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Renal artery embolization using a new liquid embolic material obtained by partial hydrolysis of polyvinyl acetate (Embol): initial experience in six patients.

OBJECTIVE: To evaluate the therapeutic efficacy of a new liquid embolic material, Embol, in embolization of the renal artery. MATERIALS AND METHODS: Embol is a new embolic material obtained by partial hydrolysis of polyvinyl acetate mixed in absolute ethanol and Iopromide 370 and manufactured by Schering Korea, Kyonggido, Korea. Six patients who underwent embolization of the renal artery using Embol were evaluated. Four were male and two were female and their ages ranged from 11 to 70 (mean, 53) years. Clinical and radiologic diagnoses referred for renal artery embolization were renal cell carcinoma (n = 3), renal angiomyolipoma (n = 2) and pseudoaneurysm of the renal artery (n = 1). After selective renal angiography, Embol was injected through various catheters, either with or without a balloon occlusion catheter. Changes in symptoms and blood chemistry which may have been related to renal artery embolization with Embol were analyzed. RESULTS: The six patients showed immediate total occlusion of their renal vascular lesions. One of the three in whom renal cell carcinoma was embolized with Embol underwent radical nephrectomy, and the specimen thus obtained revealed 40% tumor necrosis. In the two patients with angiomyolipomas, the tumors decreased in size and abdominal pain subsided. Bleeding from pseudoaneurysm of the renal artery was successfully controlled. Four patients showed symptoms of post-embolization syndrome, and one of these also showed increased levels of blood urea nitrogen and creatinine. One patient experienced transient hypertension. CONCLUSION: Embol is easy to use, its radiopacity is adequate and it is a safe and effective embolic material which provides immediate and total occlusion of renal vascular lesions.

Aged↗

[Migration of di(2-ethylhexyl) phthalate from polyvinyl chloride tubes used in preparation of foods].

Three samples of polyvinyl chloride products for food use were examined for di(2-ethylhexyl) phthalate (DEHP) migration levels under the conditions described in the Japanese Food Sanitation Law. These samples were two kinds of tubes and one stretched film, containing 12 to 41% DEHP by weight. DEHP migration levels from them were very low, all below 0.1 ppm, into 3 kinds of food simulant; water, 4% acetic acid and 20% ethanol. However, high levels of DEHP migrated into n-heptane, 12 ppm from the stretched film sample and more than 800 ppm from the tube samples. Migration from the 2 tubes was higher than 150 ppm, the limit of residues after evaporation in containers and wraps. Though the limit of residues after evaporation is not set for equipment used in the preparation of foods, the tested tubes were considered to be unsuitable for uses in which they come into direct contact with oils, fats or oily foods.

Diethylhexyl Phthalate↗

A simple and reproducible testing method for dialkyl phthalate migration from polyvinyl chloride products into saliva simulant.

We describe a method of mechanical agitation to determine rates of dialkyl phthalate migration from polyvinyl chloride (PVC) products into saliva simulant. The method consists of rotary shaking of a sample with 30 mL of saliva simulant (pH 7.0) at 35 degrees C in a 50 mL glass tube at 300 rpm for 15 min, then measuring the amount of dialkyl phthalate in the saliva simulant by HPLC with a UV detector. The migration rates of diisononyl phthalate (DINP), di-2-ethylhexyl phthalate (DEHP) and di-n-butyl phthalate (DBP) from PVC plates containing about 45% (w/w) plasticizer (molded in our laboratory) were identical. However, the migration rates from molded plates containing 13% (w/w) DBP were almost double those of DINP and DEHP at the same ratios. In addition, the amounts of DINP that migrated in vitro after rotary shaking for 15 min were equivalent to those in vivo determined in saliva from volunteers who chewed plates for 60 min. The migration rates of dialkyl phthalates from 11 commercially available toys ranged from 15.6 to 85.2 micrograms/cm2/h [relative standard deviation (RSD), 3 to 12%].

Chromatography, High Pressure Liquid↗

[Material labeling of soft plastic toys and plasticizers in polyvinyl chloride products].

We investigated the labeling and content of plasticizers of soft plastic toys. First, we investigated material labeling in 96 products purchased in fiscal years 2000 and 2001. Among these products, 43% of those purchased in fiscal 2000 and 68% of those purchased in fiscal 2001 were labeled. We then investigated the kinds and amounts of plasticizers in 73 soft polyvinyl chloride (PVC) toys. Three kinds of phthalates and six other kinds of plasticizers were detected in the soft PVC toys. Diisononyl phthalate, di(2-ethylhexyl) phthalate, diisononyl adipate, and O-acetyl tributyl citrate were detected at high frequency, and in large amounts. The average total content of all plasticizers was 280 mg/g for the products purchased in fiscal 2000 and 227 mg/g for those in fiscal 2001. In fiscal 2001, antioxidants, 4-nonylphenol, and bisphenol A were investigated in addition to plasticizers.

