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PubMed2004

Noninvasive glucose monitoring by reverse iontophoresis in vivo: application of the internal standard concept.

BACKGROUND: The GlucoWatch Biographer uses reverse iontophoresis to extract glucose across the skin to monitor glycemia in diabetes. The invasive daily calibration with a conventional "fingerstick" has been perceived as a disadvantage. We used an "internal standard" to render the approach completely noninvasive. METHODS: The simultaneous extraction of glucose and sodium by reverse iontophoresis was performed on human volunteers over 5 h, and blood glucose was measured in the conventional manner at each collection interval. These data were used for each volunteer to calculate an extraction constant (K), which equals the ratio of the extracted fluxes (JGlucose/JNa+) normalized by the corresponding ratio of the concentrations in the blood ([Glucose]/[Na+]). The values of K were compared between and within volunteers. RESULTS: The iontophoretically extracted glucose flux reflected the glucose concentration profiles in the blood, and sodium extraction remained essentially constant, consistent with the fact that its systemic concentration does not vary significantly. A constant value of K was established for two thirds of the study population. However, the efficiency of glucose extraction varied seasonally, whereas the reverse iontophoresis of Na+ did not; i.e., variation in K became apparent. CONCLUSIONS: Use of the sodium ion as an internal standard could refine the determination of glycemia by reverse iontophoresis without requiring calibration with a blood sample.

Adult↗

PubMed2004

Lithium monitoring by reverse iontophoresis in vivo.

BACKGROUND: We investigated reverse transdermal iontophoresis as an alternative, noninvasive method for lithium monitoring in vivo. The objectives of such an approach would be to facilitate compliance with treatment and to improve the quality of life for bipolar patients. METHODS: We studied 23 bipolar or schizo-affective patients. Over a 2-h period, we extracted lithium and other cations across intact skin by application of an electric current (0.8 mA) and quantified the concentrations by ion chromatography. A blood sample provided comparative reference values for the drug and other electrolytes. RESULTS: Lithium, sodium, potassium, and calcium were efficiently extracted by iontophoresis. Lithium extraction fluxes were proportional to the corresponding serum concentrations, whereas sodium, potassium, and calcium extraction fluxes were relatively constant, consistent with their stable concentrations in blood. Normalization of the lithium extraction flux with that of sodium, which acted as an "internal standard", permitted calibration of the monitoring procedure without the need for a blood measurement. This conclusion was tested retrospectively by dividing the patients into two groups. The reverse iontophoretic extraction data from the first subset (a) established the proportionality between lithium iontophoresis (or the relative electrotransport of lithium and sodium) and (b) predicted lithium blood concentrations in the second subset of patients. The predictive ability was very good, with the internal standard concept providing substantial benefit. CONCLUSIONS: Reverse iontophoresis appears to offer a novel and accurate method for lithium monitoring.

Adult↗

PubMed1989

Effectiveness of sodium fluoride on tooth hypersensitivity with and without iontophoresis.

The purpose of this study was to assess the short and long term reduction of dentinal hypersensitivity by a single application of sodium fluoride with and without iontophoresis. Two teeth in each of 16 patients were blindly evaluated before and after treatment, and at 1, 3, and 6 months. A blast of air and tactile pressure were used to assess pain. Results indicate that there is significant, immediate reduction in dentinal hypersensitivity with the use of iontophoresis that is lost with time. The use of sodium fluoride alone had no effect. Sodium fluoride with iontophoresis was demonstrated to have an immediate post treatment effect (P less than .001) that lasted through the 3-month observation period. The data suggest that iontophoresis may be a useful adjunct to sensitivity therapy and that an immediate therapeutic effect may be achieved. The efficacy of the use of sodium fluoride alone is obscured by the natural reduction of root sensitivity observed with time.

Dentin Sensitivity↗

PubMed1989

[Effect of zinc iontophoresis on sealing of dentinal tubules by a new handy electolytic applicator].

