Treatment of Infected Pseudarthrosis of the Inferior Limb with Low-Frequency Pulsing Electromagnetic Fields: Report of 16 Cases

We report our experience in the treatment of infected pseudarthrosis of the inferior limb with pulsing electromagnetic fields (PEMFs) in 16 patients. The problems arising from the treatment of the infected pseudarthrosis, in which skin lesion, bone non-union and draining infection must be faced at the same time, will be discussed. Twelve patients healed in an average stimulation time of 5.6 months. The results of PEMFs stimulation were satisfactory because of the high percentage of success (75%), and the fact that a surgical operation was avoided in most of the patients. In the failed patients, PEMF stimulation had a positive effect on the local conditions of the pseudarthroses.     

Pseudoarthrosis Treatment with Cancellous Bone Grafts and Low-Frequency Pulsing Electromagnetic Fields

We report our experience in the use of cancellous bone grafts and stimulation with pulsing electromagnetic fields (PEMFs) in the treatment of acquired pseudarthrosis in 28 patients, including 17 patients with active infections. Stimulation was begun immediately after the grafting, and all patients healed in an average time of 4 months.     

A multivariate approach to the treatment of peripheral nerve transection injury: the role of electromagnetic field therapy

A multivariate approach to the treatment of peripheral nerve transection injury has been used in a rat model. A pilot study (48 animals, 8 groups) examined variables associated with the method and timing of surgical repair, the arrest of wallerian degeneration, and the role of pulsing electromagnetic field therapy (PEMF) in functional recovery. A second phase (90 animals, 6 groups) then studied the timing and duration of pulsing electromagnetic field therapy as the only variable in larger groups of animals. The pilot study revealed that a vein-graft conduit did not improve functional recovery compared with standard epineurial repair. Additionally, delayed repair compared favorably with immediate repair. The use of chlorpromazine to inhibit the toxic effects of calcium influx appeared to enhance early functional recovery, and the combination of delayed nerve repair and pulsing electromagnetic field therapy seemed to consistently improve function. The second phase of the study has demonstrated (for the first time) statistical improvement in ambulation in animals treated with delayed surgical repair and prolonged pulsing electromagnetic field therapy. We postulate that future treatment of nerve transection injuries will involve a combined treatment regimen consisting of the immediate arrest of wallerian degeneration, delayed surgery, and pulsing electromagnetic field therapy.     

Treatment of delayed- and non-union of fractures using pulsed electromagnetic fields

A prospective series of 32 consecutive patients, with 33 long-bone fractures suffering from delayed- or non-union were treated by pulsed electromagnetic fields (PEMF) or by PEMF with surgery. The management regime for the PEMF treatment was simpler and less rigid than that reported by Bassett et al.² and our stimulation waveform was also different. Nineteen fractures (100%) treated with surgery and PEMF united within nine months of the commencement of PEMF treatment. Fourteen fractures were treated with PEMF alone. Twelve (86%) united within ten months and two failed to unite. The resulls of this study suggest that the stimulating waveform is less critical than is claimed by Bassett et al. and that a simpler and easier management regime for PEMF treatment can be just as effective. Alternatively PEMF may have no effect on fracture healing.     

Assessment of the efficacy and safety of low frequency,low intensity magnetic fields in patients after knee endoprosthesis plasty. Part 2: A Clinical Study

The purpose of this clinical study was to assess low frequency, low intensity magnetic fields in the enhancement of the physical rehabilitation of patients after knee endoprosthesis surgery. The study included 62 patients who underwent total knee arthroplasty. Group A consisted of 32 patients who were physically rehabilitated. Group B consisted of 30 patients who were physically rehabilitated and treated additionally with pulsing magnetic fields (5 mT, 30 Hz, 20 min once a day, 5 days weekly). Therapy lasted 3 weeks for both groups. The rehabilitation process was evaluated using a goniometer, tensometer, goniometric pendulum test, Lysholm scale for knee function, and a visual analogue scale (VAS) questionnaire for pain and activity. The changes of measured rates were comparable in both groups. Low frequency and low intensity magnetic fields of examined parameters were not demonstrated to effectively improve the rehabilitation of patients after knee endoprosthesis surgery. Bioelectromagnetics 30:152–158, 2009. © 2008 Wiley‐Liss, Inc.     

