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Results for “Injections, Intralesional”

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PubMed1986

Retinal and choroidal vascular occlusion following intralesional corticosteroid injection of a chalazion.

Unilateral visual loss following periocular corticosteroid injection is a reported complication of injections of tonsillar, nasal, scalp, and retrobulbar sites. This is the first reported case, to our knowledge, of intralesional corticosteroid injection of a chalazion producing ipsilateral microembolization and infarction of retinal and choroidal vasculature. An eight-year-old boy underwent reexcision of an upper lid chalazion under general anesthesia. Intraoperatively, 0.5 ml of depot-steroid preparation was injected into the excision site. Postoperatively, vision was unilaterally reduced to light perception only. Examination revealed an afferent pupillary defect, retinal and choroidal emboli, retinal edema, and a macular "cherry red spot". Anterior chamber paracentesis, carbon dioxide rebreathing, carbonic anhydrase inhibitors and ocular massage failed to change the embolic pattern. No visual recovery resulted. Fundus photography and fluorescein angiography demonstrated occlusion of the retinal and choroidal vasculature. Extreme care should be exercised during and immediately following intralesional corticosteroid injection of chalazia.

Child↗

PubMed1998

Intralesional steroid injections for corrosive induced pyloric stenosis.

Gastric outlet obstruction is a well-recognized sequela of corrosive ingestion. Such patients are traditionally treated surgically. We have treated three such patients with intralesional steroid injections combined with through-the-scope balloon dilation. All three patients responded well and are asymptomatic after 12 months, 14 months and 3 years and 3 months of follow-up, respectively. Endoscopic balloon dilation combined with intralesional steroid may be an effective alternative to surgery in such patients.

Adolescent↗

PubMed2000

[Mechanism of abnormal scars with treatment of steroid].

OBJECTIVE: To investigate the mechanism of steroid in treatment of abnormal scars. METHODS: Apoptosis of different fibroblasts from 6 samples with keloid, 6 samples with hypertrophic scar, and 6 samples of normal skin was observed under the condition of the media containing steroid in vitro. Proliferation, biosynthesis and apoptosis of fibroblasts of 6 samples of hypertrophic scars treated with intralesional injection of steroid were studied in vivo. RESULTS: Steroid could induce apoptosis of different fibroblasts in vitro in correspondence with increasing ratio of Bax/Bcl-2 proteins. Intralesional injection of steroid could inhibit proliferation of fibroblasts from hypertrophic scars by inhibiting PDGF-BB gene expression in vivo. Intralesional injection of steroid could inhibit procollagen gene expression to prohibit type I and III protein syntheses of fibroblasts from hypertrophic scars in vivo by inhibiting gene transcription. Intralesional injection of steroid could increase c-myc and p53 gene expression of hypertrophic scars in vivo, which induced apoptosis of cells. CONCLUSION: The effects of steroid on abnormal scars were achieved by inhibiting proliferation and biosyntheses of fibroblasts and promoting apoptosis of fibroblasts.

Adolescent↗

PubMed1988

Combined excision and drainage with intralesional corticosteroid injection in the treatment of chronic chalazia.

We surgically excised 146 chronic chalazia either with or without intralesional corticosteroid injections. Our results showed an 89% cure rate (79/88) for those chalazia surgically excised compared with a 96.6% cure rate (56/58) for those excised and treated with intralesional steroids as well. Encouraged by these findings, we treated an additional 149 chalazia using the combined technique of excision and steroidal injection for a total cure rate of 97.6% (202/207). Although complications were minimal for both groups, there appeared to be less edema and inflammation in the patients receiving the combined treatment.

Adolescent↗

PubMed1996

The effects of preparations of human chorionic gonadotropin on AIDS-related Kaposi's sarcoma.

