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PubMed1984

Inhibition of renin release following left circumflex bradykinin injection in dogs.

We examined the renin secretory response to bradykinin (BK) injection into the left circumflex coronary artery (LCx) in dogs. Studies were conducted in anesthetized, carotid sinus denervated dogs which had been maintained on a low sodium diet. A 25 ga needle was inserted into the LCx for injection of BK (0.15 micrograms/kg). The rate of renin secretion (RS) was obtained during a 30 min control period, at 5 min after a non-hypotensive hemorrhage (10 ml/kg), at 1, 3 and 5 min after BK injection and at 15 min after the reinfusion of withdrawn blood. Four series of studies were conducted. Series I: BK injection into the LCx, Series II: saline injection into the LCx (sham), Series III: intravenous injection of BK, and Series IV: BK injection into the LCx in dogs with prior renal denervation. RS was suppressed by 80% (P less than 0.05) 5 min after injection of BK into the LCx. Saline injection (sham) into the LCx or intravenous BK administration did not inhibit RS. Furthermore, suppression of RS was not present in dogs with prior renal denervation. These results indicate that BK injection into the LCx causes a prompt reduction in the rate of RS and that this response is reflexively mediated by the renal nerves.

Animals↗
PubMed1994

Place preference conditioning with ventral tegmental injections of cytisine.

The present experiment was designed to determine whether ventral tegmental injections of the nicotinic agonist cytisine can establish place preferences. Two groups of rats were tested: one group received injections into the ventral tegmentum and a second group received injections into sites dorsal to the ventral tegmentum; this latter group was used to assess whether the diffusion of drug into sites dorsal to the ventral tegmentum might in itself be sufficient to account for the effects associated with injections into the ventral tegmentum. A total of eight sets of injections were made. On days 1, 3, 5, and 7, animals were injected with cytisine (10 nmol per 0.5 microliter per side) and placed in one of the two main compartments of a place-preference apparatus. On days 2, 4, 6, and 8, injections of physiological saline, the drug vehicle, were paired with the other main compartment. Animals that received ventral tegmental injections of cytisine spent significantly more time in the cytisine-paired compartment than in the saline-paired compartment. Animals given cytisine injections into sites dorsal to the ventral tegmentum did not show a preference for the cytisine-paired compartment. These findings provide additional evidence in support of the hypothesis that nicotinic actions at the level of the ventral tegmentum contribute to the reinforcing actions of systemic injections of nicotine.

Alkaloids↗
PubMed1994

Pressor effects of acetylcholine injected into the lateral septal area of conscious rats.

Injections of acetylcholine (ACh) into the lateral septal area (LSA) caused blood pressure increases in unanesthetized freely moving rats. ACh was injected in the dose range of 0.1-54 nmol/500 nl using regular metal needles (200 microns o.d.). In the LSA, injections of carbachol or ACh (2.5 nmol/500 nl) were equipotent (+22 +/- 2 and +19 +/- 3 mmHg, respectively) suggesting the existence of an ACh-sensitive pressor site in the LSA. Maximum responses to ACh injected either intracerebroventricularly (i.c.v.) or into the LSA were not significantly different (+23 +/- 1 and +21 +/- 2 mmHg, respectively). However, the ED50 for the injection into the LSA (0.24 nmol) was significantly lower than that observed after i.c.v. injection (2.6 nmol), ruling out a possible leakage of ACh from the LSA and into the ventricular space. This idea is supported by data showing that the effect of the intraseptal injection of 30 nmol of ACh was blocked by pretreatment with 3 nmol of atropine either i.c.v. or into the LSA, whereas the effects of i.c.v. ACh were completely blocked by i.c.v. atropine, but only partially (42%) when atropine was injected into the LSA. The idea of the existence of an ACh-sensitive site in the LSA is further supported by the more direct observation that injections of 30 nmol/100 nl of ACh into the LSA using glass needles (50-70 microns o.d.) caused similar pressor responses. Neither the i.v. pretreatment with pentolinium or adrenalectomy affected the response to 30 nmol/500 nl of ACh injected into the LSA, ruling out the involvement of the sympathetic nervous system.(ABSTRACT TRUNCATED AT 250 WORDS)

Acetylcholine↗
PubMed1993

Analgesic effect of bamiphylline on pain induced by intradermal injection of adenosine.