Nitroblue tetrazolium test in patients with breast cancer undergoing mastectomy and radiotherapy

The reduction of nitrotetrazolium blue with stimulated and unstimulated granulocytes was performed in 40 patients with breast cancer. Blood was collected from peripheral vein before surgical intervention, during surgery from vein draining of tumor, two weeks after surgery and three months after surgery when radiotherapy was finished. In parallel experiments the NBT test was made in the peripheral blood of 20 healthy individuals. We have observed decreased reduction of nitrotetrazolium blue in stimulated granulocytes, which may indicate that granulocytes from these patients are unable for efficient stimulation. No evident effect concerning the advancement of disease and applied therapy could be found. The importance of determining the NBT test in cancer patients is briefly discussed.     

In vitro exposure of human chondrocytes to pulsed electromagnetic fields

The effect of pulsed electromagnetic fields (PEMFs) on the proliferation and survival of matrix-induced autologous chondrocyte implantation (MACI)-derived cells was studied to ascertain the healing potential of PEMFs. MACI-derived cells were taken from cartilage biopsies 6 months after surgery and cultured. No dedifferentiation towards the fibro- blastic phenotype occurred, indicating the success of the surgical implantation. The MACI-derived cultured chondrocytes were exposed to 12 h/day (short term) or 4 h/day (long term) PEMFs exposure (magnetic field intensity, 2 mT; frequency, 75 Hz) and proliferation rate determined by flow cytometric analysis. The PEMFs exposure elicited a significant increase of cell number in the SG2M cell cycle phase. Moreover, cells isolated from MACI scaffolds showed the presence of collagen type II, a typical marker of chondrocyte functionality. The results show that MACI membranes represent an optimal bioengineering device to support chondrocyte growth and proliferation in surgical implants. The surgical implant of MACI combined with physiotherapy is suggested as a promising approach for a faster and safer treatment of cartilage traumatic lesions.     

Stimulation of phagocytosis and free radical production in murine macrophages by 50 Hz electromagnetic fields

Effects of 50 Hz electromagnetic fields on phagocytosis and free radical production were examined in mouse bone marrow-derived macrophages. Macrophages were in vitro exposed to electromagnetic fields using different magnetic field densities (0.5-1.5 mT). Short-time exposure (45 min) to electromagnetic fields resulted in significantly increased phagocytic uptake (36.3% +/- 15.1%) as quantified by measuring the internalization rate of latex beads. Stimulation with 1 nM 12-0-tetradecanoylphorbol-13-acetate (TPA) showed the same increased phagocytic activity as 1 mT electromagnetic fields. However, co-exposure to electromagnetic fields and TPA showed no further increase of bead uptake, and therefore we concluded that because of the absence of additive effects, the electromagnetic fields-induced stimulation of mouse bone marrow-derived macrophages does not involve the protein kinase C signal transduction pathway. Furthermore, a significant increased superoxide production after exposure to electromagnetic fields was detected.     

Pulsed subcutaneous electrical stimulation in spinal cord injury: preliminary results

The treatment of long-term, stable para- and quadriplegics with pulsed electrical stimulation for pain control resulted in, anecdotally, a significant number of these individuals showing increased motor function as well as sensory awareness. This small pilot study was conducted in order to assess the hypothesis that pulsed electrical fields can effect diseased neurological function. Thirteen para- and quadriplegic subjects with 18 months of stable neurological signs and symptoms were exposed daily to pulsed electrical stimulation for a 6-month period and assessed for any improvement in motor function or sensory perception. The hypothesis is that pulsed electromagnetic fields can normalize viable but dysfunctional neuronal structures. Results were encouraging.     

