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PubMed2004

Povidone iodine and dextrose solution combination sclerotherapy in chyluria.

OBJECTIVES: To evaluate the effectiveness of combination (povidone iodine and 50% dextrose) renal pelvic instillation sclerotherapy (RPIS) as a minimally invasive therapy for chyluria resistant to conservative treatment. METHODS: A total of 50 patients with chyluria and hematochyluria (28 men and 22 women) were included in the study. Initially, all were offered conservative antifilarial drug therapy and dietary fat restriction. Intravenous urography was done in all cases to document normal renal functional status. In the patients in whom chyluria persisted after 3 weeks of conservative therapy, cystoscopic lateralization was done and a 5F open-ended ureteral catheter was positioned under local anesthesia. The same was left attached to a 16F Foley catheter for 3 days of RPIS. A solution of 5 mL of 5% povidone iodine and 5 mL of 50% dextrose was instilled twice a day with the patient in the Trendelenburg position for 3 days. In cases of bilateral efflux, the dominant side was treated first. The opposite side was subjected to a similar instillation sclerotherapy schedule after 6 weeks if chyluria persisted. RESULTS: Of the 50 patients, only 4 responded to conservative therapy. The remaining 46 patients underwent combination RPIS. The mean follow-up was 24 months. Complete remission of chyluria or hematochyluria occurred in 40 (87%) and persisted in 6 patients (13%). Of the 6 patients in whom symptoms persisted, 2 developed chyluria on the side opposite the one treated with RPIS. Another 2 patients developed recurrence on the same side after remaining asymptomatic for 6 months after RPIS. All four of these patients subsequently underwent chylolymphatic disconnection and nephropexy (two open and two laparoscopic) with a successful outcome. The final 2 patients with persistent symptoms were lost to follow-up. CONCLUSIONS: Combination sclerotherapy using a 5% povidone iodine and 50% dextrose solution is a safe and cost-effective minimally invasive therapy for chyluria refractory to conservative treatment.

Adult↗

PubMed1991

[ A case of successfully treated duodenal hemangioma].

In some cases the radical removal of gastrointestinal hemangiomas involves an excessive risk or too extensive operation. Consequently some other solution has to be applied. At our patient with duodenum haemangioma the combination of angiographic embolism and endoscopic sclerotization was successfully employed.

Adolescent↗

PubMedDate not supplied

Percutaneous management of benign renal cysts.

Percutaneous emptying of benign renal cysts represents the adopted treatment for this kind of pathology. The introduction of pure ethilic alcohol (95 degrees) is usually associated with emptying because it determines the necrosis of the secreting epithelious with recurrences and little significant complications. This treatment is the less bloody solution that can be executed in surgery and for this reason it is proposed in the time as an alternative to surgery treatment of removal.

Adult↗

PubMed1997

[Complete gastric wall necrosis after endoscopic sclerotherapy for a gastric ulcer with visible arterial stump].

HISTORY AND CLINICAL FINDINGS: A 43-year-old man with a gastric ulcer was admitted because of sudden onset of epigastric pain, cold sweats and dizziness. He had tachycardia (100/min); his blood pressure was 120/80 mm Hg: his epigastrium was tender to palpation. There were no tarry stools. INVESTIGATIONS: Haemoglobin concentration was 12.7 g/dl. WBC count 17,900/microliter. Gastroscopy revealed residual haematin and an ulcer with an arterial stump at the angular fold. TREATMENT AND COURSE: 3 ml epinephrine, diluted 1:20,000, and 13 ml of 1% polidocanol were injected around the arterial stump, most of the latter solution flowing back into the gastric lumen from the rather hard ulcer base. Haematemesis four days later necessitated laparotomy followed by gastrectomy with reconstruction and a Roux-Y anastomosis because of complete necrosis of the gastric wall. Histological examination of the surgical specimen showed chronic scarred gastric ulcer and ulcerating pangastritis with haemorrhagic necrosis of the wall and associated peritonitis, caused by accidental injection of polidocanol into the artery. CONCLUSION: Since the tissue-sparing injection of epinephrine, fibrin glue or salt solution is alone effective in the endoscopic treatment of bleeding gastroduodenal ulcers, polidocanol should not be injected as well.

Adult↗

PubMed1999

Use of talcum in sclerotherapy of pelvic lymphoceles.

