Radiofrequency ablation of primary and metastatic lung tumors: preliminary experience with a single center device.

BACKGROUND: This study aimed to assess the feasibility and short-term results for percutaneous radiofrequency ablation in the treatment of primary and secondary lung tumors. METHODS: Between May 2003 and July 2004, 15 patients (mean age, 64.9 years; range, 51-80 years) with 18 pulmonary lesions (9 primitive non-small cell lung cancers and 9 metastases) underwent the ablation procedure. All the patients had absolute contraindications to the surgery. The procedure was performed under computed tomography (CT) guidance with anesthesiologic assistance using a coaxial Le Veen needle electrode. The results were evaluated by postprocedural CT scan, and then by clinical and laboratory examination and CT scan 1, 3, 6, 9, and 12 months after the treatment. RESULTS: A complete ablation was obtained for 16 of 18 lesions (88.9%), and a partial ablation was achieved for the remaining 2 lesions (central tumors). In terms of complications, there were five cases of pneumothorax (2 resolved spontaneously and 3 were drained through a coaxial needle), four middle pleural reactions, and one hemothorax that required draining surgically. Follow-up evaluation was performed for 16 of 18 lesions. Stability was observed in one of two central tumors that received partial ablation. The remaining 15 tumors that received a complete ablation were followed up for a mean of 5 months (range, 1-12 months). All 15 lesions appeared to be hypodense at the CT examination. Dimension reduction with progressive fibrotic scar formation was observed in seven of seven lesions during a follow-up period of 6 months or more. A recurrence at the site of the treatment for two of three lesions was observed during a 12-month follow-up period. One of these received a second radiofrequency ablation. Five patients experienced systemic disease progression. In four of these five patients, this progression was not associated with recurrence at the site of the treatment. CONCLUSION: Radiofrequency ablation seems to be possible for "nonsurgical" patients with primary and secondary lung tumors. Good results in terms of local tumor control were observed during short-term follow-up evaluation.

The effect of electronic dental anesthesia on behavior during local anesthetic injection in the young, sedated dental patient.

PURPOSE: The purpose of this study was to evaluate the effectiveness of the 3M Electronic Dental Anesthesia (EDA) finger electrode on reducing sedated patient responsiveness during local anesthesia administration. METHODS: Thirty patients between the ages of 24 to 48 months, ASA I, and in need of treatment of maxillary anterior teeth using local anesthesia were used in this study. Each of the patients received chloral hydrate (CH) and hydroxyzine (50 mg/kg and 2 mg/kg, respectively). The patients were divided randomly in two groups. The experimental group received activated electronic dental anesthesia (AEDA) while the control group had a nonactive EDA (NAEDA). Physiological parameters were recorded and behavior was videotaped and rated using the Ohio State University Behavior Rating Scale. A repeated-measures ANOVA, Student's tests, and descriptive statistics were used. RESULTS: The results indicated that the heart rate and diastolic blood pressure of both groups were significantly affected as a function of time and dental procedures. A significant effect in the percent change of heart rate between groups was noted during local anesthetic injection with the NAEDA group having an increased heart rate. There was a higher occurrence of movement in the NAEDA compared to the AEDA. CONCLUSION: The EDA appears to be beneficial in reducing the discomfort, as judged by behavioral and physiologic observations, associated with local anesthetic administration in young sedated dental patients.

[Transcranial electrostimulation: a new approach (experimental and clinical bases and equipment)]. / Transkranial'naia élektrostimuliatsiia: novyi podkhod (éksperimental'no-klinicheskoe obosnovanie i apparatura).

The paper deals with one type of electrostimulation-transcranial electrostimulation (TES). It outlines the physiological mechanisms underlying TES, the clinical features of its application, the equipment performing TES, defines its optimum analgesic mode.

[The content of beta-endorphin, met-enkephalin and ACTH in the blood plasma during electric and drug anesthesia]. / Soderzhanie beta-éndorfina, meténkefalina i AKTG v plazme krovi pri élektromedikamentoznoi anestezii.

