ABSTRACT
Adhesive production industry wastewater can be characterized by high chemical oxygen demand (COD) sourced from high refractory organic contaminants and high total suspended solids (TSS) concentration. Biodegradability of the wastewater is low and wastewater quality is unstable. Various treatment processes have limited applicability in such characterized wastewater. In this study, the treatment performance of electrochemical processes was investigated. Because it is not possible to meet the discharge standards by application of only one process for high refractory organic content, sequential electrochemical processes were studied in this work. In the first step of the sequential process, electrocoagulation (EC) using Al electrodes by which better performance was achieved was applied. In the second step, electrooxidation (EO) and peroxi-coagulation (PC) processes were applied to the EC effluent. In EO, Ti/MMO was selected as the most effective anode whereas in PC, Fe was used as the anode, and graphite was used as the cathode. Box-Behnken Design was applied to optimize the operating conditions of EO and PC processes and to obtain mathematical model equations. In the EC process, 77% COD, 78.5% TSS, and 85% UV254 removal efficiency were obtained under the optimum conditions (pH 7.2, reaction time 35 min, and current density 0.5 mA/cm2). With the EO and PC processes applied to the effluent of EC, 68.5% COD, 77% TSS, and 83% UV254 removal and 77.5% COD, 87% TSS, and 86.5% UV254 removal were obtained, respectively. The specific energy consumption of EC-EO and EC-PC processes was 16.08 kWh/kg COD and 15.06 kWh/kg COD, respectively. Considering the treatment targets and process operating costs, it was concluded that both sequential electrochemical systems could be promising alternative systems for the treatment of adhesive production industry wastewater.
Subject(s)
Electrocoagulation , Oxidation-Reduction , Waste Disposal, Fluid , Wastewater , Wastewater/chemistry , Waste Disposal, Fluid/methods , Electrocoagulation/methods , Biological Oxygen Demand Analysis , Adhesives , Water Pollutants, Chemical/chemistry , ElectrodesABSTRACT
Coma caused by cerebral ischemia is the most serious complication of cerebral ischemia. Four-vessel occlusion can establish a cerebral ischemic coma model for disease research and drug development. However, the commonly used four-vessel occlusion method mainly involves inserting an electrocoagulation pen into the bilateral pterygoid foramen of the first cervical vertebra behind the neck to electrocoagulate the vertebral arteries. This process carries the risk of incomplete electrocoagulation, bleeding, and damage to the brainstem and spinal cord. Twenty-four hours after surgery, re-anesthetized rats undergo carotid artery ligation in front of the neck. Two surgeries expose the rats to a higher risk of infection and increase the experimental period. In this study, during a single surgical procedure, an anterior cervical incision was used to locate the key site where the vertebral artery penetrates the first cervical vertebra. The bilateral vertebral arteries were electrocauterized under visual conditions, while the bilateral common carotid arteries were separated to place loose knots. When the rats showed consciousness of the inversion reaction, the bilateral common carotid arteries were quickly ligated to induce ischemic coma. This method can avoid the risk of infection caused by two surgical operations and is easy to perform with a high success rate, providing a useful reference for relevant practitioners.
Subject(s)
Brain Ischemia , Coma , Disease Models, Animal , Vertebral Artery , Animals , Rats , Coma/etiology , Brain Ischemia/etiology , Brain Ischemia/surgery , Male , Vertebral Artery/surgery , Rats, Sprague-Dawley , Carotid Artery, Common/surgery , Electrocoagulation/methodsABSTRACT
To investigate the effects of patellar denervation (PD) and non-patellar denervation (NPD) after primary total knee arthroplasty (TKA) without patellar resurfacing, this study conducted systematic electronic searches in November 2023 using PubMed, Embase, Web of Science, Cochrane, and Scopus, adhering to Cochrane Collaboration recommendations. Only randomized controlled trials (RCTs) were included. Additionally, a manual search was performed to identify potentially eligible studies from the reference lists of review articles. Two researchers independently conducted literature reviews, data extraction, and risk of bias assessments. The outcome analysis encompassed the incidence of anterior knee pain (AKP), visual analogue scale (VAS), range of motion (ROM), American Knee Society Score (KSS), Oxford Knee Score (OKS), patellar score (PS), complications, and reoperations. Meta-analysis was executed using RevMan 5.3 software. To enhance the credibility of the study, TSA v0.9 software was utilized to perform power analysis on the overall efficacy of primary and secondary outcomes. Twelve studies involving 1745 patients (1587 knees) were included, with 852 undergoing PD and 893 undergoing NPD. Results indicated a superior reduction in AKP incidence in the PD group compared to the NPD group. Statistically significant differences were observed between PD and NPD in KSS, OKS, and PS. However, the upper limit of the 95% confidence interval for each outcome fell below the minimal clinically important difference (MCID). No significant differences were found in VAS and ROM between PD and NPD. Additionally, PD was not associated with an increased incidence of complications or reoperations. Within 12 months and beyond, PD was proven to be a beneficial intervention in reducing AKP following TKA without patellar resurfacing, achieved without an increase in complications or reoperations. Regarding KSS, OKS, and PS, the minimal advantage achievable through PD may not be clinically significant.
