Method, composition and set for carrying out intrauterine chemical necrotization

FIELD: medicine.

SUBSTANCE: method involves introducing cauterizing necrotizing composition like paste containing silver nitrate and dextrane into uterine cavity. Paste contact to target tissue is supported during time enough for reaching chemical necrosis. Then cauterizing composition is brought in contact with deactivating agent like aqueous solution of sodium chloride and removed from the uterine cavity later on. It is proposed to protect non-target tissue by supplying protection agent to it and carrying out previously described steps.

EFFECT: enhanced effectiveness of cauterization controlled in time and action intensity degree; avoided other tissue injuries.

30 cl, 8 dwg

 

BACKGROUND of INVENTION

1. The technical field to which the invention relates.

This invention relates to methods, compositions and apparatus for chemical akrotiriani tissue lining the cavity of the human body, in particular the mucous membrane of the uterus. More specifically, the methods and compositions and apparatus of the present invention provide an effective chemical necrosis of the mucous membrane of the uterus of a mammal in order to treat menorrhagia and to stimulate amenorrhea without many of the disadvantages and hazards of the known methods intrauterine akrotiriani.

2. The level of the previous techniques.

The following terms used here have the meanings given below:

Necrosis means death of the cells in the tissue.

"Mucosa" is that part of the inner lining of the uterus, which usually attaches the embryo, and eliminates part of the inner lining of the uterus, which form a neck to which the embryo is usually not attached.

"Cryogenic" is used to refer to temperatures low enough to cause necrosis.

"Cauterizing agent or cauterizing pasta" is an agent that can cause cell necrosis in the tissue, such as tissue lining the cavity of the human body, such as the uterus.

"Chemical necrosis necrosis is that who the hiccups in contact with a cauterizing agent.

"Deactivating agent", "wash solution", and "wash lotion" means any agent that can turn a cauterizing agent or cauterizing the pasta in naprigayushe.

"Menorrhagia" means excessive menstrual bleeding, i.e., more than about 80 ml of blood loss per month.

The device and methods of akrotiriani the mucous membrane of the mammalian uterus, suitable for sterilization procedures and treatment of cancer is well known. Thermal and cryogenic treatments were applied in such technical methods of akrotiriani and usually included or direct or indirect application of heat or cold to tissue that is to be processed

For example, necrosis of the mucous layer of the uterus was applied laser hysteroscope. This laser processing suffers from several drawbacks. It requires a significant amount of thermal energy to a relatively small section of the cloth, although such a large amount of heat may be unnecessary for effective tissue necrosis. In addition, this laser processing requires the doctor to constantly re-set the laser under hysteroscopic control used in the processing inside the uterus in order to handle all the mucous membranes. Such internal manipulation laser hysteroscope inside the uterus of the patient is both the AK difficult, requiring a significant level of art perform and potentially dangerous. The result of the manipulation laser device within the uterus or cavity of the body may be accidental puncture or uterine tissue wall, and tissue layers underlying the mucous membrane, can be blasted at full depth, if the laser beam is to keep focused on one area of the fabric for too long a period of time. Electrosurgical necrosis of the mucous membrane operates on a similar principle and is the same risk as laser necrosis of the mucous membrane.

There are various alternatives to laser treatment when akrotiriani mucous membrane of the uterus. In U.S. Patent 4949718 and 5105808 Neuwirth et al. disclosed method and device for holding necrosis of a tissue lining the body cavity of a mammal, in particular the mucous membrane of the uterus, by heating the liquid contents of the inflated bladder can expand inside the uterine cavity. Bloat can expand the bubble inside the uterus makes possible the contact between the wall can expand the bladder and the lining of the mucous membrane.

U.S. patent number 3924628, Droegemueller et. al. discloses a method and apparatus for akrotiriani cell tissue, which is able to expand the bubble, which is inserted into the uterus and nab neetsa circulating liquid or gas at cryogenic temperatures (related to temperatures low enough to induce cell necrosis). Bubble described Droegemueller et. al., supported in a sufficiently long contact with the inner surface of the uterine lining and leads to necrosis, basically, the whole of the mucous membrane of the uterus with a single treatment. Droegemueller et. al. describe the use of liquid nitrogen which evaporates before entering the bubble, creating, thus, the pressure in the bladder to a level that provides the desired contact with the uterus. Other liquids described Droegemueller and et al. as suitable in their way include coolants such as freon. Method and device Droegemueller et al. suffer from the disadvantage that they use cryogenic fluids that are toxic and can be fatal to the patient in case of rupture of the bladder. In addition, the device Droegemueller et al. does not allow to regulate the pressure, which is used for inflating the bladder. In the case of a bubble bursting cryogenic liquid will quickly change state from liquid to gaseous, with possible serious consequences for the patient. Another disadvantage of the technical acceptance Droegemueller et al. is that it does not limit the amount of cryogenic liquid, which can penetrate into the uterus in case of rupture of the bladder.

In U.S. patent number 2734508, Kozinski discloses a therapeutic device for primeneniya heat in the body cavities, includes applicator, which is inserted into the body cavity, withdrawing from the air, which is then inflated and heated with circulating hot air. Kozinski does not disclose the applicator, which adapts to the shape of the body cavity. Further, when the condition of the lower heat-transfer coefficients of gases in comparison with the fluid processing device Kozinski should take a long period of time to achieve necrosis, thereby exposing the patient to additional discomfort and risk. In addition, the device Kozinski is not designed for measuring and controlling the internal pressures and temperatures introduced applicator.

U.S. patent number 2077453 filed Albright, discloses a therapeutic device, comprising a relatively long tubular applicator, which has shape and form, mainly for the passage where he should be introduced, and which has a relatively thin elastic rubber wall, which transfer heat, and which is stretched to fit the irregularities of the areas to be treated under the application of internal pressure. Albright also reveals that fluid, such as heated water, can be used as heating means in the applicator. The applicator Albright, like applicator Kozinski, however, suffers from the disadvantage that the standard test bar is its walls, to conform to the irregularities of the mucous membrane, is limited, as the applicator Albright provides a solid rubber wall, which serves to prevent excessive stretching of the applicator. In addition, the applicator Albright requires that the liquid is circulated completely around the device. Albright also does not provide a device that allows you to adjust the temperature and pressure of the liquid or other means, the filling of the bladder.

U.S. patent number 3369549 filed AGMA, discloses a therapeutic device for applying heat or cold in the body cavities, including the capsule probe comprising a heat exchanger and an elastic bladder, which can swell to conform to the body cavity. AGMA, however, does not disclose a means of control for regulating the temperature and pressure of the elastic applicator, it does not and akrotiriani tissue in the cavity that is processed.

Other patents that disclose the use of heat treatment of the inner lining of the body cavity, include U.S. patent numbers 2192768, 2466042, 2777445 and 3369549.

In addition to these thermal and cryogenic treatments are also well known application of cautery chemical compounds inside the human body to achieve sterilization and treatment of cancer. She was the PR is dprint attempt to use cauterizing chemical compounds as locally destructive agents, but their use has been limited due to concerns about security and control over the delivery of different agents, as well as because of other flaws, due to application methods, for example, location blindly specific solid chemical substances. For example, as described Babcock, W., Chemical Hysterectomy. Jnl. Obstet. & Gyn., Vol. 7, p.693 (1924), the use of gauze strips soaked in a saturated solution of chloride of zinc to the walls of the uterus, was used, as reported to cause amenorrhea, sterility, and for treatment of tumors. However, this procedure has several disadvantages.

Initially, it should be noted that the use of gauze strips is a blind procedure. Gauze, impregnated with zinc chloride, is placed in the uterus until such time as the attending physician does not feel that the cavity is filled. The strips are left in place within a predetermined period of time and then removed. Shipping in the cavity and removal of the uterine cavity cauterizing gauze bandages inevitably lead to a serious risk of contact with the vaginal walls, where the cauterizing tool can damage the vaginal and other tissues that are not the purpose of processing. Accordingly, successful use of this methodology requires considerable art and experience, limiting the suitability about what edure for women availability of highly qualified medical personnel.

