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Sample records for received repeated injections

  1. Fear of repeated injections in children younger than 4 years receiving subcutaneous allergy immunotherapy.

    Science.gov (United States)

    de Vos, Gabriele; Shankar, Viswanathan; Nazari, Ramin; Kooragayalu, Shravan; Smith, Mitchell; Wiznia, Andrew; Rosenstreich, David

    2012-12-01

    Allergy immunotherapy during early childhood may have potential benefits for the prevention of asthma and allergy morbidity. However, subcutaneous immunotherapy has not yet been prospectively researched in children younger than 4 years, primarily because of safety concerns, including the fear and psychological distress young children may experience with repeated needle injections. To quantify fear in atopic children younger than 4 years with a history of wheezing who are receiving subcutaneous immunotherapy. Fear of injection was graded during a total of 788 immunotherapy injection visits in 18 children (age, 37 months; SD, 9 months) receiving subcutaneous allergy immunotherapy. The parent and the injection nurse assigned fear scores on a scale of 0 to 10 after each injection visit. At the time of analysis, children had a median of 49 injection visits (range, 12-88) during a median study period of 81.5 weeks (range, 15-165 weeks). Fifteen children (83%) lost their fear of injections during the study. A fear score of 0 was achieved after a mean of 8.4 visits (SD, 7.4). The more injection visits were missed, the more likely children were to retain fear of injections (hazard ratio, 0.13; 95% confidence interval, 0.02-1.02; P=.05). Age, adverse events, number of injections at each visit, and change of injection personnel were not associated with increased fear. Our analysis suggests that most children receiving weekly subcutaneous immunotherapy lose their fear of injections during the treatment course. Children with increased intervals between visits may be at higher risk of experiencing fear of injections. clinicaltrial.gov identifier NCT01028560. Copyright © 2012 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  2. Anesthetic efficacy of a repeated intraosseous injection following a primary intraosseous injection.

    Science.gov (United States)

    Jensen, Joanne; Nusstein, John; Drum, Melissa; Reader, Al; Beck, Mike

    2008-02-01

    The purpose of this prospective, randomized, single-blinded study was to determine the anesthetic efficacy of a repeated intraosseous injection given 30 minutes after a primary intraosseous injection. Using a crossover design, 55 subjects randomly received a primary X-tip intraosseous injection (Dentsply Inc, York, PA) of 1.4 mL of 2% lidocaine with epinephrine (using the Wand; Milestone Scientific, Deerfield, IL) and a repeated intraosseous or mock injection at 30 minutes in two appointments. The first molar and adjacent teeth were pulp tested every 2 minutes for a total of 120 minutes. Success was defined as obtaining two consecutive 80 readings with the electric pulp tester. Success of the initial intraosseous injection was 100% for the first molar. The repeated intraosseous injection mimicked the initial intraosseous injection in terms of pulpal anesthesia and statistically provided another 15 minutes of pulpal anesthesia. In conclusion, using the methodology presented, repeating the intraosseous injection 30 minutes after an initial intraosseous injection will provide an additional 15 minutes of pulpal anesthesia.

  3. Anesthetic efficacy of a repeated intraosseous injection given 30 min following an inferior alveolar nerve block/intraosseous injection.

    OpenAIRE

    Reitz, J.; Reader, A.; Nist, R.; Beck, M.; Meyers, W. J.

    1998-01-01

    To determine whether a repeated intraosseous (IO) injection would increase or prolong pulpal anesthesia, we measured the degree of anesthesia obtained by a repeated IO injection given 30 min following a combination inferior alveolar nerve block/intraosseous injection (IAN/IO) in mandibular second premolars and in first and second molars. Using a repeated-measures design, we randomly assigned 38 subjects to receive two combinations of injections at two separate appointments. The combinations w...

  4. Changes in contractile properties of muscles receiving repeat injections of botulinum toxin (Botox).

    Science.gov (United States)

    Fortuna, Rafael; Vaz, Marco Aurélio; Youssef, Aliaa Rehan; Longino, David; Herzog, Walter

    2011-01-04

    Botulinum toxin type A (BTX-A) is a frequently used therapeutic tool to denervate muscles in the treatment of neuromuscular disorders. Although considered safe by the US Food and Drug Administration, BTX-A can produce adverse effects in target and non-target muscles. With an increased use of BTX-A for neuromuscular disorders, the effects of repeat injections of BTX-A on strength, muscle mass and structure need to be known. Therefore, the purpose of this study was to investigate the changes in strength, muscle mass and contractile material in New Zealand White (NZW) rabbits. Twenty NZW rabbits were divided into 4 groups: control and 1, 3 and 6 months of unilateral, repeat injections of BTX-A into the quadriceps femoris. Outcome measures included knee extensor torque, muscle mass and the percentage of contractile material in the quadriceps muscles of the target and non-injected contralateral hindlimbs. Strength in the injected muscles was reduced by 88%, 89% and 95% in the 1, 3 and 6 months BTX-A injected hindlimbs compared to controls. Muscle mass was reduced by 50%, 42% and 31% for the vastus lateralis (VL), rectus femoris (RF) and vastus medialis (VM), respectively, at 1 month, by 68%, 51% and 50% at 3 months and by 76%, 44% and 13% at 6 months. The percentage of contractile material was reduced for the 3 and 6 months animals to 80-64%, respectively, and was replaced primarily by fat. Similar, but less pronounced results were also observed for the quadriceps muscles of the contralateral hindlimbs, suggesting that repeat BTX-A injections cause muscle atrophy and loss of contractile tissue in target muscles and also in non-target muscles that are far removed from the injection site. Copyright © 2010 Elsevier Ltd. All rights reserved.

  5. The effects of repeated Ozurdex injections on ocular hypertension.

    Science.gov (United States)

    Bahadorani, Sepehr; Krambeer, Chelsey; Wannamaker, Kendall; Tie, Wayne; Jansen, Michael; Espitia, Jason; Sohn, Jeong-Hyeon; Singer, Michael A

    2018-01-01

    The purpose of this study was to correlate the degree of ocular hypertension with the number of Ozurdex injections. Intraocular pressure (IOP) fluctuations for a total of 183 injections were studied over a period of at least 12 months. The main indications for treatment were uveitis, diabetic macular edema, and retinal vein occlusion. Results of the study demonstrate that repeated Ozurdex injections do not increase the frequency of IOP spikes beyond 30 mmHg. For lower IOPs, however, a positive correlation exists. Furthermore, patients with primary open angle glaucoma and uveitis had the highest IOP response to repeated injections. On average, patients with an IOP of ≥28.6 mmHg received pressure lowering medications, after which their IOP reached a stable level (16.7 mmHg) without the need for additional interventions. The data support the conclusion that multiple Ozurdex injections does not increase the frequency of IOP spikes beyond 30 mmHg, but patients still must be closely monitored if they have a history of primary open angle glaucoma.

  6. Can Repeat Injection Provide Clinical Benefit in Patients with Lumbosacral Diseases When First Epidural Injection Results Only in Partial Response?

    Science.gov (United States)

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-02-01

    Epidural steroid injection (ESI) is known to be an effective treatment for lower back or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after a single ESI, there has been little evidence supporting the usefulness of repeat injections in cumulative clinical pain reduction. The purpose of this study was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than that provided by intermittent injection performed only when pain was aggravated. An Institutional Review Board (IRB)-approved retrospective chart review. Spine hospital. Two hundred and four patients who had underwent transforaminal ESI (TFESI) for treatment of lower back and radicular pain due to HIVD or SS and could be followed-up for one year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (NRS = 3 after first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 96) comprised partial responders who did not receive a repeat injection at the prescribed interval, but received repeat injections only for aggravation of pain. Various clinical data including total number of injections during one year, duration of NRS group A, or after first injection in group B (time to reinjection), were assessed. These data were compared between groups A and B in terms of total population, HIVD, and SS. In the whole population, the mean time to reinjection was 6.09 ± 3.02 months in group A and 3.69 ± 2.07 months in group B. The NRS groups A and B, respectively. In HIVD patients, the mean time to reinjection was 5.82 ± 3.23 months in group A and 3.84 ± 2.34 months in group B, and NRS groups A and B, respectively. In SS patients, the mean time to

  7. Can repeat injection provide clinical benefit in patients with cervical disc herniation and stenosis when the first epidural injection results only in partial response?

    Science.gov (United States)

    Lee, Jung Hwan; Lee, Sang-Ho

    2016-07-01

    Epidural steroid injection (ESI) is known to be an effective treatment for neck or radicular pain due to herniated intervertebral disc (HIVD) and spinal stenosis (SS). Although repeat ESI has generally been indicated to provide more pain relief in partial responders after single ESI, there has been little evidence supporting the usefulness of this procedure. The purpose of this study, therefore, was to determine whether repeat ESI at a prescribed interval of 2 to 3 weeks after the first injection would provide greater clinical benefit in patients with partial pain reduction than intermittent ESI performed only when pain was aggravated. One hundred eighty-four patients who underwent transforaminal ESI (TFESI) for treatment of axial neck and radicular arm pain due to HIVD or SS and could be followed up for 1 year were enrolled. We divided the patients into 2 groups. Group A (N = 108) comprised partial responders (numeric rating scale (NRS) ≥ 3 after the first injection) who underwent repeat injection at a prescribed interval of 2 to 3 weeks after the first injection. Group B (N = 76) comprised partial responders who did not receive repeat injection at the prescribed interval, but received intermittent injections only for aggravation of pain. Various clinical data were assessed, including total number of injections during 1 year, NRS duration of Group A, or after first injection in Group B (time to reinjection). Groups A and B were compared in terms of total population, HIVD, and SS. In the whole population, HIVD subgroup, and SS subgroup, patients in Group A required significantly fewer injections to obtain satisfactory pain relief during the 1-year follow-up period. Group A showed a significantly longer time to reinjection and longer NRS Group B did. Repeat TFESI conducted at 2- to 3-week intervals after the first injection in partial responders contributed to greater clinical benefit compared with intermittent TFESI performed only upon pain

  8. The effects of repeated Ozurdex injections on ocular hypertension

    Directory of Open Access Journals (Sweden)

    Bahadorani S

    2018-04-01

    Full Text Available Sepehr Bahadorani,1 Chelsey Krambeer,2 Kendall Wannamaker,1 Wayne Tie,1 Michael Jansen,1 Jason Espitia,2 Jeong-Hyeon Sohn,1 Michael A Singer2 1Department of Ophthalmology, University of Texas Health Science Center at San Antonio, San Antonio, TX, USA; 2Medical Center Ophthalmology Associates, San Antonio, TX, USA Purpose: The purpose of this study was to correlate the degree of ocular hypertension with the number of Ozurdex injections.Methods: Intraocular pressure (IOP fluctuations for a total of 183 injections were studied over a period of at least 12 months. The main indications for treatment were uveitis, diabetic macular edema, and retinal vein occlusion.Results: Results of the study demonstrate that repeated Ozurdex injections do not increase the frequency of IOP spikes beyond 30 mmHg. For lower IOPs, however, a positive correlation exists. Furthermore, patients with primary open angle glaucoma and uveitis had the highest IOP response to repeated injections. On average, patients with an IOP of ≥28.6 mmHg received pressure lowering medications, after which their IOP reached a stable level (16.7 mmHg without the need for additional interventions.Conclusion: The data support the conclusion that multiple Ozurdex injections does not increase the frequency of IOP spikes beyond 30 mmHg, but patients still must be closely monitored if they have a history of primary open angle glaucoma. Keywords: Ozurdex, dexamethasone, glaucoma, intraocular pressure, ocular hypertension

  9. Ultrastructure of canine meninges after repeated epidural injection of S(+)-ketamine.

    Science.gov (United States)

    Acosta, Alinne; Gomar, Carmen; Bombí, Josep A; Graça, Dominguita L; Garrido, Marta; Krauspenhar, Cristina

    2006-01-01

    The safety of ketamine when administered by the spinal route must be confirmed in various animal species before it is approved for use in humans. This study evaluates the ultrastructure of canine meninges after repeated doses of epidural S(+)-ketamine. Five dogs received S(+)-ketamine 5%, 1 mg/kg, twice a day for 10 days through an epidural catheter with its tip located at the L5 level. One dog received the same volume of normal saline at the same times. The spinal cord and meninges were processed for histopathological and ultrastructural studies. Clinical effects were assessed after each injection. Motor and sensory block appeared after each injection of S(+)-ketamine, but not in the dog receiving saline. No signs of clinical or neurologic alterations were observed. Using light microscopy, no meningeal layer showed alterations except focal infiltration at the catheter tip level by macrophages, lymphocytes, and a few mast cells. The cells of different layers were studied by electron microscopy and interpreted according to data from human and other animal species because no ultrastructural description of the canine meninges is currently available. There were no cellular signs of inflammation, phagocytosis, or degeneration in meningeal layers and no signs of atrophy, compression, or demyelinization in the areas of dorsal root ganglia and spinal cord around the arachnoid. These findings were common for dogs receiving S(+)-ketamine and the dog receiving saline. Repeated doses of epidural S(+)-ketamine 5%, 1 mg/kg, twice a day for 10 days was not associated to cellular alterations in canine meninges.