The authors devised a new handy apparatus for iontophoresis in order to prevent pulp irritation caused by tooth reduction. This study was intended to observe the ability of the device. 8% zinc chloride solution was iontophoresed in the dentin of extracted human and bovine teeth by the device. Then, the dye and microbial invasion tests were carried out to investigate how effectively it could seal the dentinal tubules. The following conclusions were drawn: 1. By the zinc iontophoresis, the zinc briefly penetrated into the deep portion of the dentin. 2. The zinc iontophoresis by using the new device showed enough ability to decrease the coloring and bacterial invasion into the dentin, although all of the dentinal tubules were not sealed. 3. The tensile strengths of an adhesive luting resin 'Panavia EX' to the bovine dentin decreased significantly by the zinc iontophoresis. This phenomenon could be partly due to the lack of resin tag formation into the dentinal tubules.

Animals↗

PubMed1986

Control of blood glucose levels in alloxan-diabetic rabbits by iontophoresis of insulin.

Cathodal iontophoresis was used to deliver insulin in 23 alloxan-diabetic, male, New Zealand white rabbits. Currents of 0.2-0.8 mA were used to deliver insulin from reservoirs containing insulin concentrations of 10-500 U/ml in aqueous solution. Regardless of the level of current used, within 1 h of turning the current on, blood glucose levels decreased and serum insulin concentrations increased. Moreover, in most cases, blood glucose levels continued to decrease and serum insulin concentrations continued to increase after the current was turned off, suggesting that iontophoresis could be used to accumulate insulin in the skin and subcutaneous tissues. The amount of insulin that was delivered by iontophoresis could be controlled by the level of current used up to 0.4 mA; increasing the current to 0.8 mA did not deliver more insulin. This may have been due to greater production of hydroxide ions at 0.8 mA, which competed with insulin to carry the current, thus slowing the movement of insulin. The amount of insulin delivered could also be controlled by the amount of insulin available for iontophoresis, i.e., as the insulin reservoir concentration increased, more insulin was delivered at the same current level. Finally, skin preparation was also important in controlling insulin delivery. To deliver enough insulin to reduce blood glucose levels, the stratum corneum had to be disrupted or removed by gentle scraping.

Animals↗

PubMed1996

Successful treatment of dyshidrotic hand eczema using tap water iontophoresis with pulsed direct current.

The efficacy of tap water iontophoresis in treating palmoplantar hyperhidrosis has been sufficiently documented and has led to its extensive use in clinical practice. In order to test the efficacy of this treatment modality in cases of dyshidrotic hand eczema, 20 patients were treated with tap water iontophoresis in addition to two-sided steroid-free topical therapy in a randomized half-side-study. A special score for dyshidrotic eczema including objective and subjective criteria was developed to document the success of the therapy. Only those sides treated with tap water iontophoresis showed significant improvement. This significant effect of iontophoresis indicates the efficacy of this treatment in cases of dyshidrotic hand eczema.

Adolescent↗

PubMed2000

Iontophoresis treatment of basal cell carcinoma with cisplatin: a case report.

Iontophoresis is a process that uses electrical current to increase the flux of ionized substances through tissue. Iontophoresis has been used in rehabilitation to decrease inflammation and pain using dexamethasone and lidocaine. In 1993, Chang et al. reported visual improvements in the lesions of nine patients diagnosed with basal cell carcinoma (BCC) following iontophoresis of cisplatin. The present case report describes the successful treatment of a 67-year-old male with a histologically confirmed BCC on his upper anterolateral left leg. The treatment consisted of four cycles of five successive days of cisplatin iontophoresis, with a 2-week rest period between cycles. The cisplatin solution (5 mL at 1 mg/mL) was used in combination with epinephrine hydrochloride. The effectiveness of the treatment was confirmed by post-treatment biopsies, which revealed granulation tissue scarring without evidence of BCC. Measurements of cellular proliferation were monitored immunohistochemically with Ki-67 and cell cycle distribution analyzed by flow cytometry.

Aged↗

PubMed1991

Histopathologic effects of electric dosage in iontophoresis on dental pulp.

