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PubMed1990

Application of beta-interferon in virus-induced papillomas.

Eighty patients with bilateral common warts of the extremities were treated at weekly intervals with intralesional injections of either human fibroblast interferon or placebo. Lyophilized interferon (3 X 10(6) units) was diluted with 3 ml of normal sterile saline matched with identical vials of placebo. Eighty sets of three vials of human fibroblast interferon or placebo were labeled either A or B by a controller who maintained the code until the experiment was completed. Each patient received 0.1 X 10(6) units of interferon into the warts on one side and placebo injections into those on the matching extremity. Warts were measured each week and the progress or lack thereof was scored on a scale of -1 (worse) to 3 (cured). Therapy continued until either at least one extremity had cleared or the patient had received 10 weekly injections. A final evaluation was scored by measuring the total progress of each patient during the study. Sixty-four patients were treated to completion. More than 81% of the interferon-treated extremities were either cured or responded effectively to therapy. Only 17% of the placebo-treated lesions responded in this fashion. A statistical analysis of these data confirms the effectiveness of intralesional interferon therapy. The average number of interferon injections until cure was 5.9 +/- 1.7. No adverse effects were observed. The applications of interferon in patients with epidermodysplasia verruciformis and flat warts were also studied. Intralesional interferon beta was, to a certain degree, effective for benign lesions of epidermodysplasia verruciformis, but systemic treatments were not effective. Subcutaneous interferon beta was, in an uncontrolled study, effective in 45% of patients with flat warts.

Adolescent↗
PubMed2001

Interleukin-10 expressed at early tumour sites induces subsequent generation of CD4(+) T-regulatory cells and systemic collapse of antitumour immunity.

We investigated the relationship between transforming growth factor-beta (TGF-beta)-secreting T-regulatory (Tr) cells and anti-B16 melanoma immunity, and studied the association of early cytokines expressed at tumour sites with the generation of Tr cells. A large number of CD4(+) Tr cells producing interleukin (IL)-4, IL-10 and TGF-beta accumulated with functionally depressed CD8(+) cytotoxic T lymphocytes (CTLs) at tumour sites on day 20 after subcutaneous (s.c.) inoculation of B16 tumour cells. Tr cells consisted of two populations, which were termed T helper 3 (Th3) and Tr1 cells. B16-infiltrating Tr cells strongly inhibited the generation of B16-specific T helper 1 (Th1) cells in a TGF-beta-dependent manner and were assumed to suppress effective generation of CTLs. In addition, B16 cells markedly progressed in mice transferred adoptively by the cultured B16-infiltrating Tr cells compared with untreated mice. The capacity of these Tr cells to produce TGF-beta was hampered by neutralizing anti-IL-10 and partly anti-IL-4 monoclonal antibodies (mAbs) injected intralesionally during the early development of B16 tumours, and this treatment markedly attenuated B16 growth. Furthermore, a lesional injection of recombinant mouse IL-10 at an early tumour site resulted in the vigorous progression of B16 tumours. These results provide evidence that Tr cells, belonging to the T helper 3/T-regulatory 1 (Th3/Tr1) type, are activated in B16-bearing hosts under the influence of T helper 2 (Th2) cytokines, mainly IL-10 (produced at early tumour lesions), and that this regulatory T-cell population functions as a suppressor of anti-B16 immunity.

Animals↗
PubMed2002

Usefulness of intralesional triamcinolone in treatment of benign esophageal strictures.