BACKGROUND: Kaposi's sarcoma is the most common cancer in patients with the acquired immunodeficiency syndrome (AIDS). Recently, certain preparations of human chorionic gonadotropin (hCG) have been shown to inhibit the growth of Kaposi's sarcoma cell lines in vitro and in immunodeficient mice. METHODS: After in vitro evaluation of four commercially available hCG preparations, the most active product was evaluated in 36 patients with AIDS-related Kaposi's sarcoma. In a phase 1-2 trial, 24 patients received intralesional injections of hCG three times a week for two weeks at doses of 250, 500, 1000, or 2000 IU (6 patients each). In each patient three nodular lesions were injected, two with the drug and one with diluent alone. In a double-blind trial, 12 additional patients were randomly assigned to receive intralesional injections of 2000 IU of hCG or diluent alone (6 patients each; two lesions per patient). At the conclusion of therapy, the lesions were measured, their gross appearance assessed, and biopsy specimens evaluated. RESULTS: A.P.L. (Wyeth-Ayerst), which had the most in vitro activity against Kaposi's sarcoma cell lines, was selected for the clinical investigation. Treatment with A.P.L. was well tolerated at all doses. In the cohorts given 250, 500, 1000, and 2000 IU, 1, 5, 5, and 10 of the 12 injected lesions responded, respectively (P=0.03 for trend). Complete tumor regression was observed in one lesion each at the 250-IU and 500-IU doses, in two lesions given the 1000-IU dose, and in five lesions given the 2000-IU dose. In the double-blind study, none of the 12 lesions in the six patients injected with diluent had responses, as compared with 10 of the 12 lesions in the six patients injected with hCG (P=0.015). Microscopical evidence of apoptosis was observed only in hCG-treated lesions. The percentage of cells that died increased in a dose-dependent manner (P<0.001). Serum levels of follicle-stimulating hormone (P=0.002) and luteinizing hormone (P=0.001) declined after the last injection of hCG, but there was no effect on these hormones in the diluent-treated patients. CONCLUSIONS: The intralesional injection of hCG induces the regression of AIDS-related Kaposi's sarcoma lesions in a dose-dependent manner. The response of these tumors appears to be mediated by the induction of apoptosis.

Acquired Immunodeficiency Syndrome↗

PubMed1996

In vivo efficacy of oral and intralesional administration of 2-substituted quinolines in experimental treatment of new world cutaneous leishmaniasis caused by Leishmania amazonensis.

The antileishmanial efficacies of 2-n-propylquinoline, chimanines B and D, 2-n-pentylquinoline, 2-phenylquinoline, 2-(3,4-methylenedioxyphenylethyl) quinoline, and two total alkaloidal extracts of Galipea longiflora were evaluated in BALB/c mice infected with Leishmania amazonensis or Leishmania venezuelensis. Animals were treated for 4 to 6 weeks postinfection with a quinoline by the oral route at 50 mg/kg of body weight twice daily for 15 days or by five intralesional injections at intervals of 4 days with a quinoline at 50 mg/kg of body weight. The reference drug, N-methylglucamine antimonate (Glucantime), was administered by subcutaneous or intralesional injection (regimens of 14, 28, or 56 mg of pentavalent antimony [Sbv] per kg of body weight daily). Twice-daily oral treatment with chimanine B at 50 mg/kg resulted in a decrease in lesion weight by 70% (P < 0.001) and a decrease in the parasite loads by 95% (P < 0.001). Five injections of chimanine B at intervals of 4 days reduced the lesion weight by 74% and the parasite loads in the lesion by 90% compared with the values for the group of untreated mice. Subcutaneous administration of N-methylglucamine antimonate at 28 mg of Sbv kg per day for 15 days reduced the parasite burden by 95% (P < 0.001), and five intralesional injections at the same concentration reduced the parasite burden by 96% (P < 0.001). Other 2-substituted quinolines, 2-n-propylquinoline administered by the oral and intralesional routes, 2-phenylquinoline administered by the oral route, 2-n-pentylquinoline administered by intralesional injection, and two total alkaloidal extracts of G. longiflora administered by the oral route, had intermediate effects. These findings suggest that chimanine B may be chosen as a lead molecule in the development of oral therapy against leishmaniasis.