Growth inhibition of Staphylococcus aureus induced by low‐frequency electric and electromagnetic fields

Magnetic field therapy is an established technique in the treatment of pseudarthrosis. In cases of osteomylitis, palliation is also observed. This study focuses on the impact of different electric and electromagnetic fields on the growth of Staphylococcus aureus by in vitro technologies. Cultures of Staphylococcus aureus in fluid and gel‐like medium were exposed to a low‐frequency electromagnetic field, an electromagnetic field combined with an additional electric field, a sinusoidal electric field and a static electric field. In gel‐like medium no significant difference between colony‐forming units of exposed samples and non‐exposed references was detected. In contrast, Staphylococcus aureus concentrations in fluid medium could clearly be reduced under the influence of the four different applied fields within 24 h of experiment. The strongest effects were observed for the direct current electric field which could decrease CFU/ml of 37%, and the low‐frequency electromagnetic field with additional induced electric alternating field with a decrease of Staphylococci concentration by 36%. The effects of the electromagnetic treatment on Staphylococci within fluid medium are significantly higher than in gel‐like medium. The application of low‐frequency electromagnetic fields corroborates clinical situations of bone infections during magnetic field therapy. Bioelectromagnetics 30:270–279, 2009. © 2009 Wiley‐Liss, Inc.     

Pulsing electromagnetic field therapy in nerve regeneration: an experimental study in the cat

A multidisciplinary approach to the study of peripheral nerve regeneration in the cat has been presented. The purpose of this work has been to determine if pulsing electromagnetic field (PEMF) therapy can enhance peripheral nerve regeneration after injury. In equal groups of animals, two types of pulsing electromagnetic field treatment were compared with untreated controls. All animals underwent quantitative electrophysiologic and morphologic assessment at the area of injury. In addition, muscle fiber sizing in the periphery and retrograde labeling of anterior horn motoneurons with horseradish peroxidase were studied. Results have shown no statistical differences between the groups in electrophysiologic or morphologic parameters. However, in animals treated with a pulse-burst electromagnetic field there was a statistically significant improvement in the labeling and localization of anterior horn cells in the central nervous system. These results indicate that pulse-burst electromagnetic radiation can increase the numbers of motor neurons that reestablish appropriate connections to the periphery after nerve injury. It remains to be seen if this improved spinal cord organization can translate to improved peripheral functional return.     

Effect of Electromagnetic Stimulation on Patients Suffering from Non-Union. A Retrospective Study with a Control Group

In this study we have reviewed a group of patients suffering from non-union treated at the same hospitals by the same surgeons. Twenty six patients (control group) received an orthopaedic treatment aimed at promoting bone healing, fourty one patients (experimental group) were stimulated with an electromagnetic field generator without any further change in the orthopaedic management of the non-union. Eighteen patients healed in the control group and thirty six in the experimental group. The average healing time was shorter among patients stimulated. No difference was observed in the success rate between the 2 groups of patients for non infected non-unions. Infection proved to be detrimental for the success of the treatment in the control group, while it did not negatively influence the outcome of stimulation. Provided that the orthopaedic treatment of the non-union is considered satisfactory, electromagnetic stimulation is a valid option in the treatment of non-unions.     

Effect of Electromagnetic Fields on Two Calcium Dependent Biological Systems

Weak pulsing electromagnetic fields interfered with lymphocyte blastogenesis and thromboxane release by polymorphonuclear leukocytes, as measured with %-thymidine incorporation and radioimmunoassay, respectively. Both cellular systems are calcium-dependent. Electromagnetic exposure significantly Inhibits both DNA synthesis and uptake in transformed lymphocytes. The effect on DNA synthesis seems to be synergistic with that of verapamil, a calcium blocker.     