INTRODUCTION: The cornerstone treatment for benign esophageal strictures is endoscopic dilation. There are reports suggesting that intralesional corticosteroid injection decreases the frequency of endoscopic dilation. METHODS: Seventy-one patients (mean age 42.39 [17.52] years; range, 13-78 years) with benign esophageal strictures (corrosive 29, peptic 14, anastomotic 19, radiation-induced 9) were recruited for this study. All were being managed with a program of intermittent endoscopic dilation by using over-the-wire polyvinyl dilators. All patients were treated by intralesional injections of triamcinolone acetonide (40 mg/mL diluted 1:1 with saline solution) by using a 23-gauge, 5-mm long sclerotherapy needle in aliquots of 0.5 mL. At each session, 4 injections (4 quadrants) were made at the proximal margin of the stricture with another 4 injections into the strictured segment itself whenever possible. The intervals between dilations and frequency of dilations were calculated before and after triamcinolone injections. A periodic dilation index (defined as number of dilations required per month) before and after the triamcinolone injections was calculated. RESULTS: The overall mean (SD) duration of treatment before intralesional injection was 10.9 (19.8) months (range, 1-120 months) and the mean number (SD) of esophageal dilations required was 9.67 (13.06) (range, 1-70). The mean number of sessions of intralesional injection was 1.4 (0.62). After initiation of intralesional injections mean follow-up was 8.1 (5.6) months (range 3-30 months) and the mean number of esophageal dilations was 3.8 (3.0) (range 0-16). The periodic dilation index decreased significantly from 1.24 (0.05) (range 0.13-3.16) before injection to 0.5 (0.33) (range, 0-2) after injection (p < 0.001). For each category of stricture, the periodic dilation index decreased significantly: corrosive, 1.24 (0.5) to 0.53 (0.34) (p < 0.001); peptic, 0.92 (0.44) to 0.42 (0.2) (p < 0.001); anastomotic, 1.24 (0.49) to 0.51 (0.4) (p < 0.001); and radiation-induced, 1.32 (0.6) to 0.6 (0.3) (p < 0.02). CONCLUSION: Intralesional injections of triamcinolone augment the effects of dilation in patients with benign esophageal strictures.

Adolescent↗
PubMed1991

[A dramatic effect of continuous intra-arterial injected recombinant interleukin-2 immunotherapy on malignant hemangioendothelioma].

A malignant hemangioendothelioma (MHE) developed on the frontal scalp of an 83-year-old woman was treated with intralesional injection of recombinant interleukin-2 (rIL-2, TGP-3, Takeda Chemical Industries LTD, Osaka) which had lead the lesion to complete remission for 2 years and 9 months. After the period of the complete remission, the patient developed MHE lesion on the occipital scalp which rapidly enlarged to more than 10 cm in diameter within 7 days, though there was no recurrence of MHE on the frontal scalp at that time. Intra-arterial rIL-2 injection was conducted through the occipital artery which circulates around the tumor lesion, but resulted unsuccessful because of the obstruction of the artery. Continuous intra-arterial rIL-2 injection through bilateral superficial temporal arteries was conducted, and then the tumor lesion came to complete remission on both clinical and histological data. So far, the patient has been showing no local recurrence or metastasis for the period of 8 months. We conclude that continuous intra-arterial rIL-2 injection immunotherapy through superficial temporal arteries is the best way of all the treatment in cases with recurrent MHE located on occipital scalp.

Aged↗
PubMed1981

[Cutaneous chromomycosis: therapy with intra-lesional amphotericin B injections].

Three different types of cutaneous chromomycosis, verrucous tumor type, eroded granuloma type and scaly erythematous plaque type, are reported. All these cases were successfully treated with intralesional injections of procaine-amphotericin B solution. This treatment for cutaneous chromomycosis seems to be favorable because of evident clinical efficiency without severe local or systemic side effects.

Administration, Topical↗
PubMed1987

Lymphokine-activated killer (LAK) cells can be focused at sites of tumor growth by products of macrophage activation.

Successful adoptive cancer immunotherapy presumably depends on the accumulation of tumoricidal leukocytes at the sites of tumor growth. Large numbers of lymphokine-activated killer (LAK) cells can be generated in vitro by growth in high concentrations of interleukin-2 (IL-2), but relatively few arrive at the tumor site after intravenous injection. We hypothesize that the delivery of LAK cells to tumor sites may be augmented by previously demonstrated lymphocyte-recruiting factors, including activated macrophage products such as interleukin-1 (IL-1) and tumor necrosis factor. 111Indium-labeled LAK cells were injected intravenously into syngeneic mice bearing the macrophage activator endotoxin (LPS) in one hind footpad, and saline solution was injected into the contralateral footpad. Significantly more activity was recovered from the LPS-bearing footpad at all times during a 96-hour period. Recombinant IL-1 also attracted more LAK cells after injection into tumor-free hind footpads. Furthermore, LAK cells preferentially homed to hind footpads that were bearing 3-day established sarcomas after intralesional injections of LPS, IL-1, or tumor necrosis factor when compared with contralateral tumor-bearing footpads injected with saline solution alone. In preliminary experiments, mice with hind-footpad tumors appeared to survive longer after combined systemic IL-2 and LAK therapy if intralesional LPS was administered. These studies demonstrate that macrophage activation factors that have been shown capable of attracting circulating normal lymphocytes can also effectively attract LAK cells from the circulation. By the stimulation of macrophages at the sites of tumor growth, more LAK cells can be attracted. It is hoped that by "focusing" the migration of LAK cells to tumors, LAK cells and IL-2 would effect tumor regression more efficiently and with less toxicity.

