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PubMedDate not supplied

Autologous fat injection for soft tissue augmentation in the face: a safe procedure?

Autologous fat injection for soft tissue augmentation in the face is claimed to be a safe procedure. However, there are several case reports in the literature where patients have suffered from acute visual loss and cerebral infarction following fat injections into the face. Acute visual loss after injection of various substances into the face is a well-known complication of such interventions. We report two further patients who suffered from ocular and cerebral embolism after fat injections into the face. For the intravasation of fat particles there are three preconditions: well-vascularized tissue, fragmentation of parenchyma, and, especially, a local increase in pressure in the affected tissue. Fat injections into the face lead to an acute local increase in pressure in highly vascularized tissue. We assume that fragments of fatty tissue reach ocular and cerebral arteries by reversed flow through branches of the carotid arteries after they are introduced into facial vessels. The manifestation of fat embolism appears either immediately after the fat injection or after a latency period. Fat embolism can remain subclinical and may not be recognized, or the clinical features may be misinterpreted. To minimize the risk of such a major complication, fat injections should be performed slowly, with the lowest possible force. One should avoid fat injections into pretraumatized soft tissue, for example, after rhytidectomy, because the risk of intravasation of fat particles may be higher. Metabolic disturbances such as hyperlipidemia may also contribute to the clinical manifestation of fat embolism Routine funduscopic examinations after fat injections into the face could help to provide data for future estimation of the patient's general risk.

Adipose Tissue↗
PubMed1998

[Intravitreal injection of cidofovir in cytomegalovirus retinitis].

BACKGROUND: CMV retinitis is the most common opportunistic ocular infection and the main cause of blindness in AIDS patients with a T-helper cell count < or = 50/microliter. Cidofovir is a nucleotide analogue with a long half-life time after phosphorylation intracellularly. It is effective against CMV and can be given intravenously and intravitreally. The aim was to offer an alternative therapy for CMV retinitis to patients who could not receive standard treatment because of contraindications or refused it. The efficacy and tolerance of intravitreal injections of cidofovir should be evaluated. PATIENTS AND METHODS: We treated 16 eyes of 12 patients. The total number of injections with 15 micrograms of cidofovir each was 49, with an average of 3 injections per eye. The duration of follow-up was 75-295 days (median 170 days). Probenecid was given concomitantly. Injections were repeated after 6-10 weeks. Secondary prophylaxis of CMV organ infection was done with oral ganciclovir. RESULTS: Within a few days all areas with active retinitis turned into scars following the first injection. Under consequent treatment no reactivation was observed. Four eyes developed a mild iritis with hypotony within a mean time of 12 days after injection. All responded rapidly to topical steroids. None had a persisting loss of vision. Two eyes developed cystoid macular edema (CME). Two patients stopped anti-CMV treatment (ganciclovir orally and injections), followed by a recurrence after an average of 64-days. CONCLUSIONS: Intravitreal injection therapy with 15 micrograms cidofovir and concomitant oral probenecid is a valuable and safe alternative treatment for CMV retinitis in AIDS patients. Its main complication is iritis with hypotony, which is effectively treatable with topical steroids. No complications caused by the injection technique itself were noted. The occasional observation of CME in otherwise quiet eyes, however, is probably drug-related.

AIDS-Related Opportunistic Infections↗
PubMedDate not supplied

[Chronic polyarthritis and radiosynoviorthesis: a prospective, controlled study of injection therapy with erbium 169 and rhenium 186].

