Made available in DSpace on 2014-06-11T19:35:39Z (GMT). No. of bitstreams: 0 Previous issue date: 2013-08-23Bitstream added on 2014-06-13T20:46:40Z : No. of bitstreams: 1 000740809.pdf: 1437105 bytes, checksum: bcce4aba94a736ba421807fc3667026d (MD5) / O Pólipo endometrial é a doença endometrial mais prevalente. Sangramento uterino anormal (SUA) e infertilidade são condições clínicas frequentemente associadas com a presença dessa entidade. O risco de malignização é baixo, mas aumenta em mulheres na pós-menopausa com SUA ou idade superior a 60 anos. O tratamento consiste na exérese através de histeroscopia cirúrgica ambulatorial ou hospitalar. A energia elétrica bipolar é a forma de energia convencionalmente utilizada em ambiente ambulatorial. Como o laser apresenta algumas vantagens sobre a corrente elétrica e o custo das fibras óticas empregadas com o laser diodo é menor, pode-se adicionar uma contribuição ao campo da histeroscopia cirúrgica ambulatorial. O objetivo deste estudo foi descrever as técnicas de polipectomias histeroscópicas com laser diodo sem anestesia, identificar o perfil clínico- epidemiológico das pacientes portadoras de pólipo endometrial para caracterização da amostra estudada, analisar a viabilidade da polipectomia histeroscópica com laser diodo, assim como, a tolerabilidade das pacientes à técnica empregada, e analisar as vantagens e desvantagens da polipectomia ambulatorial com laser diodo. Trata-se de estudo clínico descritivo analítico de avaliação prospectiva com amostra de conveniência, realizada no período de dezembro de 2011 a maio de 2012, de 31 pacientes que foram submetidas à polipectomia histeroscópica ambulatorial sem anestesia com laser diodo à potência de 4W em modo contínuo por contato, após realização de histeroscopia ambulatorial diagnóstica, sendo que 24 tinham diagnóstico histeroscópico de pólipo endometrial único compreendido entre 1cm e 2cm e 7 foram tratadas no mesmo momento da histeroscopia ambulatorial diagnóstica e apresentavam pólipos compreendidos entre 3cm e 5cm de diâmetro. Todas com boa tolerância à dor, quando da realização da histeroscopia diagnóstica ambulatorial... / Endometrial polyp is the most prevalente endometrial disease. Abnormal uterine bleeding and infertility are clinical conditions often associated with the presence of this entity. The risk of malignancy is low, but increases in postmenopausal women with AUB or in women older than 60 years. Treatment consists of surgical excision via outpatient hysteroscopy or inpatient ressectopies . The electricity conventionally used in the outpatient setting is bipolar Twizzle. As the laser has some advantages over the electric current and the cost of fiber optics used with the diode laser is smaller, we think a contribution to the field of surgical outpatient hysteroscopy may be given. The aim of this study was to describe the techniques of outpatient hysteroscopic polypectomy with diode laser without anesthesia, to identify the clinical and epidemiological profile of patients with endometrial polyp to characterize the sample, analyze the feasibility of hysteroscopic polypectomy diode laser and tolerability of patients to the technique and also, analyze the advantages and disadvantages of outpatient hysteroscopic polypectomy with diode laser. Between December 2011 and May 2012 about 31 patients was studied. This study is a descriptive analytic clinical assessment with prospective convenience sample of 31 patients who underwent outpatient hysteroscopic polypectomy without anesthesia with diode laser to the power of 4W in continuous mode by contact, and that, 24 patients have had hysteroscopic diagnosis of endometrial polyp between 1cm and 2cm previously, and 7 women were underwent treated at the same time of diagnostic hysteroscopy and had polyps between 3cm and 5cm in diameter. All women had good pain tolerance when the diagnostic hysteroscopy. We used optical fibers type bare with 1003μ and 603μ in diameter. Two techniques for hysteroscopic polypectomy diode laser were described. We analyzed the clinical-epidemiological ...

