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PubMed1998

Application of tumbling melt granulation method to prepare controlled-release beads by coating with mixture of functional non-meltable and meltable materials.

A new coating method for use in preparing controlled-release beads was developed by modifying the tumbling melt granulation technique. The dissolution rate of the drug from the beads was controlled by coating the mixture of meltable and non-meltable materials by heating in a centrifugal fluidizing granulator without using any solvent. In experiments using talc as the non-meltable material, the resultant beads showed the sufficient ability to suppress the dissolution of the drug and no change in the dissolution characteristics by wetting agent and in a stability test at high temperature. Using functional polymer as the non-meltable material, the controlled-release beads with various dissolution characteristics could be prepared: entero-soluble-release beads using entero-soluble polymer, and zero-order-release beads using hydrophilic gel-forming agent and talc.

Delayed-Action Preparations↗
PubMed1995

Thoracoscopy. A prospective study of safety and outcome.

OBJECTIVE: To assess a standard classification of adverse events and evaluate the safety and long-term outcome of thoracoscopy in patients with pleural disease. DESIGN: Prospective nonrandomized cohort study. SETTING: The Pulmonary Special Procedures and Nd:YAG Laser Unit of the University of California San Diego Medical Center, San Diego. PATIENTS: Fifty consecutive patients undergoing thoracoscopy for diagnosis of pleural effusion or thickening, pleurodesis, or empyema drainage. INTERVENTION: A list of major and minor adverse events that could be temporally related to thoracoscopy performed for diagnosis or treatment of pleural processes was established before beginning this prospective study. Procedures were performed using multiple point-of-entry techniques and either local or general anesthesia. Most procedures were performed in the operating room using double-lumen intubation. Patients were seen daily during hospitalization and at least 7, 30, and 90 days after thoracoscopy. Long-term follow-up data were obtained by telephone calls, clinical visits, or medical chart reviews or all of these, until 12 months after procedures. MEASUREMENTS: Occurrence of major and minor adverse events possibly related to thoracoscopy was recorded prospectively. Demographic and clinical data, as well as efficacy and outcome after thoracoscopy, were also noted. RESULTS: Fifty-two procedures were performed in 50 patients. Median age was 60 years (range, 18 to 88 years). Thoracoscopy provided a diagnosis in 93% of patients with pleural disease of unclear origin. Pleurodesis by thoracoscopic talc insufflation was successful in 95% of cases and in 91% of patients with malignant pleural effusions still available for evaluation and follow-up examination 3 months after pleurodesis. Thoracoscopic drainage of empyema was successful in six of seven patients and led to referral for open decortication in one. There were no procedure-related deaths or intraoperative accidents. Open-chest surgery intervention was never required. Only 1 major adverse event occurred: a patient with scleroderma and trapped lung had recurrent pleural effusion requiring chest tube drainage 1 week after hospital discharge. Minor adverse events, however, were noted in ten instances (19%). These included fever after talc pleurodesis, asymptomatic pneumothorax after chest tube removal, and minor would infection in a patient with empyema. CONCLUSION: Using the proposed classification of major and minor adverse events, prospective evaluation demonstrated the safety, diagnostic utility, and long-term efficacy of thoracoscopy performed for diagnosis and management of pleural processes. Potential dangers, however, of thoracoscopy are acknowledged, and limitations of the procedure are addressed.

Adolescent↗
PubMed1995

Comparison of silver nitrate and tetracycline as pleural sclerosing agents in rabbits.

The ideal agent to produce pleurodesis has not been identified. Tetracycline, the drug used most commonly in the 1980s, is no longer available. Talc either aerosolized or in a slurry is the agent used just most commonly at the present time, but there are concerns about its safety. Another possibility is silver nitrate, which was widely used in the past, but was abandoned on account of side effects. We hypothesized that lower concentrations of silver nitrate than had been used in the past would be effective in creating a pleurodesis in rabbits. The following medications in a total volume of 2 mL were instilled intrapleurally in three groups of ten anesthetized rabbits: 0.25% or 0.50% silver nitrate and 35 mg/kg tetracycline. Twenty-eight days after the injection, the animals were sacrificed and the pleural spaces were assessed grossly for evidence of pleurodesis and microscopically for evidence of fibrosis and inflammation. The intrapleural injection of 0.50% silver nitrate produced an effective pleurodesis. The mean degree of gross pleurodesis in the rabbits that received 0.50% silver nitrate (3.4 +/- 1.2) did not differ significantly from that of the rabbits that received tetracycline (3.5 +/- 0.7) (scale 0 to 4). The mean degree of microscopic pleural fibrosis in the rabbits that received 0.50% silver nitrate (3.4 +/- 0.7) did not differ significantly from that of the rabbits that received tetracycline (3.9 +/- 0.3). However, 0.25% silver nitrate was ineffective in creating pleural fibrosis, either grossly or microscopically. No rabbits died after the intrapleural injection of the drugs. There were no observed side effects after the injection of silver nitrate. The present study demonstrates that 0.50% silver nitrate instilled into the pleural space is an effective agent for producing pleurodesis in the rabbit; its effect is comparable to tetracycline 35 mg/kg. This agent should be compared with tetracycline derivatives and talc in studies in humans.