The aim of this prospective study was to evaluate the efficiency of radiation synovectomy with rhenium-186 or erbium-169 in rheumatoid arthritis. In the control groups articulosynovitis was treated by injection of triamcinolonhexacetonid. Follow-up time was 3 years. Patients of the study had to fulfill the following criteria: rheumatoid arthritis (ARA criteria 1988), patient age above 40 years, standardized medical treatment with methotrexate, (started at least 6 month prior to injection therapy, given for the entiry study time), prednisolon < or = 7.5 mg/d and diclofenac < or = 150 mg/ d, and no previous surgery or injection therapy on this/these joint/s. Shoulder, elbow, wrist, and ankle joints were treated in group 1 by injection of rhenium-186 combined with triamcinolonhexacetonid, in group 2 by injection of triamcinolonhexacetonid alone. Each treatment group included 50 joints. Digital joints underwent injection of erbium-169 combined with triamcinolonhexacetonid (group 3 = 131 joints) or triamcinolonhexacetonid (group 4 = 86) alone. During the follow up period, the joints were assessed for pain, synovial swelling, joint motion, and stage of radiological destruction (Larsen-Dale-Eek). After 3 years follow-up, 228 joints met the above named criteria: group 1 = 41 joints, group 2 = 21 joints, group 3 = 131 joints, group 4 = 53 joints. Significantly better clinical results were achieved with the combined injection of rhenium-186 or erbium-169 and triamcinolonhexacetonid. Results for PIP joints were worse than for other joints, which is explained by better immobilization of the latter ones after injection. The progression in radiological joint destruction according to the stages of Larsen-Dale-Eek during the follow-up time of 3 years (= stage at 3 years minus stage prior to treatment) corresponded to the clinical results and was significantly slower in groups 1 and 3: group 1 = 0.62; group 2 = 1.7; group 3 = 0.75; group 4 = 1.43 Therefore, we recommend radiosynovectomy with erbium-169 or rhenium-168 in combination with triamcinolonhexacetonid and consequent immobilization after injection.

Adult↗
PubMed2004

Evaluation of alloderm and autologous skin in quadriceps muscles of rats for injection laryngoplasty.

There are three surgical methods utilized in treating glottic insufficiency: laryngeal framework surgery, reinnervation procedures and injection medialization. The trend towards the use of less invasive procedures led us to focus on injection medialization in this study. The advantages of vocal fold injection are that the procedure requires no external incisions, is easily applicable and can be applied in an office setting. Furthermore, injection medialization is applicable in cases of atrophic vocal fold and vocal fold scarring. In developing injection medialization, laryngologists are in search of an "ideal material" that should be biocompatible and resistant to resorption. In the initial applications of this method, synthetic materials were used. In the past 2 decades, however, researchers have become more and more interested in the advantages of biological materials. In our animal study, we investigated the behavior of AlloDerm and autologous skin injected in the quadriceps muscles of rats. The materials were easily injected. Histopathological and volumetric analyses were done; the rats were sacrificed the 1st day post-injection and subsequently in the 1st, 3rd and 6th months. AlloDerm's absorption levels were generally high, and its inflammation and fibrosis levels were low and medium. In the 6th month, histiocytic foreign body reaction was observed. The mean graft yield was 4.5%. Autologous skin results for inflammation and fibrosis levels were similar to those of AlloDerm. However, no foreign body reaction was observed in AS injected muscle. The graft yield was 74.6%. The growth of keratin cysts had an effect on the results of the graft yield.

Animals↗
PubMed1984

Intra-arterial injection of diisopropylfluorophosphate or phenylmethanesulphonyl fluoride produces unilateral neuropathy or protection, respectively, in hens.