不同手术方式对于气胸术后长期生活质量的前瞻性研究

目的:探讨原发性或继发性气胸治疗的两种手术方式:电视胸腔镜手术(Video-Assisted Thoracoscopic Surgery,VATS)、后外侧开胸手术(posterolateral thoracotomy,PT)术后长期生活质量(QOL)状况。方法:采用患者生活质量测定量表核心量表(EORTCQLQ-C 3 0,简称QL Q-C3 0)中文版调查从2008年12月至2009年12月在我科治疗的60例原发性或继发性气胸患者,对其术前和术后1,3,6和12个月的QL Q-C30得分与参考值进行比较。结果:①术前术后生活质量相比较,功能方面,VATS组无明显差异,而后外侧开胸组患者术后6月躯体功能降低,12月情绪功能升高;1,3,12个月总体状况显著升高,有统计学差异;症状方面,VATS组,术后1月呼吸困难症状加重;术后1,3,6个月经济困难加重,有统计学差异;后外侧开胸组,术后1,3个月疼痛加重;术后6月疲乏减轻;术后12月,呼吸困难减轻;②两组术后生活质量相比较,功能方面,后外侧开胸组,术后6月躯体功能降低,术后12月情绪功能升高,术后1,3,12个月总体状况得分升高;症状方面,VATS组,呼吸困难术后1月升高,术后12月降低;后外侧开胸手术组,术后1,3个月疼痛降低;术后6月疲乏降低;术后1,3,6个月经济困难降低。结论:术后生活质量与术前比较,不同的手术方式会产不同的效果,总体来说手术是改善气胸患者生活质量的重要方法。比较两种方法术后生活质量,VATS组较后外侧开胸组患者功能恢复较快,而症状相关项目则具有各自的优缺点。     

Protective effect of low frequency low energy pulsing electromagnetic fields on acute experimental myocardial infarcts in rats.

This series of experiments assesses the effect of exposure to low-frequency pulsing electromagnetic fields (PEMFs) in 340 rats with acute experimental myocardial infarcts. The left anterior descending artery was ligated with suture thread, and the rats underwent total body exposure to PEMFs until they were killed. Twenty-four hours after surgery, the necrotic area was evaluated by staining with triphenyltetrazolium chloride. A significant reduction of the necrotic area was observed in the animals exposed to PEMFs compared with the nonexposed controls. Exposure for up to 6 days does not appear to affect the area of necrosis, although in exposed animals an increase of vascular invasion of the necrotic area is observed: 24.3 % as against 11.3 % in controls. No effect on the necrotic area size from exposure was found when the left anterior descending artery was occluded for 60 min, followed by reperfusion. The results reported show that exposure to PEMFs is able to limit the area of necrosis after an acute ischemic injury caused by permanent ligation of the left anterior descending artery. These data are in agreement with the protective effect of PEMFs observed on acute ischemia in skin free flaps in rats and in cerebral infarcts in rabbits.     

不同子宫手术方案对生育期妇女卵巢功能的影响

目的:研究不同子宫手术方案对生育期妇女卵巢功能的影响。方法:随机选取自2014年1月至2015年4月于我院进行手术治疗的200例生育期妇女作为研究对象。针对所有患者在术前1d及术后6个月分别进行静脉采血5 m L,比较患者手术前后促卵泡激素(FSH)及雌二醇(E2)水平,不同年龄与手术方案患者手术前后血清抗苗勒氏管激素(AMH)的水平。结果:术后患者的FSH及E2水平与术前比较,差异无统计学意义(P0.05)。40岁者手术后的血清AMH水平显著低于术前,差异有统计学意义(P0.05)。在手术方式中,子宫切除术(子宫全切及广泛性子宫切除)后患者血清AMH显著低于术前的水平,差异有统计学意义(P0.05)。在手术途径中,腹腔镜辅助子宫切除术后患者血清AMH显著低于术前的水平,差异有统计学意义(P0.05)。结论:≥40岁患者在接受子宫手术时可能会影响其卵巢储备功能,而子宫全切、广泛性子宫切除以及腹腔镜辅助子宫切除术对患者术后卵巢功能影响更大。     