Beta-endorphin, metenkephaline, and ACTH were radioimmunoassayed in the peripheral blood plasma of 4 groups of patients subjected to microsurgery by different techniques. In 3 groups electropulsed exposure of the CNS was a component of general combined ataralgesia. In group 1 (13 patients) two Lenar devices were employed, in group 2 (5 patients) Skat-202 device, in group 3 (7 patients) Elean device. Group 4 (17 patients) were controls administered drugs according to the same protocols as in the rest three groups. Anesthesia was considered adequate in all the groups. The hypoalgesic effect of electroexposure was the most expressed in group 1: fentanyl was not injected in 53% cases, and in 47% its dose, 0.74 microgram/kg/h, was 2.25 times lower than in controls (1.58 micrograms/kg/hm p < 0.05); the drug doses in groups 2 and 3 (0.82 and 0.8 microgram/kg/h) were 1.9 and 2 times lower than in controls, respectively, p < 0.05. The levels of ACTH and opioid peptides were measured at 6 stages: 1) several days before surgery; 2) after premedication, 10-15 min after the patient was brought into the operation room; 3) before discontinuing nitrogen oxide; 4) after discontinuing nitrogen oxide; 5) when the patient regained consciousness after the end of surgery; and 6) after extubation of the trachea. During surgery under electromedicamentous anesthesia the level of ACTH in the plasma was the same as initially or comparable to the level of this hormone at the same stages in the control group. The content of opioid peptides changed at stressogenic stages of anesthesia and surgery. In patients administered drug anesthesia beta-endorphin levels were shifted, in those operated on under electromedicamentous anesthesia the metenkephaline compound of the opiate system was altered. Activation of various components of endogenous opiate system in electromedicamentous and drug anesthesia may be due to differences in the mechanisms of this types of anesthesia at the given level of the antinociceptive system of the organism. No stable reaction of endorphin level on the electroexposure could be detected. There was no evident relationship between changes in the levels of opioid peptides and the decrease of fentanyl consumption. Besides, it is possible that the analgesic effect of electroexposure is mediated not only by the opioid, but by other mechanisms of endogenous antinociceptive system as well.

[A trial of the clinical use of a new method of electrosleep]. / Opyt klinicheskogo primeneniia novogo sposoba élektrosna.

A novel device and technique of interference electric sleep therapy have been developed and tried in 125 children and 324 adults with different diseases. The highest clinical response, especially in children, was achieved on Elson unit.

[Transcranial electrostimulation (the mechanism of its action and its analgesic and associated effects)]. / Transkranial'naia élektrostimuliatsiia (mekhanizm vozdeistviia, anal'geticheskii i sopriazhennye éffekty).

As seen from various publications, the adjuvant use of transcranial electrostimulation (TCE) stimulates ulcer healing (the defect healed 2-3.5 times faster), promotes normalization of serum gastrin levels both in its high and low values produces analgetic, membrane stabilizing, reparative, sedative, immunomodulating and antitumor effects. The method is easy to perform, convenient, has no contraindications and serious complications.

[Experimental research on the physicochemical action of impulse currents when applied transcerebrally]. / Eksperimental'noe issledovanie fiziko-khimicheskogo deistviia impul'snykh tokov pri transtserebral'nom primenenii.

Thymocyte function and lipid peroxidation in cell membranes of the cerebral cortex and the myocardium of 72 rats were examined to study the stress-limiting mechanism of 10 and 1000 Hz impulse current effect. The additional measurements were as follows: rat and thymus weight, their proportional relations, thymocyte nuclear population, 11--OCS, thyroid hormones (T3, T4), plasma testosterone and insulin, myocardial and cerebral cortical protein. The animals were immobilized for 6 days in individual tight cages where they had food and water. Antioxidant and antistress effects of impulse currents were revealed at definite regimens of their application: 10 Hz stress limiting action was more potent when applied to stressed animals, but 1000 Hz current proved to be an effective prophylactic procedure.