Adenosine is known to cause pain when injected intravenously or intra-arterially. We have conducted a double-blind placebo-controlled study by injecting adenosine intradermally in 6 healthy subjects (5 male, 1 female; age: 27-34 years). Pain was assessed using the visual analogue scale. The intradermal injection of 2 mumol of adenosine produced pain significantly greater than normal saline after 15 sec (T0) (29 +/- 13 vs. 7 +/- 6 mm, P = 0.004), 1 min after T0 (13 +/- 9 vs. 0 +/- 0 mm, P = 0.002) and 2 min after T0 (4.5 +/- 5 vs. 0 +/- 0 mm, P < 0.05). There was evidence of hyperalgesia to mechanical and heat stimuli at the injection site (primary hyperalgesia). There was no evidence of mechanical hyperalgesia in the cutaneous area surrounding the injected site (secondary hyperalgesia). In all cases the intradermal injection of adenosine produced local hyperemia (mean surface are: 147 +/- 69 mm2) which was absent after placebo injection. The pre-injection of bamiphylline, a rather selective antagonist of A1 adenosine receptors, differently from placebo, completely suppressed the adenosine-induced pain after 15 sec (T0) (15 +/- 10 vs. 0 +/- 0 mm, P = 0.002) and 1 min after T0 (9 +/- 7 vs. 0 +/- 0 mm, P = 0.002). No anesthesia to heat, cold and mechanical stimuli was detected at the bamiphylline site. The adenosine-induced erythematous area was wider at the bamiphylline pre-injected site than at the placebo pre-injected site (173 +/- 114 vs. 119 +/- 85 mm2).(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗
PubMed1995

Cutaneous injection of the capsaicin analogue, NE-21610, produces analgesia to heat but not to mechanical stimuli in man.

Intradermal injection of the capsaicin analogue, NE-21610 (Procter and Gamble), inactivates nociceptors but not low-threshold mechanoreceptors in monkey. The present study examined the effects of cutaneous NE-21610 on heat and mechanical sensation in normal human volunteers. In the first series of experiments, subjects received intradermal (i.d.) injections (30 microliters) of the vehicle alone or with the drug (0.3, 3.0, 10 micrograms) into different sites on the volar forearm. Subjects were randomly assigned to 1 of 3 protocols to examine drug-evoked pain (n = 8), or alterations in pain to heat (n = 8) or mechanical (n = 8) stimuli induced by the drug. An additional 7 subjects rated pain to mechanical and heat stimuli before and after subcutaneous (s.c.) injections (300 microliters) of the vehicle or drug (100 micrograms). The peak pain occurred at the time of injection, was of short duration, and was similar for vehicle and drug injections. A mild, dose-related pain followed that lasted up to 2 h. Von Frey thresholds for detection, sharpness, and pain at the injection site (measured 24 h after injection) were not significantly altered by either i.d. or s.c. drug administration. However, pain to stepped heat stimuli was reduced in a dose-dependent fashion for both types of injection. At the highest drug doses, analgesia to heat stimuli was still present 1 week after injection. Recovery of heat sensitivity occurred several weeks after injection. This dissociated loss of heat but not mechanical pain sensibility may be due to: (1) a selective action of the drug on heat transducers in nociceptors responsive to both heat and mechanical stimuli, or (2) a selective action on that subset of nociceptors responsible for signaling heat-evoked pain.

Analgesia↗
PubMed1988

The triple-injection wrist arthrogram.

The last 100 patients to have wrist arthrography at our institution had, in addition to the standard radiocarpal joint injection, injections into the distal radioulnar joint and midcarpal joint. Seventy-seven of the 100 patients had abnormal arthrograms. In 29 cases abnormalities not identified by the radiocarpal joint injection were demonstrated either by the distal radioulnar joint or the midcarpal joint injection. In 38 patients abnormalities shown by radiocarpal joint injection were not demonstrable by the other two injections. Seven detachments of the triangular fibrocartilage complex from the ulnar styloid could be demonstrated only by the distal radioulnar joint injection. The midcarpal joint injection was far more useful than the radiocarpal joint injection in the evaluation of radiocarpal joint-midcarpal joint communications. All three injections appear to be necessary for a complete arthrographic evaluation.