Analysis of Variance↗
PubMed1982

Porphyrinogens in urine in various types of porphyrias.

Porphyrinogens were determined in very fresh, diluted morning urine in two types of hepatic porphyria, using a simple and very quick spectrophotometric method. It was shown that acidification by itself is insufficient for the complete conversion of colourless porphyrinogens into porphyrins in photometric determination of porphyrins in diluted urine. A correlation was shown between percentual content of porphyrinogens and the sum of pentacarboxyporphyrins and coprophyrin. A difference was found between the excretion of porphyrinogens in morning fresh urine in porphyria cutanea tarda (average porphyrinogen fraction 22.5%, SD 10.3% of total porphyrins) and in acute intermittent porphyria (average porphyrinogen fraction 77.1%, SD 9.3% of total porphyrins). The method is at the same time suitable for the detection of urobilinoids in urine. Oxidation of the urine in acute intermittent porphyria is recommended before absorption on talc and subsequent thin-layer chromatography, because porphyrinogens are not adsorbed on talc.

Adult↗
PubMed1982

Malfunctioning ventriculoperitoneal shunts. Clinical and pathological features.

The authors report the clinical and pathological findings in 201 procedures to revise malfunctioning ventriculoperitoneal shunts in 114 patients. The revised shunts were predominantly Raimondi three-piece systems. Collection of fluid along the shunt track is emphasized as an early clinical feature of shunt malfunction. In some cases, there are few clinical signs of shunt infection, and the first indication of it may be shunt malfunction. Ventricular catheter obstruction was caused by tissue from the region in addition to choroid plexus. Inflammation was frequently found around both ventricular and peritoneal catheters. Foreign bodies (cotton fiber, hair, and talc) and granulomatous inflammation were often present at both ends. Tissues obstructing the peritoneal catheter included embolic neoplastic cells, choroid plexus, and leptomeninges. There was also more necrotic debris at the peritoneal end. To prevent shunt malfunction, attention should be directed to: 1) optimal placement of ventricular catheters inside the lateral ventricle; 2) prevention of infection; 3) avoidance of contamination by cotton fibers, hair, or talc; and 4) improvements in the biocompatibility of the implanted materials.

Adolescent↗
PubMed1998

Epidemiology of occupational and environmental risk factors related to ovarian cancer.

This paper reviews articles published during 1970-1997 from 48 epidemiologic studies on occupational and environmental risk factors of ovarian cancer. Current evidence is characterized by poorly focused data for occupational and environmental agents, vulnerability to biases, and an almost complete lack of quantitative exposure-response data. The moderate amount of data on nurses, teachers, professionals, dry cleaning employees, women in agriculture, the pharmaceutical industry, pharmacists, waitresses, and cooks show very little, if any, evidence of excess risk. Hairdressers, beauticians, and women employed in the printing industry may be at increased risk, but the data are insufficient for strong conclusions. Some case-referent studies suggest a modest-to-moderate excess in association with genital talc application. Few high-quality studies have been carried out, and no chemical agents have been studied extensively, with the exception of exposure to talc. Ovarian cancer may have occupational and environmental etiologies intertwined with cultural, behavioral, and life-style factors and genetic susceptibility, but current knowledge is insufficient to quantify occupational and environmental etiologies reliably. Well-designed analytic epidemiologic studies with sufficient power are needed.

Adolescent↗
PubMed1996

Thoracoscopic surgery in Brazil. An overview.