It is well recognized that dental pulp is very sensitive to electricity. However, the extent of damage and the repair capacity of pulp tissue after the electrical excitation of iontophoresis remains to be determined. Electrical current was applied to the simian teeth via cavities on the buccal or occlusal surfaces. The current strength was set at 0.1 mA-0.4 mA. The application duration was either 1 minute or 3 minutes. The total dose of electricity received by the iontophoresed teeth varied from 0.1 mA-minute to 1.2 mA-minutes. The pulps were microscopically examined at 4, 8, and 12 weeks after electrical excitation. All of the teeth were collected and processed using routine histologic methods. The following results were obtained: (1) in the group with 1-minute iontophoresis, the histologic pictures showed no apparent differences among the specimens regardless of the strength of the current applied; (2) in the group with 3-minute iontophoresis, the pulpal response correlated positively with current strength; and (3) with an electrical current of no greater than 0.4 mA and an application period of less than 3 minutes, the pulpal changes were reversible. We conclude that iontophoresis may accelerate the repair process, if the application duration is less than 3 minutes.

Animals↗

PubMed1990

Altered epidermal morphology secondary to lidocaine iontophoresis: in vivo and in vitro studies in porcine skin.

Iontophoresis is the process of delivering ionic drugs across the skin using electric current. Iontophoresis of lidocaine hydrochloride in 30 pigs in vivo and in 112 in vitro isolated perfused porcine skin flap (IPPSF) preparations produced a drug-specific alteration in the epidermis greater than or equal to 10 min after dosing. By light microscopy, this change was characterized by the appearance of flattened dark basophilic staining nuclei oriented parallel to the stratum corneum in the stratum granulosum and spinosum layers. In severe cases, this alteration extended into the deeper usually vacuolated stratum basale. The stratum corneum appeared normal. This unique morphological alteration showed an abrupt change from the stratum basale to stratum granulosum. An immune-mediated etiology can be ruled out since this alteration is observed both in vivo and in vitro. The severity of this change, graded on a scale of 0-3 (no change to severe), was best correlated to total transcutaneous lidocaine flux as estimated in IPPSF studies and to flux as estimated by current (mA-hr) in vivo. Electron microscopic changes following iontophoresis showed specific alterations in the tonofilaments of the epidermal cells. The tonofilaments appeared unrecognizable and resembled an amorphous matrix. In pigs followed through 10 days to study the resolution of this alteration, the epidermis reverted to normal within 6 days with no additional manifestations. In conclusion, lidocaine iontophoresis can induce in swine a unique dose-dependent non-immune-mediated epidermal alteration which is expected to have minimal toxicological significance.

Administration, Cutaneous↗

PubMed1989

Histopathologic effects of various electric dosage on the dental pulp of the monkey with iontophoresis.

Iontophoresis may enhance the efficacy of some medicaments and help them to reach inaccessible parts of the treated area. However, the extent of tissue damage and its recovery after electric excitation remain to be determined. An animal experiment was performed to find out the proper combination of electric current and applied duration in iontophoresis that did no irreversible harm to the pulp tissue. Cavities of 2mm in diameter and 1-2mm in depth were prepared on the buccal or occlusal surfaces of the teeth of monkeys. The strength of electric current was regulated to 0.1 mA, 0.2 mA, 0.3mA and 0.4 mA, respectively. The applied duration was 1 or 3 minutes. The total amount of electricity received by the iontophoresed teeth varied from 0.1 mA-min to 1.2 mA-min in dosage. Observation was made at 4 weeks, 8 weeks and 10 weeks after experiments. The teeth, including the surrounding jaw bone, were resected and prepared for histopathologic study. The following results were obtained: (1) In the group with one-minute iontophoresis, the histologic pictures showed no apparent difference among the specimens regardless of the strength of the electric current applied and were similar to that of the control group. (2) In the group with 3-minute iontophoresis, pulp response correlated with an increase in the electric current applied. (3) Obvious histopathologic changes were shown in the 4-week specimens, mostly odontoblast disruption, vascular dilatation, hemorrhage and round cell infiltration. (4) Subsequent investigation of the 8-week specimens as well as the 10-week specimens revealed that the reparative process in the damaged pulp took a lot of time to heal.

Animals↗

PubMedDate not supplied

[Can one increase the analgesic effect of Mobilisin ointment by iontophoresis? Placebo controlled triple cross-over double-blind study].