Was studied using cauterizing agents, such as silver nitrate, zinc chloride and copper sulphate, for use in the chemical sterilization by chemical cauterizing the fallopian tubes. However, as discussed Richart R., Female Transcervical Sterilisation. Chapter 3, Harper & Row (1983), even when achieved strong necrosis pipes with the use of silver nitrate (AgNO3), a significant portion of the fallopian tube remained unaffected. When applied composition for continuous release cauterizing agents, it was found that the control over the release of cauterizing agents was insufficient to avoid unacceptable side effects. In addition, the use of strong cauterizing agents, such as acids and alkalis, along the way would require equally strong neutralizing agents, which also involves risk. The use of such agents also puts in a difficult position of the treating physician during the titration with neutralizing cauterizing agent in the uterus of the patient.

A BRIEF DESCRIPTION AND PURPOSE of the INVENTION

The aim of the present invention is to provide a safe and effective method for chemical akrotiriani tissue lining the body cavity, in particular the mucous membrane of the uterus person using a cauterizing agent capable of chemically microservice TC the new target to the desired depth within a reasonable period of time, and where cauterizing agent can selectively and rapidly transformed into naprigayushe by contact with the deactivating agent. In a particularly preferred variant of deactivating agent is non-toxic, that is harmless to human tissue.

Another objective of the present invention is the provision of a relatively inexpensive and easy to use compositions cauterizing agent and non-toxic media in paste form, which is easily and safely deactivated by deactivating agent composition that can be applied for effective chemical necrosis of the lining of the body cavity of a mammal.

Another purpose of this invention is the provision of a method for introducing a controlled amount of cauterizing agent under predetermined pressure into the cavity of the uterus, so as to increase the likelihood that the silver nitrate will create a mostly uniform and close contact of the paste with the mucous membrane within a predetermined time, without passing into the peritoneal cavity.

Another purpose of this invention is the provision of a method for creating chemical necrosis of a tissue lining the body cavity of a mammal, comprising the stage of introduction of the hysteroscope into the body cavity; passing the fluid through the hysteroscope to expand the body cavity, getcache the environment is not deactivating agent, for example, an inert gas or neelektrolitnye liquid; application to the tissue that is to be handled, cauterizing composition, distributing cauterizing pasta, mostly evenly over the surface of the fabric, while monitoring through the hysteroscope so that the pasta was in contact mainly with the whole fabric lining, for which necrosis is desired; ensure stay cauterizing paste in the body cavity for a period of time sufficient to create chemical necrosis, mainly throughout the tissue lining the body cavity for which necrosis is desired; the introduction of a deactivating agent on a fabric lining for decontamination cauterizing agent and removal of the deactivated cauterizing agent and decontamination agent from the body cavity; and removing the hysteroscope.

Another purpose of this invention is the provision of a method for conducting chemical necrosis of a tissue lining of the uterus of a mammal, comprising the stage of introduction of the hysteroscope into the uterus; passing gaseous CO2through the hysteroscope for the expansion of the uterus, passing through the hysteroscope first catheter for delivering a predetermined volume of paste of silver nitrate and a second catheter for delivery of an aqueous solution of sodium chloride for decontamination paste of silver nitrate; the distribution is of paste of silver nitrate, mostly evenly on the mucous membrane, while monitoring through the hysteroscope so that the pasta was in contact mainly with the entire lining of the mucous membrane; providing opportunities for gaseous CO2used to of fibroids, leaving the uterus, returning the uterus to its normal condition, thereby facilitating distribution paste of silver nitrate on the surface of the mucous membrane, while the uterus contracts; ensure stay paste of silver nitrate in the uterus over a period of time sufficient to create a chemical necrosis, mainly throughout the tissue lining of the uterus; delivery to the uterus through the second catheter aqueous solution of sodium chloride for decontamination paste of silver nitrate to actually inert chloride of silver; and leaching of silver chloride from the uterus using tidal stream or by tidal flow or continuous rinsing with sodium chloride or leaching by irrigation.

Another purpose of this invention is the provision of a method for chemical necrosis of a tissue lining the body cavity of a mammal, comprising the stage of introduction of the catheter into the body cavity; delivery cauterizing paste through the catheter into the body cavity to a natural filling the body cavity, but not exceeding the pre-mouth is blencogo volume and/or pressure; pressure regulating cauterizing paste using control means, connected to the catheter; and curing the paste, put thus, in a period of time sufficient to create a chemical necrosis, mainly throughout the tissue lining the body cavity for which necrosis is desired; the introduction of decontamination solution for decontamination cauterizing pasta to mostly inert neprigorayuschih components and removal of the deactivated cauterizing paste from the body cavity by tidal flow or continuous rinsing with sodium chloride or leaching by irrigation.

The present invention also provides a method for chemical necrosis of the mucous membrane of the uterus of a mammal, comprising the introduction phase of the first and second catheters or mnogotranshevogo catheter into the uterus; the delivery of approximately 5 to 15 ml paste of silver nitrate in the uterus, not exceeding the natural capacity of the uterus, through the first catheter, without exceeding a predetermined pressure, which must be below the pressure of the disclosure of the fallopian tube; controlling the pressure of the paste of silver nitrate; and curing the paste of silver nitrate, is introduced thus, in a period of time sufficient to create a chemical necrosis, mainly throughout the mucosa mA is Ki; delivery to the uterus through the second catheter or tubular catheter, an aqueous solution of sodium chloride for decontamination of silver nitrate to mostly inert silver chloride and leaching of silver chloride from the uterus.

The present invention also provides a method of treating menorrhagia, including the application stage cauterizing composition to the mucous membrane of the uterus; ensure stay cauterizing paste in contact with the mucosa for a period of time sufficient to create a chemical necrosis of the mucous membrane; contacting cauterizing composition with a deactivating agent to deactivate the cauterizing of the composition; and removing deactivated cauterizing composition and decontamination agent from the uterus.

The present invention also provides a method of treatment of the mucous membrane of the uterus, including the stage of application of the compositions of nitrate of silver to the mucous membrane of the uterus; ensure stay compositions of nitrate of silver in contact with the mucosa for a period of time sufficient to create a cauterizing necrosis of the mucous membrane; contacting silver nitrate with sodium chloride solution for decontamination of silver nitrate; and removal of the deactivated silver nitrate and sodium chloride from the uterus.

The present invention also provides to the impositio for processing of the mucous membrane of the uterus, comprising from about 10 to about 50 weight % of silver nitrate; from about 35 to about 80 weight % of the acid; and from about 0 to about 55 weight % of N2O.

The present invention also provides a composition for treatment of the mucous membrane of the uterus, including about 43 percent by weight of silver nitrate; about 29 percent by weight dextran; and about 34 weight % N2O.

Another object of this invention is the provision of a composition for the treatment of the mucous membrane of the uterus, including about 34 percent by weight of silver nitrate; about 31 percent by weight dextran and about 34 weight % N2O.

The present invention also provides a wash solution or wash lotion for decontamination cauterizing paste comprising from about 32 to about 40 percent by weight of dextran and from about 60 to about 68 weight % normal saline and having a viscosity of between from about 220 to about 660 CP.

Brief description of drawings

Figure 1 illustrates one variant of the invention, in which the hysteroscope is introduced into the uterus of a mammal;

Figure 2 illustrates the cannula for delivery cauterizing paste and wash solution (solution to flush or wash lotion, constructed in accordance with the invention;

Figa illustrates an alternate cannula, shown in figure 2;

Figv illustrates an alternate cannula, p is shown in figure 2;

Figure 4 illustrates an alternate cannula for the introduction of cauterizing paste, constructed in accordance with the invention;

Figure 5 illustrates an alternate cannula, shown in Figure 4;

6 illustrates dogtramadol flushing the cannula constructed in accordance with the invention;

Fig.7 illustrates the flushing cannula constructed in accordance with the invention; and

Fig illustrates an alternate cannula shown in Fig.7.