Hens injected in one sciatic artery with diisopropylfluorophosphate (DFP) (0.184 mg/kg) developed monolateral ataxia on the injected side 10-12 days later. The inhibition of neuropathy target esterase (NTE) was 85% in the sciatic nerve of the injected leg and less than 60% in the contralateral sciatic nerve, in spinal cord and in brain. Other hens injected in the wing vein with the same dose of DFP showed low inhibition of NTE in the nervous system and did not develop delayed neuropathy. Hens injected in one sciatic artery with phenylmethanesulphonyl fluoride (PMSF) (1 mg/kg) and 24 hr later with high subcutaneous dose of DFP (1.1 mg/kg) developed monolateral ataxia 10-12 days later on the side not injected with PMSF. The level of NTE inhibition after PMSF was greater than 40% in the sciatic nerve on the injected side compared with less than 20% in other parts of the nervous system. The same dose of PMSF injected in the wing vein produced low NTE inhibition in the nervous system and failed to protect the animals from the same high systemic dose of DFP. We conclude that both toxic and protective effects of NTE inhibitors for delayed neuropathy are better related to the level of NTE inhibition in the peripheral nerve on the site of injection than to NTE inhibition in other parts of the nervous system. Furthermore we suggest that NTE inhibition should also be measured in the peripheral nerve in the standard toxicity testing for organophosphate-induced delayed neurotoxicity.

Animals↗
PubMed1985

Pharmacokinetic and pharmacodynamic investigations with monthly injectable contraceptive preparations.

Eight normally menstruating women received Cycloprovera (25 mg medroxyprogesterone acetate with 5 mg estradiol cypionate) and seven other volunteers received HRP-102 (50 mg norethisterone enanthate with 5 mg estradiol valerate) injections at 30-day intervals for three consecutive months. The peripheral plasma levels of estradiol (E2), progesterone (PROG), medroxyprogesterone acetate (MPA) and norethisterone (NET) were measured in the luteal phase of a pretreatment cycle, during the third treatment month and during a subsequent recovery period of 60 days. Blood samples were drawn three times a week (Mondays, Wednesdays and Fridays) and endometrial biopsies were taken on day 20 to 26 of the pretreatment cycle, 20 to 24 days after the last injection and 20 to 24 days after the first normal menstrual-like bleeding during the recovery period. The (geometric) mean maximum level of MPA was 2.9 (2.4-3.7) nmol/1 and that of NET 10.1 (6.4-15.8) nmol/l. Thirty days after the last injection, the MPA level was 0.72 (0.46-1.1) nmol/l and that of NET 1.7 (1.2-2.3) nmol/l. The maximum level of exogenous E2 was 890 (700-1130) pmol/l after Cycloprovera and 1570 (870-2820) pmol/l after HRP-102 administration. Forty-nine and 41 days, respectively, after the last injection, a broad (endogenous) E2 peak was observed in all subjects, which was not followed by an ovulatory rise in PROG levels. The first ovulatory rise in PROG occurred between 71 and 90 days after the last Cycloprovera and 59 to 87 days after the last HRP-102 injection. One subject in each of the two groups failed to ovulate during the 90-day post injection period. Dating and morphometric analysis of the endometrial biopsy specimens obtained 20 to 24 days after the last injection revealed that the suppressive effect of Cycloprovera was stronger than that of HRP-102. Each injection of both formulations was followed by a bleeding-free period of approximately two weeks. The percentage of days with bleeding and spotting was 24% for Cycloprovera and 29% for HRP-102. It is concluded, that both monthly injectables inhibit follicle maturation for some 30 days and ovulation and corpus luteum formation for some 60 days, providing thus a considerable margin of safety in terms of the expected duration of contraceptive protection.

Adult↗
PubMed1993

Long-term persistence and migration of myogenic cells injected into pre-irradiated muscles of mdx mice.

Experiments were conducted to study the fate(s) of normal muscle precursor cells (mpc) which had been injected into the muscles of mdx mice. Right legs of mdx nu/nu mice were X-irradiated (18 Gray), to inhibit the proliferation of host mpc. Normal mpc were injected into the tibialis anterior (TA) muscles of these legs and the non-irradiated, contralateral legs. In pre-irradiated legs injected with normal mpc, the number of dystrophin-positive fibres was similar at 35, 49 and at 250 days after injection, but the number of dystrophin-negative fibres was much less at the latter time point, indicating prolonged survival of dystrophin-positive muscle fibres. Non-injected muscles neighbouring the injected TA muscle rarely contained muscle of donor origin 49 days after injection, but frequently did so 250 days after injection. This indicates that some of the injected mpc must have retained the ability to proliferate, to migrate into a neighbouring muscle and to differentiate into new muscle for a considerable period after the original cell implant. In non-irradiated legs, the implanted normal mpc formed markedly fewer dystrophin-positive fibres than in the contralateral, irradiated muscle, and undertook little or no migration to adjacent muscles.