Subject(s)
Arthroplasty, Replacement, Knee , Denervation , Electrocoagulation , Patella , Randomized Controlled Trials as Topic , Humans , Arthroplasty, Replacement, Knee/methods , Denervation/methods , Patella/surgery , Patella/innervation , Electrocoagulation/methods , Pain, Postoperative/prevention & control , Pain, Postoperative/etiology , Pain MeasurementABSTRACT
The problem of regeneration of damaged peripheral nerves is an ongoing topic and has long been the subject of intensive research worldwide. This study examined the morphological and functional evaluation of the regeneration process within the damaged sciatic nerve, a mouse animal model. The effect of impaired expression of the TSC-1 gene on the process of nerve regeneration was evaluated, depending on the mode of damage. The research object consisted of 48, 2-month-old male TSC lines. The test group consisted of animals that underwent damage to the sciatic nerve by crushing, freezing and electrocoagulation, while the control group includes mice whose sciatic nerve was not damaged. Behavioral tests were conducted to evaluate the functional return of the limb, after 3,5,7 and 14 days. The first changes in the regeneration process of the damaged neurite are observed as early as day 3 after the injury, while on day 14 after the injury the functional return of the damaged limb was noted.
Subject(s)
Disease Models, Animal , Electrocoagulation , Nerve Regeneration , Sciatic Nerve , Animals , Mice , Nerve Regeneration/physiology , Sciatic Nerve/injuries , Male , Electrocoagulation/methods , Freezing/adverse effects , Nerve Crush/methodsABSTRACT
The effluent from the oil drilling site is a complex mixture of hazardous chemicals that causes environmental impacts on its disposal. The treatment of oil drill-site wastewater has not been explored much, and understanding its characteristics and optimizing the treatment process are required. In the present study, we have optimized the electrocoagulation process with aluminum electrodes for drill-site wastewater treatment. A multi-level factorial center composite design using response surface methodology is applied to optimize the effect of current density (CD), pH, and inter-electrode distance (IED) on chemical oxygen demand (COD) removal. The increasing current density shows a significant increase in COD removal, and a similar trend was observed with a decreased pH. It was found that with current density and inter-electrode distance, the maximum COD removal achieved was 70% at the CD of 19.04 mA cm-2 and IED 2.6 cm. By varying pH and current density, the COD removal reached up to 90% at pH 6 and CD 19.04 mA cm-2. The study shows that the current density is the dominant factor for the process's energy consumption and operating cost, followed by pH. This study's findings could be effectively used to develop large-scale treatment processes through electrocoagulation.
Subject(s)
Electrocoagulation , Waste Disposal, Fluid , Wastewater , Wastewater/chemistry , Waste Disposal, Fluid/methods , Electrocoagulation/methods , Biological Oxygen Demand Analysis , Oil and Gas Industry , Water Pollutants, ChemicalABSTRACT
An investigation was conducted on the electrocoagulation treatment of high-strength young landfill leachate using an electrode made of aluminium in a batch electrochemical cell reactor. An iron sheet of 1 m⨯1 m⨯1.1 m (L: B: H) was used to construct the two landfill simulating reactors, both the reactors were operated at different conditions, i.e., one without rainfall (S1) and the other with rainfall (S2). Both reactors have 51% wet and 49% dry waste, which is the typical waste composition of India, and the quantity of waste taken was 450 kg; hence, the generated leachate was treated. This work focuses on the utilization of electrocoagulation as the sole treatment method where coagulation and adsorption occur simultaneously for young landfill leachate. The study employed a central composite design (CCD) to systematically vary the initial pH, current density (CD), and reaction time to examine their impact on the removal efficiency of COD (Chemical oxygen demand), TOC (Total organic carbon), and TSS (Total Suspended Solids). The optimum conditions obtained were a pH of 7.35, a CD of 15.29 mA/cm2, and a reaction duration of 57 min. When the conditions were optimized, the COD, TSS, and TOC removal efficiencies were 83.56%, 73.12%, and 85.58%, respectively. Also, the electrodes depleted 2.78 g of Al/L. In addition, pseudo-first-order and pseudo-second-order kinetics were employed to examine the elimination of contaminants by adsorption on aluminium hydroxide, thereby confirming the adsorption process. After investigation through energy-dispersive X-ray spectroscopy (EDX) and X-ray diffraction (XRD), with the produced sludge confirmed that electrocoagulation removed a significant amount of metals from landfill leachate.