Animals↗
PubMed2003

Lymphatic mapping with tracer administration into the primary breast cancer.

There is an ongoing debate over the best tracer injection technique in lymphatic mapping for breast cancer. The technique of low tracer volume administration into the primary breast cancer is presented. The reasons that led to this approach are explained as well as its advantages. Excision of radioactivity that remains at the injection site in the breast cancer prevents the gamma ray scatter that may hamper retrieval of a sentinel node. The intralesional injection technique avoids potential injection of tracer fluid across a lymphatic watershed, it enables identification of extra-axillary sentinel nodes and allows probe-guided excision of non-palpable tumours.

Breast Neoplasms↗
PubMed1998

Ethanolamine injection for sclerotherapy of angiodysplasia of the colon.

BACKGROUND AND STUDY AIMS: Endoscopic sclerotherapy has been a very useful method for the management of bleeding vascular lesions of the gastrointestinal tract. In this report, the injection of a sclerosant agent was evaluated for the treatment of angiodysplasias of the colon. PATIENTS AND METHODS: In a prospective study in eight patients an ethanolamine solution was injected under endoscopic observation directly into 15 lesions, typically angiodysplasias of the right colon at the index colonoscopy, and into another eight de novo lesions found at subsequent examinations. The needle injector was intended to be placed very carefully into the lesion, tangentially to the mucosal surface, to avoid penetrating the bowel wall. RESULTS: Clinical follow-up showed that in six out of the eight patients (75%) no further evidence of lower intestinal hemorrhage was registered after the sclerotherapy; follow-up ranged from 22 to 36 months. Of the four patients who needed blood transfusion before the treatment because of intestinal bleeding, only one required blood transfusion after the sclerotherapy. Neither immediate nor late complications were recorded; often light bleeding occurred immediately after the injections and stopped spontaneously, except in one case which necessitated additional injection of the sclerosant. On the other hand, only one patient had light transient right lower quadrant pain after the injection, which subsided without any medication. CONCLUSIONS: Our method was shown to be feasible and safe. The success of the intralesional injection of the sclerosing agent may be predicted when changes in the mucosal surface are observed: (a) immediately after the injection sufficient sclerosant is deemed to have been injected and to the proper depth in the bowel wall, if the mucosa bulges while the solution is being injected; and (b) if a shallow ulceration is seen in an early subsequent reexamination where the treated lesion was located, allowing scar tissue produced by the healing process of the ulcer to replace the former vascular lesion.

Aged↗
PubMed1998

Intralesional sclerotherapy in the management of hemangiomas of the glans penis.

PURPOSE: We studied the role of sclerotherapy in the management of glans penis hemangiomas. MATERIALS AND METHODS: Four patients with hemangiomas of the glans penis were treated on an outpatient basis with intralesional injections of 30% hypertonic saline. RESULTS: In all 4 patients the lesions regressed and all were satisfied with the outcome. CONCLUSIONS: Intralesional sclerotherapy is a cost-effective modality for the treatment of glans penis hemangiomas, especially in developing countries and at peripheral hospitals where expensive laser equipment may not be available.

Adolescent↗
PubMed1993

Recombinant vaccinia interleukin-2-infected tumor cell vaccines in immunotherapy of murine colon adenocarcinoma.

A recombinant vaccinia virus (vCF13) containing and expressing the gene for human interleukin (IL)-2(vCF13) was compared to a recombinant vaccinia transfection control strain containing the LacZ gene at the same insertion site (vTFCLZ-1) for their ability to augment the immunogenicity of murine colon adenocarcinoma cell lines CT26 and CA51 in Balb/c mice. Both recombinant vaccinia strains abolished tumorigenicity of 10(5) CT26 or CA51 tumor cells. vCF13-infected tumor cells that secreted human IL-2 as measured by both CTLL-2 and enzyme-linked immunosorbent assays induced delay in tumorigenesis when administered in two weekly subcutaneous injections 1 week prior to challenge with 10(5) uninfected tumor cells. Although three of five vCF13-CT26 immunized mice developed tumors by day 14 after challenge, intralesional injection of these tumors with vCF13 induced rapid regression, whereas all five tumors that developed in vTFCLZ-1 immunized mice showed no response to intralesional vTFCLZ-1. These preliminary results provide support for the potential utility of recombinant vaccinia/IL-2 in tumor immunotherapy.