In a double-blind, three-way crossover trial, with placebo controls on 41 patients with inflammatory rheumatic disorders (mono- or oligoarticular forms), the analgesic action of Mobilisin ointment, with or without iontophoresis, was significantly stronger than after iontophoresis alone or after placebo. Iontophoresis did not potentiate the analgesic properties of Mobilisin. The pain was scored on VAS in intervals 30 min, 1, 2, 4, 6, 8 h after application. The duration of analgesic effect after Mobilisin procedures was 6.5 h on average, which was significantly longer than after iontophoresis alone or after placebo.

Adolescent↗

PubMed1985

[Treatment of tinnitus with iontophoresis and local anesthesia].

50 previously unsuccessfully treated patients suffering from tinnitus were given local-anaesthesia-iontophoresis. By iontophoresis it is possible to build up an electric field, in which a local anaesthetic (lidocaine hydrochloride) is able to penetrate through the tympanic membrane. Experimentally it has been proven that this local anaesthetic has a direct effect on the inner ear. In contrast to intravenous and intratympanal application there are no toxic side effects when applying local-anaesthesia-iontophoresis. Tinnitus was reduced completely or partly in 31 patients after repeated application to one or both ears. No connection was seen between the success of therapy and the origin of the tinnitus. Treatment was unsuccessful in 19 cases. No serious side effects were seen. Local-anaesthesia-iontophoresis can be recommended as an attempt to treat tinnitus, especially in those cases who have not yet responded to drugs.

Adolescent↗

PubMed1984

Reactivation of murine latent HSV infection by epinephrine iontophoresis.

Iontophoresis of epinephrine into the cornea of previously infected mice was used in an attempt to induce reactivation of latent herpes simplex virus (HSV) infection of the trigeminal ganglia. BALB/c mice infected with HSV-1 strain McKrae following corneal scarification developed a latent infection of the trigeminal ganglia within 15 days. At 28 days postinfection, mice were subjected to a 3-day cycle of iontophoresis of epinephrine (0.01%) into the cornea. Ocular shedding of HSV occurred in 16/23 (70%) of stimulated mice; these animals did not shed HSV in the 3-day period prior to iontophoresis. Spontaneous shedding of HSV, however, was noted in 3/97 (3%) mice not subjected to epinephrine iontophoresis. "Infectious" virus was isolated only from the trigeminal ganglia of stimulated mice, whereas "latent" virus was isolated from the trigeminal ganglia of both stimulated and nonstimulated mice. All virus isolates were verified to be HSV by neutralization with a known HSV-1 antiserum. This ocular system thus allows for the study of the full spectrum of latent HSV infections, including latency, ganglionic reactivation, and peripheral virus shedding.

Animals↗

PubMed1983

Herpes simplex virus recovery in neural tissues after ocular HSV shedding induced by epinephrine iontophoresis to the rabbit cornea.

Ocular HSV-1 shedding from latently infected rabbits was induced by iontophoresis of 0.01% epinephrine into the eye. Anodal Iontophoresis of epinephrine was performed at 0.8 mAmps for 8 min once a day for 3 consecutive days. Shedding was determined by the presence of HSV-1 in the preocular tear film obtained via eye swabs. Bilateral epinephrine iontophoresis performed on selected days during 220-280 days after inoculation resulted in HSV-1 shedding in 75% of the eyes (30/40) and 100% of the rabbits (20/20). Following the induction of ocular HSV-1 shedding, rabbits were killed and selected neural tissues were homogenized. Cell-free preparations were assayed for the presence of infectious virions using primary rabbit kidney cell monolayers. When the tissues were homogenized immediately after death, virus was detected in only one neural tissue, the trigeminal ganglia. However, when the tissues were incubated in vitro for 18-24 hours prior to the homogenization, infectious HSV-1 was recovered from homogenates of the trigeminal ganglion, superior cervical ganglion, the ophthalmic branch of the trigeminal nerve, and the root entry zone of the trigeminal nerve. A relationship was noted between the time of the last ocular shedding and recovery of infectious HSV from the tissue homogenates. Furthermore, a positive correlation in 11 eyes between the recovery of HSV-1 from the perocular tear film and HSV-1 recovery from one or more corresponding neural tissues was found. These results suggested that epinephrine iontophoresis to the cornea triggered an "alteration" in the state of the virus in the neural tissues of the latently infected rabbits and that the change can be related to the induced ocular shedding.