A DETAILED DESCRIPTION of the INVENTION

Figure 1 illustrates the hysteroscope 1, provided with passages for the first catheter 2 and the second catheter 3, passing through it. The hysteroscope 1 has a near end 5 and the far end 6, and the far end 6 is located inside the uterine cavity 4 of the uterus of a mammal 13. While the outer diameter of the hysteroscope 1 should be small enough so that it can safely and conveniently be placed in the cavity 4 of the uterus through the partially extended neck 9, it must have a sufficiently large inner diameter to accommodate the first and second catheters 2 and 3. The outer diameter of the hysteroscope 1 must be large enough or able to expand so as to create a substantially solid insulation of air and fluid in the neck 9. In order to facilitate easy introduction, this isolationary be created by using any one of several devices well-known specialists in this field, such as contrarily cap, nutriceuticals cylinder or nutriceuticals swab. Near end 5 of the hysteroscope 1 can be fitted to any one of the known in this field ways to allow freely manipulate the first catheter 2 to provide a more accurate receipt cauterizing paste 7, and to allow selective delivery of gas or liquid through the second catheter 3 to expand the cavity 4 of the uterus before processing and to fill the cavity 4 of the uterus decontamination agent 8 after processing.

As shown in figure 1, the hysteroscope 1, in which are placed the first catheter 2 and the second catheter 3, is aligned with the cervical canal after the cervix opens the extender and enters the holder. After the hysteroscope 1 is introduced into the cavity 4 of the uterus, through the second catheter 3 into the cavity 4 of the uterus is pumped fluid to create a pressure sufficient to allow expansion of the cavity 4 of the uterus. The uterus 13 can be represented as a body cavity with spauskite walls, i.e. as a potential body cavity or unstretched the body cavity. Fluid medium may be, for example, inert gas, preferably CO2or neelektrolitnye liquid, or any other biologically acceptable fluid which will not detektiv is encoded or otherwise react with a cauterizing agent. This allows your doctor to make visible on the monitor 14 applying a cauterizing agent, such as a paste of silver nitrate 7, the layer of tissue of the mucous membrane on the inner surface of the mucous membrane of the cavity 4 of the uterus. The pressure of CO2preferably should be maintained equal to from about 30 to about 50 mm Hg, and preferably about 40 mm Hg in order to maintain the uterus in the expanded state, at the same time minimizing the risk of damage to the uterine wall and minimizing the risk of exceeding the opening pressure of the fallopian tubes. The pressure of CO2adjustable means for controlling the pressure of the expanding medium (not shown). The barrier can be placed in the openings of the fallopian tubes in order to reduce the risk of occurrence of a cauterizing agent 7 in the pipe 12. The hysteroscope can be removed after use of toxic paste. Alternatively, it can be left in place up until the cavity 4 of the uterus is not completely washed out. This allows the doctor to observe through the hysteroscope for action cauterizing agent 7 and decontamination agent 8.

After the cavity 4 of the uterus is expanded, cauterizing pasta 7, such as silver nitrate, can be applied to tissue that is to be handled. The first catheter 2, inside the hysteroscope 1, can be pulled through the hole located in the village who cling the end 6 of the hysteroscope 1. Shipping pasta 7 silver nitrate can be carried out through the catheter 2, preferably 2 mm catheter under control through the hysteroscope and, preferably, in an atmosphere of gaseous carbon dioxide. Pasta is a mixture cauterizing agent in a quantity sufficient to cause chemical necrosis of the target tissue, inert carrier and directionspanel fluid balance. In a preferred embodiment, the composition includes from about 10 to about 50 weight % cauterizing agent and from about 35 to about 80 percent by weight of inert carrier for the formation of a liquid paste. In a particularly preferred embodiment, the paste contains from about 10 to about 50 weight % cauterizing agent and from about 35 to about 80 weight percent Dextran 70™ or Dextran 40™ and water. Dextran 40™ and Dextran 70™ are manufactured by Pharmacia, Inc. of Pitsataway, N.J. Most preferably, the paste contains from 10 to 50 weight% of silver nitrate and 30 to 80 weight % Dextran 70™ or Dextran 40™ and water. Preferably, the paste composition was brought to a viscosity that is convenient for the particular application and for introducing and output devices used in this process. With increasing content of Dextran 70™ or Dextran 40™ in relation to water, the pasta will become more viscous and may be more difficult to pass through needles or catheters with narrow openings. The consist is tion or the viscosity of the paste is brought to density, which allows you to control the course of the paste inside the uterus during the procedure.

The hysteroscope 1 connect the monitor 14, which allows the practitioner to observe the procedure and make sure that the paste 7 silver nitrate is applied to the target tissue that is to be handled. The action of the paste 7 silver nitrate can be observed, as is usually done using a laser or electrosurgical coagulation of the mucous membrane using a hysteroscope. After application of the paste 7 is completed, the extension of the cavity 4 of the uterus achieved through CO2eliminate through the second catheter 3, which returns the cavity 4 of the uterus in its normal state. This allows the opposite inner walls 11 of the uterus 13 to come into contact with each other, thereby spreading farther paste of silver nitrate 7. Pasta 7 allow to remain in contact with the mucous membrane within a predetermined period of time or up until the practitioner will not make the conclusion, by observing through the hysteroscope, which is sufficient necrosis. The time period will vary depending on the concentration of the silver nitrate and the depth to which the desired processing, however, for most applications it is preferred period of about 3 to about 15 minutes. In a particularly Ave is doctitle version use a period from about 4 to about 6 minutes.

The amount of paste that is injected should not exceed natural full volume of the cavity 4 of the uterus, from about 5 ml to about 15 ml, and the pressure used to deliver the paste 7, should not cause the internal pressure of the uterus, which exceeds the opening pressure of the fallopian tubes approximately 40 to 50 mm Hg Means for introducing a paste of silver nitrate 7 is preferably provided with means for measuring pressure, which is added to the paste, i.e. pressure gauge, spring, cotton valve (pop-off valve) or bubble (blister) in the wall of the tube or syringe, designed for limit the pressure to the desired limit. When you apply the paste of silver nitrate 7, the procedure can be controlled by x-rays or ultrasound to monitor the location and extent of the fill.

After a sufficient time for the chemical necrosis of the mucosa to a depth of approximately 4 to 5 mm, deactivating agent, for example an aqueous solution of sodium chloride 8, preferably about 5 weight % of sodium chloride, is introduced through the first catheter 2 under coercive pressure from about 30 to 40 mm RT. Art. for the decontamination of any remaining quantity of the active paste of silver nitrate 7. In a particularly preferred embodiment, the carrier is soluble is m in decontaminating agent. Silver nitrate 7 and sodium chloride 8 will interact with the formation of inert silver chloride 10.

Washing the cavity 4 of the uterus by an excess of an aqueous solution of sodium chloride 8, for example, from about 2 to 3 liters, accelerated full decontamination paste of silver nitrate 7. Preferred are two ways lavage of the uterus. During tidal lavage solution of sodium chloride 8 is supplied and discharged through the same catheter, for example 3. A solution of sodium chloride 8 must be supplied under pressure below the opening pressure of the fallopian tubes, to reduce the likelihood of receipt of any amount remaining paste of silver nitrate 7 in the fallopian tubes 12. After passage of a sufficient period of time, during which the sodium chloride solution 8 disables the paste of silver nitrate 7 in silver chloride 10 solution of sodium chloride 8, silver chloride 10 and any number of the remaining paste of silver nitrate 7 can be removed with a vacuum of approximately 1 to 2 mm Hg, is applied to the second catheter 3. The vacuum should be adjusted to cleanse the cavity 4 of the uterus so as to minimize the risk of spadine lower end or neck.