Adolescent↗
PubMed1992

Thermodilution cardiac output: comparison between automated and manual injection of indicator.

In clinical practice, cardiac output (CO) is usually reported as the average of thermodilution determinations with injection of the thermal indicator performed at end-exhalation. However, an average of multiple determinations with injections equally dispersed throughout the respiratory cycle has been shown to provide the best estimate of mean CO. This study sought to determine the reproducibility of CO determinations obtained with manual injections of indicator solution performed at end-exhalation, compared with those determined by computer-controlled injections equally dispersed throughout the breathing cycle of 27 patients undergoing cardiac operations. Mean CO was calculated by averaging the four determinations obtained with each technique before induction of anesthesia, after induction of anesthesia, after sternotomy, after cardiopulmonary bypass, and after sternal closure. A total of 130 pairs of mean CO estimations were obtained with manual and automated injections. Mean CO values obtained with manual injections were significantly lower than those obtained with the dispersed injection technique (5.0 +/- 1.4 L/min vs 5.3 +/- 1.6 L/min, P = 0.002). The bias between CO values measured with the manual technique was -0.25 +/- 0.47 L/min lower than those obtained with the dispersed technique. The mean relative bias for the group was 7 +/- 18% with 95% confidence intervals of +/- 26%. During mechanical ventilation, the thermodilution technique with manual injection of indicator solution significantly underestimated CO. Variability in the manual injection technique and inappropriate representation of the mean CO by injections timed to occur at end-exhalation contributed to the disparity. These results indicate that the manual technique of determining CO at end-exhalation may not accurately reflect the average CO.

Anesthesia, General↗
PubMed2004

Rapid assessment of injection practices in Mongolia.

BACKGROUND: Anecdotal reports suggest that unsafe injections may transmit blood-borne pathogens in Mongolia. METHODS: The Ministry of Health of Mongolia collected information on injection practices, their determinants, and their consequences through interviews and observations of a small convenience sample of prescribers, injection providers, and members of the general population. RESULTS: The 65 members of the general population reported receiving an average of 13 injections per year. New, single-use injection devices were used in the 20 health care facilities visited. There were breaks in infection control practices while administering injections, including observations of 500-mL intravenous infusion bottles used as multiple-dose diluent vials and 8 of the 28 providers (28%) reporting reuse of device on the same patient. Injection providers reported 2.6 needle-stick injuries per year. Contaminated sharps were burned in a drum. Among persons interviewed, 19 of the 21 prescribers (90%) and 49% of the population were aware of the potential risk of HIV transmission through unsafe injections. CONCLUSIONS: A multidisciplinary initiative is necessary to achieve safe and appropriate use of injections in Mongolia through (1) behavior change, (2) increasing availability of injection devices and sharps boxes, and (3) appropriate sharps waste management.

Female↗
PubMed2004

Vitreous concentrations of triamcinolone acetonide in human eyes after intravitreal or subtenon injection.

PURPOSE: To compare vitreous concentrations of triamcinolone acetonide (TA) achieved by prior therapeutic intravitreal and subtenon injections. DESIGN: Interventional case series. METHODS: Vitreous samples were collected from patients who required vitreous surgery, six having received a subtenon injection of TA and another six, an intravitreal injection. Vitreous concentrations of TA were measured by high-performance liquid chromatography. RESULTS: Vitreous concentrations of TA after intravitreal injection were 1.22 +/- 0.24 mug/ml, significantly higher than those after subtenon injection (<0.001 mug/ml, P = .003). Vitreous concentrations of TA after subtenon injection and TA-assisted vitrectomy performed in a few patients to visualize the transparent vitreous gel were 0.20 +/- 0.11 mug/ml, an intermediate amount between these two groups. CONCLUSION: Much higher vitreous concentrations of TA after intravitreal injection than subtenon injection may accelerate therapeutic effect when intravitreal injections are given to reduce macular edema. Subtenon injections of TA may act via the sclera as opposed to the vitreous.