Adipates↗

[Determination of organotin compounds in polyvinyl chloride toys].

Organotin compounds in polyvinyl chloride toys were determined by GC/MS after ethyl derivatization with sodium tetraethylborate. The samples were 12 balls, 12 soft toys, 10 food toys and 13 face masks for children. Monooctyltin, dioctyltin and trioctyltin compounds were found in all face masks at the levels of 74.8-917 micrograms/g. 474-3,960 micrograms/g and 1.0-213 micrograms/g, respectively. They also were detected in 6 balls, 4 soft toys and 1 food toy. Monomethyltin and dimethyltin compounds were found in 8 face masks at the levels of 40.9-227 micrograms/g and 222-1,450 micrograms/g, respectively. Monobutyltin and dibutyltin (DBT) compounds were found in 1 ball, 3 food toys and 5 face masks. In particular, 1 ball and 4 face masks contained toxic DBT at the levels of 527-999 micrograms/g.

Borates↗

[Determination method of tricresyl phosphate in polyvinyl chloride].

A simple and rapid method using HPLC was developed for the determination of tricresyl phosphate (TCP) in polyvinyl chloride (PVC) articles. A test sample was extracted with acetonitrile at 37 degrees C overnight. The extract solution diluted with an equivalent amount of water was applied to a Sep-Pak C18 cartridge, and TCP was eluted with acetonitrile-water (2:1) mixture. The eluate was analyzed by HPLC with an Inertsil Ph-3 column, using 65% acetonitrile/water as the mobile phase, with UV detection (264 nm). The calibration curve was rectilinear from 0.5 to 100 micrograms/mL. The recoveries of TCP added to various kinds of PVC articles at the level of 1,000 micrograms/g were 84.7-98.6%. The determination limit of TCP was 50 micrograms/g in samples. This method was applied to products including 3.1, 6.6 and 8.8% TCP and the recoveries of TCP were 87.3-91.4%. This method is very simple, and it seems suitable for a regulatory test.

Chromatography, High Pressure Liquid↗

[Estimation of daily oral exposure to phthalates derived from soft polyvinyl chloride baby toys].

Daily oral exposure of babies to phthalate was estimated on the basis of the mouthing time of infants and the oral concentration of diisononyl phthalate (DINP) released from polyvinyl chloride (PVC) toy specimens. Total mouthing time, including the use of pacifiers, ranged widely from 11.4 min to 351.8 min with the mean of 105.3 +/- 72.1 min. The mean of the total mouthing time without pacifiers was 73.9 +/- 32.9 min. The average amount of DINP in saliva was 92.4 +/- 56.8 micrograms/10 cm2/hr, ranging from 13.2 micrograms/10 cm2/hr to 240.4 micrograms/10 cm2/hr. The exposure of phthalate in two different trials was estimated by the method of Monte Carlo simulation, one with the total mouthing time with pacifiers and the other with the total mouthing time without pacifiers. The average exposure in the former trial was 21.4 micrograms/kg/day and the 95th percentile was 65.8 micrograms/kg/day, while in the latter it was 14.8 micrograms/kg/day and the 95th percentile was 35.7 micrograms/kg/day.

Humans↗

[Headspace GC/MS analysis of residual vinyl chloride and vinylidene chloride in polyvinyl chloride and polyvinylidene chloride products].

A headspace GC/MS analysis method for the simultaneous determination of residual vinyl chloride (VC) and vinylidene chloride (VDC) in polyvinyl chloride (PVC) and polyvinylidene chloride (PVDC) products was developed. A test sample was swelled overnight with N,N-dimethylacetamide in a sealed vial. The vial was incubated for 1 hour at 90 degrees C, then the headspace gas was analyzed by GC/MS using a PLOT capillary column. The recoveries from spiked PVC and PVDC samples were 90.0-112.3% for VC and 85.2-108.3% for VDC. The determination limits were 0.01 microg/g for VC and 0.06/microg/g for VDC, respectively. By this method, VC was detected in two PVC water supply pipes at the levels of 0.61 and 0.01 microg/g. On the other hand, VC and VDC were not detected in any of the food container-packages or toys tested.

Dichloroethylenes↗

Polyvinyl alcohol and gelatin sponge particle embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis.

AIM: To assess the effectiveness of and complications associated with polyvinyl alcohol (PVA) and gelatin sponge particles embolization of splenic artery pseudoaneurysm complicating chronic alcoholic pancreatitis. METHODS: A 42-year-old man with splenic artery pseudo-aneurysm formation secondary to chronic alcoholic pancreatitis was admitted. We used PVA and gelatin sponge particles embolization of splenic artery pseudoaneurysm by superselective embolization techniques. RESULTS: The splenic artery pseudoaneurysm was successfully controlled with splenic embolization. The patient was discharged in 9 d with complete recovery. CONCLUSION: This case confirms that superselective transcatheter embolization by PVA and gelatin sponge particles may represent an effective treatment for pseudoaneurysm caused by chronic alcoholic pancreatitis in the absence of other therapeutic alternatives.