Alternatively, the lavage irrigation of the cavity 4 of the uterus is performed by the simultaneous arrival of fresh sodium chloride solution 8 and the Alenia used sodium chloride solution, 8, silver chloride 10, and any number of the remaining silver nitrate 7. Irrigation irrigation can be performed, for example, the supply of washing fluid to a freshly prepared solution of sodium chloride 8 through the first catheter 2 under forced pressure of approximately 30 to 40 mm Hg and the removal of waste drilling fluid through the second catheter 3 when the vacuum is from about 1 to 2 mm Hg sodium chloride Solution 8 can also be entered through the second catheter 3 and removed through the first catheter 2 so as to prevent the introduction into the cavity 4 of the uterus of any amount remaining in the first catheter 2 silver nitrate. Alternatively, the practitioner may remove contrarily cap, nutriceuticals cylinder nutriceuticals tampon, used for insulation of cavity 4 of the uterus, and to allow drilling fluid to exit the cavity 4 of the uterus around the hysteroscope 1 rather than by the application of suction through the first catheter.

A large part of the deactivated silver chloride 10 will be washed out from the cavity 4 of the uterus during water treatments and any number of the remaining decontaminated silver chloride 10 will be displaced from the body's natural processes.

Activity cauterizing agent can be easily controlled by the use of such compounds of silver as silver nitrate and tizanidibe or other compounds who can release silver ions. Silver ions interact with sulfides, proteins and chloride cells. As sulfides and chlorides are vital for cell metabolism, reaction leads to cell necrosis. Other potentially useful agent is iodine, which is like silver impervious to x-rays. Compositions containing iodine, interact with target-tissue result in the release of elemental free iodine, and the reaction may be stopped due to the formation of stable compounds, such as sodium iodide. The advantage of silver nitrate, however, is that the deactivating agent silver ion is a chlorine ion, which is a few solutions are routinely used in medicine, for example, intravenously or intramuscularly, such as normal saline Ringer's. Decontamination of silver nitrate is mainly process the stoichiometric formation of insoluble naprigayushe sediment. In a particularly preferred embodiment, the silver nitrate and Dextran 70™ used together, because they are easy to work with, controlled and is recognised by doctors and government regulatory agencies as a valid agent for application to humans. Dextran 40™ and 70™ can be used intravenously and vnutrimy is ecno and in several organ systems, such as the genital tract. Silver nitrate is applied on the skin, upper respiratory tract, lower genital tract and other places. Ion silver has loosened, but stable relationship with dextranomer carrier, but pulled out of it due to the ion flow in the tissue by binding to anions and protein. The carrier can be prepared from dextrans or glucose or other sugars, which are used in intravenous solutions, but preferably in concentrations sufficient for the formation of gels or pastes. In a particularly preferred embodiment, the carrier is soluble in decontaminating agent. Compositions prepared in accordance with this invention have a viscosity that is suitable for the intended purpose at temperatures between about 20°and about 37°With, however, the viscosity can be adjusted as dictated by the specific applications. Alginates, aloe, carboxymethyl cellulose, silicones and oxidized cellulose may also be used for the manufacture of pastes and gels, but the dextrans and sugar are the most preferred choice because of their acceptance by physicians and regulatory agencies.

The speed and strength of chemical necrosis can be adjusted percentage of nitrate of silver in the paste. By increasing the percentage of nitrazepa in the paste increases the possibility of a deeper burns. Through procedures well known to specialists in this field, it is possible to determine the appropriate concentration of silver nitrate to achieve the desired depth of burning in specific applications. One advantage of this invention lies in the fact that, when using silver nitrate practitioner can easily complete the introduction of normal saline, for example, NaCl, which will deactivate the silver nitrate due to the formation of silver chloride. Alternatively, the practitioner can cook pasta so that it is largely self-regulating. For example, a weak paste of silver nitrate can be prepared so that it will be spent after akrotiriani to a depth, which is only half the maximum safe allowable depth, thereby reducing the danger of too deep akrotiriani.

The viscosity of the cauterizing of the composition is adjusted in such a way that it does not flow uncontrolled inside the uterus. Cauterizing the composition should flow easily, without excessive pressure, through a catheter having an inner diameter of about 2 mm Cauterizing the composition should be sufficiently thick so as not to spread, that is, it must remain near the point of use. In a preferred embodiment, cauterizing composition having a consistency ranging from toothpaste to test for pancakes, used as dictated by the particular application. Thixotropic cauterizing composition using, for example, the clay mineral or the like, may be particularly suitable in some applications.

Research the viscosity showed that about 10 g of Dextran 70™mixed with about 10 ml of water containing varying concentrations of silver nitrate, flow slowly and smoothly under pressure through a 2 mm catheter length from 10 to 50 cm, attached to a 10 ml syringe. However, the concentration can be changed as dictated by the particular application in order to satisfy the conditions of delivery and organ or structure that will be processed. Low viscosity or "watery" compositions contain about 5 g of Dextran 70™ and about 10 ml of N2Oh, and high viscosity composition or "cool pastes are composed of from about 10 g to about 15 g or higher Dextran 70™ and about 10 ml of H2O.

The concentration of silver nitrate used in the implementation of this invention, are higher than the concentration of silver nitrate, commonly used in traditional dermatological pastes and compositions for washing the bladder, which often contain silver nitrate in amounts varying from about 1 to about 20 weight %. (The only exception is the traditional core of silver nitrate, which is often pure neath the silver atom, deposited on the applicator rod, for use in the vagina, on the skin, nose and other surface areas for cauterizing bleeding or scraped areas.) In the preferred embodiment of this invention, the concentration of cauterizing agent, used for selective destruction of tissue, ranging from about 5 grams per 10 ml of water to mostly saturated solution of about 16.5 grams per 10 ml of water at about 25°C. In a particularly preferred embodiment, the concentration of cauterizing agent used within about 7-8 g/10 ml water. In a particularly preferred embodiment, the composition includes about 40 weight % of silver nitrate, about 30 percent by weight of dextran, and about 30 percent by weight of water. In another particularly preferred embodiment, the composition comprises about 45 weight % of silver nitrate, about 28 percent by weight of dextran, and about 28 percent by weight of water. The reason for higher concentrations of silver nitrate are preferred, is that a large portion of silver ions is absorbed, i.e. interacts with chlorides, sulfides and proteins tissue. Thus, the high concentrations necessary to compensate for the decontamination of a large part of silver ions in the intercellular spaces in order to carry out the destruction of the tissue of the mucous membrane at the desired depth from about 4 to about 5 mm Atible high concentrations create the desired protein tissue damage and damage to the mitochondria and nuclei, which is confirmed by microscopic observation. These reactions can be selectively and quickly terminated in a controlled manner by introducing a saline solution, which rapidly inactivates residual free nitrate of silver due to the formation of silver chloride.

Bacteriological studies of a mixture of silver nitrate and Dextran 70™prepared in accordance with this invention showed that the paste sterilized due to the presence of silver nitrate. Dextrans support bacterial growth, while the silver/dextranase mixture show no bacterial growth. Chemical analysis of silver nitrate in dextran using atomic absorption spectroscopy showed that the silver ion is loosely contact (about 75%) with dextrans and that the binding stays for over a period of at least one week.

Specific variants of the invention will now be illustrated by the following examples.

Example 1.