Electronic dental anesthesia: a pilot study.

Electronic dental anesthesia uses the Gate Control Theory of transcutaneous electrical nerve stimulation. The battery-controlled Ultracalm electronic dental anesthesia unit is a noninvasive procedure to electrically block pain transmissions in dental patients. This pilot study to test the efficacy of electronic dental anesthesia for simple restorative procedures was subjectively reported by 20 patients who had never been exposed to this type of anesthesia. None of the patients indicated the procedure was uncomfortable, and 14 of 20 subjects indicated that they preferred electronic dental anesthesia to local anesthetic injection. Electronic dental anesthesia appears to be an effective means of obtaining local anesthesia for certain dental procedures.

The effect of an electronic analgesia device on dental pain thresholds.

The effect of UltraCalm, an electronic dental analgesia (EDA) device, on dental pain thresholds was studied in 32 volunteers. For each subject, two initial baseline measurements of dental pain thresholds were made using an electric pulp tester. Pain thresholds were then measured during EDA with either UltraCalm or an inactive (placebo) device. No significant differences were found between the first and second baseline threshold measurements nor between the pain thresholds measured during the application of the UltraCalm and placebo devices. The mean baseline pain threshold was significantly lower than the threshold measured during application of the placebo device, but was not significantly different from the threshold during application of UltraCalm. it is concluded that UltraCalm has no consistent effect in altering dental pain thresholds.

[The comparative efficacy of nondrug and drug methods of treating hypertension]. / O sravnitel'noi éffektivnosti nemedikamentoznykh i lekarstvennykh metodov lecheniia gipertonicheskoi bolezni.

Effectiveness of some physical therapeutic factors (constant magnetic field, impulse currents) and new hypotensive drugs (tobanum, prinorm, ormidol, minipress, arifon, arilix) was compared in the treatment of essential hypertension stage II. It is suggested that nonpharmaceutical therapy can regulate functions, correct hemodynamic and microcirculatory disorders, produce therapeutic effect without side effects typical for drugs.

[Electrical dental anesthesia (EDA), an alternative to local anesthesia?]. / L'anesthésie dentaire électrique (ADE), une alternative aux anesthésiques locaux?

Electrical dental anesthesia has recently been suggested as an alternative to local anesthetics for the control of pain related to certain dental acts. This article updates the evidence which supports the efficiency, indications and contra-indications of such a procedure. Although this technique has certain advantages, its use is limited by: 1) how cooperative the patient may be; 2) the time required to explain the procedure to the patient and that which is required to produce the needed clinical effect; and, 3) how efficient it may be relative to the patient in question and the dental treatment rendered.

[Changes in autonomic homeostasis during anesthesia induction in patients operated on for congenital cleft palate]. / Izmeneniia vegetativnogo gomeostaza pri vvedenii v narkoz u operiruemykh po povodu vrozhdennogo nesrashcheniia neba.

Variation pulsometry was used to study vegetative homeostasis changes over the course of induction anesthesia and tracheal intubation in children operated on for palatal clefts. The same premedication scheme was employed in all the patients. The same neuroleptic doses were administered in induction anesthesia. Induction anesthesia parallel with electroanalgesia with an Electronarcol-1 apparatus helped reduce the promedol dose necessary for adequate anesthesiologic protection from 1.2-1.4. to 0.2-0.4 mg/kg. This was associated with the minimal changes in autonomic nervous system functioning, evidencing the efficacy of electroanalgesia in induction anesthesia for this patient population.

Effect of a 350 Hz DC stunning current on evoked responses in the chicken's brain.

Somatosensory evoked responses in the chicken's brain were examined before and after stunning with a 350 Hz pulsed DC. When the current was greater than 120 mA, 93 per cent of the birds lost their evoked responses for at least 60 seconds. On this basis 120 mA per bird is recommended as an acceptable current for commercial use.