Aged↗
PubMed2005

Accuracy of anterior intra-articular injection of the glenohumeral joint.

PURPOSE: Intra-articular glenohumeral injections are an important part of orthopaedic practices, and the therapeutic benefit and diagnostic information of certain injections is based on the premise of the injection reaching its desired target. This study assessed the accuracy of an anterior intra-articular injection in awake subjects without radiologic assistance. TYPE OF STUDY: Case control study. METHODS: Forty-one patients scheduled for magnetic resonance imaging arthrography underwent anterior placement of a spinal needle using a location just lateral to the coracoid as the anterior landmark for injection, without radiographic assistance. After the needle was placed and clinically estimated to be intra-articular, 1 mL of gadolinium was injected into the joint to determine accuracy of position. The presence of intra-articular contrast was judged as an accurate injection. RESULTS: Only 26.8% (11 of 41) of injections placed anteriorly were actually intra-articular. The remaining were extra-articular, the most common location of error being either too medial or too superficial in the deltoid muscle. CONCLUSIONS: Based on our cadaveric study, we believed that an unassisted anterior injection to the glenohumeral joint would be accurately placed. However, this study shows that without some form of radiologic guidance, it is unlikely that an anteriorly placed intra-articular glenohumeral injection will be accurately placed in awake patients, and we do not recommend this technique. LEVEL OF EVIDENCE: Level IV.

Adolescent↗
PubMed2005

Flurbiprofen axetil preceded by venous occlusion in the prevention of pain on propofol injection in the hand: a prospective, randomized, double-blind, vehicle-controlled, dose-finding study in Japanese adult surgical patients.

BACKGROUND: Pain on injection is still a major problem with propofol used for general anesthesia. A number of techniques for reducing propofol-induced pain on injection have been tried, with variable results. Flurbiprofen axetil, a prodrug of the nonsteroidal anti-inflammatory drug flurbiprofen, has been used for postoperative pain management but has not been studied for managing pain on injection of propofol when preceded with venous occlusion. OBJECTIVE: The present study was undertaken to examine the efficacy of flurbiprofen axetil for reducing pain on propofol injection in Japanese adult surgical patients. METHODS: This prospective, randomized, double-blind, vehicle-controlled, dose-finding study was conducted at the Department of Anesthesiology, University of Tsukuba Institute of Clinical Medicine, Tsukuba, Japan. Japanese patients aged 18 to 65 years scheduled to undergo elective surgery were eligible. Patients were randomized to receive flurbiprofen axetil IV at 1 of 3 doses (25, 50, or 75 mg), or vehicle (control group), preceded by manual venous occlusion with a rubber tourniquet for 2 minutes and followed by administration of 25% of the total calculated dose of propofol (2 mg/kg), injected into the largest vein of the hand through a 20-gauge IV cannula. During propofol injection, a researcher who was blinded to treatment assignment asked each patient about his or her pain at the injection site. Responses were scored on a 4-point scale (0 = none, 1 = mild, 2 = moderate, 3 = severe). Median pain intensity scores in each group were determined. Adverse effects (AEs) at the injection site (pain, edema, wheal, or inflammation) were monitored for up to 24 hours after surgery. RESULTS: A total of 120 patients (62 men, 58 women; mean [SD] age, 41 [12] years, mean [SD] height, 162 [8] cm; mean [SD] body weight, 58 [10] kg) were enrolled. Each treatment group comprised 30 patients. No significant between-group differences in demographic characteristics were found. A significantly higher proportion of patients in the control group (77%) experienced pain compared with the flurbiprofen axetil 50- and 75-mg groups (47% and 43%, respectively; both, P < 0.01). The median pain intensity scores were significantly lower in the flurbiprofen axetil 50- and 75-mg groups (both, 0 [no pain]) compared with controls (2 [moderate]; both, P < 0.01). The incidence and intensity of propofol-induced pain were statistically similar between the flurbiprofen axetil 25-mg and control groups. The incidence and intensity of pain associated with the injection of propofol were significantly lower in the flurbiprofen axetil 50- and 75-mg groups compared with the 25-mg group (incidence, 70% [both, P < 0.05]; median pain intensity score, 1 [mild] [both, P < 0.01]). No AEs were observed. CONCLUSION: In this study of Japanese adult surgical patients, flurbiprofen axetil at doses of 50 and 75 mg, preceded by venous occlusion for 2 minutes, was found to be effective in reducing propofol-induced pain on injection.