Prepare a mixture of about 15 g of silver nitrate, about 10 g of Dextran 70™ and about 10 g of water was introduced through the cervical catheter in two normal uterine sample immediately after hysterectomy. The composition was sufficiently fluid (fluid) to be distributed to the almost complete filling of the uterine cavity podwysocki pressure, for example, about 200 mm Hg, but was sufficiently viscous so as not to flow into the fallopian tubes that have holes with a diameter of about 1 mm, This song was left in the uterus for about 10 minutes and created the desired histological lesion depth from about 4 mm to about 5 mm in the wall of the uterus. The chemical activity of the mixture was limited to about 10 minutes with normal saline irrigation, which caused a precipitate of silver chloride and contributed to the leaching of the mixture of dextran with nitrate of silver/silver chloride from the uterus.

Example 2

The composition used in Example 1 was also tested in vivo in Queens, female rabbits, and paste of silver nitrate/dextran again produced the desired extensive rapid destruction, which quickly stopped normal saline, as discussed before. In addition, the use of normal saline in the area surrounding the horns of the uterus during laparotomy for testing pasta in the horns, effectively prevented adjacent organs from the effects of spraying silver nitrate.

Example 3

A group of four adult females rabbit was anestesiology and subjected to laparotomy for exposure of the genital tract. One uterine horn of the first animal served as a control. In the other uterine horn was introduced pasta Dextran 70&x02122; containing about 10 g of dextran, about 9 g of silver nitrate and 10 ml of water. The composition was injected with a syringe and needle 18 size, and the fabric, which acted pasta, showed an immediate reaction. A certain amount of the emulsion was sprayed into the peritoneal cavity. The area of bowel and bladder and peritoneal surface which was in contact with the paste was treated with normal saline, which caused the formation of a white precipitate. The second female was treated similarly except that treated both horns of the uterus. Spray again appeared and blocked saline. The third female was treated in the same way, but saline was injected into the pelvic cavity prior to the introduction of pasta. Spray arose again, however, due to the fact that the pelvic cavity was pre-treated with saline, the spray never interacted with the surrounding tissues. The fourth female rabbit was treated like the third, except that pasta was introduced to only one horn. Animals were sutured and returned to the cells. The first female rabbit died the same night, possibly due to surgery and anesthesia. The autopsy showed acute inflammatory reaction of the horns of the uterus and tissues of the pelvic cavity. The second female rabbit died after seven days. The autopsy showed acute is chronic reaction horns, which were completely amazed, and inflammation of the pelvic cavity with possible perforation of the intestine from chemical damage. The third and fourth female rabbits were euthanized three weeks after normal recovery. The autopsy showed no reaction or adhesions on the intestinal or peritoneal tissues. It is assumed that this is due to the fact that the peritoneal cavity was protected salt solution before spray of silver nitrate had been in contact with the tissues. The horns of the uterus showed the desired result, that is, inflammation and ablation at the desired level, the destruction of the mucosa and lung scarring. The initial introduction of the paste in the horns of the uterus were stopped by the introduction of normal saline after six and ten minutes. This is a temporary difference is not created pathological differences, as the composition of silver nitrate mixture was effective and was chosen in the experiments with instances of human uterus, which were very large compared to the thin and small horns of the uterus of the female rabbit. The horns of the uterus of the female rabbit was seriously amazed on the treated plots and were in good condition on untreated plots. Thus, the reaction is pointwise bounded and can be controlled in intensity and duration. Were made by photosnea the key and the obtained microscopic pathology, which showed the destruction of the mucous membrane at the desired depth from about 4 to about 5 mm

It was shown that the compositions of this invention are pharmacologically active in sufficient quantity for chemical akrotiriani tissue, and can selectively and rapidly controlled to terminate after use with a saline solution to stop the reaction, and in the process of applying for restrictions hearth destructive actions from unintended damage to surrounding tissues and organs, were not targeted. Compositions are bacteriologically sterile, and the viscosity can be changed to the desired viscosity by the quantity of water added. Therefore, their delivery can be controlled by the volume, pressure and viscosity.

The compositions of this invention are not limited to the applications listed above, and have an extra wide applicability in the field of medicine. A mixture of silver ion media makes it possible for the controlled delivery of cauterizing agent on an extensive set of target organs and structures, such as the mucous membrane in the excision of the mucosa, polyps of the colon during the colonoscopy, the polyp of the bladder during cystoscopy, removal of a small diverticulum of the bladder, when the removal of the gallbladder through kaledoscope, to trilineage x-rays and ultrasound, destruction of bronchial damage during bronchoscopy, and other minimally invasive methods. Indeed, the composition and method of this invention provide an alternative mechanical, electrosurgical or laser destruction of target tissues and organs in the open, endoscopic, monographic or radiographic control. Using physiological salt solutions allows for controlled termination reactions as well as the protection of non-target tissues and organs in the treatment area. The media provide an environment for delivering an active agent and can be washed out, as they are water-soluble, or can be removed metabolically in those cases, if they are sugars or dextrans.

Alternatively, the compositions of this invention can also serve as delivering protection for other therapeutic agents or drugs, such as selected antibiotics or anti-inflammatory agents such as cortisone, hydrocortisone or prednisone, which can be used simultaneously with the active chemical destruction of or before or after such interference excision. The above tools are used in human medicine as well as in veterinary medicine because of the chemical mixture may take the form of the bodies I, which will be processed, and variations from individual to individual or from species to species may be regulated by the volume, viscosity, pressure, treatment time and concentration of the active agent. In a preferred embodiment, therapeutic agent or drug can be delivered to the site, which will be processed by means of a catheter or blindly or under ultrasonic, visual, or under radiographic observation.

It was demonstrated that the compositions of this invention will cause mostly strong cauterizing the reaction of cells to target tissues and microservice them and that saline will block the reaction as well as to protect viable non-target tissue in the appropriate application. Thus, the principle use of cauterizing agents in controlled doses, over a controlled period of time, in combination with suitable deactivating agents, demonstrated as successful in creating the planned destruction, at the same time as limiting loss fabrics-targets.

The compositions of this invention also supply other non-destructive fabric agents, such as anti-inflammatory agents, for example, cortisone, which can be delivered in high concentrations for the local short-term (1-7 days). the ti nondestructive tissue compositions provide a means to suppress the undesirable formation of adhesi, resulting, for example, myomectomy, recovery of tubular organs, recovery of joints etc.

For treatment of other body cavities can be used technique changes the ingredients and percentages of ingredients in the composition, which vary in viscosity and vary in processing time, as dictated by the particular application.

In a preferred embodiment, the composition has a viscosity that allows you to enter it into the target area using a hysteroscope and allows the composition to remain in contact with the target-tissue in the amount and within the period of time sufficient to create a chemical necrosis. In a particularly preferred embodiment, the composition is sufficiently fluid to be introduced through 2-3 mm catheter into the uterus, and sufficiently viscous so as not to flow in the uterine cavity at a pressure of about 80 mm Hg

It seems that in this process you can use many cauterizing agents and their respective decontamination agents. Cauterizing agents, such as zinc chloride, phenol, iodine, KOH, NaOH, and various acids and bases are well known to specialists in this field and are applicable to the methods of this invention and can be decontaminated by chemical processing, removed, diluted or dosed.

It also appears that in the seat of the second catheter in the first and second embodiments, the neutralizing solution can be delivered through the first catheter. In this embodiment, the volume of used decontamination solution should be regulated taking into account the residual cauterizing paste, which remains in the first catheter and needs to be decontaminated.

In a particularly preferred variant of the invention, the viscosity of the salt wash solution 8 is also governed by the viscosity increase, for example, to "creamy" viscosity similar to the viscosity, for example, traditional moisturizing skin lotions or lotions for tanning, in order to reduce the likelihood that non-activated silver nitrate, i.e. silver chloride 10, will enter in the zone, which is not a target, such as the fallopian tubes or in the bloodstream of the patient. The increase in the viscosity of the salt wash solution or wash lotion 8 prevents the paste 7 reached level too low viscosity, i.e. it prevents cauterizing paste 7 was too liquid or liquid during the washing stage, and, thus, reduces the likelihood that neutralized the silver nitrate, i.e. silver chloride 10 will penetrate into the fallopian tube or the vascular system in the process stages of neutralization and washing.

