We aimed to assess the occlusive effectiveness of open-ended vasectomy with mucosal cautery and fascial interposition and to determine the factors associated with occlusion failure. We studied all vasectomies performed between September 1, 2020, and August 31, 2021, by four vasectomy surgeons from Quebec City, Quebec, Canada. Sociodemographic and clinical characteristics were extracted from the electronic medical records. Occlusive effectiveness was assessed in all men with at least one postvasectomy semen analysis (PVSA). The effectiveness criteria were adapted from those of the American Urological Association (AUA) vasectomy guideline. Among the 4000 eligible vasectomies, 2242 (56.1%) were followed by at least one PVSA, with 99 (4.4%) requiring more than one PVSA. Occlusive effectiveness was achieved in 2233 vasectomies (99.6%; 95% confidence interval [CI]: 99.3%-99.8%), with 2199 (98.1%) and 34 (1.5%) classified as confirmed and probable success, respectively. The final status of the three vasectomies (0.1%) was indeterminate. Occlusive failure was observed in six vasectomies (0.3%; 95% CI: 0.1%-0.6%). The four surgeons had a similar risk of failure. The only significant factor associated with failure was the difficulty in performing the vas occlusion reported by the surgeon (7.4% [2/27] vs 0.2% [4/2212]; relative risk = 41.0; 95% CI: 7.8-214.2). The high occlusive effectiveness observed in our study validates AUA recommendations, supporting the use of this technique. Difficulty in occlusion of the vas deferens, as reported by surgeons, was the only factor associated with vasectomy failure. This finding highlights the need for PVSA in such cases.
Humans ; Male ; Vasectomy/instrumentation* ; Cautery/methods* ; Adult ; Middle Aged ; Treatment Outcome ; Semen Analysis ; Quebec

Objective:To explore the diagnosis and minimal invasive treatment of neonatal pyriform sinus fistula. Methods:A retrospective analysis was conducted on the clinical data of newborns diagnosed with pyriform sinus fistula in the Children's Hospital, Zhejiang University School of Medicine from January 2016 to December 2023, including the diagnostic process and treatment methods. Results:There were 8 children, 2 males and 6 females, with 7 cases on the left side and 1 case on the right side. Six cases revealed a lump in the fetal neck during prenatal examination, and two cases were found to have a neck mass after birth. All cases presented with varying degrees of respiratory disorders. After admission, all patients underwent neck ultrasound and contrast-enhanced CT examination. Neck ultrasound showed cystic masses, with 3 of the cysts accompanied by septa, and an air-fluid level was observed in the cysts in 6 cases from contrast-enhanced CT. All patients underwent ultrasound-guided neck mass puncture and/or tube placement combined with endoscopic electrocauterization. The cystic fluid was found to be yellow and thin, with no signs of infection. The surgical operations were uneventful, and the follow-up time ranged from 12 to 72 months postoperatively. There were no complications such as hoarseness, and no recurrence cases were reported. Conclusion:Neonatal pyriform sinus fistula is often characterized by a large cystic mass in the neck combined with respiratory depression. The presence of an air-fluid level in the cyst from contrast-enhanced CT can be considered an important basis for early diagnosis of pyriform sinus fistula. Ultrasound-guided puncture combined with endoscopic electrocauterization is minimally invasive and safe, making it a suitable minimal invasive treatment for neonatal pyriform sinus fistula.
Humans ; Female ; Male ; Pyriform Sinus/surgery* ; Retrospective Studies ; Infant, Newborn ; Cautery/methods* ; Endoscopy ; Fistula/surgery* ; Punctures ; Tomography, X-Ray Computed

The retinal degeneration resulting from elevated intraocular pressure was evaluated through functional and morphological analyses, for better understanding of the pathophysiology of glaucoma. Ocular hypertension was induced via unilateral episcleral venous cauterization in rats. Experimental time was set at 1 and 3 days, and 1, 2, 4, and 8 weeks post-operation. Retinal function was analyzed using electroretinography. For morphological analysis, retinal tissues were processed for immunochemistry by using antibodies against the calcium-sensing receptor and calcium-binding proteins. Apoptosis was analyzed using the TUNEL method and electron microscopy. Amplitudes of a- and b-wave in scotopic and photopic responses were found to be reduced in all glaucomatous retinas. Photopic negative response for ganglion cell function significantly reduced from 1-day and more significantly reduced in 2-week glaucoma. Calcium-sensing receptor immunoreactivity in ganglion cells remarkably reduced at 8 weeks; conversely, protein amounts increased significantly. Calcium-binding proteins immunoreactivity in amacrine cells clearly reduced at 8 weeks, despite of uneven changes in protein amounts. Apoptosis appeared in both photoreceptors and ganglion cells in 8-week glaucomatous retina. Apoptotic feature of photoreceptors was typical, whereas that of ganglion cells was necrotic in nature. These findings suggest that elevated intraocular pressure affects the sensitivity of photoreceptors and retinal ganglion cells, and leads to apoptotic death. The calcium-sensing receptor may be a useful detector for alteration of extracellular calcium levels surrounding the ganglion cells.
Amacrine Cells ; Animals ; Antibodies ; Apoptosis ; Calcium ; Calcium-Binding Proteins ; Cautery ; Electroretinography ; Ganglion Cysts ; Glaucoma ; Immunochemistry ; In Situ Nick-End Labeling ; Intraocular Pressure ; Methods ; Microscopy, Electron ; Ocular Hypertension ; Rats ; Receptors, Calcium-Sensing ; Retina ; Retinal Degeneration ; Retinal Ganglion Cells ; Retinaldehyde