Surgical debulking of podoconiosis nodules and its impact on quality of life in Ethiopia

BackgroundIn Ethiopia, severe lymphedema and acute dermato-lymphangio-adenitis (ADLA) of the legs as a consequence of podoconiosis affects approximately 1.5 million people. In some this condition may lead to woody-hard fibrotic nodules, which are resistant to conventional treatment. We present a series of patients who underwent surgical nodulectomy in a resource-limited setting and their outcome.MethodsIn two teaching hospitals, we offered surgical nodulectomies under local anaesthesia to patients with persisting significant fibrotic nodules due to podoconiosis. Excisions after nodulectomy were left to heal by secondary intention with compression bandaging. As outcome, we recorded time to re-epithelialization after surgery, change in number of ADLA episodes, change in quality of life measured with the Dermatology Quality of Live Index (DQLI) questionnaire, and recurrence rate one year after surgery.Results37nodulectomy operations were performed on 21 patients. All wounds re-reepithelialised within 21 days (range 17–42). 4 patients developed clinically relevant wound infections. The DLQI values were significantly better six months after surgery than before surgery (P<0.0001). Also the number of ADLA episodes per three months was significantly lower six months after surgery than before surgery (P<0.0001).ConclusionNodulectomy in podoconiosis patients leads to a significant improvement in the quality of life with no serious complications, and we recommend this to be a standard procedure in resource-poor settings.     

Surgical treatment of infective endocarditis with special reference to prosthetic valve endocarditis.

Patients with native valve endocarditis treated surgically between 1968 and 1978 (n = 15) and all patients presenting with prosthetic valve endocarditis during this period (n = 21) were followed up for at least four years. Five of the patients with native valve endocarditis required urgent early surgical intervention, of whom two died. The remaining 10 underwent valve replacement after a course of antibiotic treatment: all survived, though one required further valve replacement. The 21 patients with prosthetic valve endocarditis suffered 25 attacks. Nine were cured by medical treatment alone; two died before surgical intervention was possible; 11 required valve replacement, of whom three died; and two required valve replacement after a course of antibiotic treatment. The incidence of early prosthetic valve endocarditis--that occurring within two months of operation--was 0.67%, but that of late prosthetic valve endocarditis could not be determined. Medical treatment when started early should cure endocarditis in most patients, but vigilance should be maintained for the appearance of indications for surgery. When such indications exist surgery should not be delayed.     

三种不同手术方式治疗精索静脉曲张患者的临床研究

目的:研究三种不同的手术方式治疗精索静脉曲张患者(VC)的临床疗效。方法:选择2015年1月至2017年6月在我院接受VC手术的患者128例进行研究,其中接受腹膜后高位结扎术者45例,纳入腹膜后组;接受腹腔镜手术者39例,纳入腹腔镜组;接受显微手术者44例,纳入显微手术组,对比各组患者的手术时间、出血量、住院时间及住院总费用,对比术前、术后3个月各组的睾丸体积、性激素水平,随访1年,记录各组复发率和并发症发生情况。结果:显微手术组的手术时间长于腹膜后组与腹腔镜组,出血量、住院时间、住院总费用少于腹膜后组与腹腔镜组(P0.05)。术前、术后3个月各组左侧、右侧睾丸体积对比差异均无统计学意义(P0.05)。术后3个月各组睾酮(T)水平高于术前,卵泡刺激素(FSH)、黄体生成素(LH)水平低于术前(P0.05),术后3个月显微手术组T水平高于腹膜后组与腹腔镜组,FSH、LH水平低于腹膜后组与腹腔镜组(P0.05)。与腹膜后组、腹腔镜组相比,显微手术组的复发率及并发症发生率更低(P0.05)。结论:不同手术方案治疗VC均可获得一定的疗效,但显微术式可明显改善性激素水平,降低复发率及并发症发生率,术后恢复好,费用少。