The initial use of optical fibres to transmit laser energy intravascularly was accompanied by a high rate of perforations and the production of inadequate vascular channels when used for recanalisation. The laser thermal probe - in which all laser energy is converted into heat by a metal cap at the tip of the fibre, prior to tissue application - was one of the earliest modifications designed to overcome these problems. The studies in this thesis were concerned with the application of the laser thermal probe to percutaneous peripheral and coronary artery angioplasty and His bundle ablation. In vitro studies were commenced in March 1987 when the first (argon) laser generator was installed in the cardiac catheterisation laboratory at Guy's Hospital and these were followed by clinical studies in three groups of patients: nine with peripheral artery occlusions, three with coronary artery stenoses and four with supraventricular arrhythmias using either argon or Nd-YAG energies. Suggestions that enhanced safety might be possible with on-line monitoring and/or control of the probe temperature were studied by recording the temperature responses in simulated circulations at flow rates observed clinically. The highly variable temperatures recorded in blood indicate that these measures are unlikely to contribute to improvements in either efficacy or clinical safety. An earlier report of successful peripheral artery recanalisation using the laser thermal probe was confirmed in the patients studied here, though a learning curve was evident. Coronary laser angioplasty had also been performed in a few patients with a similar device but without as much success. A more flexible "over the wire" laser probe was assessed here, first in cadaver coronary arteries and then in three patients undergoing coronary angioplasty. The lack of success seen with this laser thermal probe relates to the considerable differences found between peripheral and coronary arteries: percutaneous accessibility, vessel size and the susceptibility to thermal injury being the most important. These aspects and subsequent developments in coronary laser angioplasty are discussed further. The final chapter considers a hitherto new area for laser thermal probe application the interruption of arrhythmia circuits. Cadaver and electrophysiological studies indicated that ablation of the bundle of His might be possible with this device - without the need for a general anaesthetic. The course of the first patient ever to undergo this procedure is described, as well as the implications for percutaneous His bundle ablation using other energy sources.

Master of Science / Strangles is an extremely infectious disease of horses that has negative financial and health consequences. After infection, some horses form balls of concrete-like pus in a structure in an air-filled sac of the ear canal called guttural pouches (GPs). These concretions, called chondroids, allow affected horses to continue to pass on infection to other horses. Removal of chondroids is needed to stop disease transmission but current non-surgical and surgical removal techniques have limitations. Surgical laser passed through an endoscope (medical camera) allows minimally invasive surgery of the guttural pouches. We performed laser surgery on cadaver horse heads to create access to the GP, then evaluated our ability to remove chondroid-like beads from the GP using a custom-made 3D-printed instrument. Our results showed efficient and complete removal of the beads compared to lavage without the 3D-printed instrument, with little damage to the heads. These findings are an initial step to development of a new chondroid-removal technique and may allow surgeons to more efficiently remove chondroids without the need for invasive surgery.

No / All forms of corneal refractive surgery can sometimes cause an increase in optical aberrations and scattered light, which can affect visual performance. The purpose of this study was to develop a suitable test that was sensitive to retinal image degradation in subjects who have undergone excimer laser refractive surgery and that was also relevant to visual demands in commercial aviation. Methods: Assessment of the visual environment and the tasks involved in piloting a commercial aircraft formed the basis for the selection of the test parameters. The new contrast acuity assessment (CAA) test covers a functional visual field of ±5° and is based on minimum spatial vision requirements for commercial pilots. Results: Data measured in 100 normal subjects were used to define the `standard normal observer' and the range of variation for the parameters of the test. This approach makes it possible to quickly establish whether a given subject's performance falls within the range of the standard normal observer. The test is also administered under low ambient illumination since flying at night involves mesopic levels of light adaptation when the pupil size is large and the effects of aberrations and scattered light are therefore more pronounced. Conclusion: The results of the test are simple to interpret and reveal visual performance that falls outside the normal range as a result of either significant degradation of retinal image quality (caused by increased aberrations and scattered light) or abnormal processing of visual information in the retina and/or the visual pathway.

No description available.

published_or_final_version / Surgery / Doctoral / Doctor of Philosophy

published_or_final_version / Anatomy / Master / Master of Philosophy

Thesis (M.H.S.A.)--University of Michigan, 1982.

Thesis (M.H.S.A.)--University of Michigan, 1982.

Thesis--University of Finland, 1987. / At head of title: Department of Cariology and Department of Pathology, University of Helsinki, Finland. Abstract sheet inserted. "Also published in Proceedings of the Finnish Dental Society, 1987, vol. 83, Suppl. XII"--T.p. verso. Includes bibliographical references (p. 60-70).