Animals↗
PubMed1983

Periodontal ligament injection: evaluation of systemic effects.

By means of a pistol-grip syringe, 0.3 ml. of normal saline solution, 2 percent lidocaine with and without 1:100,000 epinephrine, 3 percent mepivicaine, and 1:100,000 epinephrine alone were injected into large adult dogs via the intravenous, intraosseous, intrapulpal, subcutaneous, periodontal, intramuscular, and submucosal, routes. Changes in heart rate, blood pressure, and respiration were recorded in relation to the time of injection. In the quantities injected, normal saline solution, 2 percent lidocaine, and 3 percent mepivicaine had no measurable effect on the systemic parameters, regardless of the site of injection. Injection of 2 percent lidocaine with epinephrine and of epinephrine alone caused transient decreases in blood pressure and increases in heart rate. The results were similar, whether the injections were done intravenously, intraosseously, or periodontally. Systemic changes were not detected when the epinephrine-containing agents were injected intramuscularly, subcutaneously, submucosally, or intrapulpally. These results support the contention that the periodontal injection is intraosseous in nature and that solutions injected by the periodontal technique are rapidly absorbed into the systemic circulation.

Anesthesia, Dental↗
PubMed1985

CCK-octapeptide injected into cerebral ventricles of sheep decreases plasma insulin level.

Cholecystokinin-8 (CCK-8) was injected into the lateral cerebral ventricles (LV) of conscious sheep to determine its effect on secretion of three hormones important in regulation of peripheral metabolism: growth hormone (GH), glucagon, and insulin. Three hr continuous LV injection of 0.64 pmol/min CCK-8 decreased plasma insulin concentration approximately 30% throughout the three hr period, compared to control injection, and this effect occurred independently of whether or not the sheep were permitted to eat during injection. Only high doses of desulfated CCK-8 affected plasma insulin levels, thus suggesting the involvement of specific CCK receptors. Plasma glucose and GH concentrations were unaffected by LV injections, but plasma glucagon concentration was also decreased by CCK-8. LV injection of 0.64 pmol/min CCK-8 in sheep given an IV bolus injection of glucose (1.0 g/kg body mass) resulted in significantly lower plasma insulin and higher plasma glucose concentrations than during control LV injections; thus CCK-8 is capable of suppressing insulin secretion even under stimulated conditions. Since cisterna magna injections of CCK-8 were not effective in suppressing insulin secretion, more rostral brain sites are probably responsible for mediating this effect.

Animals↗
PubMed1994

Effects of intraventricular injection of morphine and beta-endorphin on serotonin release from the spinal cord in rats.

Effects of intraventricular (third ventricle) injection of morphine and beta-endorphin on the release of serotonin (5-HT; 5-hydroxytryptamine) and 5-HIAA (5-hydroxy indolacetic acid) from the spinal cord were studied using urethane anesthetized spinally perfused rats. Intraventricular injection of morphine (25 micrograms) increased the 5-HT level in the perfusate about threefold. The increase of 5-HT release reached at peak between 30 and 60 min after the first injection of morphine. However, the levels of 5-HIAA, a metabolite of 5-HT, was not significantly altered by intraventricular injection of morphine. Furthermore, second intraventricular injection of morphine at the same dose did not increase 5-HT level in the spinal perfusate. In contrast to the results with morphine, beta-endorphin (10 micrograms) administered intraventricularly did not alter the release of 5-HT and 5-HIAA from the spinal cord. In addition, acute antinociceptive tolerance to intraventricular morphine induced by a prior intraventricular injection of morphine was studied in pentobarbital anesthetized rats. Acute tolerance was induced by intraventricular pretreatment with morphine (20 micrograms) for 120 min and the same dose of morphine was injected intraventricularly. The tail-flick test was used as an antinociceptive test. Pretreatment of rats with morphine intraventricularly reduced inhibition of the tail-flick response to intraventricularly injected morphine. The results support our previous hypothesis that beta-endorphin and morphine administered supraspinally activate separate descending systems. Spinopetal serotonergic descending pathway is selectively activated by intraventricularly injected morphine but not beta-endorphin.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1990