Subject(s)
Water Pollutants, Chemical , Adsorption , Water Pollutants, Chemical/chemistry , Kinetics , Biological Oxygen Demand Analysis , Electrocoagulation/methodsABSTRACT
PURPOSE: To use computational modeling to provide a complete and logical description of the electrical and thermal behavior during stereoelectroencephalography-guided (SEEG) radiofrequency thermo-coagulation (RF-TC). METHODS: A coupled electrical-thermal model was used to obtain the temperature distributions in the tissue during RF-TC. The computer model was first validated by an ex vivo model based on liver fragments and later used to study the impact of three different factors on the coagulation zone size: 1) the difference in the tissue surrounding the electrode (gray/white matter), 2) the presence of a peri-electrode gap occupied by cerebrospinal fluid (CSF), and 3) the energy setting used (power-duration). RESULTS: The model built for the experimental validation was able to predict both the evolution of impedance and the short diameter of the coagulation zone (error < 0.01 mm) reasonably well but overestimated the long diameter by 2 - 3 mm. After adapting the model to clinical conditions, the simulation showed that: 1) Impedance roll-off limited the coagulation size but involved overheating (around 100 °C); 2) The type of tissue around the contacts (gray vs. white matter) had a moderate impact on the coagulation size (maximum difference 0.84 mm), and 3) the peri-electrode gap considerably altered the temperature distributions, avoided overheating, although the diameter of the coagulation zone was not very different from the no-gap case (<0.2 mm). CONCLUSIONS: This study showed that computer modeling, especially subject- and scenario-specific modeling, can be used to estimate in advance the electrical and thermal performance of the RF-TC in brain tissue.
Subject(s)
Electrocoagulation , Electroencephalography , Electrocoagulation/methods , Humans , Electroencephalography/methods , Electrodes , Computer SimulationABSTRACT
BACKGROUND: Radiofrequency thermocoagulation (RFT) is a treatment used to relieve symptoms of cranial nerve disorders. The current study is the first to describe the results of hemifacial spasm (HFS) patients with a history of repeated RFT in the second-largest consecutive single-center patient series with long-term follow-up. METHOD: This retrospective study was conducted in the largest hospital district in Finland (Helsinki and Uusimaa). Consecutive HFS patients who had an RFT to treat HFS in the Hospital District of Helsinki and Uusimaa between 2009-2020 were included. RESULTS: Eighteen patients with 53 RFTs were identified from the medical records. 11 (61 %) patients had repeated RFTs, and the mean number of RFTs per patient was 3.33 (3.29 SD). The mean follow-up was 5.54 years (7.5 SD). 12 (67 %) patients had had microvascular decompression (MVD) before RFT. Patients were satisfied with the results after 87 % of RFTs. Relief of the twitching of the face lasted 11.27 months (11.94 SD). All patients had postoperatively transient facial paresis. Postoperative paresis lasted a mean of 6.47 months (6.80 SD). The depth of paresis was postoperatively typically moderate (36.54 %, House Brackmann III). 23.08 % had mild paresis (House-Brackmann II), 23.08 % had moderately severe dysfunction (House-Brackmann IV), 9.62 % had severe dysfunction, and 7.69 % had total paralysis of the facial muscles (House-Brackmann VI). Duration of relief in the face twitching (p 0.002) and temperature at the final coagulation point (p 0.004) were statistically significant predictors of satisfaction with the RFT results. CONCLUSIONS: RFT can be used to treat recurrences of HFS repeatedly. It provides symptom relief for around 11 months, lasting four times longer than with botulinum toxin injections. Patients are satisfied, although an RFT produces transient, sometimes even severe, facial paresis.