BACKGROUND AND OBJECTIVES: To investigate the common site of recurrent epistaxis after initial intervention such as packing and cauterization had failed and to evaluate the efficacy of surgical endoscopic electrocautery. SUBJECTS AND METHOD: Retrospective review of 47 patients with recurrent and uncontrolled idiopathic epistaxis between October 1995 and March 2016. All patients underwent endoscopic examination in the operating room after hospitalization. We performed electrocautery when a bleeding site was found. RESULTS: The most common sites of bleeding were the inferior meatus (28%), sphenoethmoid recess (23%), superior septum around the olfactory cleft (13%), and the posterior end of the middle turbinate (15%). There was no serious complication during the one week after surgery. In 46 (98%) patients, refractory epistaxis was successfully controlled. One patient had recurrent epistaxis after electrocautery and underwent endoscopic sphenopalatine artery ligation. CONCLUSION: In patients with refractory idiopathic epistaxis after failure of first-line treatment, endoscopic examination through a surgical approach and electrocautery for suspected bleeding are effective.
Arteries ; Cautery ; Electrocoagulation ; Epistaxis* ; Hemorrhage ; Hospitalization ; Humans ; Ligation ; Methods ; Operating Rooms ; Retrospective Studies ; Turbinates

OBJECTIVETo probe and systematize the ancient cauterization with pyropuncture needle for evacuation of pus.

METHODSOne hundred and eight cases of body surface abscess were randomly divided into 2 groups. The cauterization group (n=84) were treated by drainage with electric cauterization and the incision group (n=24) by drainage with incision. Clinical therapeutic effect, the healing time and the scar area of the wound were compared between the two groups.

RESULTSAll of the patients in the two groups were effective with a similar therapeutic effect (P > 0.05); the cauterization group in the healing time and the scar area of the wound was superior to the incision group (P < 0.05).

CONCLUSIONElectric cauterization for evacuation of pus has advantages of rapid healing and small scar area of wound.

Abscess ; therapy ; Adult ; Aged ; Cautery ; methods ; Female ; Humans ; Male ; Medicine, Chinese Traditional ; Middle Aged ; Skin Diseases ; therapy

Vasectomy is a commonly used, highly effective method for the control of fertility in the human male. It is almost always performed as an outpatient procedure, is safer than tubal occlusion and has few side effects. The number of people relying on vasectomy as a method of contraception varies widely from country to country. Though vasectomy is highly effective, failures may occur due to re-canalization of the vas, surgical error, anatomical variants or failure of contraception during the post-operative waiting period. One of the disadvantages of this technique is that sperm are present in the posterior end of the vas following surgery and hence patients have to use alternative methods of contraception for a waiting period of 12 weeks to 15 weeks before relying on a vasectomy for contraception. This review summarizes recent research on vasectomy conducted by Family Health International, USA.
Adult ; Cautery ; Humans ; Ligation ; Male ; Nepal ; Oligospermia ; Sperm Count ; Vas Deferens ; surgery ; Vasectomy ; methods

This dealt with the 23 cases of giant cell tumor of femur and tibia who were treated with curettage and cementation of the lesion, over 14 year period. Cement by virtue of it's heat of polymerization may “sterilize” the wall upto 3-5mm in depth. Authors adoped cement treatment as an effective adjuvant after intra-lesional surgery(curettage). Curettage was indicated in all stage I lesions; most stage 2 and some stage 3 lesions, provided the residual bone stock were sufficient to make it oncologically and mechanically effective. The follow-up period ranged from 3 to 14 years(oaverage 8 years and 6 months). The sites of the lesions were proximal tibia in 8, dital femur in 13, proximal femur in one, and distal tibia in one. Among these cases, 3(13.0%) cases(two grade 1 and one grade 2) of stage II(To: active), and 2(8.7%) of stage III(grade 2) (Tl or T2: aggressive). Utmost attention was paid to nulify or to reduce the local seeding of the tumor cell during aggressive curettage, which was followed by electrical cautery of the cavitey wall, and lastly by the cavity obliteration with bone cement. None of the cases had lung metastasis. Only in a stage III GCT case(4.3%) of local recurrence after curettage and bone and artificial bone graft, recurettage and cementation brought the successful outcome. Through this study, it was reconfirmed that with correct indications the use of cement as a local adjuvant in conjuction with curettage was effective method in treating GCT without any side effects.
Cautery ; Cementation ; Curettage ; Femur ; Follow-Up Studies ; Giant Cell Tumors ; Hot Temperature ; Lung ; Methods ; Neoplasm Metastasis ; Polymerization ; Polymers ; Recurrence ; Tibia ; Transplants ; Virtues