  10. Repeated tender point injections of granisetron alleviate chronic myofascial pain--a randomized, controlled, double-blinded trial.

    Science.gov (United States)

    Christidis, Nikolaos; Omrani, Shahin; Fredriksson, Lars; Gjelset, Mattias; Louca, Sofia; Hedenberg-Magnusson, Britt; Ernberg, Malin

    2015-01-01

    Serotonin (5-HT) mediates pain by peripheral 5-HT3-receptors. Results from a few studies indicate that intramuscular injections of 5-HT3-antagonists may reduce musculoskeletal pain. The aim of this study was to investigate if repeated intramuscular tender-point injections of the 5-HT3-antagonist granisetron alleviate pain in patients with myofascial temporomandibular disorders (M-TMD). This prospective, randomized, controlled, double blind, parallel-arm trial (RCT) was carried out during at two centers in Stockholm, Sweden. The randomization was performed by a researcher who did not participate in data collection with an internet-based application ( www.randomization.com ). 40 patients with a diagnose of M-TMD according to the Research Diagnostic Criteria for Temporomandibular Disorders (RDC/TMD) were randomized to receive repeated injections, one week apart, with either granisetron (GRA; 3 mg) or isotonic saline as control (CTR). The median weekly pain intensities decreased significantly at all follow-ups (1-, 2-, 6-months) in the GRA-group (Friedman test; P  0.075). The numbers needed to treat (NNT) were 4 at the 1- and 6-month follow-ups, and 3.3 at the 2-month follow-up in favor of granisetron. Repeated intramuscular tender-point injections with granisetron provide a new pharmacological treatment possibility for myofascial pain patients with repeated intramuscular tender-point injections with the serotonin type 3 antagonist granisetron. It showed a clinically relevant pain reducing effect in the temporomandibular region, both in a short- and long-term aspect. European Clinical Trials Database 2005-006042-41 as well as at Clinical Trials NCT02230371 .

  11. Risk of sensitization in healthy adults following repeated administration of rdESAT-6 skin test reagent by the Mantoux injection technique

    DEFF Research Database (Denmark)

    Lillebaek, Troels; Bergstedt, Winnie; Tingskov, Pernille N

    2009-01-01

    1 open clinical trial was to assess the sensitization risk and safety of repeated administration of rdESAT-6 reagent in 31 healthy adult volunteers. Three groups of volunteers received two fixed doses of 0.1 microg rdESAT-6 28, 56 or 112 days apart, respectively. After the second injection...... of 31 (3%) volunteers showed a positive skin reaction (sensitization) upon a second injection of rdESAT-6 after 28days and an increased IFN-gamma response to ESAT-6. For 7 (23%) of the volunteers, local adverse reactions related to the product were registered, but all reactions were mild and predictable...

  12. Fibrous Myopathy as a Complication of Repeated Intramuscular Injections for Chronic Headache

    Directory of Open Access Journals (Sweden)

    R Burnham

    2006-01-01

    Full Text Available Two cases of fibrous myopathy associated with repeated, long-term intramuscular injections for treatment of chronic temporomandibular joint pain and chronic headache, respectively, are described. Both patients developed severe, function-limiting contractures in upper and lower extremity muscles used as injection sites. In one of the cases, the contractures were painful. Electrophysiological testing, magnetic resonance imaging and muscle biopsy results were all consistent with myopathy and replacement of skeletal muscle with noncontractile fibrous tissue. These cases are presented to increase awareness of fibrous myopathy and to promote surveillance for this serious potential complication of long-term intramuscular injections in chronic headache and other pain patients.

  13. [Reducing fear in preschool children receiving intravenous injections].

    Science.gov (United States)

    Hsieh, Yi-Chuan; Liu, Hui-Tzu; Cho, Yen-Hua

    2012-06-01

    Our pediatric medical ward administers an average of 80 intravenous injections to preschool children. We found that 91.1% exhibit behavior indicative of fear and anxiety. Over three-quarters (77.8%) of this number suffer severe fear and actively resist receiving injections. Such behavior places a greater than normal burden on human and material resources and often gives family members negative impressions that lower their trust in the healthcare service while raising nurse-patient tensions. Using observation and interviews, we found primary factors in injection fear to be: Past negative experiences, lack of adequate prior communication, measures taken to preemptively control child resistance, and default cognitive behavioral strategies from nursing staff. This project worked to develop a strategy to reduce cases of severe injection fear in preschool children from 77.8% to 38.9% and achieve a capacity improvement target for members of 50%. Our team identified several potential strategy solutions from research papers and books between August 1st, 2009 and April 30th, 2010. Our proposed method included therapeutic games, self-selection of injection position, and cognitive behavioral strategies to divert attention. Other measures were also specified as standard operating procedures for administering pediatric intravenous injections. We applied the strategy on 45 preschool children and identified a post-injection "severe fear" level of 37.8%. This project was designed to reduce fear in children to make them more accepting of vaccinations and to enhance children's positive treatment experience in order to raise nursing care quality.

  14. Estimation of radiation dose received by the radiation worker during 18F FDG injection process

    International Nuclear Information System (INIS)

    Jha, Ashish Kumar; Zade, Anand; Rangarajan, Venkatesh

    2011-01-01

    The radiation dosimetric literature concerning the medical and non-medical personnel working in nuclear medicine departments are limited, particularly radiation doses received by radiation worker in nuclear medicine department during positron emission tomography (PET) radiopharmaceutical injection process. This is of interest and concern for the personnel. To measure the radiation dose received by the staff involved in injection process of Fluorine-18 Fluorodeoxyglucose (FDG). The effective whole body doses to the radiation workers involved in injections of 1511 patients over a period of 10 weeks were evaluated using pocket dosimeter. Each patient was injected with 5 MBq/kg of 18 F FDG. The 18 F-FDG injection protocol followed in our department is as follows. The technologist dispenses the dose to be injected and records the pre-injection activity. The nursing staff members then secure an intravenous catheter. The nuclear medicine physicians/residents inject the dose on a rotation basis in accordance with ALARA principle. After the injection of the tracer, the nursing staff members flush the intravenous catheter. The person who injected the tracer then measures the post-injection residual dose in the syringe. The mean effective whole body doses per injection for the staff were the following: Nurses received 1.44 ± 0.22 μSv/injection (3.71 ± 0.48 nSv/MBq), for doctors the dose values were 2.44 ± 0.25 μSv/injection (6.29 ± 0.49 nSv/MBq) and for technologists the doses were 0.61 ± 0.10 μSv/injection (1.58 ± 0.21 nSv/MBq). It was seen that the mean effective whole body dose per injection of our positron emission tomography/computed tomography (PET/CT) staff who were involved in the 18 F-FDG injection process was maximum for doctors (54.34% differential doses), followed by nurses (32.02% differential doses) and technologist (13.64% differential doses). This study confirms that low levels of radiation dose are received by staff during 18 F-FDG injection and

  15. The effects of repeated low-dose sarin exposure

    International Nuclear Information System (INIS)

    Shih, T.-M.; Hulet, S.W.; McDonough, J.H.

    2006-01-01

    This project assessed the effects of repeated low-dose exposure of guinea pigs to the organophosphorus nerve agent sarin. Animals were injected once a day, 5 days per week (Monday-Friday), for 2 weeks with fractions (0.3x, 0.4x, 0.5x, or 0.6x) of the established LD 5 dose of sarin (42 μg/kg, s.c.). The animals were assessed for changes in body weight, red blood cell (RBC) acetylcholinesterase (AChE) levels, neurobehavioral reactions to a functional observational battery (FOB), cortical electroencephalographic (EEG) power spectrum, and intrinsic acetylcholine (ACh) neurotransmitter (NT) regulation over the 2 weeks of sarin exposure and for up to 12 days postinjection. No guinea pig receiving 0.3, 0.4 or 0.5 x LD 5 of sarin showed signs of cortical EEG seizures despite decreases in RBC AChE levels to as low as 10% of baseline, while seizures were evident in animals receiving 0.6 x LD 5 of sarin as early as the second day; subsequent injections led to incapacitation and death. Animals receiving 0.5 x LD 5 sarin showed obvious signs of cholinergic toxicity; overall, 2 of 13 animals receiving 0.5 x LD 5 sarin died before all 10 injections were given, and there was a significant increase in the angle of gait in the animals that lived. By the 10th day of injection, the animals receiving saline were significantly easier to remove from their cages and handle and significantly less responsive to an approaching pencil and touch on the rump in comparison with the first day of testing. In contrast, the animals receiving 0.4 x LD 5 sarin failed to show any significant reductions in their responses to an approaching pencil and a touch on the rump as compared with the first day. The 0.5 x LD 5 sarin animals also failed to show any significant changes to the approach and touch responses and did not adjust to handling or removal from the cage from the first day of injections to the last day of handling. Thus, the guinea pigs receiving the 0.4 and 0.5 x LD 5 doses of sarin failed to

  16. Repeated intraperitoneal injections of interleukin 1 beta induce glucose intolerance in normal rats

    DEFF Research Database (Denmark)

    Wogensen, L; Reimers, J; Mandrup-Poulsen, T

    1991-01-01

    Previous in vitro findings suggest the involvement of interleukin 1 (IL-1) in the pathogenesis of insulin-dependent diabetes mellitus. The aims of the present study were to investigate the effects of single or repeated ip injections of recombinant IL-1 beta on blood glucose and glucose tolerance...... in vivo. Normal Wistar Kyoto rats were injected ip with a single injection of 4 micrograms/kg of the mature form of recombinant IL-1 beta (amino acids 117-269) or once daily on 5 consecutive days. Control rats were given vehicle and were fed ad libitum or pair-fed together with the rIL-1 beta treated rats...... in food intake, a lasting mild depression of blood glucose (7 days) and a transiently impaired glucose tolerance on day 5. We conclude that systemic IL-1 should be considered an important regulator of glucose homeostasis in vivo....

  17. Experimental Analysis for Factors Affecting the Repeatability of Plastics Injection Molding Tests on the Self-developed Apparatus

    Directory of Open Access Journals (Sweden)

    Yugang Huang

    2013-06-01

    Full Text Available Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 To improve the repeatability of the injection molding test result, the affecting factors were investigated by means of experiments. Besides the traditional processing parameter, the factors of test conditions were also considered. In order to focus on the molding process rather than the molded part, the curve measurement of the melt pressure at the entrance to the nozzle was used as the output characteristic. Experiments for polypropylene (PP showed that the injected volume was the key processing parameter. Within the test conditions, the injection number is the most important factor. According to the analysis the operating procedure was improved effectively. Normal 0 false false false IN X-NONE X-NONE MicrosoftInternetExplorer4 Doi: 10.12777/ijse.5.1.6-11 [How to cite this article: Huang, Y., Li, D., Liu, Y. (2013. Experimental Analysis for Factors Affecting the Repeatability of Plastics Injection Molding Tests on the Self-developed Apparatus. International Journal of Science and Engineering, 5(1,6-11. Doi: 10.12777/ijse.5.1.6-11]

  18. Usefulness of fluoroscopy-guided intra-articular injection of the knee

    Energy Technology Data Exchange (ETDEWEB)

    Myung, Jae Sung; Lee, Joon Woo [Seoul National University Bundang Hospital, Seongnam (Korea, Republic of); Lee, Ji Yeon [Kangwon National University College of Medicine, Chuncheon (Korea, Republic of)] (and others)

    2007-06-15

    To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injection (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test ({rho} value = 0.14). Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee.