Subject(s)
Electrocoagulation , Hemifacial Spasm , Recurrence , Humans , Female , Hemifacial Spasm/surgery , Male , Middle Aged , Electrocoagulation/methods , Retrospective Studies , Follow-Up Studies , Aged , Adult , Treatment OutcomeABSTRACT
BACKGROUND: Postendoscopic submucosal dissection electrocoagulation syndrome (PEECS) is commonly observed after performing endoscopic submucosal dissection (ESD) for esophageal neoplasia. However, data on the incidence and risk factors for PEECS in the esophagus are lacking due to an unclear definition of PEECS and varied clinical settings. Therefore, we aimed to determine the risk factors for PEECS in patients undergoing ESD for esophageal neoplasia. METHODS: We retrospectively reviewed data of relevant clinical and endoscopy-specific parameters from 202 consecutive patients with esophageal neoplasias (139 carcinomas and 63 dysplasias) who underwent ESD under general anesthesia. Esophageal PEECS was defined by satisfying at least two of the following criteria: fever ≥ 37.8 °C, leukocytosis ≥ 10,800/mm3, and localized chest pain ≥ 5/10 points as assessed on a numeric rating scale within 24 h after ESD. Significant factors associated with PEECS were determined by regression analysis. RESULTS: PEECS was recorded in 98 of 202 (48.5%) patients. Patients with PEECS exhibited a larger tumor size (25.0 vs. 17.0 mm, P = 0.002), longer procedure (40.0 vs. 29.5 min, P = 0.021) and hemostasis times (5.0 vs. 3.5 min, P = 0.004), required greater submucosal injection volume (60.0 mL vs. 50.0 mL, P = 0.030), and had a lower rate of local steroid injection (4.1% vs. 12.5%, P = 0.029) than those without PEECS. Multivariate regression analysis revealed tumor size ≥ 17 mm (P = 0.047), procedure time ≥ 33 min (P = 0.027), and hemostasis time ≥ 5 min (P = 0.007) as risk factors for PEECS. In addition, local steroid injection was a significant negatively associated factor (P = 0.001). CONCLUSIONS: Patients with a large tumor, prolonged procedure and hemostasis times are at a high risk of PEECS occurrence. Further, local steroid injection is a negatively associated factor.
Subject(s)
Electrocoagulation , Endoscopic Mucosal Resection , Esophageal Neoplasms , Postoperative Complications , Humans , Male , Female , Esophageal Neoplasms/surgery , Endoscopic Mucosal Resection/adverse effects , Retrospective Studies , Risk Factors , Electrocoagulation/adverse effects , Electrocoagulation/methods , Aged , Syndrome , Middle Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , IncidenceABSTRACT
Some studies have reported the removal of As (As) and fluoride (F-) using different sacrificial anodes; however, they have been tested with a synthetic solution in a batch system without hydrated silica (SiO2) interaction. Due to the above, concurrent removal of As, F-, and SiO2 from natural deep well water was evaluated (initial concentration: 35.5 µg L-1 As, 1.1 mg L-1F-, 147 mg L-1 SiO2, pH 8.6, and conductivity 1024 µS cm-1), by electrocoagulation (EC) process in continuous mode comparing three different configurations of sacrificial anodes (Al, Fe, and Al-Fe). EC was performed in a new reactor equipped with a small flow distributor and turbulence promoter at the entrance of the first channel to homogenize the flow. The best removal was found at j = 5 mA cm-2 and u = 1.3 cm s-1, obtaining arsenic residual concentrations (CAs) of 1.33, 0.45, and 0.77 µg L-1, fluoride residual concentration ( [Formula: see text] ) of 0.221, 0.495, and 0.622 mg L-1, and hydrated silica residual concentration ( [Formula: see text] ) of 21, 34, and 56 mg L-1, with costs of approximately 0.304, 0.198, and 0.228 USD m-3 for the Al, Fe and Al-Fe anodes, respectively. Al anode outperforms Fe and Al-Fe anodes in concurrently removing As, F- and SiO2. The residual concentrations of As and F- complied with the recommendations of the World Health Organization (WHO) (As < 10 µg L-1 and F- < 1 mg L-1). The spectroscopic analyses of the Al, Fe, and Al-Fe aggregates showed the formation of aluminosilicates, iron oxyhydroxides and oxides, and calcium and sodium silicates involved in removing As, F-, and SiO2. It is concluded that Al would serve as the most suitable sacrificial anode.