Lymphoceles sometimes constitute an inconvenient problem after pelvic surgery combined with lymphadenectomy. We report on a case of a patient with carcinoma of the prostate treated by radical prostatectomy and pelvic lymphadenectomy, who developed a large pelvic lymphocele after surgery. The lymphocele was drained by a nephrostomy tube and sclerotherapy using a talcum solution was performed. Talcum is frequently used successfully in pleurodesis. The lymphocele disappeared within 2 weeks after one administration of the solution. Sclerotherapy with a talcum solution can be recommended as a simple, safe, and effective method in pelvic lymphoceles. The single dose and the lack of side effects are advantageous to other agents.

Humans↗

PubMed2005

Modified pair technique for treatment of hydatid cysts in the spleen.

The aim of this study was to evaluate the results of single-session sclerotherapy with mixture of alcohol and polidocanol and a subsequent injection of albendazole for devisceration of hydatid cysts in the spleen. Eight patients (four women and four men, average age 22.9+/-11.4 with hydatid cyst in the spleen were treated with 10 minutes time of exposure to mixture of ethanol 95% and polidocanol 1%. After that, 2 to 5 ml of albendazole was injected into the cyst cavity. Two patients had 2 cysts. At follow-up the patients were examined with clinical and biochemical examinations, ultrasonography, and serologic test for echinococcal antibody titres. The mean hospital stay was 2.5+/-0.93 days. During the follow-up period, mean cyst diameter decreased from 46+/-16.4 mm to 13.6+/-16.26 mm. In all ten cysts, a reduction of post procedural recolection of fluid over 40% was observed. Five cysts (50%) disappeared during the follow-up period. All cysts (5) smaller then 50 mm in diameter disappeared during follow-up period. After an initial rise, the echinococcal-antibody titres fell progressively and at the last follow-up were negative (< 1: 160) in 7 (88%) patients. No complications were observed, except for pain, fever and urticaria during the first 24-hours after the procedure. Sclerotherapy using only one session and 10 min time of exposure to the mixture of ethanol and polidocanol, and a subsequent injection of albendasole solution represents an effective treatment of hydatid cysts in the spleen. This procedure is even more efficacious for hydatid cyst with diametar smaller then 50 mm.

Adolescent↗

PubMed2001

Phenol block of peripheral nerve conduction: Titrating for optimum effect.

OBJECTIVES: To verify the dose-response relationship in phenol nerve block and to determine the concentration and volume of phenol injectate required for effective nerve conduction block. DESIGN: Before-after, experimental study. SETTING: A research institute laboratory. ANIMALS: Seventy-one New Zealand white rabbits. INTERVENTIONS: Group I (n = 48) received tibial nerve block by perineural injection (phenol, n = 40; saline, n = 8), group II (n = 21) by submerging the nerve in phenol solution. The 6 subgroups of group I each received different concentrations (3%, 4%, 5%) and volumes (0.1mL, 0.2mL, 0.3mL). The 2 subgroups of group II received 3% (n = 8) and 5% (n = 13) phenol. MAIN OUTCOME MEASURES: Compound muscle action potential (CMAP) and tension of triceps surae muscles by electric stimulation of the sciatic nerve were measured preintervention and at day 1, and weeks 1, 2, 4, and 8 postblock. Histologic studies were performed on 2 animals from group I. RESULTS: Two rabbits in group I died before results were obtained. In the remaining animals, CMAP amplitude reduced significantly (p <.05) as the volume of 5% phenol solution increased from 0.1mL, 0.2mL, to 0.3mL. A high concentration of phenol produced a more pronounced conduction block; however, no significant (p =.0589) difference existed among the 3 concentrations. Submerged tibial nerve had a greater degree of conduction block than perineurally injected nerve. Depth of the degeneration area in nerve fascicle varied with distance from the injection point. CONCLUSIONS: The nerve block effect of phenol can be titrated by adjusting the concentration and volume of phenol solution if the technique of application and localization of a block site are standardized.

Action Potentials↗

PubMed1988

[Treatment of hydrocele testis by injection of tetracycline solution].

