Hot Knife Research Articles

A comparison of microbipolar cautery dissection to hot knife and cold knife cautery tonsillectomy

Background: Morbidity following tonsillectomy continues to be a major concern to parents, children, and physicians alike. Reduction in post-operative complications, optimal control of pain, and satisfactory return to a normal lifestyle are all important to both family and society. This study compares both the complication and recovery rates after microbipolar dissection (MBPD) technique of tonsillectomy to two well established tonsillectomy techniques: hot knife (HK) and cold knife/cautery (CK/C). Methods: A total of 200 consecutive patients presenting for tonsillectomy by the first author (MP) were randomized to either undergo MBPD or HK tonsillectomy. Concurrently, an additional two hundred patients were randomized to undergo MBPD or CK/C tonsillectomy by the second author (LB). Patients were prospectively followed for complications including bleeding and dehydration and multiple indicators of recovery rate. Results: Postoperative bleeding of any kind was significantly less in the MBPD group than in the CK/C and HK groups (5 vs 12.4 vs 12.5% ( P<0.001). The need for post-operative intervention for bleeding, i.e. local control or return to the operating room, was also significantly less in the MBPD group. Return to normal activity occurred 2 days earlier in the MBPD group versus either CK/C or HK ( P<0.001). Additionally, earlier recovery was reflected in fewer total doses of pain medication in the MBPD group. Operative time was 3–5 min longer for MBPD (24.2 min) than for CK/C or HK (21.1 and 16.5 min, respectively); blood loss was similar (within 15 cc) among all treatment groups. Conclusion: MBPD tonsillectomy compared most favorably to conventional techniques (CK/C and to HK tonsillectomy). Important clinical outcome differences included a lower bleed rate, earlier recovery and fewer days lost from work and school. The financial impact is estimated to be quite favorable. MBPD tonsillectomy is now our preferred method in children.

A 35-Year-Old Man With Epigastric Pain

Dr Daley : Mr H is 35-year-old registered nurse who has recurrent episodes of epigastric pain. Divorced and the father of one child, he works in local hospital and receives private health insurance through his employer. Since he was child, Mr H has experienced intermittent pain in the epigastric area that radiates to the When the pain is mild, he describes it as burning, sometimes accompanied by chest heaviness or tightness. When the pain is severe, Mr H describes it as a hot knife being pushed under my rib cage and out my back. His symptoms are aggravated by emotional stress, alcohol, cigarettes, and spicy foods. He denies nausea, vomiting, melena, hematemesis, symptoms of reflux, or anemia. He has never taken aspirin or nonsteroidal anti-inflammatory drugs (NSAIDs). For many years, he took large quantities of antacids to relieve the pain, and sucralfate and cimetidine have also provided

Inguinalbestrahlung versus keine Lymphknotentherapie beim kleinen Vulvakarzinom mit klinisch negativen Lymphknoten (T1, N0-1)

The objective of this retrospective study was to determine if groin radiation was superior to no therapy in patients with small vulvar cancer with not palpable or not suspicious inguinal lymph nodes (T1, N0-N1). From 1974 to 1990, 135 patients with invasive T1, NO-1 vulvar cancer underwent radical vulvectomy with hot knife, groin nodes were left in situ. In 65 patients vulvectomy was followed by inguinofemoral irradiation: 70 patients had none. There were more cases with clitoris carcinoma (p < 0.04) in the group with groin irradiation but no other significant difference in prognostic factors was found. The actuarial 5-year survival was 93.7% with groin irradiation versus 92.4% without lymph node therapy. Inguinal relapses occurred in only 4.6% of cases with groin irradiation versus 10% without lymph node treatment (n.s.). Radiation therapy to the groin seems to reduce groin relapses in early vulvar cancer.

A modeling hot knife used to remove palates from waxed trial dentures

A modeling hot knife used to remove palates from waxed trial dentures

Hot knife microtomy for large area sectioning and combined light and electron microscopy in neuroanatomy and neuropathology

The technical details given in this paper meet the demand in neuroanatomy and neuropathology for methods which combine broad light microscopical surveys with detailed ultrastructural studies of logically selected areas in well perfused brain material, and emerge directly from experiences in Palay's laboratory at the National Institutes of Health in 1956. Using the procedures recommended will give good sections of exceptionally large areas (up to, and above 1 cm x 1 cm) of fully hardened blocks available at all points for electron microscopy. On such large blocks fully correlative, combined light and electron microscopy may be carried out easily. The process is termed 'hot knife microtomy'. In three different laboratories, primary aldehyde fixation by perfusion and hot knife microtomy have given uniformly excellent data from normal, diseased, and virus-infected brain tissues. These techniques permit full neuroanatomical control and orientation, make comprehensive correlative mapping throughout the CNS feasible, and allow study of the time course of infective processes.

Uptake of Inorganic Phosphate by Plastids Purified from the Roots ofPisum sativumL.

Uptake of Inorganic Phosphate by Plastids Purified from the Roots of<i>Pisum sativum</i>L.

Absence of Uvula in South Sinai Bedouins

To the Editor.— One of the most serious problems of the Bedouins living in South Sinai is shortage of drinking water because of few rainfalls and scant wells. The Bedouins believe that removal of the uvula decreases thirst. When I served as a physician among the Bedouins in the South of Sinai, I noticed that all members of a Bedouin tribe had no uvula. Instead of a uvula, some persons had just a stump. Others, in addition to that, had a defect in the soft palate. I found out that during the first year of life the uvula is removed. This operation is performed by an old member of the tribe who travels from camp to camp for this purpose. He owns a tweezer-like instrument with which he clamps the uvula and cuts above the clamp with a hot knife. When this Bedouin became ill, the operation was performed by