Adenocarcinoma↗
PubMed1998

Treatment of cutaneous and subcutaneous tumors with electrochemotherapy using intralesional bleomycin.

BACKGROUND: Electrochemotherapy (ECT) is performed by locally administering a chemotherapeutic agent in combination with electric pulses. Previous clinical studies have demonstrated the effectiveness of ECT. In these initial trials, the drug was administered intravenously, followed by administration of electric pulses directly to the tumor. This study was initiated to determine whether an intralesional injection of the drug in combination with electric pulses could provide an improved result. A group of 34 patients was studied. METHODS: The dose of intralesional bleomycin was based on tumor volume. This was followed 10 minutes later by 6 or 8 99-microsec pulses of electricity at an amplitude of 1.3 kV/cm. Both the bleomycin and the electric pulses were administered after 1% lidocaine with epinephrine solution was injected around the treatment site. RESULTS: All patients responded to the treatment. Responses were observed in 142 (99%) of 143 metastatic nodules or primary tumors within 12 weeks, with complete responses observed in 130 (91%) of the nodules. No complete responses were observed in nodules treated with bleomycin only or electric pulses only. Random biopsies confirmed the clinical findings. All patients tolerated the procedure well, and no significant side effects were noted. Muscle contraction was evident during administration of each electric pulse but promptly subsided after the pulse. CONCLUSIONS: ECT was shown to be an effective local treatment for cutaneous malignancies. The results suggest that ECT may have a tissue-sparing effect and result in minimal scarring. ECT may be a suitable alternative therapy for the treatment of basal cell carcinoma, local or regional recurrent melanoma, and other skin cancers.

Adult↗
PubMedDate not supplied

Keloid scar of the face.

Although all the consultants agreed that this patient deserved to be treated, they disagreed as to the method. Dr. Wise suggested excision of the scar with postoperative irradiation. Dr. Thomas would excise the scar, inject the lesion with steroids intraoperatively and postoperatively, and apply a pressure dressing. Dr. Cook would not operate at all and favored intralesional injection of steroids. When used, Kenalog was the steroid preparation of choice. Dr. Wise would not use steroids in this situation because of the possible complications of skin atrophy, change in pigmentation, and telangiectasias. Dr. Thomas would avoid low-dose irradiation for fear of inducing a head and neck malignancy. Dr. Cook would avoid all surgical intervention, believing that it would only compound the present problem. All consultants agreed that the patient deserved close follow-up, and that he was at risk for similar scar formation in the future. They also pointed out the genetic predisposition for his offspring to have similar problems.

Adult↗
PubMed2000

[Epidemics of cutaneous leishmaniasis in military personnel working in French Guiana].

Cutaneous leishmaniasis transmitted by phlebotomine sandflies is endemic in the rain forests of French Guyana. The 3rd Régiment Etranger d'Infanterie, based in Kourou carries out numerous operations in the Amazonian areas. In 1998 two outbreaks of cutaneous leishmaniasis occurred: one during an exercise at the training center in the equatorial forest of Regina (10 patients) and the other during a mission in Saint Elie (21 patients). Clinical findings were variable and diagnosis was confirmed by skin smear tests. Patients were treated by two intramuscular injections of pentmidine isethionate (Pentacarinate). Recurrence was observed in two patients who were retreated using the same agent. Persistent lesions were treated by intralesional injection of meglumine antimoniate (Glucantime). Both outbreaks were characterized by high attack rates (91 p. 100 and 84 p. 100) and were facilitated by non-observance of standard procedures because of training or operational requirements at the beginning of the leishmaniasis season. Strict planning of activities, wearing protective clothing, deployment of insecticide treated bed nets, and of candles rather than electrical lamps for lighting are key preventive measures. Greater emphasis is needed on the use of insect repellents.

Antiprotozoal Agents↗
PubMed1996

Effect of locally injected medications on healing of pad wounds in dogs.