Eleven cases of hydrocele testis were treated with injection of a 1% or 2% dedoxycycline hydrochloride or minocycline hydrochloride, and a cure was obtained in 9 cases (81.8%). Of these 9 cases, 7 cases were cured after one injection, and 2 cases after 2 injection. Both of the latter 2 cases in which physiological salt solution was used as the dissolving solution experienced scrotal pain immediately after injection. Among the cases in which 1% lidocaine was used as the dissolving solution only 1 injection (11.1%) was associated with slight pain out of 9 injections. This treating method is highly effective and little or no pain is experienced if lidocaine is used. In conclusion, we recommend this method as a treatment for hydrocele testis.

Adult↗

PubMed1989

[Is resection still a timely procedure in the treatment of keratocysts?].

Between 1977 and 1987 a total of 31 patients with keratocysts were treated at the maxillofacial surgery department of the University of Cologne. In two patient groups with 11 major mandibular cysts each, two different approaches were used: mandibular resection in one, and enucleation following previous fixation of the cyst epithelium with Carnoy's solution in the other group. The fact that only one recurrence was observed in the second group, gives us reason to recommend this safe and, for the patient, unstressful procedure.

Acetates↗

PubMed1985

Hemorrhoids and anal fissures. Common problems, current solutions.

Recent insights into the nature of hemorrhoids and anal fissures have led to specific strategies for treatment. Symptomatic hemorrhoids often result from prolapse of submucosal vascular cushions. Appropriate treatments include dietary change, injection therapy, rubber-band ligation, and hemorrhoidectomy. Patients with anal fissures usually have an abnormal contraction of the sphincter. Many fissures heal spontaneously. Treatment often centers on helping the patient avoid constipation, although surgery is indicated in some cases.

Cryosurgery↗

PubMed1993

Mechanism of action of sclerotherapy.

An understanding of the mechanism by which diverse chemical solutions can initiate the process of vein-wall disruption and resorption, ie, sclerotherapy, is important when using this technique as a therapeutic modality. Insight into the pathophysiologic changes that this procedure effects within the vein wall can insure maximal clinical efficacy while minimizing the incidence of complications. This article elucidates the factors that determine the extent of mural disruption and the mechanism by which injury is produced.

Humans↗

PubMed2005

Preparation of microencapsulated phase-change materials (MCPCMs) by means of interfacial polycondensation.

Microcapsules for energy storage and/or heat transfer applications containing phase-change materials (PCMs-including n-pentadecane, n-eicosane and a paraffin wax) were successfully produced by emulsifying the PCMs as small droplets in an aqueous, water-soluble urea-formaldehyde pre-polymer solution substantially free of emulsifier while polymerizing the pre-polymer at the interface by acid-catalyst. The core/shell structured microcapsules were also characterized with size distribution analysis, scanning electron microscopy, FTIR spectrometry and differential scanning calorimetry.

Alkanes↗

PubMed2005

Polidocanol at different concentrations for pleurodesis in rats.

PURPOSE: We previously found that 0.5% polidocanol was more effective than tetracycline for pleurodesis in rats. Thus, we conducted the present study to evaluate the efficacy of different concentrations of polidocanol for pleurodesis in rats. METHODS: We divided 54 albino Wistar rats into six groups. Groups 1, 2, and 3 were given isotonic saline, 35 mg/kg tetracycline, and 0.6 mg of diluted polidocanol, respectively, being the daily recommended dose for humans. Groups 4, 5, and 6 were given 0.5%, 1%, and 2% polidocanol, respectively. All solutions were given intrapleurally in a volume of 0.5 ml. We examined the rats for macroscopic pleural adhesions and compared the mean values of macroscopic scoring among the six groups. RESULTS: The rats given polidocanol and tetracycline had significantly more adhesions than the control group, and polidocanol at concentrations of 0.5%, 1%, and 2% was more effective for pleurodesis than tetracycline. The diluted polidocanol was not more effective than tetracycline. There was no difference between the effects of the 0.5% and 1% concentrations, but the 2% polidocanol group had significantly more adhesions than the other groups. CONCLUSIONS: Polidocanol at concentrations of 0.5%, 1%, and 2% was a more effective sclerosing agent than tetracycline for pleurodesis. While 2% polidocanol was the most efficient sclerosing agent, the daily maximum recommended dose of polidocanol for humans was not more effective than tetracycline.

Animals↗

PubMed2002

Recurrent plunging ranula treated with OK-432.