Subject(s)
Arsenic , Electrodes , Fluorides , Silicon Dioxide , Fluorides/chemistry , Silicon Dioxide/chemistry , Water Pollutants, Chemical/chemistry , Water Purification/methods , Aluminum/chemistry , Iron/chemistry , Water Wells , Electrocoagulation/methodsABSTRACT
BACKGROUND: Many devices are used for dissection and hemostasis during reduction mammoplasty. While one of the most common methods is monopolar electrocautery, tissue damage due to thermal spread remains a controversial topic. New devices have been designed to minimize this effect. In this study, plasmakinetic cautery was hypothesized to reduce sensation loss, drainage, and wound-healing problems in reduction mammoplasty because it is less harmful to the surrounding tissues. METHODS: Sixty-eight patients were evaluated in a matched pair design, with random (blinded) assignment of 34 patients with conventional monopolar electrocautery (Group A) and 34 patients with plasmakinetic cautery (group B). Postoperative drainage volume, drain duration, nipple-areolar complex (NAC) sensation, and complications (dehiscence, seroma, ischemia, and nipple circulatory problems) were compared by the researcher, who was blinded to the device used for the patient. RESULTS: The groups were comparable in terms of age, body mass index (BMI), comorbidities, and medications (p > 0.05). The mean age of the patients were 38.50 ± 9.14 years in group A and 37.54 ± 8.17 in group B. The mean BMI was 25.19 ± 3.22 kg/m2 in group A and 25.65 ± 2.96 kg/m2 in group B. No differences were detected between the groups in terms of drain duration time, NAC sensation, or complications, but the drainage volume was statistically lower with plasmakinetic cautery (p < 0.05). CONCLUSION: The study findings indicate that the main advantage of plasmakinetic cautery in reduction mammoplasty was a decrease in drainage volume when compared with monopolar electrocautery.
Subject(s)
Cautery , Electrocoagulation , Mammaplasty , Humans , Female , Electrocoagulation/instrumentation , Electrocoagulation/methods , Adult , Mammaplasty/methods , Mammaplasty/instrumentation , Middle Aged , Cautery/instrumentation , Cautery/methods , Treatment Outcome , Electrosurgery/instrumentation , Electrosurgery/methods , Postoperative Complications/prevention & control , Postoperative Complications/epidemiology , Postoperative Complications/etiologyABSTRACT
INTRODUCTION: During laparoscopic cholecystectomy for acute cholecystitis, it is often difficult to keep the surgical view dry because of inflammation-related tissue fragility and susceptibility to bleeding. The resulting inadequate surgical view can lead to bile duct or vascular injury. Soft coagulation systems are used to achieve hemostasis during various surgeries; however, the usefulness of soft coagulation during laparoscopic cholecystectomy for acute cholecystitis is unclear. We here demonstrate the usefulness and feasibility of blunt dissection and soft coagulation during this procedure. MATERIALS AND SURGICAL TECHNIQUE: We used blunt dissection and soft coagulation when performing laparoscopic cholecystectomy on two patients with acute cholecystitis. As with conventional laparoscopic cholecystectomy, four ports were inserted. After cutting the serosa by electrocautery, blunt dissection using soft coagulation was performed, exposing the inner subserosa. Maintaining this layer using blunt dissection with soft coagulation achieved a sufficiently clear view for safety. After resecting the cystic artery and duct, the gallbladder bed was also dissected by blunt dissection with soft coagulation. Blood loss was <20 mL in both patients. DISCUSSION: Blunt dissection with soft coagulation may be a useful and feasible means of keeping the surgical view dry and minimizing blood loss during laparoscopic cholecystectomy for acute cholecystitis.
Subject(s)
Cholecystectomy, Laparoscopic , Cholecystitis, Acute , Dissection , Electrocoagulation , Humans , Cholecystectomy, Laparoscopic/methods , Cholecystitis, Acute/surgery , Electrocoagulation/methods , Dissection/methods , Female , Male , Middle Aged , Feasibility Studies , Aged , Hemostasis, Surgical/methods , AdultABSTRACT
The presence of a large amount of organic and inorganic pollutants in dairy effluent is a substantial environmental issue. This study investigated electrocoagulation (EC) as a potential treatment method for dairy wastewater under different operating conditions, such as applied voltage (5-25 V), electrolysis time (30-90 min), and inter-electrode distance (1-2 cm) by using aluminum electrodes. This study focuses on achieving the maximum removal of BOD, COD, and nitrate in dairy effluents with the aforementioned operating conditions. The process was optimized using the response surface methodology (RSM) and Taguchi method. RSM method optimized the electrocoagulation operating conditions such as the voltage at 23.75 V, time of 90 min, and inter-electrode distance at 1.07 cm. This optimization achieved the maximum removal percentage of BOD, COD, and nitrate at 79.06%, 84.35%, and 79.64%, respectively, in dairy effluent. Taguchi method optimized the electrocoagulation parameters such as the voltage at 25 V, time duration of 90 min, and inter-electrode distance of 1.00 cm, showcasing improved removal percentages of BOD, COD, and nitrate as 90.54%, 89.28%, and 82.74% respectively. The current study attempts to understand the optimization efficiencies between Taguchi method and response surface method for diary wastewater treatment.