OBJECTIVE: To ascertain the effects of locally injected immunostimulant and tripeptide-copper complex (TCC) on improving healing of pad wounds. DESIGN: Wounds in pads of large dogs were injected with either medication or physiologic saline solution (controls). Healing was evaluated. ANIMALS: 12 mature English Pointers. PROCEDURE: Full-thickness 6 x 8-mm wounds in metatarsal and third and fourth digital pads were injected with immunostimulant or TCC at 0, 3, and 6 days after wounding. Wounds on control dogs were injected with physiologic saline solution. Using planimetric measurements at 0, 3, 6, 14, and 21 days, rates of healing were evaluated. Biopsy of the digital pad wounds at 3, 6, and 14 days was used to evaluate collagen content by hydroxyproline analysis. Biopsy specimens were also evaluated for type-I and type-III collagen, using Sirius red differential staining. RESULTS: Effect on healing rate and hydroxyproline content was best during the first week for immunostimulant. Immunostimulant- and TCC-injected wounds had more type-I collagen than did controls at 6 days; TCC-injected wounds had the most type-I collagen. At 14 days, the amount of type-I collagen in TCC-injected wounds was significantly greater than that in other wounds. CONCLUSIONS: Tested medications had positive effects on healing of pad wounds. CLINICAL RELEVANCE: Intralesional injection of medications helps ensure their presence for enhancement of wound healing. The benefit could be lost with topical use in a bandage if the bandage is lost or becomes wet.

Adjuvants, Immunologic↗
PubMed2000

Large intraosseous arteriovenous malformation of the maxilla - a case report with review of literature.

Large intraosseous arteriovenous malformations (AVM) of the maxilla are rare lesions, which are probably hamartomas. We report a case of an 8-year-old child who presented with exsanguinating hemorrhage after an attempted dental biopsy. The management of dental intraosseous AVMs includes transarterial embolization and direct intralesional injection of liquid acrylic (NBCA). This approach avoids mutilating surgery and its sequelae in children. We present this case for its rarity and the intralesional use of acrylic glue in its management.

Angiography↗
PubMed1997

Activity of compounds isolated from Chilean lichens against experimental cutaneous leishmaniasis.

Three secondary metabolites isolated from Chilean lichens, (+) usnic acid, pannarine and 1'-chloropannarine, were tested against promastigotes forms of three strains of Leishmania ssp. Pannarine and 1'-chloropannarine exhibited in vitro activity at 50 micrograms/ml and (+) usnic acid at 25 micrograms/ml. BALB/c mice infected with Leishmania amazonensis were treated 4 weeks post-infection with (+) usnic acid by subcutaneous or oral routes for 15 days at 25 mg/kg or by five intralesional injections at interval of 4 days at 25 mg/kg of body weight. The reference drug, N-methylglucamine antimonate (Glucantime), was administered by subcutaneous injections (regimens of 28 mg of pentavalent antimony) for 15 days. The subcutaneous and oral treatments with (+) usnic did not produce any effect, but by intralesional administration we observed a significant effect that reduced by 43.34% the weight lesions and by 72.28% the parasites loads in infected footpads.

Animals↗
PubMed2004

OK-432 and lymphatic malformations in children: the Starship Children's Hospital experience.

BACKGROUND: Surgery has previously been the mainstay of treatment for lymphatic malformations but has attendant problems of marked scarring, high chance of recurrence and potential nerve damage. Alternative management for these lesions involves the intralesional injection of OK-432. The present paper reviews OK-432 use in lymphatic malformations in children. METHODS: A retrospective chart review was carried out of children undergoing intralesional OK-432 therapy from the Departments of Paediatric Surgery, Paediatric Otolaryngology and Plastic Surgery at Starship Children's Hospital, Auckland. RESULTS: Over the past 4 years, seven children under the age of 5 years underwent OK-432 therapy as day-case procedures requiring between one and seven procedures each. Four children had lesions involving the axilla/chest wall, two involved extra-mylohyoid tissues in the neck and one child had lymphatic malformation involving tongue, floor of mouth and an extra-mylohyoid component. Spontaneous haemorrhage into a cystic space may be the cause of the observed partial resolution of the lymphangiomas in two. A predictor of a successful outcome was the ability to aspirate fluid prior to injection. Ultrasound guidance was useful to localize the lesions for aspiration and injection. Macrocystic lesions respond well to OK-432 therapy but the response of microcystic or cavernous lesions to OK-432 is disappointing and surgery remains the definitive treatment for these microcystic lesions. CONCLUSION: OK-432 appears to be a safe and effective treatment for the macrocystic component of lymphatic malformations.

Antineoplastic Agents↗
PubMed1988

Perilesional linear atrophy and hypopigmentation after intralesional corticosteroid therapy. Report of two cases and review of the literature.

We report on the cases of two patients in whom linear perilesional hypopigmentation and atrophy developed after intralesional injection of corticosteroids for treatment of keloids. Evaluation of our patients and the previously reported cases showed that perilesional linear atrophy or hypopigmentation (or both) is a distinct complication after intralesional or intraarticular administration of corticosteroids and is probably due to lymphogenous spread of the steroid suspension.

Atrophy↗