  19. Usefulness of fluoroscopy-guided intra-articular injection of the knee

    International Nuclear Information System (INIS)

    Myung, Jae Sung; Lee, Joon Woo; Lee, Ji Yeon

    2007-01-01

    To determine the accuracy of the intra-articular location of hyaluronic acid injection using a blind approach and to establish the usefulness of fluoroscopy-guided intra-articular injection. A fluoroscopy unit was used for 368 intra-articular injections of hyaluronic acid to 93 knees in 65 patients. Initially, blind needle positioning was conducted on the fluoroscopy table. The failure rate of the blind approach among the 368 injections was evaluated, and a relationship between the Kellgren-Lawrence grade (K-L grade) and the incidence of repeated failures using the blind approach was determined for injections to 52 knees in 37 patients who received a complete cycle of injections (five consecutive injections with a one-week interval between injections). Using a blind approach, 298 of 368 trials (81.2%) resulted in a needle tip being placed in an intra-articular location, while 70 of 368 trials resulted in an extra-articular placement of the needle tip. Among 52 knees to which a complete cycle of injection (five consecutive injections with a one-week interval between injections) was administered, repeated failure of intra-articular placement using the blind approach was seen for 18 knees (34.6%); a more severe K-L grade assigned was associated with a higher rate of repeated failure. However, the trend was not statistically significant based on the Chi-squared test (ρ value = 0.14). Fluoroscopy-guided needle placement may be helpful to ensure therapeutic intra-articular injection of the knee

  20. Dramatic changes in muscle contractile and structural properties after 2 botulinum toxin injections.

    Science.gov (United States)

    Minamoto, Viviane B; Suzuki, Kentaro P; Bremner, Shannon N; Lieber, Richard L; Ward, Samuel R

    2015-10-01

    Botulinum toxin is frequently administered serially to maintain therapeutic muscle paralysis, but the effect of repeated doses on muscle function are largely unknown. This study characterized the muscle response to 2 onabotulinum toxin (BoNT) injections separated by 3 months. Animal subjects received a single toxin injection (n = 8), 2 BoNT injections separated by 3 months (n = 14), or 1 BoNT and 1 saline injection separated by 3 months (n = 8). The functional effect of 2 serial injections was exponentially greater than the effect of a single injection. While both groups treated with a single BoNT injection had decreased torque in the injected leg by approximately 50% relative to contralateral legs, the double BoNT injected group had decreased torque by over 95% relative to the preinjection level. Both single and double BoNT injections produced clear signs of fiber-type grouping. These experiments demonstrate a disproportionately greater effect of repeated BoNT injections. © 2015 Wiley Periodicals, Inc.

  1. Repeated intravenous doxapram induces phrenic motor facilitation.

    Science.gov (United States)

    Sandhu, M S; Lee, K Z; Gonzalez-Rothi, E J; Fuller, D D

    2013-12-01

    Doxapram is a respiratory stimulant used to treat hypoventilation. Here we investigated whether doxapram could also trigger respiratory neuroplasticity. Specifically, we hypothesized that intermittent delivery of doxapram at low doses would lead to long-lasting increases (i.e., facilitation) of phrenic motor output in anesthetized, vagotomized, and mechanically-ventilated rats. Doxapram was delivered intravenously in a single bolus (2 or 6mg/kg) or as a series of 3 injections (2mg/kg) at 5min intervals. Control groups received pH-matched saline injections (vehicle) or no treatment (anesthesia time control). Doxapram evoked an immediate increase in phrenic output in all groups, but a persistent increase in burst amplitude only occurred after repeated dosing with 2mg/kg. At 60min following the last injection, phrenic burst amplitude was 168±24% of baseline (%BL) in the group receiving 3 injections (Pphrenic response to doxapram (2mg/kg) was reduced by 68% suggesting that at low doses the drug was acting primarily via the carotid chemoreceptors. We conclude that intermittent application of doxapram can trigger phrenic neuroplasticity, and this approach might be of use in the context of respiratory rehabilitation following neurologic injury. © 2013.

  2. Repeated nicotine exposure enhances reward-related learning in the rat.

    Science.gov (United States)

    Olausson, Peter; Jentsch, J David; Taylor, Jane R

    2003-07-01

    Repeated exposure to addictive drugs causes neuroadaptive changes in cortico-limbic-striatal circuits that may underlie alterations in incentive-motivational processes and reward-related learning. Such drug-induced alterations may be relevant to drug addiction because enhanced incentive motivation and increased control over behavior by drug-associated stimuli may contribute to aspects of compulsive drug-seeking and drug-taking behaviors. This study investigated the consequences of repeated nicotine treatment on the acquisition and performance of Pavlovian discriminative approach behavior, a measure of reward-related learning, in male rats. Water-restricted rats were trained to associate a compound conditioned stimulus (tone+light) with the availability of water (the unconditioned stimulus) in 15 consecutive daily sessions. In separate experiments, rats were repeatedly treated with nicotine (0.35 mg/kg, s.c.) either (1) prior to the onset of training, (2) after each daily training session was completed (ie postsession injections), or (3) received nicotine both before the onset of training as well as after each daily training session. In this study, all nicotine treatment schedules increased Pavlovian discriminative approach behavior and, thus, prior repeated exposure to nicotine, repeated postsession nicotine injections, or both, facilitated reward-related learning.

  3. THE ELIMINATION OF FOREIGN PARTICLES INJECTED INTO THE ...

    African Journals Online (AJOL)

    ... particulate matter injected into holothurians has received more attention ... ground, phase-contrast illumination in order to show up individual particles of ... Individuals of C. stephensoni, varying between 10·0 and 13·5 cm in length ..... M. Spencer, undertook repeat experiments on the effect of Thorotrast on the coelomocyte.

  4. Seizure threshold to lidocaine is decreased following repeated ECS (electroconvulsive shock)

    DEFF Research Database (Denmark)

    Kragh, J; Seidelin, J; Bolwig, T G

    1993-01-01

    Seizure susceptibility to lidocaine was investigated in rats which had received repeated ECS (electroconvulsive shock). In the first experiment three groups of rats received an ECS daily for 18 days, an ECS weekly for 18 weeks, and 18 sham treatments, respectively. Twelve weeks after the last ECS...... all rats received a lidocaine challenge (LC) in the form of an intraperitoneal (IP) injection of lidocaine (65 mg/kg). After the injection the animals were observed for occurrence of motor seizures. A total of 67% (10/15), 47% (7/15), and 0% (0/18) of the daily, weekly, and sham groups, respectively......, had motor seizures in response to the LC. In the second experiment five groups of rats received an ECS daily for 0, 1, 6, 18, and 36 days, respectively. Eighteen weeks after the last ECS all rats received an LC and 0% (0/15), 13% (2/15), 20% (3/15), 53% (8/15), and 58% (7/12), respectively, developed...

  5. Subacromial triamcinolone acetonide, hyaluronic acid and saline injections for shoulder pain an RCT investigating the effectiveness in the first days.

    Science.gov (United States)

    Penning, Ludo I F; de Bie, Rob A; Walenkamp, Geert H I M

    2014-10-23

    Subacromial impingement is a common cause of shoulder complaints in general practice. When the initial treatment with acetaminophen and low dose Non Steroidal Anti Inflammatory Drugs fails, triamcinolone acetonide injections are commonly used. Triamcinolone acetonide injections are effective at four to six weeks. Little is known about the pain relief effect of triamcinolone acetonide injections in the first days after injection and the effect of repeated injection. In this study we investigate the effect of triamcinolone acetonide injections compared to hyaluronic acid and NaCl injections using a pain diary. 159 Patients recruited for an RCT comparing the effect of subacromial injections of triamcinolone acetonide, hyaluronic acid and sodium chloride (NaCl) were used in this study. They were blinded for their treatment and could receive up to three injections. Primary outcome consisted of the patient perceived pain on a VAS score recorded on a daily basis during 21 days following injection. Secondary outcome consisted of the amount of taken escape medication following injection and adverse effects. All patients received the first injection. 150 patients also received the second and third injections. 97% Of the paper and pencil pain diaries were returned for data analysis.The triamcinolone acetonide group showed the largest decrease in pain on the VAS scores after injection compared to the hyaluronic acid and NaCl group in the first week after injection. The reduction in pain was best achieved after the first injection, the second triamcinolone acetonide injection showed a further reduction in pain. The third triamcinolone acetonide injection only showed a slight improvement in pain reduction. In this study we could show a booster effect in pain reduction after repeated triamcinolone acetonide injection. The triamcinolone acetonide group showed a faster reduction in pain after injection compared to the hyaluronic acid and NaCl group. The effect was best seen after

  6. A repeated injection of polyethyleneglycol-conjugated recombinant human butyrylcholinesterase elicits immune response in mice

    International Nuclear Information System (INIS)

    Chilukuri, Nageswararao; Sun Wei; Parikh, Kalpana; Naik, Ramachandra S.; Tang Lin; Doctor, Bhupendra P.; Saxena, Ashima

    2008-01-01

    Human serum butyrylcholinesterase (Hu BChE) serves as an efficacious bioscavenger of highly toxic organophosphorus (OP) compounds. Since there is a concern that the supply of native Hu BChE may be limited, monomeric and tetrameric forms of recombinant Hu BChE (rHu BChE) were evaluated as replacements and found that they lacked sufficient stability in vivo. However, their in vivo stability could be significantly prolonged by conjugation with polyethyleneglycol-20K (PEG) suggesting that monomeric and tetrameric PEG-rHu BChE could function as bioscavengers. Here, the immunogenicity of PEG-rHu BChE was evaluated in mice following two injections given four weeks apart. In addition to pharmacokinetic parameters, such as mean residence time, maximal concentration, time to reach the maximal concentration, elimination half-life and area under the plasma concentration-time curve extrapolated to infinity, the presence of circulating anti-rHu BChE antibodies was also determined. Although the pharmacokinetic parameters were significantly improved for the first injection of monomeric and tetrameric PEG-rHu BChEs, they were much lower for the second injection. Anti-rHu BChE antibodies were detected in the blood of mice following the first and second enzyme injections and their levels were approximately higher by 5-fold and 2-fold in mice injected with monomeric and tetrameric PEG-rHu BChEs as compared to mice injected with unconjugated enzymes. The findings that the rapid clearance of a repeat injection of PEG-rHu BChEs in mice which coincides with the presence of circulating anti-rHu BChE antibodies suggest that PEG conjugation prolonged the circulatory stability of rHu BChE but failed to eliminate its immunogenicity in mice

  7. Minocycline Prevents Muscular Pain Hypersensitivity and Cutaneous Allodynia Produced by Repeated Intramuscular Injections of Hypertonic Saline in Healthy Human Participants.

    Science.gov (United States)

    Samour, Mohamad Samir; Nagi, Saad Saulat; Shortland, Peter John; Mahns, David Anthony

    2017-08-01

    Minocycline, a glial suppressor, prevents behavioral hypersensitivities in animal models of peripheral nerve injury. However, clinical trials of minocycline in human studies have produced mixed results. This study addressed 2 questions: can repeated injections of hypertonic saline (HS) in humans induce persistent hypersensitivity? Can pretreatment with minocycline, a tetracycline antibiotic with microglial inhibitory effects, prevent the onset of hypersensitivity? Twenty-seven healthy participants took part in this double-blind, placebo-controlled study, consisting of 6 test sessions across 2 weeks. At the beginning of every session, pressure-pain thresholds of the anterior muscle compartment of both legs were measured to determine the region distribution and intensity of muscle soreness. To measure changes in thermal sensitivity in the skin overlying the anterior muscle compartment of both legs, quantitative sensory testing was used to measure the cutaneous thermal thresholds (cold sensation, cold pain, warm sensation, and heat pain) and a mild cooling stimulus was applied to assess the presence of cold allodynia. To induce ongoing hypersensitivity, repeated injections of HS were administered into the right tibialis anterior muscle at 48-hour intervals. In the final 2 sessions (days 9 and 14), only sensory assessments were done to plot the recovery after cessation of HS administrations and drug washout. By day 9, nontreated participants experienced a significant bilateral increase in muscle soreness (P minocycline-treated participants experienced a bilateral 70% alleviation in muscle soreness (P minocycline-treated participants showed cold allodynia. This study showed that repeated injections of HS can induce a hypersensitivity that outlasts the acute response, and the development of this hypersensitivity can be reliably attenuated with minocycline pretreatment. Four repeated injections of HS at 48-hour intervals induce a state of persistent hypersensitivity in

  8. Efficacy of Repeated Botulinum Toxin Type A Injections for Spastic Equinus in Children with Cerebral Palsy-A Secondary Analysis of the Randomized Clinical Trial.