4-Quinolones↗

PubMed1999

[188Re]Rhenium sulfide suspension: a potential radiopharmaceutical for tumor treatment following intra-tumor injection.

Intralesional therapy has been shown to be an effective treatment for tumors. In this study, the suitability of [188Re]rhenium sulfide suspension for tumor treatment following intra-tumor injection was evaluated. The [188Re]rhenium sulfide suspension was radiolabeled with 188Re with a radiochemical yield of more than 96%. In vitro stability studies revealed that more than 99% of the 188Re remained in sulfide form over a 3-day period. After ultrasonication for 5 or 10 min, the main particle size was 1-5 microm. Two [188Re]rhenium sulfide suspensions ultrasonicated for 5 and 10 min, respectively, were injected into separate group of tumor-bearing mice that were killed after specified times to compare the retention of 188Re in tumors and the leakage to different organs by periods and organs removed to gamma counting. The mean retention percentages of 188Re in tumors injected with suspension ultrasonicated for 5 (or 10) min were as follows: 1 h, 90.5 +/- 7.7% (83.1 +/- 13.7%); 24 h, 92.2 +/- 8.6% (83.9 +/- 9.8%); 48 h, 88.3 +/- 10.9% (80.2 +/- 3.8%); and 72 h, 91.5 +/- 7.6% (78.8 +/- 3.0%). Tumor-inhibiting ratio was 96.5%. These results demonstrated that [188Re]rhenium sulfide suspension is an effective radiopharmaceutical for tumor treatment by intralesional therapy.

Animals↗

PubMed1994

Cystic lymphangioma and plunging ranula treated by OK-432 therapy: a report of two cases.

Among head and neck angiotumors, cystic lymphangioma occurs in infancy in most cases and it is rare in adulthood. Plunging ranula is one of the diseases which need to be distinguished from lymphangioma, though operation is the first choice therapy for both of these. In the present study, we report on 2 cases in whom we conducted intralesional injection of OK-432 for cervical lymphangioma and ranula found in 20 and 35 year-old female patients. We obtained excellent improvement. First of all, we punctured the tumors and sucked out the liquid content as much as possible, and then used OK-432 in the same volumes to those drawn out. No swelling was observed in either patient after 1 month, and cysts disappeared in CT 4 and 12 months after injection, respectively; at present, the prognosis is satisfactory, without recurrence. The intralesional injection of OK-432 is considered an effective method, as the speed of complete disappearance by this therapy is high. Cosmetically it is superb, leaving no lesions in the skin of the injection site.

Adult↗

PubMed2000

The injection of nodules of Dupuytren's disease with triamcinolone acetonide.

Over a 4-year period 63 patients (75 hands) with Dupuytren's nodules were treated with a series of injections with the steroid triamcinolone acetonide directly into the area of disease. The purpose of this study was to determine whether intralesional injections of triamcinolone acetonide could produce softening and flattening in nodules of Dupuytren's disease as seen in the intralesional injections of hypertrophic scars and keloids. After an average of 3.2 injections per nodule 97% of the hands showed regression of disease as exhibited by a softening or flattening of the nodule(s). Although some patients had complete resolution of the nodules, most experienced definite but incomplete resolution of the nodules in the range of 60% to 80%. Although a few patients did not experience recurrence or reactivation of the disease in the injected nodules or development of new nodules, 50% of patients did experience reactivation of disease in the nodules 1 to 3 years after the last injection, necessitating 1 or more injections. The findings of this study indicate that the intralesional injection of nodules of Dupuytren's disease with triamcinolone acetonide may modify the progression of the disease.

Chronic Disease↗

PubMedDate not supplied

Transendoscopic chemical ablation of progressive ethmoidal hematomas in standing horses.