Adult↗

Comparison of immediate polyvinyl alcohol (PVA) fixation with delayed Schaudinn's fixation for the demonstration of protozoa in stool specimens.

Immediate fixation of stool specimens in polyvinyl alcohol fixative (PVA) was compared with Schaudinn's fixation delayed until the specimens were received in the laboratory, in a series of 100 consecutive positive stool specimens. More specimens were found positive following PVA fixation, and the numbers of organisms present on the slides were greater in specimens processed by this technique than after Schaudinn's fixation. It is concluded that immediate fixation results in the preservation of larger numbers of organisms in a recognizable state. The routine use of PVA fixation prior to transportation of the specimen to the laboratory is recommended.

Amebiasis↗

Pulmonary effects of polyvinyl chloride dust exposure on compounding workers.

Spirometry, chest radiography, environmental measurements, and a questionnaire on respiratory symptoms were used to evaluate the effects of exposure to polyvinyl chloride (PVC) dust on 171 Chinese and Malay PVC compounding workers in comparison with an unexposed reference group. Workers with high cumulative PVC dust exposure had a lower forced expiratory volume in 1 s and forced vital capacity, and a higher prevalence of radiological profusion of small opacities. Wheezing or chest tightness was also significantly more frequent in this group. Unlike previous studies, the PVC compounding workers in this study were exposed to only negligible amounts, if any, of vinyl chloride monomer or thermal degradation products of PVC such as hydrogen chloride, phosgene, or chlorine. The conclusion was drawn that a low grade of pneumoconiosis and a small degree of lung function impairment is associated with PVC dust exposure. Reversible airways obstruction is also likely and warrants further investigation.

Adult↗

Immobilization of enzymes on spongy polyvinyl alcohol cryogels: the example of beta-galactosidase from Aspergillus oryzae.

The catalytic properties of a beta-galactosidase from Aspergillus oryzae, entrapped into a spongy polyvinyl alcohol cryogel, were studied. This polymeric matrix was selected because of its mild conditions of preparation and its stability, biocompatibility, structural strength and diffusive properties. The enzyme was entrapped, in high percentage, into cryogel sponges and its activity and kinetic parameters were determined and compared with those of the free enzyme, using as substrates o-nitrophenyl-beta-galactopyranoside (ONPG) or lactose. The immobilized enzyme showed a reduced activity with ONPG and lactose, probably because of substrate diffusion limitations through the matrix, but it was more stable to temperature, pH and ionic strength than the free enzyme. Lactose hydrolysis under continuous experimental conditions was performed using the matrix-enzyme cited above.

Animals↗

Embolization of cerebral arteriovenous malformations achieved with polyvinyl alcohol particles: angiographic reappearance and complications.

BACKGROUND AND PURPOSE: The appropriate choice of embolic materials with respect to the permanency of obliterated nidi after embolization and complications related to the procedure is essential for safe and effective embolization of cerebral arteriovenous malformations (AVMs). Our purpose was to ascertain the recanalization and complication rates after AVM treatment with polyvinyl alcohol (PVA) particles. METHODS: Between 1988 and 1994, 36 AVMs were embolized with PVA particles at our institution. Follow-up angiographic findings and occurrence of complications during the embolization procedures were analyzed retrospectively. RESULTS: Complete obliteration of the nidus immediately after embolization was achieved in five patients, and 80% to 99% obliteration was attained in 12 patients. Fifty-one follow-up angiographic examinations were performed 1 week to 60 months (mean, 7 months) after embolization in 31 patients. An increase in nidal size was seen on 15 follow-up angiograms (29%) and a decrease was seen in seven (14%). In 28 of the 51 angiograms obtained more than 1 month after follow up (mean, 13 months), 12 (43%) showed AVM enlargement. In four (80%) of five cases of complete obliteration, nidi reappeared on follow-up angiograms. Hemorrhagic complications occurred in three cases and ischemic ones in seven. One patient (3%) died and five (14%) suffered persistent neurologic deficits. CONCLUSION: Embolization with PVA particles can produce significant volume reduction in AVM nidal size, but recanalization is a distinct possibility.

Adolescent↗

Vinyl chloride and polyvinyl chloride.

Polyvinyl chloride (PVC) is an important plastic resin for construction, pipe and tubing, siding, and other uses. Exposures to vinyl chloride monomer during the early years of production resulted in an important sentinel health event: the recognition of an excess of a rare liver cancer, hepatic angiosarcoma, at facilities throughout the world. Several other syndromes, including acro-osteolysis, also have been associated with PVC, but less clearly with vinyl chloride. Extensive research ranging from large-scale epidemiologic studies to biomarker research into molecular mechanisms continues to provide valuable insight into the pathogenesis of occupational cancer.