    Science.gov (United States)

    Hong, Bo Young; Chang, Hyun Jung; Lee, Sang-Jee; Lee, Soyoung; Park, Joo Hyun; Kwon, Jeong-Yi

    2017-08-21

    Botulinum toxin A is considered an important tool to control spasticity in children with cerebral palsy. Several factors are known to affect the efficacy of botulinum toxin, such as dosage, appropriate muscle selection and application, age, and accompanying therapy. A multicenter, double-blind, randomized, prospective phase III clinical trial of botulinum toxin A for the treatment of dynamic equinus in 144 children with cerebral palsy was performed to compare the efficacies of letibotulinumtoxin A and onabotulinumtoxin A. Secondary analyses were performed to evaluate factors that affected the outcome, focusing on the number of times injections were repeated. Effectiveness was defined as a change of 2 or more in the physician's rating scale. Multivariate regression analyses were performed with multiple variables. The first injection of botulinum toxin A significantly improved D subscale of Gross Motor Function Measure-88 scores at 3 months compared to repeated injections ( p < 0.05). After 6 months, patients who had one injection or none before the study showed significantly better outcomes than those who had more than one injection in terms of observational gait scores.

  9. Laryngeal electromyography-guided hyaluronic acid vocal fold injection for unilateral vocal fold paralysis: a prospective long-term follow-up outcome report.

    Science.gov (United States)

    Wang, Chen-Chi; Chang, Ming-Hong; Jiang, Rong-San; Lai, Hsiu-Chin; De Virgilio, Armando; Wang, Ching-Ping; Wu, Shang-Heng; Liu, Shi-An; Liang, Kai-Li

    2015-03-01

    Unilateral vocal fold paralysis (UVFP) is a common voice disorder that may cause glottal closure insufficiency with hoarseness of voice. Laryngeal electromyography (LEMG)-guided hyaluronic acid vocal fold (VF) injection has been proposed as a treatment option to improve glottal closure with a satisfactory short-term effect. To our knowledge, this study reports the first long-term follow-up result of this treatment modality. To present the long-term treatment results of LEMG-guided hyaluronic acid VF injection for UVFP. Prospective study of the treatment results of 74 patients who received LEMG-guided hyaluronic acid VF injection for UVFP at a tertiary referral medical center from March 2010 to February 2013. In the office-based procedure, 1.0 mL of hyaluronic acid was injected via a 26-gauge monopolar injectable needle electrode into paralyzed thyroarytenoid muscles by LEMG guidance. Various glottal closure evaluations such as normalized glottal gap area, maximal phonation time, phonation quotient, mean airflow rate, perceptual GRBAS (grade, roughness, breathiness, asthenia, strain) scale, and Voice Handicap Index were compared before and after injection using the nonparametric Wilcoxon signed rank test within 1 month, at 6 months, and at the last follow-up examination. Sixty patients had been followed up for at least 6 months. Forty-four patients received only 1 injection, and 16 patients received repeated injections (2 injections for 13 patients and 3 for 3 patients). All the glottal closure parameters improved significantly (P injection and 16 (22%) who received repeated injections did not require another treatment after long-term follow-up. Laryngeal electromyography-guided hyaluronic acid VF injection is an option for treating UVFP with satisfactory results.

  10. Safety and efficacy of bi-annual intra-articular LBSA0103 injections in patients with knee osteoarthritis.

    Science.gov (United States)

    Lee, Jin Kyu; Choi, Chong-Hyuk; Oh, Kwang-Jun; Kyung, Hee-Soo; Yoo, Ju-Hyung; Ha, Chul-Won; Bin, Seong-Il; Kang, Seung-Baik; Kim, Myung Ku; Lee, Ju-Hong; Lee, Myung Chul

    2017-11-01

    The objective of this study is to assess the safety and efficacy of repeated intra-articular injection of high molecular weight hyaluronic acid (LBSA0103) at a 26-week interval, in patients with osteoarthritis of the knee. The study was an open-label, single arm, multicentre prospective trial conducted in patients with symptomatic knee osteoarthritis. The intervention consisted of two intra-articular injections of LBSA0103, with the second injection performed 26 weeks after the first injection. The primary outcome was the incidence of adverse drug reactions related to each injection. Assessment of efficacy of repeated injections in terms of maintenance of pain relief was a secondary objective of this study. Of the 185 patients screened, 174 patients received the first injection and 153 patients received both injections of LBSA0103. Nine adverse drug reactions occurred in seven patients (4.02%) after the first injection, while only one adverse drug reaction occurred (0.65%) after the second injection. As a secondary outcome measure, the improvements in the efficacy parameters including total WOMAC score and weight-bearing pain were all significant at both week 13 and 39 compared to the baseline value (P injection were consistent with those after the initial injection of LBSA0103 (between week 26 and week 39, P injection of LBSA0103 at a 26-week interval is safe without increased risk of adverse drug reactions. Additionally, LBSA0103 is effective in reduction of osteoarthritis knee pain and in maintenance of pain reduction for a 39-week period when a second injection is administered.

  11. Unicameral bone cysts treated by injection of bone marrow or methylprednisolone.

    Science.gov (United States)

    Chang, C H; Stanton, R P; Glutting, J

    2002-04-01

    In 79 consecutive patients with unicameral bone cysts we compared the results of aspiration and injection of bone marrow with those of aspiration and injection of steroid. All were treated by the same protocol. The only difference was the substance injected into the cysts. The mean radiological follow-up to detect activity in the cyst was 44 months (12 to 108). Of the 79 patients, 14 received a total of 27 injections of bone marrow and 65 a total of 99 injections of steroid. Repeated injections were required in 57% of patients after bone marrow had been used and in 49% after steroid. No complications were noted in either group. In this series no advantage could be shown for the use of autogenous injection of bone marrow compared with injection of steroid in the management of unicameral bone cysts.

  12. Platelet-rich plasma for chronic lateral epicondylitis: is one injection sufficient?

    Science.gov (United States)

    Glanzmann, Michael C; Audigé, Laurent

    2015-12-01

    Chronic lateral epicondylitis is generally treated using nonsurgical methods including physiotherapy and infiltrations of cortisone or platelet-rich plasma (PRP). The latter is known for its simple application as well as associated low risk of adverse events, which lend to its widespread use in treating various musculoskeletal conditions. There is limited evidence on the effectiveness of PRP injections to optimally treat chronic lateral epicondylitis. This study explored the effectiveness of single or repeated injections for patients with symptoms that spanned 6 months or more and were unresponsive to alternate conservative measures. Patients with chronic lateral epicondylitis received PRP injections in 4-week intervals that were complemented with standardized physical therapy. Patient-reported outcomes based on the patient-rated elbow evaluation (PREE), quick disabilities of the arm, shoulder and hand (qDASH), and EuroQol (five dimensions) 3-level version (EQ5D3L) questionnaires were documented at each visit including 6 months after the first injection. These outcomes were compared between patients receiving 1 vs. 2 or 3 PRP injections. Sixty-two patients received one (n = 36) or more (n = 26) PRP injections. The mean baseline to 6-month follow-up scores of the PREE and qDASH questionnaires improved significantly from 54.0 to 23.0 and 50.3 to 20.7, respectively. The mean baseline EQ5D3L-visual analogue scale score improved from 62.5 to 82.9 by 6 months post-injection. These outcomes did not significantly differ between the patients who received varying numbers of injections. Patients with chronic lateral epicondylitis reported significant pain relief and gain in function as well as quality of life 6 months after localized PRP treatment. A single PRP injection may be sufficient.

  13. Safety and effectiveness of a single and repeat intramuscular injection of a GnRH vaccine (GonaCon™) in adult female domestic cats.

    Science.gov (United States)

    Vansandt, L M; Kutzler, M A; Fischer, A E; Morris, K N; Swanson, W F

    2017-04-01

    Sterilization is a key strategy to reduce the number of domestic cats entering and killed in shelters each year. However, surgical sterilization is expensive and labour-intensive and cannot fully address the 70 million free-roaming cats estimated to exist in the United States. GonaCon™ is a gonadotropin-releasing hormone vaccine originally developed for use as a wildlife immunocontraceptive. An earlier formulation was tested in domestic cats and found to be safe and effective for long-term contraception. However, the current Environmental Protection Agency (EPA)-registered formulation consists of a different antigen-carrier protein and increased antigen concentration and has never been tested in cats. A pilot study was undertaken to evaluate the short-term safety of a single GonaCon immunization, assess the consequences of vaccinated cats receiving an accidental second GonaCon injection and determine the humoral immune response to immunization. During Phase 1, cats in Group A (n = 3) received a single intramuscular injection of GonaCon and Group B (n = 3) received a single intramuscular injection of saline. During Phase 2, Group A received a second GonaCon injection and Group B received their initial GonaCon injection. All cats developed GnRH antibodies within 30 days of vaccine administration. The endpoint titre (1:1,024,000) was similar among all cats, and levels remained high throughout the duration of the study. Four cats developed a sterile, painless, self-limiting mass at the site of injection. The mean number of days to mass development was 110.3 (range, 18-249 days). In conclusion, this preliminary study suggests that the EPA-registered GonaCon formulation is safe for continued testing in domestic cats, an accidental revaccination should not increase the risk of a vaccine reaction and the EPA-registered formulation effectively elicits a strong humoral immune response. © 2016 Blackwell Verlag GmbH.

  14. Efficacy and Safety of Levosulpiride Versus Haloperidol Injection in Patients With Acute Psychosis: A Randomized Double-Blind Study.

    Science.gov (United States)

    Lavania, Sagar; Praharaj, Samir Kumar; Bains, Hariender Singh; Sinha, Vishal; Kumar, Abhinav

    2016-01-01

    Injectable antipsychotics are frequently required for controlling agitation and aggression in acute psychosis. No study has examined the use of injectable levosulpiride for this indication. To compare the efficacy and safety of injectable levosulpiride and haloperidol in patients with acute psychosis. This was a randomized, double-blind, parallel-group study in which 60 drug-naive patients having acute psychosis were randomly assigned to receive either intramuscular haloperidol (10-20 mg/d) or levosulpiride (25-50 mg/d) for 5 days. All patients were rated on Brief Psychiatric Rating Scale (BPRS), Overt Agitation Severity Scale (OASS), Overt Aggression Scale-Modified (OAS-M) scores, Simpson Angus Scale (SAS), and Barnes Akathisia Rating Scale (BARS). Repeated-measures ANOVA for BPRS scores showed significant effect of time (P haloperidol group as shown by group × time interaction (P = 0.076). Repeated-measures ANOVA for OASS showed significant effect of time (P haloperidol group as shown by group × time interaction (P = 0.032). Lorazepam requirement was much lower in haloperidol group as compared with those receiving levosulpiride (P = 0.022). Higher rates of akathisia and extrapyramidal symptoms were noted in the haloperidol group. Haloperidol was more effective than levosulpiride injection for psychotic symptoms, aggression, and severity of agitation in acute psychosis, but extrapyramidal adverse effects were less frequent with levosulpiride as compared with those receiving haloperidol.

  15. Design and development of a direct injection system for cryogenic engines

    Science.gov (United States)

    Mutumba, Angela; Cheeseman, Kevin; Clarke, Henry; Wen, Dongsheng

    2018-04-01

    The cryogenic engine has received increasing attention due to its promising potential as a zero-emission engine. In this study, a new robust liquid nitrogen injection system was commissioned and set up to perform high-pressure injections into an open vessel. The system is used for quasi-steady flow tests used for the characterisation of the direct injection process for cryogenic engines. An electro-hydraulic valve actuator provides intricate control of the valve lift, with a minimum cycle time of 3 ms and a frequency of up to 20 Hz. With additional sub-cooling, liquid phase injections from 14 to 94 bar were achieved. Results showed an increase in the injected mass with the increase in pressure, and decrease in temperature. The injected mass was also observed to increases linearly with the valve lift. Better control of the injection process, minimises the number of variables, providing more comparable and repeatable sets of data. Implications of the results on the engine performance were also discussed.