The Video Assisted Thoracic Surgery (VATS) was introduced in Brazil in 1992 by Losso, Ghefter and Imaeda. Since its advent up to November 1994, 488 patients have been submitted to 497 VATS procedures in four Medical Centers of São Paulo city. The indications for the procedures were: lung diseases in 244 patients (50%), pleural disease in 155 patients (31.7%), thoracic traumas in 42 patients (8.6%), mediastinal diseases in 35 patients (7.1%), cardiovascular diseases in 7 patients (1.4%), chest wall diseases in 3 patients (0.6%) and esophageal diseases in 2 patients (0.4%). In the group of lung disease the most commonly used procedures were the lung biopsy in order to diagnose diffuse pulmonary disease and the indeterminate solitary nodule resection. Among the occurrences of pleural diseases, the most commonly used procedures were the pleurodesis with talc (talc poudrage) for the treatment of recurrent pleural effusion, the driven pleura biopsy and debridment or decortication of trapped lung in cases of pleural empyema. Concerning the mediastinal diseases, the pathology which was most frequently treated by VATS was the recurrent pericardic effusion through partial pericardiectomy. Among the patients presenting chest traumatic diseases, the VATS was used to explore thoracoabdominal penetrating injuries, to control bleeding, to remove clotted hemothorax, to suture diaphragm lesions and to remove intrapleural foreign bodies. Out of 497 procedures, there were 28 convertions to thoracotomy (5.7%) and two deaths occurred all over the cases. The complications, limitations and growth related to this method as well as a future overview of the VATS in Brazil will be presented.

Brazil↗
PubMed2002

[Diagnosis and treatment of pleural mesothelioma].

UNLABELLED: The objective of our paper was to show the data of our treated patients with malignant pleural mesothelioma. In the Department of Thoracic Surgery of Oncology Institute at Vilnius University from 1980 till 01.06.2002, 33 patients (pts), to whom diagnosis of pleural mesothelioma was confirmed by pathologist, were treated in the Clinic. A malignant pleural mesothelioma was diagnosed in 31 pts, two pts had a non-malignant form of mesothelioma. Among patients were 19 men and 14 women. The distribution of pts according to the stage of the disease was: I stage - 3, II - 1, III - 17, IV - 10. Videothoracoscopy is the best method for diagnosing pleural mesothelioma. Radical operations were performed only in 17 cases: 6 - pulmonectomy with pleuroectomy, 1 - lobectomy, 3 - atypical segmentectomy, 4 - pleuroectomy, 4 - tumorectomy. Thoracotomy was performed in 9 cases. Insufflation of talc was performed in 6 pts. Adjuvant therapy (chemotherapy or radiotherapy) was given to 10 pts. RESULTS: Nineteen pts died of the progression of disease. Median survival of pts was 15.7 months. CONCLUSIONS: 1. Diagnosis of malignant pleural mesothelioma is difficult and confirmation of the disease is possible only after histological examination of tumor. 2. The best results of treatment were achieved after combined treatment: surgery, after chemotherapy and radiotherapy. 3. In cases of pleural effusion of diffuse pleural mesothelioma insufflation of talc or other chemical substances into pleural cavity is recommended.

Adult↗
PubMed2001

The use of magnetic resonance imaging in the differential diagnosis between starch and fecal peritonitis.

Granulomatous peritonitis, caused by the starch from the surgeons' gloves, is a hypersensitivity reaction that can complicate abdominal surgery and mimic other causes of peritonitis. The diagnosis of this entity is difficult to make, and relies on a high index of suspicion. We suggest the use of magnetic resonance imaging to facilitate the diagnosis of this condition, based on an experimental animal model. 84 rats were subjected to laparotomy, and the abdominal cavity was exposed to either saline solution, talc solution, starch solution or fecal material by creating a cecal perforation. TI-weighted magnetic resonance images, with and without gadolinum enhancement, were taken after 3, 5 and 10 days. The animals were then sacrificed and the abdominal contents were evaluated both macroscopically and microscopically. Both talc and starch caused gross adhesions involving the entire abdominal viscera, and microscopy revealed signs of inflammation and fibrosis. Starch induced reactive granulomas. The adhesions in the cases of fecal peritonitis were confined to the area of the perforation. MR images of the starch peritonitis group was remarkable for a diffuse pathological process with enhancement of the omentum and the peritoneum after gadolinum injection. The MR readings of the fecal peritonitis group showed a localized process with no diffuse enhancement of the peritoneum. The striking differences between the magnetic resonance images of starch and fecal peritonitis in rats suggest that this modality is both sensitive and specific in diagnosing starch peritonitis in a rat model. Early non-invasive diagnosis of these separate entities would ease the establishment of the appropriate treatment. We are currently investigating the use of MRI imaging in suspected starch peritonitis in humans.