OBJECTIVE: To examine the response of horses with progressive ethmoidal hematoma (PEH) to intralesional injection of 4% formaldehyde solution. STUDY DESIGN: Nasal passages of horses affected with PEH were examined endoscopically at different intervals to determine the effects of intralesional injection of formaldehyde solution. ANIMALS: 21 horses with PEH. METHODS: PEHs were injected transendoscopically with 4% formaldehyde solution. Horses were examined endoscopically and retreated at different intervals until the PEH was eliminated or was so small that reinjection was not possible. RESULTS: Lesions diminished significantly in size or were eliminated after 1 to 18 injections (median, 5; mean, 7.0 +/- 5.62). Seventeen lesions (60.7%) resolved completely after 1 to 18 injections (median, 5; mean, 7.2 +/- 5.71). Five lesions decreased markedly in size but did not resolve after receiving 1 to 18 injections (median, 5; mean, 7.6 +/- 6.66). Injection of these lesions was discontinued 4.0 to 25.1 months (median, 9.5; mean, 11.02 +/- 8.446) after the first injection. The PEH of one horse was removed surgically after one injection. Three horses, one with bilateral PEH, were lost to follow-up. One horse developed signs of laminitis. No other complications were observed. CONCLUSIONS: Horses with a PEH can be treated effectively by transendoscopic, intralesional injection of 4% formaldehyde solution. CLINICAL RELEVANCE: Ablation of PEH using formaldehyde solution avoids general anesthesia and problems associated with ablation by conventional surgery or laser.

Animals↗

PubMed1983

Intralesional corticosteroid injection for the treatment of chalazia.

Twenty chalazia were treated with intralesional triamcinolone acetonide injections. The diameter of 9 of the chalazia was less than 6 mm. Eight of them were cured after a single injection and 1 after 2 injections. The diameter of 11 of the chalazia was greater than or equal to 6 mm. Four cases responded to 1 injection and 5 to 2 injections. Two were operated on. Six patients had a recurrence 3-6 months later and were operated on. Corticosteroid injection is a serviceable alternative to surgery in the treatment of small chalazia. The indications are discussed.

Adolescent↗

PubMed1997

Biodistribution of 111In-labelled SCN-bz-DTPA-BC-2 MAb following loco-regional injection into glioblastomas.

We analyzed the biodistribution of the 111In-labelled murine anti-tenascin-C MAb BC-2 after intralesional injection in 15 glioblastoma patients. The activated ligand DTPA was conjugated via the isothiocyanato-benzyl group onto BC-2. Conjugates were labelled with 111In, displaying immunoreactivity greater than 90% and labelling efficiency of 99 +/- 1%. In contrast to i.v. injections, excellent tumor uptake was obtained by direct intralesional injection of conjugates that showed only slow systemic release. In serum, conjugates were found to be intact; in urine, only low-molecular-weight decay products were detected. In 8 patients, outflow from the site of injection into systemic circulation was low; daily activity in the serum and urine was found to be below 2% of the total injected radioactivity; most of the injected activity was retained within the tumor, resulting in effective half-lives of 58 +/- 5 hr. In contrast, higher outflow up to 10% of regionally injected 111In-DTPA-BC-2 MAb into systemic circulation resulted in considerable shortening of the effective half-lives to 20 to 40 hr in 7 patients. This outflow was found to correlate with tumor size and blood/brain barrier disruption. In one patient, HPLC analysis of tumor cyst fluid 3 and 6 days after intralesional injection revealed conjugates to be intact and allowed the estimate of about 70% of the total injected 111In-DTPA-BC-2 to be confined to tumor tissue. We conclude that different outflow patterns can be observed following locoregional injection of 111In-DTPA-BC-2, leading to considerable variations in the effective half-lives of isotopes within the tumor, requiring adjustment of the radiation dose in therapeutic trials.

Aged↗

PubMed1993

Intralesional steroid injection after nerve block anesthesia in the treatment of orofacial granulomatosis.