  16. Pregnancy outcomes in women with repeated implantation failures after intracytoplasmic morphologically selected sperm injection (IMSI

    Directory of Open Access Journals (Sweden)

    Mauri Ana L

    2011-07-01

    Full Text Available Abstract Background The purpose of this study was to compare laboratory and clinical outcomes of intracytoplasmic morphologically selected sperm injection (IMSI and conventional intracytoplasmic sperm injection (ICSI in couples with repeated implantation failures. Methods A total of 200 couples with at least two prior unsuccessful ICSI cycles were enrolled: 100 couples were submitted to IMSI and 100 were submitted to routine ICSI. For IMSI, spermatozoa were selected at 8400× magnification using an inverted microscope equipped with Nomarski (differential interference contrast optics. For conventional ICSI, spermatozoa were selected at 400× magnification. Clinical outcomes were evaluated between the two groups. Results Study patients were comparable in age, number of treatment failures, aetiology of infertility, percentage of normal form assessed by MSOME (motile sperm organelle morphology examination, semen parameters, total number of oocytes collected, number of mature oocytes collected, total number of embryos transferred and number of high-quality embryos transferred. No statistically significant differences between the two groups were observed with regard to rates of fertilisation, implantation and pregnancy/cycle. Although not statistically significant, rates of miscarriage (IMSI:15.3% vs ICSI:31.7%, ongoing pregnancy (IMSI:22% vs ICSI:13% and live births (IMSI:21% vs ICSI:12% showed a trend towards better outcomes in the IMSI group. In addition, analysis of subpopulations with or without male factor showed similar results. Conclusions Our results suggest that IMSI does not provide a significant improvement in clinical outcome compared to ICSI, at least in couples with repeated implantation failures after conventional ICSI. However, it should be noted that there were clear trends for lower miscarriage rates (≈50% reduced and higher rates of ongoing pregnancy and live births (both nearly doubled within the IMSI group. Further confirmation

  17. Reproducibility and Reliability of Repeated Quantitative Fluorescence Angiography

    DEFF Research Database (Denmark)

    Nerup, Nikolaj; Knudsen, Kristine Bach Korsholm; Ambrus, Rikard

    2017-01-01

    INTRODUCTION: When using fluorescence angiography (FA) in perioperative perfusion assessment, repeated measures with re-injections of fluorescent dye (ICG) may be required. However, repeated injections may cause saturation of dye in the tissue, exceeding the limit of fluorescence intensity...... that the camera can detect. As the emission of fluorescence is dependent of the excitatory light intensity, reduction of this may solve the problem. The aim of the present study was to investigate the reproducibility and reliability of repeated quantitative FA during a reduction of excitatory light....

  18. Repeating pneumatic pellet injector in JAERI

    Energy Technology Data Exchange (ETDEWEB)

    Kasai, Satoshi; Hasegawa, Kouichi; Suzuki, Sadaaki; Miura, Yukitoshi (Japan Atomic Energy Research Inst., Naka, Ibaraki (Japan). Naka Fusion Research Establishment); Oda, Yasushi; Onozuka, Masanori; Tsujimura, Seiichi.

    1992-09-01

    A repeating pneumatic pellet injector has been developed and constructed at Japan Atomic Energy Research Institute. This injector can provide repetitive pellet injection to fuel tokamak plasmas for an extended period of time, aiming at the improvement of plasma performance. The pellets with nearly identical speed and mass can be repeatedly injected with a repetition rate of 2-3.3 Hz and a speed of up to 1.7 km/s by controlling the temperature of the cryogenic system, the piston speed and the pressure of the propellant gas. (author).

  19. Repeating pneumatic pellet injector in JAERI

    International Nuclear Information System (INIS)

    Kasai, Satoshi; Hasegawa, Kouichi; Suzuki, Sadaaki; Miura, Yukitoshi; Oda, Yasushi; Onozuka, Masanori; Tsujimura, Seiichi.

    1992-09-01

    A repeating pneumatic pellet injector has been developed and constructed at Japan Atomic Energy Research Institute. This injector can provide repetitive pellet injection to fuel tokamak plasmas for an extended period of time, aiming at the improvement of plasma performance. The pellets with nearly identical speed and mass can be repeatedly injected with a repetition rate of 2-3.3 Hz and a speed of up to 1.7 km/s by controlling the temperature of the cryogenic system, the piston speed and the pressure of the propellant gas. (author)

  20. Repeated injections of piracetam improve spatial learning and increase the stimulation of inositol phospholipid hydrolysis by excitatory amino acids in aged rats

    NARCIS (Netherlands)

    Canonico, P. L.; Aronica, E.; Aleppo, G.; Casabona, G.; Copani, A.; Favit, A.; Nicoletti, F.; Scapagnini, U.

    1991-01-01

    Repeated injections of piracetam (400 mg/kg, i.p. once a day for 15 days) to 16-month old rats led to an improved performance on an 8-arm radial maze, used as a test for spatial learning. This effect was accompanied by a greater ability of excitatory amino acids (ibotenate and glutamate) to

  1. Analysis of pulsed injection for microgravity receiver tank chilldown

    Science.gov (United States)

    Honkonen, Scott C.; Pietrzyk, Joe R.; Schuster, John R.

    The dominant heat transfer mechanism during the hold phase of a tank chilldown cycle in a low-gravity environment is due to fluid motion persistence following the charge. As compared to the single-charge per vent cycle case, pulsed injection maintains fluid motion and the associated high wall heat transfer coefficients during the hold phase. As a result, the pulsed injection procedure appears to be an attractive method for reducing the time and liquid mass required to chill a tank. However, for the representative conditions considered, no significant benefit can be realized by using pulsed injection as compared to the single-charge case. A numerical model of the charge/hold/vent process was used to evaluate the pulsed injection procedure for tank chilldown in microgravity. Pulsed injection results in higher average wall heat transfer coefficients during the hold, as compared to the single-charge case. However, these high levels were not coincident with the maximum wall-to-fluid temperature differences, as in the single-charge case. For representative conditions investigated, the charge/hold/vent process is very efficient. A slightly shorter chilldown time was realized by increasing the number of pulses.

  2. Effects on mitochondrial metabolism in livers of guinea pigs after a single or repeated injection of As sub 2 O sub 3

    Energy Technology Data Exchange (ETDEWEB)

    Reichl, F.X.; Kreppel, H.; Forth, W. (Muenchen Univ. (Germany, F.R.). Walter-Straub-Institut fuer Pharmakologie und Toxikologie); Szinicz, L. (Akademie des Sanitaets- und Gesundheitswesens der Bundeswehr, Muenchen (Germany, F.R.). Inst. fuer Pharmakologie und Toxikologie)

    1989-09-01

    Differences in the metabolite pattern were observed in previous experiments in guinea pig livers after a single injection or prolonged (5 days) treatment with AS{sub 2}O{sub 3} (Reichl et al. 1988). To elucidate the underlying mechanism the effect of As{sub 2}O{sub 3} on liver metabolism was therefore investigated. Male guinea pigs received either a single dose (s.d.) of As{sub 2}O{sub 3} 10 mgxkg{sup -1} s.c. or repeated doses (r.d.) of 2.5 mgxkg{sup -1} b.i.d. on 5 consecutive days. One hour after the s.d. or 1 h and 16 h after the last injection in the r.d. groups the animals were sacrificed in anaesthesia. The livers were removed by freeze clamping for the determination of various metabolites. In the s.d. group a significant decrease in hydroxybutyrate, acetylCoA, adenosinemonophosphate and in the ratio of hydroxybutyrate/acetoacetate and an increase in pyruvate, citrate, malate, and adenosinetriphosphate were observed. A significant decrease in glycogen, pyruvate, {alpha}-ketoglutarate, acetylCoA, and acetoacetate and a significant increase in malate and in the ratios of lactate/pyruvate and hydroxybutyrate/acetoacetate were observed in the r.d.1-h group. In the r.d.16-h group a significant decrease in glycogen, pyruvate, lactate, and adenosinemonophosphate was found, but the values tended towards control values. The data are consistent with mechanisms of As{sub 2}O toxicity in other species as PDH inhibition with consecutive citric acid cycle and gluconeogenesis inhibition and excessive carbohydrate depletion. (orig.).

  3. Safety Evaluation of EXPAREL (DepoFoam Bupivacaine Administered by Repeated Subcutaneous Injection in Rabbits and Dogs: Species Comparison

    Directory of Open Access Journals (Sweden)

    Brigitte M. Richard

    2011-01-01

    Full Text Available EXPAREL (bupivacaine extended-release liposome injection, DepoFoam bupivacaine, is in development for prolonged postsurgical analgesia. Repeat-dose toxicity studies were conducted in rabbits and dogs to compare the potential local and systemic toxicities of EXPAREL and bupivacaine HCl (Bsol, and the reversibility of any effects. Dogs tolerated much larger doses than rabbits. EXPAREL-related minimal-to-moderate granulomatous inflammation was noted at the injection sites. In recovery animals, the granulomatous inflammation was observed less frequently and was characterized by an increased number of multinucleated giant cells. These effects were considered a normal response to liposomes and nonadverse. Rabbits are more sensitive than dogs. In rabbits, convulsions were noted with EXPAREL and more frequently with Bsol; a NOAEL was not identified. In dogs, EXPAREL was well tolerated (NOAEL > 30 mg/kg/dose. The cumulative exposure of EXPAREL in these studies is well in excess of the proposed maximum single-dose exposure that is intended in humans.

  4. Repeated Exposure to the “Spice” Cannabinoid JWH-018 Induces Tolerance and Enhances Responsiveness to 5-HT1A Receptor Stimulation in Male Rats

    Directory of Open Access Journals (Sweden)

    Joshua S. Elmore

    2018-02-01

    Full Text Available Naphthalen-1-yl-(1-pentylindol-3-ylmethanone (JWH-018 is a synthetic compound found in psychoactive “spice” products that activates cannabinoid receptors. Preclinical evidence suggests that exposure to synthetic cannabinoids increases 5-HT2A/2C receptor function in the brain, an effect which might contribute to psychotic symptoms. Here, we hypothesized that repeated exposures to JWH-018 would enhance behavioral responsiveness to the 5-HT2A/2C receptor agonist DOI. Male Sprague-Dawley rats fitted with subcutaneously (sc temperature transponders received daily injections of JWH-018 (1.0 mg/kg, sc or its vehicle for seven consecutive days. Body temperature and catalepsy scores were determined at 1, 2, and 4 h post-injection each day. At 1 and 7 days after the final repeated treatment, rats received a challenge injection of either DOI (0.1 mg/kg, sc or the 5-HT1A receptor agonist 8-OH-DPAT (0.3 mg/kg, sc, then temperature and behavioral responses were assessed. Behaviors induced by DOI included wet dog shakes and back muscle contractions (i.e., skin jerks, while behaviors induced by 8-OH-DPAT included ambulation, forepaw treading, and flat body posture. On the first day of repeated treatment, JWH-018 produced robust hypothermia and catalepsy which lasted up to 4 h, and these effects were significantly blunted by day 7 of treatment. Repeated exposure to JWH-018 did not affect behaviors induced by DOI, but behavioral and hypothermic responses induced by 8-OH-DPAT were significantly augmented 1 day after cessation of JWH-018 treatment. Collectively, our findings show that repeated treatment with JWH-018 produces tolerance to its hypothermic and cataleptic effects, which is accompanied by transient enhancement of 5-HT1A receptor sensitivity in vivo.

  5. Injection-Site Reactions in Wild Horses (Equus caballus) Receiving an Immunocontraceptive Vaccine

    Science.gov (United States)

    Roelle, James E.; Ransom, Jason I.