In a particularly preferred embodiment, the wash solution or the washing lotion 8, used to do not what tralization and leaching of silver chloride, includes from about 32 to about 40 percent by weight of dextran and from about 60 to about 68 weight % normal saline and has a viscosity of between from about 220 to about 600 centipoise.

Cauterizing pasta 7 preferably is inserted into the uterus at a pressure approximately equal to or less than about 200 mm Hg In the process of scouring pastes 7 wash solution or wash lotion 8 intrauterine pressure should be maintained at a pressure approximately equal to or less than about 40 mm Hg in order to further reduce the likelihood that silver chloride 7 will penetrate into the bloodstream or to enter areas that are not targeted. If you are using continuous irrigation is the preferred pressure of the internal flow equal to about 40 mm Hg and the pressure of the output stream is equal to from about 0 to about -5 mm Hg

Figure 2 illustrates the cannula 20 that delivers cauterizing pasta and wash solution or wash lotion, constructed in accordance with the invention. The cannula 20 has a near end 21 and the far or the injection end 22 and a longitudinal hole inside her. Near end 21 adapted for the formation of a substantially dense insulation liquid by using the introduction of cauterizing paste 7, such as a syringe 30. Means for measuring the pressure of 24 set in the far or inyecci nom the end 22 of the cannula 20 and fit and have so, to measure the internal pressure of the cavity 4 of the uterus. Due to the fact that the pressure of injection is higher near end 21 of the injection cannula 20, in order to overcome the resistance forces Pousielle movement cauterizing paste 7, the location of the means for measuring pressure 24 at or near the far end 22 of the injection cannula 20 will provide a more accurate measurement of the internal pressure of the cavity 4 of the uterus. Means for measuring pressure 24 you can choose from a large set of tools that are well known to specialists in this area as suitable for this purpose, however, in the preferred embodiment is used, the Registrar or the pressure sensor. Means for measuring pressure 24 is connected by a wire 25 with the control means 26 designed to demonstrate the internal pressure of the uterus 13, to limit the pressure at which the cauterizing paste 7 is introduced into the cavity 4 of the uterus, and to limit the pressure at which the wash solution or the washing lotion 8 is introduced into the cavity 4 of the uterus.

As shown in figure 2, the lug 27, located at the far end 22, is provided in the form of, for example, the tip of the conical or oligopolies form so as to facilitate the introduction into the neck 9 and the formation of a substantially dense insulation liquid when the tip 27 from Agueda in the neck 9 to reduce the likelihood that cauterizing pasta 7 will leave the cavity 4 of the uterus and enter the vaginal canal 102. In a particularly preferred embodiment, the outer surface 28 of the tip 27 is through the spiral grooves 29 or corkscrew-like configuration of its outer surface 28 to enhance the insulation between the outer surface 28 of the tip 27 and the neck 9. When using this variant of the invention, after cauterizing the paste 7 is introduced into the cavity 4 of the uterus, the cannula 20 for delivery of the paste is removed from the neck 9 and clean cannula 20 is inserted into the neck 9. Clean the syringe 30 is filled with wash solution or wash lotion 8, is attached to the near end 21 of the cannula 20, and wash solution or wash lotion 8 is introduced into and removed from the cavity 4 of the uterus using a syringe 30.

Figures 3A and 3B illustrate an alternative cannula, shown in figure 2. In the variant shown in Figures 3A and 3B, the cannula 39 includes a cannula 40 of the first part, having a near end 41 and the far end 42, and the tip 43 of the second part, having a near end 44 and the far end 45. The connecting device 46 is fitted between the near end 41 of the cannula 40 of the first part and the far end 45 of the tip 43 of the second part, as shown in Figa. The connecting device 46 preferably include a near end 41 of the cannula 40 of the first part, as p is shown on Figv. The connecting device 46 is adapted to provide a substantially solid insulation fluid between the first part 40 and the second part 43 and is also adapted to provide communication between the wire connection 25, located on the second part 43, which is connected with the tool demonstrations pressure and control means 26. The connecting device 46 may be chosen from a large set of connecting devices, well known to specialists in this area as suitable for this purpose, for example compounds landing with friction or connection with inside/outside lock, however, in the preferred embodiment, the connection is used with leuer constipation. May include a device, such as a plunger device near end 44 of the cannula 43 of the second part to facilitate connection and disconnection of the cannula 43 the second part of the connecting device 46 located near end 41 of the cannula 40 of the first part. In a particularly preferred embodiment, the connecting device 46 is provided by a valve 47 (shown in Figv), which blocks the longitudinal hole 23 of the cannula 40 of the first part, when the cannula 43 the second part is disconnected from the connecting device 46. This valve 47 helps to maintain the desired pressure in the cavity 4 of the uterus and reduces the likelihood of leakage of prig is suggesting paste into the vaginal canal 102. In the process, when using this option, the near end 41 of the cannula 40 of the first part is connected with the far end 45 of the cannula 43 the second part of the connecting device 46. The tip 27 of the cannula 40 of the first part can then be inserted into the vaginal canal 102 and the tip 27 is moving forward and is introduced into the neck 9 with the formation of the substantially dense insulation fluid between the outer surface 28 of the tip 27 and the neck 9. In a preferred embodiment, the wash solution or the washing lotion 8 then introduced into the vaginal canal 102 to protect the vaginal tissues from any cauterizing paste 7, which may be accidentally introduced into the vaginal canal 102 during the procedure. The syringe 30 containing cauterizing pasta 7, then attached to the middle end 44 of the cannula 43 of the second part and cauterizing the paste 7 is introduced into the cavity 4 of the uterus at a controlled pressure, as discussed previously. The catheter 43 the second part can then be disconnected from the connecting device 46 and removed from the vaginal canal 102. Then put a clean cannula of the second part or flush the cannula 43 and moves forward into the vaginal canal 102, and the far end 45 is connected with the connecting device 46. The syringe 30 is then connected to the near end 44 net cannula of the second part or flush cannula 43 and wash solution or wash loso the 8 is introduced into the cavity 4 of the uterus and allow him to remain inside the cavity 4 of the uterus over a period of time, sufficient to neutralize cauterizing paste 7. Then use the syringe 30 to remove the neutralized and diluted paste 10 of the cavity 4 of the uterus, as discussed earlier.

Figure 4 illustrates an alternate cannula 50 for the introduction of cauterizing paste, constructed in accordance with the invention. As shown in figure 4, the tip 51 is provided in the form of, for example, the tip of the conical or oligopolies form so as to facilitate the entrance into the neck 9 and the formation of a substantially dense insulation liquid when the tip 51 is located in the neck 9 so as to reduce the likelihood that cauterizing pasta 7 will leave the cavity 4 of the uterus and enter the vaginal canal 102. In a particularly preferred embodiment, the outer surface 52 of the tip 51 is provided with spiral grooves 53 or in the form of a corkscrew-like configuration of its outer surface 52 to reinforce isolation, as discussed above. The tip 51 is supplied with a channel 54 having a far end 55, which is in liquid communication with the longitudinal bore 56 of the cannula 50, and the middle end 57, which is in liquid communication with cotton bladder 58 to control the pressure cauterizing paste 7 within the cavity 4 of the uterus. In a preferred embodiment, the cannula 50, used to introduce a cauterizing paste 7, cotton bladder 58 is installed on from etco about 100 mm Hg Thus, if the pressure in the cavity 4 of the uterus greater than about 100 mm Hg, cotton bubble 58 will "clap" or open, reducing the pressure in the cavity 4 of the uterus and allowing cauterizing the paste to enter the vaginal canal 102, which is preferably protected in advance by the introduction of wash solution or wash lotion 8. After cauterizing the paste 7 is introduced into the cavity 4 of the uterus, the cannula 50 is removed. Then the second net cannula or flushing the cannula 50' is inserted in the neck 9, as discussed earlier, so that the wash solution or the washing lotion 8 could be injected into the cavity 4 of the uterus.