BACKGROUND: The facial disfigurement produced by orofacial granulomatosis causes enormous embarrassment. None of the many therapies recommended is reliably successful. Oral corticosteroids cause significant side effects and repeated injections of small quantities of triamcinolone are painful. We have injected large volumes of triamcinolone after numbing the lips using nerve block anesthesia. OBSERVATIONS: Nine patients (six males and three females, aged 10 to 47 years) with orofacial granulomatosis were investigated. No evidence of an allergic cause was found using patch or contact urticaria tests. Eating chocolate produced lip swelling in one man, and his lip shrank in size after avoiding this for 12 months. Five patients, aged 10 to 24 years, were treated with high-volume intralesional triamcinolone injections (3 to 10 mL of 10 mg/mL) after first numbing the lips using infraorbital nerve branch and mental nerve block. After 6 weeks, the lip size returned to normal in four patients and was reduced in a fifth. One patient was injected on four occasions over a 2-year period; in four other patients treated once, lip size remained reduced for over 10 months. CONCLUSION: Intralesional triamcinolone reduces lip swelling in patients with orofacial granulomatosis. Numbing the lips by nerve block anesthesia before triamcinolone injection enables adequate volumes and repeated injections to be given painlessly.

Adolescent↗

PubMed2005

Corticosteroid treatment of periorbital haemangioma of infancy: a review of the evidence.

AIM: To systematically review the literature for corticosteroid treatment of periorbital haemangioma of infancy (HOI) and determine the relative efficacy and safety of oral, topical and intralesional corticosteroids. METHODS: PubMed and the Cochrane Library were queried using keywords, and further articles were obtained by reviewing bibliographies. Inclusion and exclusion criteria were applied to create a subset of literature for analysis. RESULTS: Systematic review revealed 81 original reports of periorbital HOI cases treated with steroids. Most studies and case series failed to document refractive error or visual acuity before and after treatment. Of cases meeting inclusion criteria, five patients received topical steroids and 25 patients received intralesional steroids. Patients receiving intralesional injections tended to demonstrate reduced astigmatism at follow up after treatment (21 of 28). The lack of studies with relevant objective ophthalmological end points prevented statistical meta-analysis. CONCLUSION: Intralesional injections may reduce refractive error, while the efficacy of topical steroids is unclear. Studies measuring objective ophthalmic data before and after treatment are sparse, and more studies are needed to determine the relative efficacy of different steroids. There are insufficient data to estimate the incidence of steroid side effects in patients treated with steroids for periorbital HOI or complications of intralesional injections in particular.

Administration, Oral↗

PubMed2003

Stepped-dose protocol of cidofovir therapy in recurrent respiratory papillomatosis in children.

OBJECTIVE: To evaluate a stepped-dose protocol for intralesional injection of cidofovir in children with recurrent respiratory papillomatosis (RRP). DESIGN: Prospective, nonrandomized case series. SETTING: Tertiary care children's hospital. PARTICIPANTS: Eleven children undergoing evaluation for RRP from June 1, 2000, through December 31, 2001. INTERVENTION: Intralesional injection of cidofovir was performed after microlaryngoscopy and carbon dioxide laser treatment. Patients received 4 monthly injections at a concentration of 5 mg/mL and returned 1 month after the last injection for follow-up. Patients with recurrent or recalcitrant disease then started a series of 4 monthly injections at a concentration of 10 mg/mL. OUTCOME MEASURE: Papilloma stage (0-3) documented at multiple subsites by means of serial microlaryngoscopy. We calculated a severity score by summing the scores at all affected subsites. RESULTS: The severity score decreased in each of the 11 patients during the course of therapy, from a mean +/- SD of 13.7 +/- 6.0 at enrollment to 2.1 +/- 3.4 at 1-month follow-up. Six patients experienced complete resolution (stage 0) and 4 others had mild disease (stage, </=5) after 4 treatments at the 5-mg/mL concentration. Five patients with residual or recurrent RRP subsequently started a series of 4 cidofovir treatments at a concentration of 10 mg/mL, with a mixed response. CONCLUSIONS: Intralesional injection of cidofovir seems to reduce the burden of disease in children with RRP. Patients with persistent or recurrent disease may benefit from an increased cidofovir concentration of 10 mg/mL, although some aggressive papillomatous disease remains refractory to cidofovir treatment.