    2009-01-01

    The U.S. Geological Survey and the Bureau of Land Management are conducting research on the efficacy of the immunocontraceptive agent porcine zona pellucida (PZP) in reducing fertility of wild horses (Equus caballus). As an antigen, PZP stimulates antibody production when injected into many mammalian species. These antibodies bind to the external surface of the ovum, preventing fertilization. By itself, PZP is only weakly immunogenic and is therefore delivered with an adjuvant, most commonly one of the Freund adjuvants, designed to further stimulate antibody production. Freund's complete adjuvant (FCA) in particular is known to be very effective, but may also be associated with undesirable side effects such as formation of abscesses at injection sites. Such reactions may be exacerbated when accompanied by the additional trauma of a remotely delivered dart. Because horses in our three study herds were individually identifiable by color markings and harem association, we were able to monitor mares for injection-site reactions (abscesses, nodules, swelling, and stiffness) following inoculation with PZP. In 100 injections delivered by hand we observed a single nodule, two instances of swelling, and no other reactions. In two herds that received remotely delivered (dart) injections, the frequency of reactions was about 1 and 6 percent for abscesses, 25 percent for nodules (both herds), 11 and 33 percent for swelling, and 1 and 12 percent for stiffness. Abscesses were too infrequent to allow meaningful analysis of the relation to covariates, but for the other types of reactions we used logistic regression to examine the relation of occurrence to the delivery method (rifle or CO2-powered blowgun), adjuvant (FCA, Freund's modified adjuvant, and Freund's incomplete adjuvant), dart trauma (normal or abnormal), and age of mare. Abnormal dart trauma included cases where the dart hit bone or the needle broke off. We found strong evidence (odds ratio = 5.023, P = 0.001) for a

  6. Dental Fear in Children with Repeated Tooth Injuries.

    Science.gov (United States)

    Negovetić Vranić, Dubravka; Ivančić Jokić, Nataša; Bakarčić, Danko; Carek, Andreja; Rotim, Željko; Verzak, Željko

    2016-06-01

    Tooth injuries are serious clinical conditions. Some children experience dental trauma only once, while others are more prone to repeated tooth injuries. Repeated dental trauma occurs in 19.4% to 30% of patients. Pain and dental trauma are the most common reasons for fear and anxiety. The main objective of this study was to investigate how dental trauma, as well as repeated dental trauma affects the occurrence and development of dental fear in children. The study was conducted on a random sample of 147 subjects (88 boys and 59 girls) aged 5-8 and 9-12 years. Subjects in both age groups were divided into subroups without dental trauma, with one dental trauma and with repeated dental trauma. The validated Children’s Fear Survey Schedule – Dental Subscale was used on fear assessment. Results showed that only 12.2% of children without trauma, 33.3% with one trauma and 51.7% with repeated trauma were not afraid of injection. Older children had a significantly lower fear of injections, touch of an unknown person, choking, going to the hospital and people in white uniforms. Dentist was not the cause of fear in 65.5% of patients with repeated trauma. With each repeated injury of teeth, the degree of their fear of dental treatment was lower.

  7. 21 CFR 522.1182 - Iron injection.

    Science.gov (United States)

    2010-04-01

    ... follows: (i) For prevention of iron deficiency anemia, inject 100 mg (1 mL) by intramuscular injection at 2 to 4 days of age. (ii) For treatment of iron deficiency anemia, inject 100 mg (1 mL) by... repeated in 14 to 21 days. (ii) For the treatment of anemia due to iron deficiency, administer an...

  8. Compatibility and Stability of VARUBI (Rolapitant) Injectable Emulsion Admixed with Intravenous Palonosetron Hydrochloride Injection and Dexamethasone Sodium Phosphate Injection.

    Science.gov (United States)

    Wu, George; Powers, Dan; Yeung, Stanley; Chen, Frank

    2018-01-01

    Prophylaxis or therapy with a combination of a neurokinin 1 (NK-1) receptor antagonist (RA), a 5-hydroxytryptamine-3 (5-HT3) RA, and dexamethasone is recommended by international antiemesis guidelines for the prevention of chemotherapy-induced nausea and vomiting for patients receiving highly emetogenic chemotherapy and for selected patients receiving moderately emetogenic chemotherapy. VARUBI (rolapitant) is a substance P/NK-1 RA that was recently approved by the U.S. Food and Drug Administration as an injectable emulsion in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy. Palonosetron is one of the 5-HT3 RAs indicated for the prevention of nausea and/or vomiting associated with initial and repeat courses of emetogenic cancer therapy, including high-dose cisplatin. Herein, we describe the physical and chemical compatibility and stability of VARUBI injectable emulsion (166.5 mg/92.5 mL [1.8 mg/mL, free base], equivalent to 185 mg of rolapitant hydrochloride) admixed with palonosetron injection 0.25 mg free base in 5 mL (equivalent to 0.28 mg hydrochloride salt) and with either 5 mL (20 mg) or 2.5 mL (10 mg) of dexamethasone sodium phosphate. Admixtures were prepared and stored in VARUBI injectable emulsion ready-to-use glass vials as supplied by the rolapitant manufacturer and in four types of commonly used intravenous administration (tubing) sets. Assessment of the physical and chemical compatibility and stability of the admixtures in the VARUBI ready-to-use vials stored at room temperature (20°C to 25°C) under fluorescent light and under refrigeration (2°C to 8°C protected from light) was conducted at 0, 1, 6, 24, and 48 hours, and that of the admixtures in the intravenous tubing sets was evaluated at 0, 2, and 6 hours of storage at 20°C to 25°C. Physical stability

  9. The association between nicotine dependence and physical health among people receiving injectable diacetylmorphine or hydromorphone for the treatment of chronic opioid use disorder

    Directory of Open Access Journals (Sweden)

    Heather Palis

    2018-06-01

    Full Text Available Introduction: People with chronic opioid use disorder often present to treatment with individual and structural vulnerabilities and remain at risk of reporting adverse health outcomes. This risk is greatly compounded by tobacco smoking, which is highly prevalent among people with chronic opioid use disorder. Despite the known burden of tobacco smoking on health, the relationship between nicotine dependence and health has not been studied among those receiving injectable opioid agonist treatment. As such, the present study aims to explore the association between nicotine dependence and physical health among participants of the Study to Assess Longer-Term Opioid Medication Effectiveness (SALOME at baseline and six-months. Methods: SALOME was a double-blind phase III clinical trial testing the non-inferiority of injectable hydromorphone to injectable diacetylmorphine for chronic opioid use disorder. Participants reporting tobacco smoking were included in a linear regression analysis of physical health at baseline (before receiving treatment and at six-months. Results: At baseline, nicotine dependence score, lifetime history of emotional, physical, or sexual abuse and prior month safe injection site access were independently and significantly associated with physical health. At six-months nicotine dependence score was the only variable that maintained this significant and independent association with physical health. Conclusions: Findings indicate that after six-months, the injectable treatment effectively brought equity to patients' physical health status, yet the association with nicotine dependence remained. Findings could inform whether the provision of treatment for nicotine dependence should be made a priority in settings where injectable opioid agonist treatment is delivered to achieve improvements in overall physical health in this population.

  10. Perturbations in different forms of cost/benefit decision making induced by repeated amphetamine exposure.

    Science.gov (United States)

    Floresco, Stan B; Whelan, Jennifer M

    2009-08-01

    Psychostimulant abuse has been linked to impairments in cost-benefit decision making. We assessed the effects of repeated amphetamine (AMPH) treatment in rodents on two distinct forms of decision making. Separate groups of rats were trained for 26 days on either a probabilistic (risk) or effort-discounting task, each consisting of four discrete blocks of ten choice trials. One lever always delivered a smaller reward (one or two pellets), whereas another lever delivered a four-pellet reward. For risk-discounting, the probability of receiving the larger reward decreased across trial blocks (100-12.5%), whereas on the effort task, four pellets could be obtained after a ratio of presses that increased across blocks (2-20). After training, rats received 15 saline or AMPH injections (escalating from 1 to 5 mg/kg) and were then retested during acute and long-term withdrawal. Repeated AMPH administration increased risky choice 2-3 weeks after drug exposure, whereas these treatments did not alter effort-based decision making in a separate group of animals. However, prior AMPH exposure sensitized the effects of acute AMPH on both forms of decision making, whereby lower doses were effective at inducing "risky" and "lazy" patterns of choice. Repeated AMPH exposure leads to relatively long-lasting increases in risky choice, as well as sensitization to the effects of acute AMPH on different forms of cost/benefit decision making. These findings suggest that maladaptive decision-making processes exhibited by psychostimulant abusers may be caused in part by repeated drug exposure.

  11. Effects of moxifloxacin exposure on the conjunctival flora and antibiotic resistance profile following repeated intravitreal injections

    Directory of Open Access Journals (Sweden)

    Mustafa Ataş

    2014-10-01

    Full Text Available AIM:To evaluate the effects of moxifloxacin exposure on the conjunctival flora and antibiotic resistance profile following repeated intravitreal injections.METHODS:Seventy-two eyes of 36 patients [36 eyes in control group, 36 eyes in intravitreal injection (IVI group] were enrolled in the study. All the eyes had at least one IVI and had diabetic macular edema (DME or age-related macular degeneration (ARMD. Moxifloxacin was prescribed to all the patients four times a day for five days following injection. Conjunctival cultures were obtained from the lower fornix via standardized technique with every possible effort made to minimize contamination from the lids, lashes, or skin. Before the application of any ophthalmic medication, conjunctival cultures were obtained from both eyes using sterile cotton culture. An automated microbiology system was used to identify the growing bacteria and determine antibiotic sensitivity. RESULTS:The bacterial cultures were isolated from 72 eyes of 36 patients, sixteen of whom patients (44.4% were male and twenty (55.6% were female. Average age was 68.4±9.0 (range 50-86. The average number of injections before taking cultures was 3.1+1.0. Forty-eight (66.7% of 72 eyes had at least one significant organism. There was no bacterial growth in 8 (20.5% of IVI eyes and in 16 (44.4% of control eyes (P=0.03. Of the bacteria isolated from culture, 53.8% of coagulase negative staphylococci (CoNS in IVI eyes and 47.2% CoNS in control eyes. This difference between IVI eyes and control eyes about bacteria isolated from culture was not statistically significant (P=0.2. Eleven of 25 bacteria (44.0% isolated from IVI eyes and 11 (57.9% of 19 bacteria isolated from control eyes were resistant to oxacillin. The difference in frequency of moxifloxacine resistance between two groups was not statistically significant (12.0% in IVI eyes and 21.1% in control eyes (P=0.44. There were no cases of resistance to vancomycin, teicoplanin and

  12. Multiple collagenase injections are safe for treatment of Dupuytren's contractures.

    Science.gov (United States)

    Gajendran, Varun K; Hentz, Vincent; Kenney, Deborah; Curtin, Catherine M

    2014-07-01

    The authors report the case of a 65-year-old, right-hand-dominant man who had severe Dupuytren's disease with multiple cords and flexion contractures of the metacarpophalangeal and proximal interphalangeal joints of both hands and underwent repeated collagenase injections for treatment. Collagenase has been shown to be safe and effective in the treatment of Dupuytren's contractures when administered as a single dose, but the results of multiple injections over a prolonged period are unknown. Antibodies to collagenase develop in all patients after several treatments, raising concerns about safety and efficacy as a result of sensitization from repeated exposures. The antibodies generated as a result of repeated exposure to collagenase could theoretically render it less effective with time and could also lead to immune reactions as severe as anaphylaxis. The authors present the case of a single patient who experienced continued correction of his contractures with only minor and self-limited adverse reactions after administration of 12 collagenase doses through 15 injections during a 4-year period. Over time, the injections continued to be effective at correcting metacarpophalangeal joint contractures, but less effective at correcting proximal interphalangeal joint contractures. The patient did eventually require a fasciectomy, but the safety and modest success of the repeated collagenase injections shows promise for a less invasive treatment with a better risk profile than open fasciectomy. Although further studies are needed, repeated administration of collagenase appears to be safe and modestly effective for severe Dupuytren's contractures, although a fasciectomy may ultimately be required in the most severe cases. Copyright 2014, SLACK Incorporated.

  13. Secondary immune response of rainbow trout following repeated immersion vaccination

    DEFF Research Database (Denmark)

    Jaafar, R. M.; Al-Jubury, A.; Chettri, J. K.