Rat paw-lick/muscle irritation model for evaluating parenteral formulations for pain-on-injection and muscle damage.

A two-phase assay was developed in the rat to evaluate parenteral formulations intended for intramuscular administration for the induction of both acute pain-on-injection and delayed pain/discomfort at the injection site (secondary to muscle damage). Phase 1 of the assay assessed pain-on-injection using a modified version of the previously published rat paw-lick assay. Adult male CD rats (10/group) were given subplantar (footpad) injections of 0.1 ml and then observed for 15 min for paw-lick responses. To increase assay sensitivity, responses more subtle than paw licks (ie., paw lifts) were scored, and injection-site clinical signs were recorded 6, 24, and 48 hr after injection. Phase 2 of the assay assessed myotoxic potential, using the same rats after a 1-week recovery period. The rats were injected intramuscularly in the anterior thigh with 0.2 ml, bled from the orbital sinus at 2, 6, and 24 hr for analysis of serum creatine kinase (CK), and then necropsied at 24 hr to prepare tissue sections of the injection site for microscopic examination. A series of cephalosporin-type antibiotics produced pain-on-injection and muscle damage consistent with reported clinical experience (cefazolin less than cephalothin less than cefoxitin). Several nonantibiotic parenteral formulations (diazepam, digoxin, phenytoin, and lidocaine) tested in the paw-lick/muscle irritation model also produced responses that correlated with the clinic, i.e., virtually no acute pain but moderate to marked muscle damage. The results indicate that the two-phase rat paw-lick/muscle irritation model is effective in evaluating parenteral formulations for clinical acceptability, and that both phases of the assay are necessary to optimize predictability of the assay for human clinical experience.

Animals↗
PubMed1996

Enhanced withdrawal responses to heat and mechanical stimuli following intraplantar injection of capsaicin in rats.

Withdrawal responses to heat and mechanical stimuli applied to the plantar surface of the rat hindpaw were measured before and after an intraplantar injection of capsaicin. In separate groups of rats, capsaicin doses of 1, 10 and 30 micrograms, and the vehicle were given into the center of the plantar surface in a volume of 10 microliters. Withdrawal latency evoked by radiant heat and the frequency of withdrawal evoked by mechanical stimuli (von Frey monofilaments) were obtained from both hindpaws before and after injection. Hyperalgesia to heat was defined as a decrease in withdrawal latency and mechanical hyperalgesia was indicated by an increase in withdrawal response frequency. Intraplantar injection of capsaicin evoked nocifensive behavior characterized by lifting and guarding the injected paw which typically lasted up to 3 min following injection. Capsaicin produced a decrease in withdrawal latency to heat and increased the frequency of withdrawal to mechanical stimuli in a dose-dependent manner. These effects were observed on the injected paw only. The duration of hyperalgesia produced by capsaicin was also dose-dependent. Withdrawal latencies to heat were decreased up to 45 min following capsaicin while withdrawal responses to mechanical stimuli remained elevated up to 4 h. The area of mechanical hyperalgesia included most of the plantar surface and extended approximately 9 mm proximal and distal to the injection. Injection of the vehicle did not significantly alter withdrawal responses to heat or mechanical stimuli. These studies demonstrate that intraplantar injection of capsaicin in rats produces hyperalgesia to heat and mechanical stimuli. This model should be useful for correlative behavioral, physiological and pharmacological studies of underlying mechanisms of capsaicin-evoked hyperalgesia.