Hemangiosarcoma↗

Efficacy of trisacryl gelatin microspheres versus polyvinyl alcohol particles in the preoperative embolization of meningiomas.

BACKGROUND AND PURPOSE: Trisacryl gelatin microspheres are a new, commercially available nonabsorbable embolic agent. The purpose of this study was to evaluate their efficacy in the preoperative embolization of meningiomas as compared with polyvinyl alcohol (PVA) particles of various sizes. METHODS: In 30 consecutive patients, trisacryl gelatin microspheres (150-300 microm) were used for the preoperative superselective embolization of meningiomas (group 1). Thirty other consecutive patients had embolization with PVA particles of 45 to 150 microm (n = 15, group 2) and of 150 to 250 microm (n = 15, group 3). Extent of devascularization, intraoperative blood loss, blood transfusion, and hemostasis at the time of surgery were recorded for every patient. The inflammatory reaction, the extent of necrotic areas, and the most distal intravascular location of the embolic agent (arterial, arteriolar, precapillary, capillary) were recorded. RESULTS: There was no significant difference in the extent of angiographic devascularization among the groups. Intraoperative blood loss differed significantly between groups 1 and 2 and groups 1 and 3, but not between groups 2 and 3. The trisacryl gelatin microspheres were located more distally in tumor vessels than were the PVA particles of either size. The extent of intratumoral necrosis was not significantly different between the two embolic agents. In all groups there was a mild inflammatory tissue reaction in the vicinity of the embolic agent. CONCLUSION: Trisacryl gelatin microspheres may be effective in the preoperative embolization of meningiomas, producing significantly less blood loss at surgery than seen with PVA particles of either size, possibly because of the significantly more distal vascular penetration of the microspheres.

Acrylates↗

The accelerated polyvinyl-alcohol method for GSR collection--PVAL 2.0.

The polyvinyl-alcohol collection method (PVAL) is used in forensic practice to gather topographical information about gunshot residues (GSR) from the hands to decide if the subject has made use of firearms. The results allow a distinction between suicide and homicide. The only inconvenience of PVAL was that the procedure took about 60 min because three layers of liquid PVAL had to be applied and dried. Therefore, the collection method was only applied to corpses. The improved and accelerated PVAL 2.0 uses a sandwich technique. Cotton gauze for stabilization is moistened with a 10% PVAL solution. A solid film of PVAL (Solublon) is spread on the cotton mesh. The gauze is then modeled to the hand and dried with a hair dryer. After removing the cotton gauze, the traces are embedded in the water-soluble PVAL. The procedure does not take more than 15 min. The results demonstrate the qualities and advantages of PVAL: topographical distribution of GSR, highest gain of GSR, sampling of all other traces like blood, backspatter etc., and humidity does not reduce the gain. In addition, with the new PVAL 2.0 dislocation of GSR or contamination are excluded. PVAL 2.0 can also be applied on live suspects.

Autopsy↗

Cytogenetic damage in plastic industry workers exposed to polyvinyl chloride.

Cytogenetic investigations on peripheral blood lymphocytes of 40 workers exposed to polyvinyl chloride in the plastic industry were undertaken. These were compared with an equal number of occupationally unexposed and matched controls in relation to age, sex and smoking habits. The mitotic index (MI), chromosomal aberrations (CA), sister chromatid exchanges (SCE) and satellite associations (SA) were analysed. All the parameters showed a significant increase (p <0.01) in the exposed sample compared with the controls, viz MI, 3.64-6.30, CA 1.02-3.77, SCE 3.40-7.83 and SA 5.57-12.05. The occurrence of the DG type of satellite association B was highest and that of 3D type lowest. The frequencies of all the parameters increased with the duration of exposure, but MI declined after 15 years of exposure.

Adolescent↗

[Comparative study of adherence of five Candida species to polyvinyl chloride].

Colonization of biomaterial by Candida species could be the first step of Candida infection. We examined the in vitro adherence capabilities of five Candida species to polyvinyl chlorure (PVC). Twenty stains were tested: C. albicans (9), C. glabrata (3), C. tropicalis (3), C. kefyr (4) and C. parapsilosis (1). The adherence to PVC was evaluated by direct microscopic examination. The results indicate that the adherence of C. albicans to PVC is similar to that of C. glabrata and C. tropicalis. Only C. kefyr adheres to a lower degree. We conclude that the adherence capabilities of non-albicans species were similar to that of C. albicans. There is a relationship between the adherence of Candida species and their abilities to colonize the biomaterial. The species, which are more adherent, are those, which are more virulent.

Biocompatible Materials↗