Adult↗
PubMed2006

Effect of intrauterine injection of casein on fetal survival in rat: a new pharmacological approach for contraception.

BACKGROUND: The incidental finding of casein as a possible new local pharmacological contraceptive prompted us to assess its validity in an experimental rat model. METHODS: The intrauterine injection of 150 microg of bovine alpha-casein dissolved in 150 microL phosphate-buffered saline (PBS) was performed on one uterine rat horn on days L(5)-L(7), whereas the contralateral horn was used for injection of 150 microL PBS as a control. Intraperitoneal injection of alpha-casein (5 mg/mL, 2 mL/rat) was performed on day L(5). The rats were killed by cervical dislocation on the day L(14). RESULTS: The effect of an alpha-casein on fetal resorption rate was assessed following the unilateral injection of 150 microL of alpha-casein (1 mg/mL in PBS) and compared with the effect obtained following the contralateral injection of 150 microL PBS. The unilateral injection of alpha-casein on day L(5) caused a significant increase in fetal resorption rate as compared with the contralateral uterine horn injected with PBS (p<.00001). The decrease in alpha-casein concentration from 1 to 0.3 mg/mL caused a reduced, but still significant, effect on fetal resorption rate (p<.0001). The injection on days L(6)-L(7) caused a local effect of resorption near the injection site. There was no effect on fetal resorption rate following the injection of alpha-casein intraperitoneally. CONCLUSION: Our data suggest a new pharmacological approach for contraception, based on local intrauterine effect of alpha-casein in an experimental rat model. The exact mechanism of action related to casein should be further studied.

Animals↗
PubMed2006

A novel method of endoscopic submucosal dissection with blunt abrasion by submucosal injection of sodium carboxymethylcellulose: an animal preliminary study.

BACKGROUND: Endoscopic submucosal dissection (ESD), particularly the process of submucosal incision with a knife, is technically difficult and carries a high risk of perforation. Submucosal injection of a viscous substance, eg, jelly, obviates the need of submucosal incision with a knife. Sodium carboxymethylcellulose (SCMC), known as cellulose gum, is highly viscous when dissolved in water. OBJECTIVE: To evaluate the efficacy and the safety of ESD by submucosal injection of SCMC solution in a porcine stomach. DESIGN AND SETTING: A prospective, single-center study. INTERVENTIONS: The viscosity of various concentrations (0.5%-3.5%) of SCMC was measured by a viscometry. First, we injected 10 mL of various concentrations of SCMC solution into the submucosal layer of resected porcine stomachs in vitro and examined whether the submucosal injection dissected the mucosal layer from the muscular layer by EUS. Second, we performed ESD by injecting, with an 18-gauge needle, the SCMC solution into the submucosal layer of the stomach in white domestic pigs in vivo to evaluate the efficacy and the safety of SCMC for ESD. MAIN OUTCOME MEASUREMENTS AND RESULTS: Submucosal injection of the SCMC solution dissected most of the mucosal layer from the muscular layer at the concentration above 2.0%. We, therefore, decided to use 2.5% SCMC for ESD with a 18-gauge needle to ensure dissection. Submucosal injection of 2.5% SCMC dissected the mucosal layer from the muscular layer without complications, such as massive bleeding or perforation, in white domestic pigs. Histologically, injection of 2.5% SCMC revealed no damage to the muscular layer and surrounding tissue. LIMITATIONS: Our novel injection technique was evaluated in an animal model with a normal stomach; it was relatively easy to approach the target mucosa. CONCLUSIONS: ESD by submucosal injection of viscous SCMC solution appeared to be an easy, safe, and technically efficient method for dissection of gastric lesions.

Animals↗
PubMed2004

Increased success rate with infraclavicular brachial plexus block using a dual-injection technique.