Animals↗
PubMed1995

Transneuronal labeling in hamster brainstem following lingual injections with herpes simplex virus-1.

Brainstem projections to hypoglossal motoneurons innervating the intrinsic and extrinsic muscles of the tongue were determined using the transneuronal transfer of Herpes simplex virus-1. Injections of Herpes simplex virus-1 into the intrinsic muscles of the anterior tongue, the geniohyoid and styloglossus muscles each produced specific patterns of label within the hypoglossal nucleus that corresponded closely to the distributions of retrogradely labeled neurons produced by similar injections of horseradish peroxidase. With relatively short survival times, Herpes simplex virus-1 injections further labeled neurons in both the brainstem reticular formation lateral to the hypoglossal nucleus and in the nucleus of the solitary tract. Intrinsic lingual muscles injections of Herpes simplex virus-1 labeled reticular formation neurons distributed laterally along the entire anterior-posterior length of hypoglossal nucleus. In contrast, labeled reticular formation neurons in the immediate vicinity of the hypoglossal nucleus following extrinsic muscles injections, were located lateral to intermediate and anterior levels of hypoglossal nucleus. Thus, despite extensive areas of overlap, there was evidence for a differential distribution of pre-hypoglossal reticular formation neurons along the anterior-posterior axis associated with different lingual injections. Most of the overlap occurred anteriorly, at a level where the nucleus of the solitary tract abuts the fourth ventricle. The potential importance of this area is lingual integrative function was further suggested by camera lucida reconstructions that showed overlapping dendritic fields of labeled neurons in the reticular formation and nucleus of the solitary tract. The dendritic fields of other labeled neurons located more rostral and lateral in the reticular formation sometimes extended into the rostral (gustatory) nucleus of the solitary tract and spinal trigeminal nuclei, suggesting possible multisynaptic pathways through which tactile and gustatory information might influence hypoglossal nucleus. Not all injections of Herpes simplex virus-1 produced label in the hypoglossal nucleus. Some injections into the anterior tongue labeled neurons in the reticular formation near the exiting facial nerve, a region containing populations of preganglionic parasympathetic neurons. Other injections, particularly into the extrinsic lingual muscles, labeled brainstem neurons associated with the sympathetic nervous system, e.g. nuclei raphe magnus and pallidus, the rostral ventrolateral reticular formation, and neurons in the A5 region. These patterns of labeled neurons within the brainstem are suggestive of a differential autonomic innervation of the intrinsic and extrinsic muscles of the tongue.

Animals↗
PubMed1994

Improved Doppler signal intensity in coronary arteries after intravenous peripheral injection of a lung-crossing contrast agent (SHU 508A)