Figure 5 illustrates the cannula 4, which is modified for use in tidal flushing system to flush neutralized and diluted cauterizing paste 10. Wash solution or wash lotion 8 injected into the cavity 4 of the uterus and allow him to remain inside the cavity 4 of the uterus over a period of time sufficient to neutralize cauterizing paste 7. Neutralized and diluted paste 10 is then removed using a syringe. Second clean the cannula or flushing the cannula 50' is similar in construction to the first cannula 50 except that the cotton bubble 58' is set at around 60 mm Hg, because in the process of washing is desirable to lower the pressure, as what was rassmatrivalos earlier. Thus, if the pressure in the cavity 4 of the uterus greater than about 60 mm Hg in the washing process, the cotton bubble 58' will "clap" or open, reducing the pressure in the cavity 4 of the uterus, allowing cauterizing the paste to enter into the vaginal cavity 102.

6 illustrates dogtramadol flushing the cannula 70, constructed in accordance with the invention for use in flushing the system with a continuous flow. The cannula 70 is secured to the first tube 71 having a near end 72, which is in liquid communication with a source of wash solution or wash lotion 8, and the far end 74, which is in liquid communication with the hole 75 of the tip. In a preferred embodiment, the first tube 71 has a diameter of about 2 mm Cannula 70 is also provided with a second tube 76 having a near end 77 and the far end 78. The far end 78 is in fluid communication with the hole 75 of the tip and middle end 77 is in fluid communication with a means 79 to remove the neutralized and diluted cauterizing paste. In a preferred embodiment, the second tube 76 has a diameter that is equal to or greater than about 5 mm, and a means 79 to remove the neutralized cauterizing paste 10 fit to remove neutralized cauterizing pasta 10 at a pressure of from about 0 to about -5 mm Hg of vacuum. Nikon is CNIC 75 is supplied with a channel 150, with the far end 151, which is in liquid communication with the longitudinal bore 78 of the cannula, and the middle end 152, which is in liquid communication with cotton bubble 80 to control the pressure of the washing solution or the washing lotion 8 inside cavity 4 of the uterus. In a preferred embodiment, the cotton bubble 80 is set at around 60 mm Hg or less, as discussed earlier.

Fig.7 illustrates the cannula 90, having a near end 104 and the far end 105 constructed in accordance with the invention for use in category a flushing system. In this embodiment, the tip 91, located at the far end 105, is provided with many holes 92 in order to optimise the washing solution or the washing lotion 8, which in the preferred embodiment, is injected under a pressure of 60 mm Hg or less. The tool 93 to register pressure, which is in liquid communication with the control means 96 can be placed on the tip 91 or far end 105. Wash solution or wash lotion 8 with a low viscosity can be carefully irrigate the cavity 4 of the uterus by moving or reciprocating motion of the cannula 90 within the cavity 4 of the uterus.

The control means 96 adapted to control the pressure at which the wash solution or wash moose the h 8 is injected into the cavity 4 of the uterus. This option and the method are particularly preferred, when the viscosity of the washing solution or wash lotion is high, for example equal to about or greater than about 1000 centipoise. The cannula 90 is made of such size that it had a diameter that is less than that required for the formation of a substantially dense insulation fluid in the neck 9, allowing, thus, neutralized and diluted cauterizing pasta 10 to leave the cavity 4 of the uterus through the space between the catheter 90 and neck 9.

Fig illustrates an alternate cannula shown in Fig.7. As illustrated in Fig, the cannula 106 is secured to the second tube 107, which is connected with means 79 to apply a vacuum to facilitate the removal of the neutralized and diluted paste 10 of the cavity 4 of the uterus.

1. A method of treating menorrhagia, including the introduction of cauterizing composition into the cavity of the uterus, ensuring contact of this composition to the mucous membrane of the uterus in the course of time, sufficient for its chemical necrosis, subsequent introduction into the uterine cavity for rapid termination of necrosis decontamination for the specified cauterizing the composition of the agent and then removing deactivated cauterizing composition and decontamination agent from the uterus.

2. A method of treating menorrhagia, including the surrounding the use of a composition of silver nitrate to the mucous membrane of the uterus, the provision of stay specified composition of nitrate of silver in contact with the specified mucosa for a period of time sufficient to create a chemical necrosis specified mucous membrane, contacting the specified composition of silver nitrate with sodium chloride for decontamination of the specified composition of silver nitrate and quick termination of necrosis and destruction of specified deactivated composition of silver nitrate and the sodium chloride from the specified uterus.

3. The processing method of lining the body cavity, protecting at the same time, fabric, non-target, which includes the summing up to a specified tissue deactivating agent selected for decontamination cauterizing composition, which is then injected into the cavity of the body and provide contact this composition with the specified pavement cavity for a time sufficient to create its chemical necrosis, with subsequent introduction into the body cavity for rapid termination of necrosis deactivating agent comprising from about 32 to about 40 wt.% dextran and from about 60 to about 68 wt.% salt solution, and having a viscosity 220-600 JV, and then removing deactivated cauterizing composition and decontamination agent from the body cavity.

4. The method according to claim 3, in which provide contact cauterizing composition with the lining of Palast the body within 3-15 minutes

5. The method according to claim 4, which provide the contact cauterizing compositions with lining the body cavity for 4-6 minutes

6. The method according to claim 3, also including the state regulation of the pressure at which the cauterizing composition is applied so that the pressure is high enough to increase the likelihood that cauterizing composition will create a uniform and close contact with the lining of the body cavity, and so that the pressure is low enough to reduce the likelihood that cauterizing composition will penetrate into the fallopian tube.

7. The method according to claim 6, wherein the pressure is adjusted so as to provide 40-50 mm Hg

8. The method according to claim 3, in which stage of removal is carried out using a method selected from the group consisting of tidal flow, continuous propulsive solution of sodium chloride and washing with irrigation.

9. Set for processing of the mucous membrane of the uterus, including chemical composition cauterizing paste comprising a) from 10 to 50 wt.% cauterizing agent; b) from 30 to 80 wt.% inert carrier and (c) from 0 to 55 wt.% H2Oh, in which the viscosity of the specified composition is adjusted so that the composition will remain in contact with the mucous membrane of the uterus in the amount and within the period of time that is sufficient is to create a chemical necrosis, the paste composition having a viscosity sufficiently fluid so as to cover most of the mucous membrane of the uterus, and sufficiently viscous so as to reduce the likelihood that cauterizing composition will penetrate into the fallopian tube; and a neutralizing agent comprising from 32 to 40 wt.% dextran and from 60 to 68 wt.% normal saline and having a viscosity of from 220 to 600 CPS.

10. The kit according to claim 9, in which the cauterizing agent is silver nitrate and an inert carrier is dextran.

11. The set of claim 10, also comprising the hysteroscope is provided means for applying the paste composition to the mucous membrane of the uterine cavity; means for introducing a fluid medium into the uterus to expand the uterus; means for introducing a neutralizing agent into the uterus; means for removing the neutralized composition of the paste from the uterus and means for controlling the pressure of the paste composition to the mucous membrane of the uterus.

12. Set according to claim 11 in which the means for controlling the pressure of the paste composition to the mucous membrane of the uterus, is selected from the group consisting of pressure gauge, spring, cotton valve and bladder.

13. Set according to claim 11, in which the hysteroscope is also provided a means to monitor the stages of the procedure.