STUDY OBJECTIVE: To test the hypothesis that dual injection of the local anesthetic in coracoid infraclavicular brachial plexus block might enhance both sensory and motor block for anesthesia of the upper limb when compared with a single-injection technique. DESIGN: Comparative, prospective, randomized, investigator-blinded study. SETTING: University-affiliated hospital. PATIENTS: 60 patients scheduled for surgery of the hand, forearm, or elbow. INTERVENTIONS: Patients were randomly assigned to receive either a coracoid infraclavicular block guided by nerve stimulator with a single injection technique (Group 1) or a dual-injection technique (Group 2). Injection of 40 mL 1.5% mepivacaine was made after eliciting one evoked motor response in the upper limb with a nerve stimulator for coracoid infraclavicular block in Group 1 and injection of two separate doses of 20 mL 1.5% mepivacaine after elicitation of two motor responses in Group 2. MEASUREMENTS: Assessment of sensory and motor block in the upper limb 5 and 20 minutes after the end of the injection of the local anesthetic. The time needed to elicit the second response and to inject the second dose of local anesthetic was also recorded. MAIN RESULTS: Significantly higher rates of sensory block to pinprick on the distributions of axillary, musculocutaneous, radial, ulnar, and medial cutaneous of the forearm nerves were found in Group 2 at 20 minutes. Significantly higher rates of motor block for arm, wrist, and hand movements were found in Group 2 at 20 minutes. CONCLUSIONS: Dual injection of local anesthetic guided by nerve stimulator increases the efficacy of coracoid block when compared with a single injection of the same dose of local anesthetic.

Anesthetics, Local↗
PubMedDate not supplied

The effect of corticosteroid injection for trigger finger on blood glucose level in diabetic patients.

PURPOSE: To determine how corticosteroid injections for trigger finger affect the blood glucose level in diabetic patients and the clinical results of those injections. METHODS: Eighteen diabetic patients receiving a methylprednisolone injection for a single trigger finger were studied. Six patients had type I (juvenile-onset) diabetes and 12 patients had type II (adult-onset) diabetes. Patients recorded their usual blood glucose measurements and then they recorded their blood glucose measurements for 5 days after injection. Clinical efficacy of the injections was measured by avoidance of surgery. RESULTS: There were 3 men and 15 women with an average age of 58 years. The blood glucose level increased after corticosteroid injection for all patients. The first morning after injection showed the biggest increase in blood glucose level: 73% more than the average preinjection levels. By the fifth morning after injection the blood glucose levels still were increased by 26% more than the preinjection levels. This trend was marked particularly in type I diabetic patients, who had an average blood glucose level increase the first morning after injection of 145%, which decreased over 5 days to 22% greater than baseline levels. Sixteen patients had follow-up evaluation over a period of 1 year and of these 16 patients 7 required surgery for this condition. CONCLUSIONS: A digital injection of the corticosteroid methylprednisolone acetate in diabetic patients with trigger finger causes a hyperglycemic effect that lasts for at least 5 days but can help prevent the need for surgery more than half the time. TYPE OF STUDY/LEVEL OF EVIDENCE: Therapeutic, Level IV.

Adult↗
PubMed2004

Complications of collagen injection of the vocal fold: report of several unusual cases and review of the literature.

UNLABELLED: Injection laryngoplasty is one of the most frequently performed procedures in patients with voice complaints. Various biomaterials have been used to medialize vocal folds or to treat symptoms of vocal fold scar. The ideal biomaterial would be easily injected through a fine-gauge needle, well tolerated, and long lasting. Injectable collagen preparations fulfill at least two of these criteria, and collagen has been used widely for vocal fold injections. MATERIALS AND METHODS: We present a retrospective review of two unusual complications of collagen injection and a review of the relevant literature on the complications of medical use of collagen compounds. RESULTS: Two patients in whom collagen was injected formed firm submucosal deposits that interrupted the normal mucosal wave and produced significant dysphonia. Surgical removal of these deposits restored the mucosal wave and improved voice quality. Management of this unusual complication of human collagen injection in the vocal fold has not been reported previously. Other complications of collagen injection include hypersensitivity reactions to bovine collagen, local abscess formation at injection sites, and possibly induction of collagen vascular disease in some patients. CONCLUSIONS: Although collagen injections of the vocal fold rarely result in complications, physicians using collagen must be familiar with the types of complications that can occur. Proper diagnosis and prompt management of complications can result in good outcomes.