OBJECTIVES: We tested the hypothesis that SHU 508A, a new lung-crossing contrast agent capable of increasing the Doppler signal to noise ratio in the right heart as well as left heart cavities after intravenous injection, could increase Doppler signal intensity in coronary arteries, thus improving the feasibility and quality of transesophageal Doppler echocardiographic evaluation of coronary blood flow velocity. BACKGROUND: Coronary blood flow velocity can be evaluated by transesophageal Doppler echocardiography. However, an adequate Doppler tracing is obtainable in a relatively low percent of patients. METHODS: Transesophageal Doppler echocardiography of coronary arteries was performed in 35 patients before and after SHU 508A injection at four different dosages (200 mg/ml in 5 ml, 200 mg/ml in 10 ml, 300 mg/ml in 5 ml and 300 mg/ml in 10 ml). Color Doppler mapping of coronary flow and pulsed wave Doppler measurement of coronary blood flow velocity were attempted in all patients. RESULTS: Color Doppler flow mapping of 105 evaluated coronary segments (left main, left anterior descending and circumflex in 35 patients) was not detectable or was weak in 88% of patients before and 33% of patients after echo contrast injection (p < 0.0001); it was optimal (that is, well delineated with complete flow mapping of the explored vessel) in only 11% of patients before and 67% after echo contrast injection (p < 0.0001). In addition, pulsed wave Doppler signal quality improved after echo contrast injection: Pulsed wave Doppler recording of coronary blood flow velocity was not obtainable or was weak in 78% of cases before and 34% after echo contrast injection (p < 0.0001); pulsed wave Doppler recording of coronary blood flow velocity was optimal (that is, there was a complete and well defined outline of diastolic coronary blood flow velocity in 23% of cases before and 66% after echo contrast injection [p < 0.0001]. Both length and width of color Doppler mapping in the left anterior descending coronary artery increased after SHU 508A injection (from 5.75 +/- 5.32 and 1.51 +/- 1.17 to 17.04 +/- 8.76 and 4.21 +/- 1.78 mm, respectively, mean +/- SD, p < 0.0001). CONCLUSIONS: The feasibility and quality of recording coronary blood flow velocity by transesophageal Doppler echocardiography are considerably improved by intravenous injection of SHU 508A. The improved feasibility of this new semi-invasive method for evaluating coronary blood flow velocity and flow reserve can considerably increase its research and clinical utilization.

Aged↗
PubMed2006

Multiphase contrast medium injection for optimization of computed tomographic coronary angiography.

RATIONALE AND OBJECTIVES: Electron beam angiography is a minimally invasive imaging technique. Adequate vascular opacification throughout the study remains a critical issue for image quality. We hypothesized that vascular image opacification and uniformity of vascular enhancement between slices can be improved using multiphase contrast medium injection protocols. MATERIALS AND METHODS: We enrolled 244 consecutive patients who were randomized to three different injection protocols: single-phase contrast medium injection (Group 1), dual-phase contrast medium injection with each phase at a different injection rate (Group 2), and a three-phase injection with two phases of contrast medium injection followed by a saline injection phase (Group 3). Parameters measured were aortic opacification based on Hounsfield units and uniformity of aortic enhancement at predetermined slices (locations from top [level 1] to base [level 60]). RESULTS: In Group 1, contrast opacification differed across seven predetermined locations (scan levels: 1st versus 60th, P < .05), demonstrating significant nonuniformity. In Group 2, there was more uniform vascular enhancement, with no significant differences between the first 50 slices (P > .05). In Group 3, there was greater uniformity of vascular enhancement and higher mean Hounsfield units value across all 60 images, from the aortic root to the base of the heart (P < .05). CONCLUSIONS: The three-phase injection protocol improved vascular opacification at the base of the heart, as well as uniformity of arterial enhancement throughout the study.

Adult↗
PubMed2006

Intravitreal triamcinolone acetonide concentration after subtenon injection.

PURPOSE: To determine concentration of intravitreal triamcinolone after subtenon injection. DESIGN: Prospective series of vitrectomy candidates and laboratory investigation. METHODS: Twenty eyes of 20 patients received subtenon injections of triamcinolone acetonide, 40 mg, before vitrectomy surgery. Exclusion criteria included previous history of vitrectomy, triamcinolone injection, and retinal detachment. Posterior subtenon injections were performed using the standard technique. Undiluted vitreous specimens were obtained at the time of vitrectomy, which was performed from one to 29 days after subtenon injection. Intravitreal triamcinolone concentration was determined by high-performance liquid chromatography. RESULTS: No complications were associated with subtenon injections. Intravitreal triamcinolone concentrations varied considerably, from zero in five eyes to a high of 4.94 microg/ml. CONCLUSIONS: Intravitreal triamcinolone concentrations vary considerably after subtenon injection. The findings indicate that subtenon injection can be a method for administering intravitreal triamcinolone acetonide that is comparable, in some cases, to the levels achieved after intravitreal injection.