Animals↗
PubMed2003

Final report on the safety assessment of aluminum silicate, calcium silicate, magnesium aluminum silicate, magnesium silicate, magnesium trisilicate, sodium magnesium silicate, zirconium silicate, attapulgite, bentonite, Fuller's earth, hectorite, kaolin, lithium magnesium silicate, lithium magnesium sodium silicate, montmorillonite, pyrophyllite, and zeolite.

This report reviews the safety of Aluminum, Calcium, Lithium Magnesium, Lithium Magnesium Sodium, Magnesium Aluminum, Magnesium, Sodium Magnesium, and Zirconium Silicates, Magnesium Trisilicate, Attapulgite, Bentonite, Fuller's Earth, Hectorite, Kaolin, Montmorillonite, Pyrophyllite, and Zeolite as used in cosmetic formulations. The common aspect of all these claylike ingredients is that they contain silicon, oxygen, and one or more metals. Many silicates occur naturally and are mined; yet others are produced synthetically. Typical cosmetic uses of silicates include abrasive, opacifying agent, viscosity-increasing agent, anticaking agent, emulsion stabilizer, binder, and suspending agent. Clay silicates (silicates containing water in their structure) primarily function as adsorbents, opacifiers, and viscosity-increasing agents. Pyrophyllite is also used as a colorant. The International Agency for Research on Cancer has ruled Attapulgite fibers >5 microm as possibly carcinogenic to humans, but fibers <5 microm were not classified as to their carcinogenicity to humans. Likewise, Clinoptilolite, Phillipsite, Mordenite, Nonfibrous Japanese Zeolite, and synthetic Zeolites were not classified as to their carcinogenicity to humans. These ingredients are not significantly toxic in oral acute or short-term oral or parenteral toxicity studies in animals. Inhalation toxicity, however, is readily demonstrated in animals. Particle size, fibrogenicity, concentration, and mineral composition had the greatest effect on toxicity. Larger particle size and longer and wider fibers cause more adverse effects. Magnesium Aluminum Silicate was a weak primary skin irritant in rabbits and had no cumulative skin irritation in guinea pigs. No gross effects were reported in any of these studies. Sodium Magnesium Silicate had no primary skin irritation in rabbits and had no cumulative skin irritation in guinea pigs. Hectorite was nonirritating to the skin of rabbits in a Draize primary skin irritation study. Magnesium Aluminum Silicate and Sodium Magnesium Silicate caused minimal eye irritation in a Draize eye irritation test. Bentonite caused severe iritis after injection into the anterior chamber of the eyes of rabbits and when injected intralamellarly, widespread corneal infiltrates and retrocorneal membranes were recorded. In a primary eye irritation study in rabbits, Hectorite was moderately irritating without washing and practically nonirritating to the eye with a washout. Rats tolerated a single dose of Zeolite A without any adverse reaction in the eye. Calcium Silicate had no discernible effect on nidation or on maternal or fetal survival in rabbits. Magnesium Aluminum Silicate had neither a teratogenic nor adverse effects on the mouse fetus. Female rats receiving a 20% Kaolin diet exhibited maternal anemia but no significant reduction in birth weight of the pups was recorded. Type A Zeolite produced no adverse effects on the dam, embryo, or fetus in either rats or rabbits at any dose level. Clinoptilolite had no effect on female rat reproductive performance. These ingredients were not genotoxic in the Ames bacterial test system. In primary hepatocyte cultures, the addition of Attapulgite had no significant unscheduled DNA synthesis. Attapulgite did cause significant increases in unscheduled DNA synthesis in rat pleural mesothelial cells, but no significant increase in sister chromosome exchanges were seen. Zeolite particles (<10 microm) produced statistically significant increase in the percentage of aberrant metaphases in human peripheral blood lymphocytes and cells collected by peritoneal lavage from exposed mice. Topical application of Magnesium Aluminum Silicate to human skin daily for 1 week produced no adverse effects. Occupational exposure to mineral dusts has been studied extensively. Fibrosis and pneumoconiosis have been documented in workers involved in the mining and processing of Aluminum Silicate, Calcium Silicate, Zirconium Silicate, Fuller's Earth, Kaolin, Montmorillonite, Pyrophyllite, and Zeolite. The Cosmetic Ingredient Review (CIR. The Cosmetic Ingredient Review (CIR) Expert Panel concluded that the extensive pulmonary damage in humans was the result of direct occupational inhalation of the dusts and noted that lesions seen in animals were affected by particle size, fiber length, and concentration. The Panel considers that most of the formulations are not respirable and of the preparations that are respirable, the concentration of the ingredient is very low. Even so, the Panel considered that any spray containing these solids should be formulated to minimize their inhalation. With this admonition to the cosmetics industry, the CIR Expert Panel concluded that these ingredients are safe as currently used in cosmetic formulations. The Panel did note that the cosmetic ingredient, Talc, is a hydrated magnesium silicate. Because it has a unique crystalline structure that differs from ingredients addressed in this safety assessment, Talc is not included in this report.

