclusions: From the results of
this study, liquid nitrogen therapy may be considered an effective
treatment for cutaneous leishmaniasis.
2. Schmidt, J D.
Transperineal ultrasound-guided prostate cryosurgery.
Journal of Surgical Oncology, v.65, n.3, (1997): 228-229.
3. Lertzman, B H; McMeekin, T; Gaspari, A A.
Pulsed dye laser treatment of angiolymphoid hyperplasia with eosinophilia
lesions.
Archives of Dermatology, v.133, n.7, (1997): 920-921.
4. McMurrick, P J; Nelson, H.
Liver-directed therapies for gastrointestinal malignancies.
Current Opinion in Oncology, v.9, n.4, (1997): 367-372.
(none)
(none)
1. Yamauchi S; Imura H; Bessho R; Yamada K; Tanaka S.
Simultaneous surgical correction of a common atrium and impure flutter.
Annals of Thoracic Surgery, 1997 Aug, 64(2):548-52.
(UI: 97408096)
Abstract: We performed surgical correction and treatment of a common atrium and
chronic impure flutter using a computerized mapping system in a 49-year-old
man. A reentrant circuit was observed to exist around the left atrial
appendage. In contrast to the regular activation in the left atrium, the
activation sequence of the right atrium was extremely chaotic. Cryolesions
were applied to the area of the reentrant pathway. After the operation,
sinus rhythm was restored.
2. Boullie MC.
Nitrous oxide cryosurgery applied to skin cancers [letter].
Dermatologic Surgery, 1997 Aug, 23(8):714-6.
Pub type: Letter.
(UI: 97401084)
3. Tempe DK; Joshi N; Mehta N; Khanna SK; Banerjee A; Tyagi S.
Anaesthetic management of patients undergoing surgery for
tachyarrhythmias. Initial experience with 16 patients.
Indian Heart Journal, 1997 Mar-Apr, 49(2):173-8.
(UI: 97375220)
Abstract: Sixteen patients suffering from various cardiac arrhythmias were
treated surgically. Intraoperative computerised electrophysiologic mapping
was used in 14. Thirteen patients were suffering from Wolff-Parkinson-White
syndrome. They underwent surgical division or cryoablation of accessory
pathways. Two patients who had rheumatic mitral stenosis with left atrial
clot underwent "Maze III" procedure with open mitral commissurotomy and
clot removal. One patient with paroxysmal refractory ventricular
tachycardia and a left ventricular aneurysm had an aneurysmectomy with
subendocardial resection of the arrhythmic focus. All antiarrhythmic
medications were discontinued preoperatively. Morphine was the principal
anaesthetic agent, supplemented with halothane. Muscle relaxation was
provided with pancuronium bromide. The various problems encountered
included hypotension and arrhythmia during placement of epicardial band
array for mapping (4 patients), ventricular tachycardia during internal
jugular vein cannulation (1 patient) and continuance of delta wave after
cryoablation in 2 patients. Halothane may have interfered with
electrophysiologic mapping and accurate localization of accessory pathway
leading to persistence of delta wave. The choice of anaesthetic agents
should be guided by the electrophysiologic effects and potential influence
of these agents on the accessory pathways.