Subject(s)
Dairying , Waste Disposal, Fluid , Wastewater , Water Pollutants, Chemical , Wastewater/chemistry , Waste Disposal, Fluid/methods , Dairying/methods , Water Pollutants, Chemical/analysis , Electrocoagulation/methods , Nitrates/analysis , Biological Oxygen Demand AnalysisABSTRACT
In this study, a novel carbon fiber brush (CFB) electrode was designed using carbon fiber filaments and conductive metals. It was used as the cathode to construct an efficient coupled electro-Fenton and electrocoagulation (EF-EC) process for tetracycline (TC) treatment. An optimal 97.9% removal rate of 10 mg L-1 TC was achieved within 20 min. The coupled process is less pH-dependent and more effective in treating TC compared to the traditional individual electro-Fenton (EF) or electrocoagulation (EC) process, achieving efficient TC removal under neutral pH conditions. The removal rate of 10 mg L-1 TC consistently remained above 92% at 20 min after ten cycle experiments using the same electrodes in a Fe-CFB system (92.7-97.9%), indicating excellent reusability and stability of the CFB cathode. Mechanism analysis showed both EF and EC processes were involved in the system. Radicals (such as â¢OH and SO4-â¢) generated by EF contributed to the degradation of TC, yielding nine intermediates. Coagulants (such as Fe(OH)3) generated by EC contributed to the removal of TC. Toxicity prediction results indicated that over half of the nine intermediates exhibited lower biotoxicity compared to TC. This study provides a feasible alternative cathode for the efficient treatment of TC using EF-EC process.
Subject(s)
Iron , Tetracycline , Water Pollutants, Chemical , Tetracycline/chemistry , Tetracycline/toxicity , Water Pollutants, Chemical/chemistry , Water Pollutants, Chemical/toxicity , Iron/chemistry , Electrocoagulation/methods , Hydrogen Peroxide/chemistry , Electrodes , Electrochemical Techniques/methods , Carbon Fiber/chemistry , Anti-Bacterial Agents/chemistry , Anti-Bacterial Agents/toxicity , Hydrogen-Ion ConcentrationABSTRACT
This study retrospectively evaluated the outcomes of endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) using novel electrocautery-enhanced lumen-apposing metal stents (LAMS) in high-risk patients with acute cholecystitis (AC). Between January 1, 2021, and November 30, 2022, 58 high-risk surgical patients with AC underwent EUS-GBD with the novel electrocautery-enhanced LAMS. The technical success rate was 94.8% (55/58), with one case of duodenal perforation requiring surgery with complete stent migration and two of partial stent migration into the gallbladder. However, the clinical success rate was 100% (55/55). Recurrent AC occurred in 3.6% of the cases (2/55), managed with double pigtail plastic stents through the LAMS. Early AEs observed in 1.8% (1/55) due to stent obstruction. Late AEs occurred in 5.4% (3/55), including two cases of cholangitis and one of stent obstruction. For 33 patients followed over 6 months, LAMS maintenance was sustained in 30 cases. Two patients underwent double-pigtail plastic stent replacement after LAMS removal, and one underwent LAMS removal during surgery following tumor stage regression after chemotherapy for cholangiocarcinoma. The novel electrocautery-enhanced LAMS demonstrated high technical and clinical success rates in high-risk surgical patients with AC, maintaining effective gallbladder drainage with minimal AEs during long-term follow-up, thus highlighting its efficacy and safety in challenging patients.