14. Set for processing of the mucous membrane of the uterus, including the store chemical composition cauterizing paste, includes (a) 43 wt.% silver nitrate; (b) 29 wt.% dextran; (c) water - the rest, in which the viscosity of the composition of the paste is adjusted so that the composition of the paste will remain in contact with the mucous membrane in the amount and within the period of time sufficient to create a chemical necrosis of the composition of the paste having a viscosity sufficiently fluid so as to cover most of the mucous membrane of the uterus, and sufficiently viscous so as to reduce the likelihood that cauterizing composition will penetrate into the fallopian tube; and an aqueous solution of sodium chloride to neutralize the silver nitrate to mostly inert chloride of silver, the specified solution of sodium chloride containing 32 to 40 wt.% dextran and from 60 to 68 wt.% normal saline and having a viscosity of between 220 to 600 CPS.

15. Set 14 also includes a hysteroscope is provided means for applying the paste composition to the mucous membrane of the uterine cavity; means for introducing a fluid medium into the uterus to expand the uterus; means for introducing a neutralizing agent into the uterus; means for removing the neutralized composition of the paste from the uterus and means for controlling the pressure of the paste composition to the mucous membrane of the uterus.

16. Set on 15 in which the means for controlling the pressure exerted by the computer what position the paste on the mucous membrane of the uterus, is selected from the group consisting of: pressure gauge, spring, cotton valve and bladder.

17. Set indicated in paragraph 15, in which the hysteroscope is also provided a means to monitor the stages of the procedure.

18. Set for processing of the mucous membrane of the uterus, including chemical composition cauterizing paste comprising (a) 31 wt.% silver nitrate; (b) 34 wt.% dextran and (c) water - the rest, where the viscosity of the specified composition of the paste is adjusted so that the composition will remain in contact with the mucous membrane in the amount and within the period of time sufficient to create a chemical necrosis of the composition of the paste having a viscosity sufficiently fluid so as to cover most of the mucous membrane of the uterus, and sufficiently viscous so as to reduce the likelihood that the composition will penetrate into the fallopian tube; and an aqueous solution of sodium chloride to neutralize the silver nitrate to mostly inert chloride of silver, the specified solution of sodium chloride ranging from 32 up to 40 wt.% dextran and from 60 to 68 wt.% normal saline and having a viscosity of from 220 to 600 CPS.

19. Set p, also including the hysteroscope is provided means for applying the paste composition to the mucous membrane of the uterine cavity; means for introducing a fluid medium into the uterus to expand the uterus; means to bring the Oia neutralizing agent into the uterus; means for removing the neutralized composition of the paste from the uterus and means for controlling the pressure of the paste composition to the mucous membrane of the uterus.

20. Set according to claim 19, in which the means for controlling the pressure of the paste composition to the mucous membrane of the uterus, is selected from the group consisting of pressure gauge, spring, cotton valve and bladder.

21. Set according to claim 19, in which the hysteroscope is also provided a means to monitor the stages of the procedure.

22. Set for processing of the mucous membrane of the uterus, including chemical composition cauterizing paste comprising (a) 40 wt.% silver nitrate; (b) 30 wt.% dextran and (c) 30 wt.% H2O, in which the viscosity of the specified composition of the paste is adjusted so that the composition of the paste will remain in contact with the mucous membrane in the amount and within the period of time sufficient to create a chemical necrosis of the composition of the paste having a viscosity sufficiently fluid so as to cover most of the mucous membrane of the uterus, and sufficiently viscous so as to reduce the likelihood that the composition will penetrate into the fallopian tube; and an aqueous solution of sodium chloride to neutralize the silver nitrate to mostly inert chloride of silver, the specified solution of sodium chloride ranging from 32 to 40 ve the.% dextran and from 60 to 68 wt.% normal saline and having a viscosity of from 220 to 600 CPS.

23. Set on p.22, also including the hysteroscope is provided means for applying the paste composition to the mucous membrane of the uterine cavity; means for introducing a fluid medium into the uterus to expand the uterus; means for introducing a neutralizing agent into the uterus; means for removing the neutralized composition of the paste from the uterus and means for controlling the pressure of the paste composition to the mucous membrane of the uterus.

24. Set in item 23, where the means for controlling the pressure of the paste composition to the mucous membrane of the uterus, is selected from the group consisting of pressure gauge, spring, cotton valve and bladder.

25. Set in item 23, where the hysteroscope is also provided a means to monitor the stages of the procedure.

26. Set for processing of the mucous membrane of the uterus, including chemical composition cauterizing paste comprising (a) 45 wt.% silver nitrate; (b) 28 wt.% dextran and (c) water - the rest, in which the viscosity of the specified composition of the paste is adjusted so that the composition of the paste will remain in contact with the mucous membrane in the amount and within the period of time sufficient to create a chemical necrosis of the composition of the paste having a viscosity sufficiently fluid so as to cover most of the mucous membrane of the uterus, and quite viscous so that anisate the probability the composition of the paste to penetrate into the fallopian tube; and an aqueous solution of sodium chloride to neutralize the silver nitrate to mostly inert chloride of silver, the specified solution of sodium chloride ranging from 32 to 40 wt.% dextran and from 60 to 68 wt.% normal saline and having a viscosity of from 220 to 600 CPS.

27. Set p, also including the hysteroscope is provided means for applying the paste composition to the mucous membrane of the uterine cavity; means for introducing a fluid medium into the uterus to expand the uterus; means for introducing a neutralizing agent into the uterus; means for removing the neutralized composition of the paste from the uterus and means for controlling the pressure of the paste composition to the mucous membrane of the uterus.

28. Set item 27 in which the means for controlling the pressure of the paste composition to the mucous membrane of the uterus, is selected from the group consisting of pressure gauge, spring, cotton valve and bladder.

29. Set according to claim 11, where the hysteroscope is also provided a means to monitor the stages of the procedure.

30. The kit according to claim 9, where the inert carrier is soluble neutralizing agent.



 

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SUBSTANCE: one should introduce gelatin-based colloids: gelatinol or gelofusin and crystalloids at 1:1 ratio at total volume of 40-50 ml/kg patient's body weight daily; additionally, since the 2nd to the 7th d after operation it is necessary to conduct enteral nutrition in the form of hypercaloric mixtures by increasing their volume at higher rate of injection starting from 25 ml/h/kg body weight on the 2nd and 3d d up to 100 ml/h on the 6th-7th d. The present innovation enables to improve nutrition of intestinal endothelium, decrease pathogenic and conditionally pathogenic microflora, prevents appearance of postoperational intestinal paresis and restores its function in more shortened terms.

EFFECT: higher efficiency.

1 ex, 3 tbl

The invention relates to medicine, obstetrics and anesthesia, and can be used for delivery of women with preeclampsia in the second half of pregnancy

The invention relates to medicine, in particular to vascular surgery

The invention relates to a device for slowing the passage through the pylorus introduced oral dosage forms

The invention relates to medical instruments and can be used, for example, removing an ornate krovosnabjaemah of brain tumors using direct interstitial introduction of an embolizing substance

The invention relates to medicine, namely to Oncology, and can be used for the treatment of generalized neoplastic process with bilateral metastatic pleural effusion

The invention relates to medicine, in particular to abdominal surgery, and is designed to seal and treat the external intestinal fistulas
The invention relates to medicine, gynecology, may be used with the introduction of anticancer agents in cancer of uterine body

FIELD: medicine, pharmacology, pharmacy.

SUBSTANCE: invention proposes an agent for treatment of infected wounds that comprises zeolite of Kcholinskiy deposit that represents zeolite powder modified with silver with particles size 17-20 . The proposed form provides enhancing the curative effect of agent due to elevating porosity of zeolite and increasing area in interaction of precipitated silver with wound surface. Invention can be used in surgery for healing wounds, among them chronic sluggish wound and trophic ulcers showing refractory properties to treatment with conventional agents.

EFFECT: improved and valuable properties of agent.

1 tbl, 7 ex

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