Adolescent↗

PubMed2001

Intralesional corticosteroid injection for treatment of central giant-cell granuloma.

BACKGROUND: The central giant cell granuloma, or CGCG, is a benign intraosseous lesion of the jaw. It is found predominantly in children and young adults. It is an asymptomatic lesion, which often becomes evident on routine radiographic examination. Giant cell lesions have been described as both nonaggressive and aggressive in nature, with recurrence noted in cases of aggressive lesions. Central giant cell lesions present as unilocular or multilocular radiolucent defects on radiographs. Multinucleated giant cells within a collagenous stroma are the characteristic histopathologic feature of CGCG. CASE DESCRIPTION: The authors describe a 10-year-old girl with an expansile lesion of the mandible. The panoramic radiograph showed a well-circumscribed mixed radiolucent-radiopaque lesion of the left mandibular body. An incisional biopsy of the lesion was performed to establish a histologic diagnosis. The specimen was submitted for frozen-section examination, and a diagnosis of CGCG was made. Serum calcium, parathyroid hormone and phosphorous levels were normal. The patient was treated successfully with intralesional corticosteroid injections. CLINICAL IMPLICATIONS: Central giant cell lesions have been treated surgically with aggressive curettage. More aggressive and recurrent lesions require resection, which leads to major defects of the jaws. This form of surgical treatment can be particularly disfiguring for a child or young adult. An alternative nonsurgical approach is the intralesional administration of corticosteroids, which have been effective in the treatment of CGCG. If a dentist suspects a patient may have CGCG, he or she should refer the patient to an oral surgeon for follow-up.

Anti-Inflammatory Agents↗

PubMed1996

Nasopharyngeal conidiobolomycosis in a horse.

Nasopharyngeal conidiobolomycosis caused by Conidiobolus coronatus was diagnosed in a horse after endoscopic and histopathologic examinations of a biopsy specimen. The fungal lesions in the nasopharynx were substantially reduced in size after intralesional injection of amphotericin B through the biopsy channel of a videoendoscope in combination with i.v. administration of sodium iodide and oral administration of potassium iodide during a 2-month period. Endoscopy performed 15 months after initial examination revealed regression of the granulomatous masses in the nasopharynx and complete disappearance of the nasal masses. Two months later, clinical signs recurred, and the owner elected euthanasia without evaluation and treatment. Nasopharyngeal conidiobolomycosis may be treated successfully with intralesional injection of amphotericin B in combination with administration of sodium iodide and potassium iodide, but there is a possibility of recrudescence of infection.

Administration, Oral↗

PubMed2003

[Use of corticosteroids after esophageal dilations on patients with corrosive stenosis: prospective, randomized and double-blind study].

OBJECTIVE: To determine triancinolone intralesional injections effects in association with esophageal dilations in corrosive stenosis cases, by means of a double-blind and randomized study. METHOD: Fourteen adults patients (6 men and 8 women) with severe esophageal corrosive stenosis were randomized in two groups: Group A: treated by esophageal dilations and posterior triancinolone 10 mg/ml intralesional injection; Group B: treated by esophageal injections and posterior saline solution 0,9% injection (placebo). New applications were made based on the patient symptomatology. It had been analysed dilation frequency, obtained diameters and dysphagia before and after the research, for 12 months. RESULTS: Eleven patients had ingested sodium hydroxide, two had ingested ammoniac and one had taken muriatic acid. There was no statistic difference (p > 0.05) in dilation frequency and dysphagia between the groups. However, an improvement in obtained diameter was observed in the corticosteroids group in comparison with control group (p < 0.05). By comparing groups before and after steroids, the final results were very favorable in group A CONCLUSION: Multiple intralesional injections of triancinolone hexacetonide 10 mg/ml in association with esophageal dilations increase obtained diameters in succeeding sessions.

Adult↗