Subject(s)
Drainage , Electrocoagulation , Endosonography , Gallbladder , Stents , Humans , Male , Female , Drainage/methods , Aged , Electrocoagulation/methods , Endosonography/methods , Middle Aged , Retrospective Studies , Gallbladder/surgery , Aged, 80 and over , Treatment Outcome , Cholecystitis, Acute/surgery , AdultABSTRACT
BACKGROUND: The method of transecting the pancreatic parenchyma during pancreatic resection may influence the rate of complications, including pancreatic fistula and bleeding. The objective of this study was to compare the transection of the pancreatic parenchyma during pancreatoduodenectomy with monopolar electrocautery versus scalpel in terms of postoperative complications. METHODS: A retrospective analysis of patients with open pancreatoduodenectomy from the German DGAV StuDoQ|Pancreas registry (January 2013 to December 2021) was performed. Transection of the pancreatic parenchyma with a scalpel versus monopolar electrocautery was compared regarding postoperative pancreatic fistula B/C, post-pancreatectomy hemorrhage B/C, and major complications (Clavien-Dindo classification ≥3) rates. Multivariable analysis with adjustment for potential confounders and surgical center cluster effect was performed. RESULTS: Overall, 6,752 patients were included in the study. In 4,072 (60.3%), transection was performed with a scalpel and, in 2,680 (39.7%), with electrocautery. Transection with electrocautery was associated with higher postoperative pancreatic fistula B/C (15.4% vs 12.8%; P = .003), post-pancreatectomy hemorrhage B/C (11% vs 7.4%; P < .001), and major complications (33.4% vs 29.6%; P = .001) rates. In the multivariable analysis, after adjustment for potential confounders and surgical center, the association of the transection method with postoperative pancreatic fistula B/C (odds ratio = 1.01; 95% CI, 0.79-1.2; P = .962), post-pancreatectomy hemorrhage B/C (odds ratio = 1.23; 95% CI, 0.94-1.6; P = .127), and major complications (odds ratio = 1.09; 95% CI, 0.93-1.27; P = .297) was not significant. CONCLUSION: The study found no significant association between transection of the pancreatic parenchyma during open pancreatoduodenectomy with a scalpel compared with monopolar electrocautery regarding pancreatic fistula, postoperative bleeding, or overall major complication rates.
Subject(s)
Electrocoagulation , Pancreas , Pancreatic Fistula , Pancreaticoduodenectomy , Postoperative Complications , Registries , Humans , Pancreaticoduodenectomy/adverse effects , Pancreaticoduodenectomy/methods , Retrospective Studies , Male , Female , Electrocoagulation/adverse effects , Electrocoagulation/instrumentation , Electrocoagulation/methods , Middle Aged , Aged , Postoperative Complications/epidemiology , Postoperative Complications/etiology , Pancreatic Fistula/etiology , Pancreatic Fistula/epidemiology , Pancreas/surgery , Postoperative Hemorrhage/etiology , Postoperative Hemorrhage/epidemiology , Pancreatic Neoplasms/surgery , Surgical Instruments/adverse effectsABSTRACT
Stereoelectroencephalography-guided radiofrequency thermocoagulation (SEEG-guided RF-TC) is a treatment option for focal drug-resistant epilepsy. In previous studies, this technique has shown seizure reduction by ≥50% in 50% of patients at 1 year. However, the relationship between the location of the ablation within the epileptogenic network and clinical outcomes remains poorly understood. Seizure outcomes were analyzed for patients who underwent SEEG-guided RF-TC and across subgroups depending on the location of the ablation within the epileptogenic network, defined as SEEG sites involved in seizure generation and spread. Eighteen patients who had SEEG-guided RF-TC were included. SEEG-guided seizure-onset zone ablation (SEEG-guided SOZA) was performed in 12 patients, and SEEG-guided partial seizure-onset zone ablation (SEEG-guided P-SOZA) in 6 patients. The early spread was ablated in three SEEG-guided SOZA patients. Five patients had ablation of a lesion. The seizure freedom rate in the cohort ranged between 22% and 50%, and the responder rate between 67% and 85%. SEEG-guided SOZA demonstrated superior results for both outcomes compared to SEEG-guided P-SOZA at 6 months (seizure freedom p = .294, responder rate p = .014). Adding the early spread ablation to SEEG-guided SOZA did not increase seizure freedom rates but exhibited comparable effectiveness regarding responder rates, indicating a potential network disruption.