    2017-01-01

    Teleosts are able to raise a protective immune response, comprising both innate and adaptive elements, against various pathogens. This is the basis for a widespread use of vaccines, administered as injection or immersion, in the aquaculture industry. It has been described that repeated injection...... vaccination of fish raises a secondary immune response, consisting of rapid, accelerated and increased antibody reaction. This study reports how rainbow trout responds to repeated immersion vaccination against yersiniosis (ERM) caused by the bacterial pathogen Yersinia ruckeri. It was found that rainbow trout...... does not raise a classical secondary response following repeated immersion vaccination. Serum antibody titres were merely slightly increased even after three immunizations, using 30-s immersion into a bacterin consisting of formalin-inactivated Y. ruckeri (serotype O1, biotypes 1 and 2), performed over...

  14. Secondary immune response of rainbow trout following repeated immersion vaccination

    DEFF Research Database (Denmark)

    Jaafar, R. M.; Al-Jubury, Azmi; Chettri, Jiwan Kumar

    2018-01-01

    Teleosts are able to raise a protective immune response, comprising both innate and adaptive elements, against various pathogens. This is the basis for a widespread use of vaccines, administered as injection or immersion, in the aquaculture industry. It has been described that repeated injection...... vaccination of fish raises a secondary immune response, consisting of rapid, accelerated and increased antibody reaction. This study reports how rainbow trout responds to repeated immersion vaccination against yersiniosis (ERM) caused by the bacterial pathogen Yersinia ruckeri. It was found that rainbow trout...... does not raise a classical secondary response following repeated immersion vaccination. Serum antibody titres were merely slightly increased even after three immunizations, using 30-s immersion into a bacterin consisting of formalin-inactivated Y. ruckeri (serotype O1, biotypes 1 and 2), performed over...

  15. CT-guided cervical nerve root injections: comparing the immediate post-injection anesthetic-related effects of the transforaminal injection with a new indirect technique

    International Nuclear Information System (INIS)

    Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K.; Zanetti, Marco; Hodler, Juerg

    2011-01-01

    To describe an ''indirect'' cervical nerve root injection technique with a dorsal approach that should carry less inherent risk than the ''direct'' cervical transforaminal injection approach, and to compare the immediate post-injection results of the two procedures. The indirect and direct cervical nerve root injection procedures are described in detail. Fifty-three consecutive patients receiving the indirect nerve root injections during 2009-2010 were age- and gender-matched to 53 patients who underwent direct transforaminal nerve root injections performed in 2006. Pain level data were collected immediately before and 20-30 min after each procedure. The percentages of pain change in the two groups were compared using the unpaired Student's t test. Fifty-two men (mean age 49) and 54 women (mean age 55) were included. The mean percentage of pain reduction for patients receiving indirect nerve root injections was 38.4% and for those undergoing the direct nerve root injections approach it was 43.2%. This was not significantly different (P = 0.455). No immediate or late adverse effects were reported after either injection procedure. The indirect cervical nerve root injection procedure is a potentially safer alternative to direct cervical transforaminal nerve root injections. The short-term pain reduction is similar using the two injection methods. (orig.)

  16. Sodium Ferric Gluconate Injection

    Science.gov (United States)

    Sodium ferric gluconate injection is used to treat iron-deficiency anemia (a lower than normal number of ... are also receiving the medication epoetin (Epogen, Procrit). Sodium ferric gluconate injection is in a class of ...

  17. Comparative Pharmacokinetics of Cefquinome (Cobactan 2.5% following Repeated Intramuscular Administrations in Sheep and Goats

    Directory of Open Access Journals (Sweden)

    Mohamed El-Hewaity

    2014-01-01

    Full Text Available The comparative pharmacokinetic profile of cefquinome was studied in sheep and goats following repeated intramuscular (IM administrations of 2 mg/kg body weight. Cefquinome concentrations in serum were determined by microbiological assay technique using Micrococcus luteus (ATCC 9341 as test organism. Following intramuscular injection of cefquinome in sheep and goats, the disposition curves were best described by two-compartment open model in both sheep and goats. The pharmacokinetics of cefquinome did not differ significantly between sheep and goats; similar intramuscular dose rate of cefquinome should therefore be applicable to both species. On comparing the data of serum levels of repeated intramuscular injections with first intramuscular injection, it was revealed that repeated intramuscular injections of cefquinome have cumulative effect in both species sheep and goats. The in vitro serum protein-binding tendency was 15.65% in sheep and 14.42% in goats. The serum concentrations of cefquinome along 24 h after injection in this study were exceeding the MICs of different susceptible microorganisms responsible for serious disease problems. These findings indicate successful use of cefquinome in sheep and goats.

  18. Postinjection delirium/sedation syndrome in patients with schizophrenia receiving olanzapine long-acting injection: results from a large observational study.

    Science.gov (United States)

    Meyers, Kristin J; Upadhyaya, Himanshu P; Landry, John L; Chhabra-Khanna, Rashna; Falk, Deborah M; Seetharama Rao, Balasubramanya; Jones, Meghan E

    2017-07-01

    Postinjection delirium/sedation syndrome (PDSS) has been reported uncommonly during treatment with olanzapine long-acting injection (LAI), a sustained-release formulation of olanzapine. The primary aim of the study was to estimate the incidence per injection and per patient of PDSS events in adult patients with schizophrenia who were receiving olanzapine LAI in real-world clinical practice. Secondary aims were to further characterise the clinical presentation of PDSS events, to identify potential risk factors associated with PDSS events and to characterise hospitalisations at baseline and post-baseline. A prospective observational study of adult patients with schizophrenia receiving olanzapine LAI from 24 countries. Data were collected on patient characteristics, olanzapine LAI treatment and any adverse events (AEs). All AEs were reviewed and adjudicated for PDSS using predetermined criteria. There were 46 confirmed PDSS events (0.044% of the 103 505 injections) in 45 patients (1.17% of the 3858 patients). Based on 45 confirmed events with time-to-onset information, 91.1% ( n =41) occurred within 1 h of injection. Time-to-recovery from the event was within 72 h for 95.6% of patients (range 6 h to 11 days). Risk factors for PDSS (per-injection) included high dose (odds ratio (OR) high/low =3.95; P =0.006) and male gender (OR female/male =0.42; P =0.017). Results of this study confirm previously reported PDSS rates, time to onset and recovery, and the severity of PDSS events, and suggest that higher doses and male gender are potential risk factors associated with PDSS. All authors are full-time employees and hold stock/stock options in Eli Lilly, which funded this study. This post-authorisation safety study (PASS) was proposed by Eli Lilly when submitting the original marketing authorisation application for olanzapine LAI in 2007. The protocol and final study report for this European Union regulatory commitment are publicly accessible via the European Network of

  19. Repeated exposure to corticosterone increases depression-like behavior in two different versions of the forced swim test without altering nonspecific locomotor activity or muscle strength.

    Science.gov (United States)

    Marks, Wendie; Fournier, Neil M; Kalynchuk, Lisa E

    2009-08-04

    We have recently shown that repeated high dose injections of corticosterone (CORT) reliably increase depression-like behavior on a modified one-day version of the forced swim test. The main purpose of this experiment was to compare the effect of these CORT injections on our one-day version of the forced swim test and the more traditional two-day version of the test. A second purpose was to determine whether altered behavior in the forced swim test could be due to nonspecific changes in locomotor activity or muscle strength. Separate groups of rats received a high dose CORT injection (40 mg/kg) or a vehicle injection once per day for 21 consecutive days. Then, half the rats from each group were exposed to the traditional two-day forced swim test and the other half were exposed to our one-day forced swim test. After the forced swim testing, all the rats were tested in an open field and in a wire suspension grip strength test. The CORT injections significantly increased the time spent immobile and decreased the time spent swimming in both versions of the forced swim test. However, they had no significant effect on activity in the open field or grip strength in the wire suspension test. These results show that repeated CORT injections increase depression-like behavior regardless of the specific parameters of forced swim testing, and that these effects are independent of changes in locomotor activity or muscle strength.

  20. Synovial response to intraarticular injections of hyaluronate in frozen shoulder. A quantitative assessment with dynamic magnetic resonance imaging

    International Nuclear Information System (INIS)

    Tamai, Kazuya; Mashitori, Hirotaka; Ohno, Wataru; Hamada, Jun'ichiro; Sakai, Hiroya; Saotome, Koichi

    2004-01-01

    To clarify the response of frozen shoulder (FS) to intraarticular injections of high-molecular-weight sodium hyaluronate (HA), a mixture of 2.5 ml of HA and 1.5 ml of 1% lidocaine was injected into the glenohumeral joint of 11 patients with FS, 8 of whom received five weekly injections. The patients were assessed using the Japanese Orthopaedic Association shoulder score (JOA score) before the first injection, 1 week after the first injection, and 1 week after the final injection. Following each clinical evaluation, the patients underwent dynamic magnetic resonance imaging enhanced with Gd-DTPA, and the coefficient of enhancement (CE) in the glenohumeral synovium was calculated, with the examiners blinded to the clinical information. The JOA score tended to be greater and the CE smaller after injection than before injection. The changes in the CE following both single and repeated injections were negatively correlated with changes in the JOA score. Thus, clinical improvement in patients with FS was associated with a decrease in the CE. Because the CE depends on the degree of synovitis, the therapeutic effect of intraarticular HA injection for FS results, at least in part, from suppression of synovitis in the glenohumeral joint through an antiinflammatory effect. (author)

  1. Metabolic and cytoprotective effects of in vivo peri-patellar hyaluronic acid injections in cultured tenocytes.

    Science.gov (United States)

    Salamanna, F; Frizziero, A; Pagani, S; Giavaresi, G; Curzi, D; Falcieri, E; Marini, M; Abruzzo, P M; Martini, L; Fini, M

    2015-02-01

    The purpose of this study was to investigate tenocyte mechanobiology after sudden-detraining and to examine the hypothesis that repeated peri-patellar injections of hyaluronic acid (HA) on detrained patellar tendon (PT) may reduce and limit detrained-associated damage in tenocytes. Twenty-four male Sprague-Dawley rats were divided into three groups: Untrained, Trained and Detrained. In the Detrained rats, the left tendon was untreated while the right tendon received repeated peri-patellar injections of either HA or saline (NaCl). Tenocyte morphology, metabolism and synthesis of C-terminal-propeptide of type I collagen, collagen-III, fibronectin, aggrecan, tenascin-c, interleukin-1β, matrix-metalloproteinase-1 and-3 were evaluated after 1, 3, 7 and 10 days of culture. Transmission-electronic-microscopy showed a significant increase in mitochondria and rough endoplasmic reticulum in cultured tenocytes from Detrained-HA with respect to those from Detrained-NaCl. Additionally, Detrained-HA cultures showed a significantly higher proliferation rate and viability, and increased synthesis of C-terminal-Propeptide of type I collagen, fibronectin, aggrecan, tenascin-c and matrix-metalloproteinase-3 with respect to Detrained-NaCl ones, whereas synthesis of matrix-metalloproteinase-1 and interleukin-1β was decreased. Our study demonstrates that discontinuing training activity in the short-term alters tenocyte synthetic and metabolic activity and that repeated peri-patellar infiltrations of HA during detraining allow the maintenance of tenocyte anabolic activity.

  2. Development of repeating pneumatic pellet injector

    International Nuclear Information System (INIS)

    Oda, Y.; Onozuka, M.; Shimomura, T.