Giant cell tumor is a predominantly benign condition but often the tumor is locally aggressive and tends to have high rate of recurrence and it can evolve into a malignant tumor. Thus the lesions have a practically difficult therapeutic problem for the orthopaedic surgeon and any method of treatment has not been satisfied. Between March 1984 and March 1993, clinical observation was carried out on 22 cases of giant cell tumor of bone to analyse the recurrence rate and functional evaluation of the joint according to the treatment methods, pathological grade and cortical destruction. The mean follow-up time was 75. 2 months. The recurrence rate of the intralesional excision group was 54.5% and that of the wide excision group was 9%, There was no relationship between the pathologic grade and recurrence rate. There was no recurrent case in the grade I cortical destruction but almost all of recurrence was occurred in the grade I or II cortical destruction. The functional result of the giant cell tumor occurred around the knee joint was that the mean ratings in the intralesional excision group were 79% and in the wide excision group were 51%. In conclusion, to achieve better joint function and less recurrence rate, intralesional or marginal excision with heat using bone cement or with chemical cauterization using phenol and alcohol can be used for cases of radiological grade I or II, and wide excision for grade III.
Cautery ; Follow-Up Studies ; Giant Cell Tumor of Bone ; Giant Cell Tumors ; Giant Cells ; Hot Temperature ; Joints ; Knee Joint ; Methods ; Phenol ; Recurrence

Suppurative arthritis of the knee is a well known complication following intra-articular injection of steroids on the other hand, tuberculous arthritis following such injection is rare. From January, 1981 to April, 1986, 46 patients of tuberculous arthritis of the knee were admitted to Severance Hospital and Yong-Dong Severance Hospital of Yonsei University College of Medicine. Among them 22 patient (48%) had a history of intra-articular injection of steroids and we analyzed them. The results were as follows: 1. The average age was 48.6 years (3–71 years). And sex ratio was in 1:2.7 as female predominant. 2. Initial diagnosis before the steroid injection were osteoarthritis (13 patients), rheumatoid arthritis (6 patients), and traumatic arthritis (3 patients). The fifty percent of the patients were injected by the local practitioner and fourty five percent had a history of accupuncture and moxa cautery. The preoperative diagnosis (diagnosis on admission) were tuberculous arthritis (12 patients), pyogenic arthritis (5 patients), rheumatoid arthritis (3 patients) and osteoarthritis(2 patients). 3. The number of intra-articular injection ranged from 2 to 100 times (average 12.8) during periods ranging from 1 month to 4 years (average 19.2 months). And interval between last injection and confirmation of tuberculous arthritis ranged from 1 week to 2 years (average 7.0 months). 4. Eight patients (36%) had a active or inactive pulmonary tuberculosis. 5. The positive cultures of typical Mycobacteria tuberculosis were obtained from 11 patients 59%). 6. The modalities of treatment were synovectomy or curettage in 16 patients and arthrodesis in 6 patients. And all patients were treated by antibuberculous chemotherapy. In conclusion, we observed that tuberculous arthritis developed not infrequently after intra-articular injection of steroids. And we considered the causes of tuberculous arthritis following intra-articular injection of steroids were; 1) reactivation of dormant injection or hematogenous, spreed due to interferance of host defence mechanisms, 2) contamination by the instrument and equipment, 3) aggravation of preexisting tuberculous lesions. Whenever one try to inject the steroid into joint, bacterial culture foi the pyogenic organism including tuberculosis and fluid analysis from the joint fluid should be done before the injection. We recommend that other method for the confirmation for the tuberculosis is needle biopsy of the synovium. If the symptoms are not improved after injection or the joint shows inflammatory reaction, one must discontinue the injection and reexamine the joint fluid analysis and culture for the confirmation of the infection.
Arthritis ; Arthritis, Infectious ; Arthritis, Rheumatoid ; Arthrodesis ; Biopsy, Needle ; Cautery ; Curettage ; Diagnosis ; Drug Therapy ; Female ; Hand ; Humans ; Injections, Intra-Articular ; Joints ; Knee Joint ; Knee ; Methods ; Osteoarthritis ; Sex Ratio ; Steroids ; Synovial Membrane ; Tuberculosis ; Tuberculosis, Pulmonary

3 cases of giant cell tumor in the distal femur or upper tibia were treated by curettage and acrylic cement packing between October 1978 and May 1981. All were females. The postoperative courses were satisfactory with no recurrence or malignant change for periods of 16 months to 30 months. In one case, acrylic cement reinforced with tantalum wire was used because it is superior to acrylic cement alone in mechanical properties. The adventages of this method are: 1. The cautery effect of setting cement. 2. Avoidence of the need for large quantities of cancellous bone 3. The possibility of incorporating a prosthesis if the lesion is extensive. 4. Rapid mobilization. 5. Ease of early diagnosis of recurrence.
Cautery ; Cementation ; Curettage ; Early Diagnosis ; Female ; Femur ; Giant Cell Tumors ; Giant Cells ; Humans ; Methods ; Prostheses and Implants ; Recurrence ; Tantalum ; Tibia