Rapid endoscopic control of bleeding gastric erosions by laser radiation.
TL;DR: In seven dogs, anesthetized and heparinized, bleeding ulcers caused by hot acid jets stopped after five seconds of laser radiation, and the rapid production of hemostasis leads to consideration of the CO2laser in certain poor-risk patients who have massive bleeding from gastric erosions.
Abstract: An unfocused continuous-wave carbon dioxide (CO2) laser was used in dogs with bleeding gastric ulcers or erosions. The laser radiation was delivered through an endoscope introduced orally. In seven dogs, anesthetized and heparinized, bleeding ulcers caused by hot acid jets stopped after five seconds of laser radiation. In four additional dogs, similar ulcers required five minutes of electrocoagulation for hemostasis. In seven dogs, bleeding from mechanically caused abrasions was stopped in three to five seconds by laser. In five other dogs, such abrasions required five minutes of coagulation. Laser radiation produced a thin coagulum on the surface of the lesions. Regenerating mucosa was seen in all dogs at killing after seven days. The rapid production of hemostasis leads to consideration of the CO2laser in certain poor-risk patients who have massive bleeding from gastric erosions.
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TL;DR: In this article, an integrated CO2 laser and beam manipulator designed specifically for surgical research work is descirbed, and operational characteristics of the instrument relevant to such work are reported.
Abstract: The characteristics of CO2 lasers that render them interesting for surgical applications are reviewed. An instrument consisting of an integrated CO2 laser and beam manipulator, designed specifically for surgical research work, is descirbed. Operational characteristics of the instrument relevant to such work are reported. An accessory for endoscopic surgery is described and instrumentation for microsurgery is discussed. Surgical researches now in progress with this instrument are mentioned.
126 citations
TL;DR: Preliminary results on the spectral dependence of the absorption of light in tissue are presented and discussed with respect to medical laser application.
Abstract: Preliminary results on the spectral dependence of the absorption of light in tissue are presented and discussed with respect to medical laser application.
104 citations
TL;DR: The experience of this study suggests that the major value of laser treatment of the lower genital tract will be in the management of vaginal intraepithelial lesions, while similar results in the treatment of cervical neoplasia may be achieved by much simpler methods.
101 citations
TL;DR: Using this ulcer model nonsurgical modalities for the treatment of upper gastrointestinal bleeding can be compared in a controlled manner and this standard experimental model may also facilitate comparison of results among different research groups.
74 citations
TL;DR: A greater acceptance and use of lasers by neurosurgeons will depend upon automated control over defined specific parameters for laser applications based upon the type of tissue, the desired effect on tissue, and application to the clinical situation without loss of precision and a lot of expense.
Abstract: Lasers have been used in neurosurgery for the past 25 years, undergoing modifications to suit the specific needs of this medical discipline. The present report reviews the current use of lasers in neurosurgical practice and examines the pros and cons of lasers in specific neurosurgical applications. In spite of their advantages, laser use is still not widespread in neurosurgery. One reason is the continued lack of complete control over real-time laser interactions with neural tissue. A greater acceptance and use of lasers by neurosurgeons will depend upon automated control over defined specific parameters for laser applications based upon the type of tissue, the desired effect on tissue, and application to the clinical situation without loss of precision and a lot of expense. This will require the integration of newer lasers, computers, robotics, stereotaxy, and concepts of minimally invasive surgery into the routine management of neurosurgical problems.
62 citations
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TL;DR: Technical improvements in endoscopy have increased the frequency with which a clinical diagnosis of acute gastric mucosal bleeding can be made, and physicians tend to attribute radiologically negative gastrointestinal bleeding to "peptic ulceration."
Abstract: Bleeding from superficial gastric erosions was described for the first time in 1898 by Dieulafoy. 1 Since then, our understanding of this condition has increased but little. One of the confusing aspects of this condition is that of semantics. This phenomenon has been variously called "acute erosive gastritis," "acute hemorrhagic gastritis," "Curling's ulcer," "Cushing's ulcer," "acute peptic ulcer," and "stress ulcer." Moreover, because there usually is a break in the continuity of the mucosa (erosion, ulceration, ulcer), often it is labeled "gastric ulcer, bleeding." Also, physicians tend to attribute radiologically negative gastrointestinal (GI) bleeding to "peptic ulceration." As a result, the incidence of this condition is not well known. For instance, in 1964 Sullivan et al 2 wrote that hemorrhagic gastritis is "... relatively uncommon as a cause of major gastrointestinal bleeding...." Technical improvements in endoscopy have increased the frequency with which a clinical diagnosis of acute gastric mucosal bleeding can
60 citations
TL;DR: Gastric physiology and its relation to cortisone and ACTH are discussed and early gastric resection offers the best chance of survival.
Abstract: 1.1. Thirty-five cases of postoperative gastrointestinal hemorrhage are presented. 2.2. Only ten of these patients had a history of ulcers. 3.3. Infection was significant in 74 per cent of cases. 4.4. Operative mortality is related to delay in operative therapy. 5.5. Early gastric resection offers the best chance of survival. 6.6. Gastric physiology and its relation to cortisone and ACTH are discussed.
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