A 36-year-old man was admitted who had a 2-month history of swelling of the right submandibular area and the right side of the mouth floor. He had undergone operations for right plunging ranula with a lesion on the floor of the mouth twice 7 years ago. Under fluoroscopic guidance, the contents of the cyst were aspirated as much as possible and injected with the same amount of OK-432 solution (Picibanil 0.1 mg; 10 ml) twice with 3-week intervals. Examination after 6 weeks showed that the cystic mass seen before therapy had disappeared completely, and no recurrence was encountered after 1 year. We here report a case in which a successful sclerotherapy with OK-432 for recurrent plunging ranula after surgery was performed.

Adult↗

PubMed2006

Current treatments of primary aneurysmal bone cysts.

The management of aneurysmal bone cyst depends on the age of the patient, the location, extent, aggressiveness and the size of the lesion. In the light of their experience and a review of the literature of 1256 aneurysmal bone cysts, the authors analyzed various treatment modalities. Inactive lesions can heal with biopsy or curettage alone. In active or aggressive lesions, elective treatment usually consists of curettage, whether associated or not with bone grafting and local adjuvants. Aneurysmal bone cyst in young children do not seem more aggressive than in older children. In pelvic locations, the emergence of a few cases of spontaneous healing (even in active or aggressive lesions) encourages the adoption of clinical and radiological supervision for some months after biopsy when possible. In some cases, the localization and extent of the cyst are such that operative treatment is extremely hazardous. Selective arterial embolization has made a considerable contribution towards the therapeutic solution of such cases. For some authors, direct percutaneous Ethibloc injection can be recommended as the first-choice treatment except in spinal lesions. Nevertheless, the complications encountered in some series after percutaneous embolization of aneurysmal bone cyst with Ethibloc should encourage the use of Ethibloc injection not as an initial treatment but as a reliable alternative to surgery.

Arteries↗

PubMed1995

Multicystic recurrence of hydrocele testis after sclerosing with polidocanol followed by spontaneous cure.

Scrotal ultrasound has been used to confirm the resolution of hydrocele testis after sclerosing with different solutions, and so, early recurrences with a multicystic appearance were occasionally observed. This finding was considered a complication of the sclerosant treatment needing a surgical option [1]. We have observed that a multilocular recurrence of hydrocele after percutaneous sclerosing with polidocanol is frequently followed by spontaneous cure.

Adult↗

PubMed1985

A simple catheter technique for production of AV block.

Atrioventricular (AV) block was produced in animals for experimental purposes by use of a newly devised cannula. It has bipolar electrodes; one electrode on the needle tip and the other 5.0 mm proximally from the tip. Otherwise, the cannula was electrically completely insulated. The cannula was inserted from the right external jugular vein and advanced close to the AV ring. While His bundle electrogram was obtained with the electrodes, the AV node was accessed. The injection site was determined as the point where His bundle electrogram can be well recorded and the atrial electrogram is close to or larger than the ventricular electrogram in amplitude. Xylocain solution, 0.2 to 0.4 ml, was injected with the syringe attached on the other end of the cannula. Transient AV block occurred when the needle tip was properly positioned. Then, 0.2 ml to 0.4 ml of anhydrous alcohol was added to make permanent a AV block. A possible application of this technique was implicated.

Animals↗

PubMed2005

Sclerotherapy to a large cervicofacial vascular malformation: a case report with 24 years' follow-up.

BACKGROUND: Large craniofacial venous malformations frequently cause significant cosmetic and functional problems. Treatment of the lesions early in life helps to avoid these problems. We present a case of a large cervicofacial venous malformation. METHODS: The patient was treated with a 5% benzyl alcohol solution of sodium morrhuate. The treatment was begun when the patient was 3 months of age, with a total of 23 injections. RESULTS: The lesion had completely disappeared by age 10. No major complications were observed except a superficial tissue loss on the temporal region. It was healed by conservative treatment. There were no recurrences during the 14-year follow-up. CONCLUSIONS: It is difficult to conclude that this type of treatment is the best choice for patients with venous malformation on the basis of a single case. However, intralesional sclerotherapy should be kept in mind as a saving treatment option in cases of large venous malformations in anatomic regions that present challenges to both the surgeon and the patient. Intralesional sclerotherapy can be performed without serious complications if the sclerosing agent is selected and injected cautiously.

Arteriovenous Malformations↗