Adult↗
PubMed2004

Vocal fold augmentation with injectable calcium hydroxylapatite: short-term results.

Symptoms of unilateral vocal fold paralysis are improved significantly by augmenting the paralyzed vocal fold via vocal fold injection. In this trial, augmentation with a new calcium hydroxylapatite implant was evaluated. In addition, two different phonosurgical injection techniques were used, and these procedures were compared for accuracy and reliability. A total of 11 terminal patients with unilateral vocal fold paralysis underwent vocal fold injection with calcium hydroxylapatite. Efficacy of the implant was evaluated by comparing results from the Voice Handicap Index (VHI) and mean airflow measurements before and 6 months after injection. Surgeon evaluations determined the comparative benefits of either endoscopic direct vocal fold injection or percutaneous vocal fold injection. Six-month data were obtained for a cohort of five patients. VHI scores improved for all five patients available for full evaluation and four of the five achieved improvements in mean airflow rates. Of the remaining patients, one later had a medialization laryngoplasty, two died from their terminal diseases before the 6-month follow-up, and two of the remaining three reported satisfaction with the results via telephone follow-up. Vocal fold injection via endoscopic, direct laryngoscopy was found to be a more reliable procedure for vocal fold injection than percutaneous injection. Slight overinjection (10% to 15%) was found to provide optimum results. Vocal fold injection of calcium hydroxylapatite for unilateral vocal fold paralysis improved voice quality and reduced mean airflow rates in this patient group with short-term results. Long-term studies are needed to confirm the durability of these findings.

Aged↗
PubMed2006

Posterior sub-Tenon's capsule injection of triamcinolone acetonide prevents panretinal photocoagulation-induced visual dysfunction in patients with severe diabetic retinopathy and good vision.

PURPOSE: To evaluate prospectively the efficacy of a single sub-Tenon's capsule injection of triamcinolone acetonide (TA) against panretinal photocoagulation (PRP)-induced macular thickening and visual disturbance in patients with severe diabetic retinopathy and good vision. DESIGN: Prospective, comparative, interventional case series. PARTICIPANTS: Twenty eyes of 10 patients with severe nonproliferative diabetic retinopathy or non-high-risk proliferative diabetic retinopathy whose visual acuity was 20/40 or better (<0.3 in logarithm of the minimum angle of resolution [logMAR] acuity) before the PRP, whose retinopathy was bilateral and symmetrical. The averaged parafoveal retinal thickness was more than 300 microm, leading to a worse visual prognosis after PRP. INTERVENTION: Sub-Tenon's capsule injection of 20 mg TA. MAIN OUTCOME MEASURES: Best-corrected visual acuity (BCVA) with logMAR chart and averaged foveal thickness (FT) using the retinal mapping program of optical coherence tomography. METHODS: In all patients, PRP was performed every other week for 4 sessions on both eyes, and 1 week before PRP; 1 eye received the TA injection, and the other eye served as a control. The clinical course of BCVA and FT was monitored for up to 24 weeks after beginning PRP. RESULTS: Before TA injection, BCVA and FT were 0.055+/-0.072 and 235.5+/-37.5 microm in the TA-injected eye and 0.065+/-0.071 and 233.7+/-39.8 microm in the control eye, respectively; there was no significant difference between eyes. After the TA injection, FT in the TA-injected eyes was significantly decreased. During and after the PRP, FT in the control eye increased dramatically and reached 312.0+/-68.2 microm at 24 weeks, which was significantly different from that in the TA-injected eyes (235.3+/-38.6 microm at 24 weeks). Best-corrected visual acuity in the control eye decreased with time to 0.24+/-0.13; in contrast, and BCVA in the TA-injected eye was good (to 0.085+/-0.11) . CONCLUSIONS: As a pretreatment for PRP, a single sub-Tenon's capsule injection of TA has beneficial effects for preventing PRP-induced foveal thickening and visual dysfunction in patients with severe diabetic retinopathy and good vision.

Aged↗