Adult ; Electrocoagulation ; adverse effects ; methods ; Fatal Outcome ; Glossopharyngeal Nerve ; surgery ; Glossopharyngeal Nerve Diseases ; surgery ; Humans ; Male ; Microwaves

Chronic lower back pain is one of the most common musculoskeletal problems; it is also the most expensive industrial injury. Not surprisingly, many treatments have been developed to combat this expensive and debilitating condition. One of these, intradiscal electrothermal treatment (IDET), was developed for patients with chronic discogenic lower back pain who failed to improve with any of the wide variety of non- surgical treatments. The present study sought to evaluate the efficacy of IDET for patients with chronic lower back pain. Twenty-five patients were enrolled in this prospective study; the patients received IDET between June 2001 and June 2003. MRI was used to confirm the diagnosis of internal disc disruption in all patients. The patients then underwent a pre-operative provocative test and discography. The follow-up duration was at least 1 year in all cases, and the visual analogue scale, recovery rate, and satisfaction of each patient were evaluated. The average age of the patients was 32 years (age range 18 to 49 years), and the patient group was 33% male and 67% female. Of the 25 patients, 5 underwent lumbar fusion surgery within 1 year of IDET. After IDET, 8 patients (32%) reported more pain than before, 14 patients (56%) reported less pain, and 3 patients (12%) experienced no change. Twelve patients (48%) were satisfied with IDET, 11 (44%) were dissatisfied, and 2 (8%) were undecided about the treatment. At least 1 year after IDET, nearly half the study patients were dissatisfied with their medical outcome. Consequently, 5 patients (20%) underwent fusion surgery at 1 year after IDET. Although other studies have shown good results with IDET for at least 2 years, this investigation suggests the IDET may be somewhat less effective. In order to firmly establish the efficacy of IDET for treating chronic discogenic lower back pain, additional studies with larger numbers of patients evaluated over longer time periods are recommended.
Adolescent ; Adult ; Chronic Disease ; Electrocoagulation/adverse effects/*methods ; Female ; Humans ; Intervertebral Disk Displacement/*surgery ; Low Back Pain/*surgery ; Male ; Middle Aged ; Prospective Studies

OBJECTIVE: A number of new techniques have been developed to prevent lymphocele formation after pelvic lymphadenectomy in gynecologic cancers. We assessed whether the electrothermal bipolar vessel sealing device (EBVSD) could decrease the incidence of postoperative lymphocele secondary to pelvic lymphadenectomy. METHODS: A total of 321 patients with gynecologic cancer underwent pelvic lymphadenectomy from 2005 to 2011. Pelvic lymphadenectomy without EBVSD was performed in 134 patients, and pelvic lymphadenectomy with EBVSD was performed in 187 patients. We retrospectively compared the incidence of lymphocele and symptoms between both groups. RESULTS: Four to 8 weeks after operation, 108 cases of lymphocele (34%) were detected by computed tomography scan examination. The incidence of lymphocele after pelvic lymphadenectomy was 56% (75/134) in the tie ligation group, and 18% (33/187) in the EBVSD group. We found a statistically significant difference in the incidence of lymphocele between both groups (p<0.01). To detect the independent risk factor for lymphocele development, we performed multivariate analysis with logistic regression for three variables (device, number of dissected lymph nodes, and operation time). Among these variables, we found a significant difference (p<0.001) for only one device. CONCLUSION: Use of the EBVSD during gynecological cancer operation is useful for preventing the development of lymphocele secondary to pelvic lymphadenectomy.
Adult ; Electrocoagulation/instrumentation/*methods ; Female ; Genital Neoplasms, Female/pathology/*surgery ; Humans ; Lymph Node Excision/adverse effects/*methods ; Lymphatic Metastasis ; Lymphocele/etiology/*prevention & control ; Middle Aged ; Neoplasm Staging ; Pelvis ; Retrospective Studies ; Risk Factors

BACKGROUNDThe efficacy of percutaneous intradiscal radiofrequency thermocoagulation (PIRFT) for the treatment of discogenic low back pain (LBP) remains controversial. However, all the PIRFT studies utilized monopolar radiofrequency thermocoagulation (RFTC). The aim of this study was to investigate the safety and efficacy of bipolar RFTC for the treatment of discogenic LBP.

METHODSA total of 23 patients with discogenic LBP were treated with single-level bipolar RFTC. The patients were assessed before the procedure and at 1 week, 1 month, 3 months, 6 months, and 1 year after the procedure. The primary outcome included the visual analog scale (VAS) score and the Oswestry Disability Index (ODI) score. The secondary outcome included pain relief, reduction of analgesic dose, and patient satisfaction.

RESULTSThe VAS and ODI scores were significantly decreased after bipolar RFTC treatment at all time points of follow-up (P < 0.05). Bipolar RFTC treatment also resulted in a significant change in all secondary measures, such as pain relief, reduction of analgesic dose, and patient satisfaction. No serious complications or neurological sequelae were observed in any of the patients.

CONCLUSIONSBipolar RFTC treatment can significantly attenuate pain and improve the function of patients with discogenic LBP.