Animals↗
PubMed1992

[Thoracoscopy: diagnostic and therapeutic use].

From 1986 to 1989, we performed 74 thoracoscopies in 70 patients (37 persisting or relapsing pneumothoraces, 30 chronic pleural effusions, 3 primary pleural tumors, 2 chylothoraces, 1 empyema, 1 persisting bronchopleural fistula). 29 supplementary diagnoses were established by thoracoscopy: 11 carcinomas, 4 cases of pleural tuberculosis, 12 of nonspecific pleurisy, 1 pleural fibroma, and 1 hamartoma. Pleurodesis was done with talc under thoracoscopy with success in 32/34 cases of pneumothorax (94%) and in 19/20 patient with chronic pleural effusion (95%). Talc was also successful in 2 instances of chylothorax and the bronchopleural fistula. The empyema was successfully treated by drainage under thoracoscopy and local instillation of streptokinase. Altogether, we recorded 3 deaths in the 30 days following thoracoscopy in 3 plurimetastatic patients. No other major complication was observed. The procedure is a well tolerated tool for diagnosis and treatment of pleural diseases. The indication should however be established with care in debilitated plurimetastatic patients.

Adult↗
PubMed1991

Development and use of a pneumoconiosis database of human pulmonary inorganic particulate burden in over 400 lungs.

Over 400 cases with data from in situ electron microprobe quantitation of non-fibrous inorganic particles (e.g., silica, alumino-silicates, talc, metals) in pulmonary tissue sections, and data from quantitative digestion analyses for fiber content (e.g., asbestos, silica, alumino-silicates, man-made fibers, talc) comprise an extensive microcomputer data set of lung particle burden. When allied with demographic and histopathologic information the result is a comprehensive database of occupational pulmonary pathology. Examples of the kinds of information which can be extracted from the database include: 1) summary information on the types sizes and associations of particles in lungs with a variety of exposures, 2) concentrations of etiologic particle type in cases with recognized pneumoconioses, and 3) correlations between particle type, pathology, occupation and social history. The database provides a powerful tool for assessing such information on statistically meaningful sample sets.

Asbestos↗
PubMed2006

[The value of thoracoscopy for diagnosis and management of refractory hepatic hydrothorax].

OBJECTIVE: To study the value of thoracoscopy for diagnosis and management of refractory hepatic hydrothorax (HH). METHODS: Twenty-six patients with refractory HH were enrolled in this study. Twenty-four of them underwent therapeutic thoracoscopy to achieve pleurodesis by application of talc poudrage. RESULTS: Nineteen of the 26 patients had dilated chest wall veins, 6 had dilated azygos veins, and 16 had diaphragm blebs. Of the 24 patients who received pleurodesis via thoracoscope, 14 cases showed complete response, and 8 showed partial response. Mild chest pain and temperature elevation were the most complaints during or after the procedure. Liver function abnormalities were the most serious side effects after pleurodesis. During the follow-up period ranging from 6 months to 3 years, 1 patient died of upper gastrointestinal hemorrhage and encephalopathy in 1 month, 3 patients died of hemorrhage in 6, 12, 18 months respectively, and 1 case experienced recurrence in 18 months. CONCLUSIONS: Defects in the diaphragm seemed to be the main cause for the development of HH. Pleurodesis achieved by thoracoscopy and talc poudrage was effective in the treatment of HH, but complications and impaired liver functions should be considered.

Adult↗
PubMed1990

[Effects of processing on volatile oil constituents in nutmeg and on the contents of myristicin].