Animals↗

PubMed1978

Iontophoresis of vidarabine monophosphate into rabbit eyes.

In order to investigate the efficacy of iontophoresis for increasing the penetration of vidarabine monophosphate into the eye, tritium-labeled vidarabine monophosphate was applied to rabbit eyes by topical and iontophoretic application, and the penetration of the compound into the eye, and its subsequent metabolism, were studied. At 20 min after treatment, the ratios of radioactivity for cathodal iontophoresis compared to topical application alone were cornea 8.6, aqueous humor 4.8, and iris 2.4; for 60 min the ratios were cornea 12.2 aqueous humor 17.5 and iris 2.5. In addition, the acid-soluble components were extracted from the cornea and aqueous humor. Vidarabine monophosphate, vidarabine, hypoxanthine arabinoside, adenosine, hypoxanthine, and adenine from the acid-soluble fraction were separated by thin-layer chromatography. The amount of vidarabine monophosphate and vidarabine in the cornea and aqueous humor from the iontophoretically treated group was six to 15 times higher than from the group that received topical application of the drug. It was concluded that cathodal iontophoresis resulted in significantly increased penetration of the antiviral drug vidarabine monophosphate into the anterior chamber of the eye. The effects of iontophoresis of vidarabine monophosphate on corneal epithelium, as observed by scanning electron micrographs, were equal to or less than those seen with the topical application of widely used preservatives in ophthalmic preparations.

Adenine↗

PubMed1984

Mini set for iontophoresis for topical analgesia before injection.

Findings are reported on a prototype mini set for iontophoresis used to topically anesthetise the puncture spot before injection. The anesthetizing drug applied was a 2% solution of lignocaine which was iontophoresed for 10 min at a current of 1-2.5 mA. Observations were made according to a double-blind trial. After the lignocaine iontophoresis had been performed, 76% of injections were painless and 24% were reported painful. After the placebo iontophoresis, however, 87% of injections were painful. The difference is statistically significant. We conclude that iontophoresis by means of the mini set protects effectively against injection pain. The electronic structure of the device is unique and makes possible safe outpatient use.

Analgesia↗

PubMed1980

Lidocaine anesthesia: comparison of iontophoresis, injection, and swabbing.

The duration and depth of anesthesia produced by lidocaine with three methods of administration were studied. To test duration of anesthesia, either lidocaine or placebo was administered by iontophoresis, subcutaneous infiltration, or swabbing to each of three sites 3 cm apart on the flexor surface of each forearm of 27 subjects. To test for feeling, the tip of a 21-gauge hypodermic needle was pressed on each application site every five minutes until feeling returned. The depth of anesthesia achieved with iontophoresis or infiltration of lidocaine was tested on the flexor surface of each forearm of 12 subjects, with a random assignment of application methods to each arm. Lidocaine iontophoresis produced local anesthesia of significantly longer duration (p less than 0.001) than topical application of lidocaine or placebo by any route of administration, but of significatnly shorter duration (p less tahn 0.001) than lidocaine infiltration. The results showed that lidocaine iontophoresis is an effective method of producing local anesthesia for about five minutes without requiring the use of a hypodermic needle and syringe.

Administration, Topical↗

PubMed1995

[The analgesic effect of iontophoresis with magnesium sulfate].

The analgesic effect of iontophoresis with magnesium sulfate was studied in fourteen healthy adult volunteers. Magnesium sulfate 0.5 mg.5 ml-1 was locally administered by the iontophoresis with 1.0 mA electric current for 10 min. The pain recognition time was measured by the pain thermometer before and after 5, 15, 30, 60 and 120 min of iontophoresis. The pain recognition time was significantly extended and lasted for 60 min. These results support the view that the iontophoresis with magnesium sulfate has analgesic effect and produces a good pain relief clinically.

Adult↗