Adult ; Aged ; Electrocoagulation ; adverse effects ; methods ; Female ; Fluoroscopy ; methods ; Humans ; Intervertebral Disc Displacement ; complications ; therapy ; Low Back Pain ; genetics ; therapy ; Male ; Middle Aged ; Patient Satisfaction ; Time Factors ; Treatment Outcome

BACKGROUNDPercutaneous radiofrequency thermocoagulation of the trigeminal ganglion (PRTTG) is regarded as the first choice for most patients with trigeminal neuralgia (TN) because of its safety and feasibility. However, neuronavigator-guided PRTTG has been seldom reported. The purpose of this study was to assess the safety and efficacy of neuronavigator-guided PRTTG for the treatment of intractable TN.

METHODSBetween January 2000 and December 2004, 54 patients with intractable TN were enrolled into this study and were randomly divided into two groups. The patients in navigation group (n = 26) underwent PRTTG with frameless neuronavigation, and those in control group (n = 28) received PRTTG without neuronavigation. Three months after the operation, the efficacy, side effects, and complications of the surgery were recorded. The patients in the control group were followed up for 10 to 54 months (mean, 34 +/- 5), and those in the navigation group were followed up for 13 to 58 months (mean, 36 +/- 7). Kaplan-Meier analyses of the pain-free survival curves were used for the censored survival data, and the log-rank test was used to compare survival curves of the two groups.

RESULTSThe immediate complete pain-relief rate of the navigation group was 100%, whereas it was 95% in the control. The proportion of sustained pain-relief rates at 12, 24 and 36 months after the procedure were 85%, 77%, and 62% in the navigation group, and 54%, 40%, and 35% in the control. Recurrences in the control group were more common than that in the navigation group. Annual recurrence rate in the first and second years were 15% and 23% in the navigation group, and 46%, 60% in the control group. No side-effect and complication was noted in the navigation group except minimal facial hypesthesia.

CONCLUSIONNeuronavigator-guided PRTTG is a safe and promising method for treatment of intractable TN with better short- and long-term outcomes and lower complication rate than PRTTG without neuronavigation.

Aged ; Electrocoagulation ; adverse effects ; instrumentation ; methods ; Female ; Follow-Up Studies ; Humans ; Hypesthesia ; etiology ; Male ; Middle Aged ; Recurrence ; Survival Analysis ; Survival Rate ; Treatment Outcome ; Trigeminal Ganglion ; pathology ; surgery ; Trigeminal Neuralgia ; mortality ; surgery

OBJECTIVETo observe the short-term efficacy and safety of Shenqi mixture (SQM) combined with microwave coagulation in treating primary hepatocellular carcinoma (HCC).

METHODSSeventy-two patients with primary HCC of stage II-III, Karnofsky scoring > or = 50 scores and predicted survival period > or = 3 months were selected and randomly assigned into two groups, the treated group and the control group, 36 in each. Microwave therapy was applied to both groups by double leads, 60 W, 800 sec once a week for two weeks. To the treated group, SQM was given additionally through oral intake of 20 ml, three times a day for 1 month. The changes in tumor size, main symptoms, serum level of alpha-fetoprotein (AFP), immune function and adverse reaction were observed after treatment and the immune parameters of the patients were compared with 30 healthy persons in the normal control group.

RESULTS(1) In the SQM treated group, after treatment 3 patients got completely remitted (CR), 24 partial remitted (PR), 4 unchanged (NC) and 5 progressively deteriorated (PD), the effective rate being 75.00%; while in the control group, 1 got CR, 19 PR, 9 NC and 7 PD, the effective rate being 55.56%. Comparison of the effective rate between the two groups showed significant difference (P < 0.05). (2) AFP level decreased after treatment in both groups, but the decrement in the treated group was significantly higher than that in the control group (P < 0.01). (3) After treatment, in the treated group, CD3(+), CD4(+), CD4(+)/CD8(+) and NK activity were improved, Karnofsky scores increased and liver function bettered, with these improvements significantly superior to those in the control group (P < 0.01). (4) The improvement in symptoms such as hepatic region pain, fever, weakness, poor appetite and jaundice in the treated group after treatment was also superior to that in the control group (P < 0.01). (5) The 12-month, 18-month and 24-month survival rates were higher and the recurrence rate was lower in the treated group than those in the control group, showing significant difference (P < 0.05).

CONCLUSIONCombined therapy with SQM and microwave coagulation could not only kill the tumor and residue tumor cells to prevent recurrence, but also enhance the cellular immunity of organism. It is one of the effective therapies for patients with middle-advanced hepatocarcinoma, who have lost the chance of surgical operation. It could improve clinical symptoms, elevate the quality of life, prolong the survival period of patients, but shows no evident adverse reaction.

Adult ; Carcinoma, Hepatocellular ; drug therapy ; immunology ; mortality ; pathology ; Combined Modality Therapy ; Drugs, Chinese Herbal ; administration & dosage ; adverse effects ; Electrocoagulation ; methods ; Female ; Humans ; Leukocyte Count ; Liver Function Tests ; Liver Neoplasms ; drug therapy ; immunology ; mortality ; pathology ; Male ; Microwaves ; therapeutic use ; Middle Aged ; Neoplasm Recurrence, Local ; Survival Rate ; alpha-Fetoproteins ; metabolism