This paper reports a GC analysis of the volatile oil contained in the nutmeg (Semen Myristicae) prepared by simmering wrapped in flour in hot purified talc, scalding in hot purified talc and stir-frying in smoking wheat bran. The experimental results showed that before and after processing the volatile oil compounds in nutmeg are the same and during processing no known compounds disappeared. The contents of the main volatile oil compounds in nutmeg changed, however, before and after processing, including the amounts of myristicin, one of the toxic compounds in nutmeg. It is suggested that the amounts of myristicin could be decreased notably under certain processing conditions.

Allylbenzene Derivatives↗
PubMed1990

[Effects of processing methods on the amounts of volatile oil of nutmeg and on isolation and characterization of the volatile oil constituents].

In this paper, the authors investigated the effects of various processing methods, i.e., scalding in hot purified talc, simmering wrapped in flour in hot purified talc and stir-frying in smoking wheat bran, on nutmeg (Semen Myristicae) in terms of the quantities of the volatile oil. The experimental results revealed that the amounts of volatile oil contained in nutmeg vary remarkably with the lengths of cooking time and the fluctuation of temperature. Detected by GC-MS-computer, 32 compounds of nutmeg were characterized, and their contents were determined by GC respectively.

Allylbenzene Derivatives↗
PubMed1989

Smoking and the pulmonary mineral particle burden.

The total pulmonary mineral particle burden and types of environmental particles were assessed in relation to smoking in 11 unselected autopsy lungs from adult male smokers and paired male non-smokers matched by age and lung. The lungs were fixed intrabronchially with formalin-polyethylene glycol-alcohol solution at a standard pressure and air-dried. A sample of 1-2 cm3 was taken from the posterior or apicoposterior segment of the right/left upper lobe and plasma ashed at low temperature. The mineral particles were identified by scanning transmission electron microscopy (STEM), electron microprobe analysis and electron diffraction. The number, mass and volume were calculated from the STEM image. The smokers' lung tissue had a lower number (54 +/- 15 X 10(6), mass (5.1 +/- 3.2 micrograms), volume (183 +/- 122 X 10(-5) mm3) and surface area (104 +/- 44 mm2/cm3 of lung tissue) of particles than the non-smokers' lung tissue (68 +/- 42 X 10(6), 12.6 +/- 13.4 micrograms, 468 +/- 501 X 10(-5) mm3 and 191 +/- 167 mm2/cm3 of lung tissue, respectively). All mineral types except talc were more numerous in the non-smokers' than in the smokers' lung tissue. The mineral particles were typical of the Finnish bedrock: quartz 15 +/- 7%, plagioclase 8 +/- 4%, microcline 13 +/- 5%, micas 22 +/- 10%, talc 4 +/- 4% and kaolinite 10 +/- 5%. Fibres were observed in only 2 cases, amounting to 1% in each. The lower mineral particle content of the smokers' lungs probably reflects more active clearance mechanisms caused by cigarette smoke.

Adult↗
PubMed1989

Adenomatoid tumour of the ovary and uterus in the same patient.

The paper describes an unusual case of two adenomatoid tumours in one patient. The first tumour was diagnosed in a hysterectomy specimen, when the patient was 39 years old. A wedge-shaped fragment was intraoperatively obtained from the left ovary. An adenomatoid tumour of the left ovary was diagnosed two years later. Multiple talc granulomas, inclusion cysts, and adhesions were found in close proximity to the tumour. It seems from this observation and from the reviewed literature that talc crystals as well as repair and inflammatory processes should be taken into account as initiating factors in the development of ovarian adenomatoid tumours in patients with susceptibility to such tumours.

Adult↗
PubMed1986

An attempt to develop a model to study the effects of intrathecal steroids.

An attempt has been made to develop a chronic inflammatory arachnoiditis model in the rat to study the influence of subarachnoid or epidural steroids. Through chronically implanted catheters in Wistar rats (250-350 g), either triamcinolone (3.5-350 micrograms) or methylprednisolone (3.5-350 micrograms) was injected intrathecally, daily for 7 days or weekly for 7 weeks. Some rats also received 100 mg kg-1 cefoxitin and 0.5 mg deoxycortone by intramuscular injection. Equivalent control groups were included. High doses of intrathecal steroids caused marked weight loss and infection and many rats died. These effects were mitigated at a lower dosage especially by the addition of cefoxitin and deoxycortone. The effects of triamcinolone were more marked than those of methylprednisolone. No systematic histological evidence of neurotoxicity was observed after either steroid. Injections of talc failed to cause arachnoiditis or meningitis probably because sufficient particulate talc could not be injected through the narrow catheter.

Animals↗