Chromatography, High Pressure Liquid↗
PubMed2004

Influence of arginine vasopressin receptors and angiotensin receptor subtypes on the water intake and arterial blood pressure induced by vasopressin injected into the lateral septal area of the rat.

In this study we investigated the influence of d(CH2)5-Tyr(Me)-[Arg8]vasopressin (AAVP) and [adamanteanacetyl1,0-ET-d-Tyr2,Val4,aminobutyryl6,Arg8,9]-[Arg8]vasopressin (ATAVP), which are antagonists of vasopressin V1 and V2 receptors, and the effects of losartan, a selective angiotensin AT1 receptor antagonist, and CGP42112A, a selective AT2 receptor antagonist, injected into the lateral septal area (LSA) on thirst and hypertension induced by [Arg8]vasopressin (AVP). AAVP and ATAVP injected into the LSA reduced the drinking responses elicited by injecting AVP into the LSA. Both the AT1 and AT2 ligands administered into the LSA elicited a concentration-dependent decrease in the water intake induced by AVP injected into the LSA, but losartan was more effective than CGP42112A. The increase in MAP, due to injection of AVP into the LSA, was reduced by prior injection of AAVP from 18 +/- 1 to 6 +/- 1 mm Hg. Losartan injected into the LSA prior to AVP reduced the increase in MAP to 7 +/- 0.8 mm Hg. ATAVP and CGP42112A produced no changes in the pressor effect of AVP. These results suggest that the dipsogenic effects induced by injecting AVP into the LSA were mediated primarily by AT1 receptors. However, doses of losartan were more effective when combined with CGP42112A than when given alone, suggesting that the thirst induced by AVP injections into LSA may involve activation of multiple AVP and angiotensin II receptor subtypes. The pressor response of AVP was reduced by losartan and by AAVP. CGP42112A and ATAVP did not change the AVP pressor response. These results suggest that facilitator effects of AVP on water intake are mediated through the activation of V1 receptors and that the inhibitory effect requires V2 receptors. The involvement of AT1 and AT2 receptors can be postulated. Based on the present findings, we suggest that the AVP in the LSA may play a role in the control of water and arterial blood pressure balance.

Animals↗
PubMed2005

Behavioral effects of 8-OH-DPAT injections into pontine and mesencephalic areas containing 5-HT-immunoreactive perikarya in the pigeon.

This study examined the distribution of 5-HT-immunoreactive perikarya (5-HT-IRp) and the effects of local injections of 8-OH-DPAT into 5-HT-IRp-containing pontine and mesencephalic regions on feeding and drinking behaviors in free-feeding pigeons. When infused into the midline 5-HT-IRp-containing areas, 8-OH-DPAT (6.1 nmol) reliably elicited drinking and, to a lesser extent, feeding responses during the first hour after injection. These responses were significantly higher than the ingestive indexes observed (1) after vehicle (ascorbic acid 0.1%, 200 nl) injections at the same sites and (2) after 8-OH-DPAT injections into adjacent sites devoid of 5-HT-IRp. Increases in drinking were proportionally higher than those observed in feeding and a significant negative correlation was observed between water and food after midline 8-OH-DPAT injections. Similar dipsogenic responses were observed after injections of different 8-OH-DPAT doses (0.6, 2.0, and 6.1 nmol). Pretreatment with local injections of p-MPPI (an antagonist of 5-HT1A receptors) attenuated the ingestive responses evoked by 8-OH-DPAT injections. Injections of 8-OH-DPAT into lateral 5-HT-IRp-containing sites evoked only inconsistent and weak ingestive responses. These results indicate that 5-HT1A receptor-mediated circuits located in the midline superior raphe system of the pigeon may play an important role in mechanisms controlling water intake, similar to that observed in mammals.

8-Hydroxy-2-(di-n-propylamino)tetralin↗