Subject(s)
Drug Resistant Epilepsy , Electrocoagulation , Electroencephalography , Stereotaxic Techniques , Humans , Male , Female , Electroencephalography/methods , Electrocoagulation/methods , Adult , Drug Resistant Epilepsy/surgery , Drug Resistant Epilepsy/physiopathology , Young Adult , Adolescent , Middle Aged , Treatment Outcome , Child , Epilepsies, Partial/surgery , Epilepsies, Partial/physiopathologyABSTRACT
Based on a personal experience of 4200 surgeries, radiofrequency thermocoagulation is useful lesional treatment for those trigeminal neuralgias (TNs) not amenable to microvascular decompression (idiopathic or secondary TNs). Introduced through the foramen ovale, behind the trigemnial ganglion in the triangular plexus, the needle is navigated by radiology and neurophysiological testing to target the retrogasserian fibers corresponding to the trigger zone. Heating to 55-75 °C can achieve hypoesthesia without anaesthesia dolorosa if properly controlled. Depth of anaesthesia varies dynamically sedation for cannulation and lesioning, and awareness during neurophysiologic navigation. Proper technique ensures long-lasting results in more than 75% of patients.
Subject(s)
Electrocoagulation , Trigeminal Neuralgia , Trigeminal Neuralgia/surgery , Trigeminal Neuralgia/diagnostic imaging , Humans , Electrocoagulation/methods , Trigeminal Nerve/surgery , Foramen Ovale/surgery , Foramen Ovale/diagnostic imaging , Trigeminal Ganglion/surgery , Microvascular Decompression Surgery/methods , Treatment OutcomeABSTRACT
Dissolve organic matters (DOM) usually showed negative effect on the removal of inorganic arsenic (As) in groundwater by electrochemical approaches, yet which parts of sub-component within DOM played the role was lack of evidence. Herein, we investigated the effects of land-source humic-like acid (HA) on groundwater As(III) removal using air cathode iron electrocoagulation, based on the parallel factor analysis of three-dimensional excitation-emission matrix and statistical methods. Our results showed that the land-source HA contained five kinds of components and all components presented significantly negative correlations with the removal of both As(III) and As(V). However, the high aromatic fulvic-like acid and low aromatic humic-like acid components of land-source HA presented the opposite correlations with the concentration of As(III) during the reaction. The high aromaticity fulvic-like components of land-source HA (Sigma-Aldrich HA, SAHA) produced during the reaction facilitated the oxidation of As(III) due to its high electron transfer capacities and good solubility in wide pH range, but the low aromaticity humic-like ones worked against the oxidation of As(III). Our findings offered the novel insights for the flexible activities of DOM in electron Fenton system.
Subject(s)
Arsenites , Electrodes , Groundwater , Humic Substances , Iron , Water Pollutants, Chemical , Groundwater/chemistry , Water Pollutants, Chemical/chemistry , Water Pollutants, Chemical/analysis , Iron/chemistry , Humic Substances/analysis , Arsenites/chemistry , Oxidation-Reduction , Electrocoagulation/methods , Water Purification/methodsABSTRACT
PURPOSE: To evaluate the safety and efficacy of stereoelectroencephalography (SEEG)-guided radiofrequency thermocoagulation (RFTC) for drug-resistant focal epilepsy and investigate the relationship between post-RFTC remission duration and delayed excision surgery effectiveness. METHODS: We conducted a retrospective analysis of 43 patients with drug-resistant focal epilepsy who underwent RFTC via SEEG electrodes. After excluding three, the remaining 40 were classified into subgroups based on procedures and outcomes. Twenty-four patients (60%) underwent a secondary excision surgery. We determined the predictive value of RFTC outcome upon subsequent surgical outcome by categorizing the delayed secondary surgery outcome as success (Engel I/II) versus failure (Engel III/IV). Demographic information, epilepsy characteristics, and the duration of seizure freedom after RFTC were assessed. RESULTS: Among 40 patients, 20% achieved Engel class I with RFTC alone, while 24 underwent delayed secondary excision surgery. Overall, 41.7% attained Engel class I, with a 66.7% success rate combining RFTC with delayed surgery. Seizure freedom duration was significantly longer in the success group (mean 4.9 months, SD = 2.7) versus the failure group (mean 1.9 months, SD = 1.1; P = 0.007). A higher proportion of RFTC-only and delayed surgical success group patients had preoperative lesional findings (p = 0.01), correlating with a longer time to seizure recurrence (p < 0.05). Transient postoperative complications occurred in 10%, resolving within a year. CONCLUSION: This study demonstrates that SEEG-guided RFTC is a safe and potential treatment option for patients with drug-resistant focal epilepsy. A prolonged duration of seizure freedom following RFTC may serve as a predictive marker for the success of subsequent excision surgery.