    1990-01-01

    A repeating pneumatic pellet injector has been constructed to experiment with the technique of continuous injection for fueling fusion reactors. This device is composed of a cryogenic extruder and a gun assembly in (among others) a high-vacuum vessel, diagnostic vessels, LHe, fuel-gas and propellant-gas supply systems, control and data acquisition systems, etc. The performance tests, using hydrogen, have proved that the device provides the function of extruding frozen hydrogen ribbons at the speed of 6 mm s -1 , chambering pellet at the rate of 5 Hz, and injecting pellet at the speed of 900 m s -1 , as planned. (author)

  3. Frequency of booster injections of allergoids.

    Science.gov (United States)

    Norman, P S; Creticos, P S; Marsh, D G

    1990-01-01

    In 1982, 43 ragweed-sensitive patients receiving maintenance injections of full doses of ragweed allergoid were selected for a study of the immunologic and clinical efficacy of booster injections only four times a year. These patients had participated for 2 to 7 years as part of a trial of mixes of up to four allergoids to common pollens in the mid-Atlantic area tailored to each patient's skin test sensitivity. They were divided into a group (21 patients) to receive injections every 3 months and a group (22 patients) to receive injections about every 6 weeks (eight injections per year). Patients were rerandomized after 1 year so that half of each original group switched to the alternate treatment, and this program was continued until after the ragweed season of 1985. Thirty-four patients were still under study the last year. Doses, per injection, were 100 allergoid units (1 allergoid unit equals 100 PNU) of each allergen in the mixture. Symptom scores during the 8 weeks of each of the four ragweed seasons were not significantly higher in the 3-month treated group. IgG antibody levels to Amb a I (antigen E) were followed until early 1984 and were not significantly different in the two groups, even though the 6-week treated patients received a two times higher cumulative dose per year. Rates of local and systemic reactions (percent of injections eliciting reactions) were not different in the groups, which means that the 3-month treated group had about half as many reactions by virtue of taking half as many injections.(ABSTRACT TRUNCATED AT 250 WORDS)

  4. Worldwide Injection Technique Questionnaire Study: Injecting Complications and the Role of the Professional.

    Science.gov (United States)

    Frid, Anders H; Hirsch, Laurence J; Menchior, Astrid R; Morel, Didier R; Strauss, Kenneth W

    2016-09-01

    From February 1, 2014, through June 30, 2015, 13,289 insulin-injecting patients from 423 centers in 42 countries participated in one of the largest surveys ever performed in diabetes. The first results of this survey are published elsewhere in this issue. Herein we report that the most common complication of injecting insulin is lipohypertrophy (LH), which was self-reported by 29.0% of patients and found by physical examination in 30.8% by health care professionals (HCPs). Patients with LH consumed a mean of 10.1 IU more insulin daily than patients without LH. Glycated hemoglobin levels averaged 0.55% higher in patients with vs without LH. Lipohypertrophy was associated with higher rates of unexplained hypoglycemia and glycemic variability as well as more frequent diabetic ketoacidosis, incorrect rotation of injection sites, use of smaller injection zones, longer duration of insulin use, and reuse of pen needles (each P<.05). Routine inspection of injection sites by the HCP was associated with lower glycated hemoglobin levels, less LH, and more correct injection site rotation. Patients were also more likely to rotate correctly if they received injection instructions from their HCP in the past 6 months. Fewer than 40% of patients claimed to have gotten such instructions in the past 6 months, and 10% said that they have never received training on how to inject correctly despite injecting for a mean of nearly 9 years. Use of these data should stimulate renewed commitment to optimizing insulin injection practices. Copyright © 2016 Mayo Foundation for Medical Education and Research. Published by Elsevier Inc. All rights reserved.

  5. Development of repeating pneumatic pellet injector

    Energy Technology Data Exchange (ETDEWEB)

    Oda, Y.; Onozuka, M.; Shimomura, T. (Mitsubishi Heavy Industries Ltd., Kobe (Japan)) (and others)

    1990-01-01

    A repeating pneumatic pellet injector has been constructed to experiment with the technique of continuous injection for fueling fusion reactors. This device is composed of a cryogenic extruder and a gun assembly in (among others) a high-vacuum vessel, diagnostic vessels, LHe, fuel-gas and propellant-gas supply systems, control and data acquisition systems, etc. The performance tests, using hydrogen, have proved that the device provides the function of extruding frozen hydrogen ribbons at the speed of 6 mm s{sup -1}, chambering pellet at the rate of 5 Hz, and injecting pellet at the speed of 900 m s{sup -1}, as planned. (author).

  6. Selective segmental sclerotherapy of the liver by transportal absolute ethanol injection: an animal experimental study

    International Nuclear Information System (INIS)

    Pan Jie; Yang Ning; Zhang Zhongzhong; Hu Libin; Chen Jie; Wu Wei; Jin Zhengyu; Liu Wei

    2003-01-01

    Objective: To evaluate the safety and efficacy of selective segmental sclerotherapy (SSS) of the liver by transportal absolute ethanol injection with an animal experimental study, and to discuss several technical points involved in this method. Methods: Thirty dogs received SSS of the liver by transportal absolute ethanol injection with the injection dose of 0.2-1.0 ml/kg, repeated examinations of blood ethanol level, WBC, and liver functions were done, and CT and pathological examinations of the liver were performed. Results: All dogs treated with SSS survived during the study. The maximum elevation of blood ethanol values occurred in group F. Its average value was (1.603 ± 0.083) mg/ml, which was much lower than that of death level. Transient elevations of blood WBC and ALT were seen. The average values of WBC and ALT were (46.36 ± 7.28) x 10 9 and (827.36 ± 147.25) U/L, respectively. CT and pathological examinations proved that the dogs given SSS by transportal absolute ethanol injection with the injection dose of 0.3-1.0 ml/kg had a complete wedge-shaped necrosis in the liver. Conclusion: Selective segmental sclerotherapy of the liver by transportal ethanol injection was quite safe and effective if the proper dose of ethanol was injected. SSS may be useful in the treatment of HCC

  7. Risperidone Injection

    Science.gov (United States)

    ... release (long-acting) injection is used to treat schizophrenia (a mental illness that causes disturbed or unusual ... may help control your symptoms but will not cure your condition. Continue to keep appointments to receive ...

  8. Haloperidol Injection

    Science.gov (United States)

    ... haloperidol extended-release injection are used to treat schizophrenia (a mental illness that causes disturbed or unusual ... may help control your symptoms but will not cure your condition. Continue to keep appointments to receive ...

  9. Multilevel Botulinum Toxin A (Abobotulinum Toxin A Injections in Spastic Forms of Cerebral Palsy: Retrospective Analysis of 8 Russian Centers Experience

    Directory of Open Access Journals (Sweden)

    O. A. Klochkova

    2016-01-01

    Full Text Available Background: The contemporary application of Botulinum toxin A (BTA in cerebral palsy (CP implies multilevel injections both in on-label and off-label muscles. However, there is no single international opinion on the effective and safe dosages, target muscles, and intervals between the injections.Objective: Our aim was to analyze the Russian multicenter independent experience of single and repeated multilevel injections of Abobotulinum toxin А in patients with spastic forms of CP.Methods: 8 independent referral CP-centers (10 hospitals in different regions of Russia. Authors evaluated intervals between the injections, dosages of the BTA for the whole procedure, for the body mass, for the each muscle, and functional segment of the extremities.Results: 1872 protocols of effective BTA injections (1–14 repeated injections for 724 patients with spastic CP were included. The age of the patients was between 8 months to 17 years 4 months at the beginning of the treatment (with a mean of 3 years 10 months. Multilevel BTA injections were indicated for the majority (n = 634, 87.6% of the patients in all the centers. The medians of the dosages for the first BTA injection were between 30–31 U/kg (500 U, the repeated injections doses up to 45 U/kg (1000 U (in most centers. The median intervals between the repeated injections were 180–200 days in 484 (66.9% patients and 140–180 days in 157 (24.7% patients. In 2 centers, children with GMFCS IV–V were injected more often than others.Conclusion: Multilevel BTA injections were indicated for the most patients. The initial dose of Abobotulinum toxin A was 30–31 U/kg. The repeated injections dose could increase up to 40 U/kg. The repeated injections were done in 140–200 days after the previous injection.

  10. Double insemination and gonadotropin-releasing hormone treatment of repeat-breeding dairy cattle.

    Science.gov (United States)

    Stevenson, J S; Call, E P; Scoby, R K; Phatak, A P

    1990-07-01

    Our objective was to determine if double inseminations during the same estrous period of dairy cattle eligible for their third or fourth service (repeat breeders) would improve pregnancy rates equivalent to injections of GnRH given at the time of AI. Repeat-breeding, lactating cows from six herds (five herds in the San Joaquin Valley of central California and one herd in northeast Kansas) were assigned randomly to four treatment groups when detected in estrus: 1) single AI plus no injection, 2) single AI plus 100 micrograms GnRH at AI, 3) double AI plus no injection, or 4) double AI plus 100 micrograms of GnRH at AI. Inseminations were performed according to the a.m.-p.m. rule. The second AI for the double AI treatment was given 12 to 16 h after the first AI. Injections of GnRH were given intramuscularly immediately following the single AI or the first AI of the double AI. Pregnancy rates of cows given a single AI and hormone injection were numerically higher in all six herds than those of their herdmates given only a single AI. In five of six herds, the pregnancy rates of cows given a double AI and hormone injection were numerically higher than pregnancy rates of their herdmates given only a double AI. Overall pregnancy rates for the four treatments were 1) 112/353 (32.1%), 2) 165/406 (41.6%), 3) 119/364 (33.5%), and 4) 135/359 (37.5%). Gonadotropin-releasing hormone increased pregnancy rates of repeat breeders compared with controls given only a single AI. No further benefit beyond the single AI was accrued from the double AI treatment, with or without concurrent hormone administration.

  11. Pain in adolescent girls receiving human papillomavirus vaccine with concomitantly administered vaccines.

    Science.gov (United States)

    Walter, Emmanuel B; Kemper, Alex R; Dolor, Rowena J; Dunne, Eileen F

    2015-02-01

    Using the Faces Pain Scale - Revised, we assessed injection site pain 10 minutes after vaccination in young females randomized to receive either quadrivalent human papillomavirus vaccine (HPV4) before or after concomitantly administered vaccines. Although pain was modestly more after HPV4 injection than after other vaccines, the pain intensity after HPV4 injection was significantly less in those who received HPV4 before receiving other concomitant vaccines.

  12. Non-injection Drug Use and Injection Initiation Assistance among People Who Inject Drugs in Tijuana, Mexico.

    Science.gov (United States)

    Ben Hamida, Amen; Rafful, Claudia; Jain, Sonia; Sun, Shelly; Gonzalez-Zuniga, Patricia; Rangel, Gudelia; Strathdee, Steffanie A; Werb, Dan

    2018-02-01

    Although most people who inject drugs (PWID) report receiving assistance during injection initiation events, little research has focused on risk factors among PWID for providing injection initiation assistance. We therefore sought to determine the influence of non-injection drug use among PWID on their risk to initiate others. We used generalized estimating equation (GEE) models on longitudinal data among a prospective cohort of PWID in Tijuana, Mexico (Proyecto El Cuete IV), while controlling for potential confounders. At baseline, 534 participants provided data on injection initiation assistance. Overall, 14% reported ever initiating others, with 4% reporting this behavior recently (i.e., in the past 6 months). In a multivariable GEE model, recent non-injection drug use was independently associated with providing injection initiation assistance (adjusted odds ratio [AOR] = 2.42, 95% confidence interval [CI] = 1.39-4.20). Further, in subanalyses examining specific drug types, recent non-injection use of cocaine (AOR = 9.31, 95% CI = 3.98-21.78), heroin (AOR = 4.00, 95% CI = 1.88-8.54), and methamphetamine (AOR = 2.03, 95% CI = 1.16-3.55) were all significantly associated with reporting providing injection initiation assistance. Our findings may have important implications for the development of interventional approaches to reduce injection initiation and related harms. Further research is needed to validate findings and inform future approaches to preventing entry into drug injecting.

  13. Incidence of hypertriglyceridemia in critically ill neonates receiving lipid injectable emulsions in glass versus plastic containers: a retrospective analysis.

    Science.gov (United States)

    Martin, Camilia R; Dumas, Gregory J; Shoaie, Claire; Zheng, Zheng; Mackinnon, Brenda; Al-Aweel, Issa; Bistrian, Bruce R; Pursley, DeWayne M; Driscoll, David F

    2008-02-01

    To evaluate plasma clearance of lipid injectable emulsions packaged in either glass or plastic containers in neonates from 2 7-month periods, 1 year apart. Clinical records from June 1 to December 31, 2003 (glass [G] period) and the same months in 2004 (plastic [P] period) were assessed. Neonates who received lipid injectable emulsions were studied. Lipid container (glass vs plastic) was the independent variable. Of the 197 patients studied, 122 (G, 50/81; P, 72/116) had evaluable triglyceride (TG) levels, for an overall rate of 62%. Only birth weight (G, 1.09 +/- 0.32 kg vs P, 1.23 +/- .45 kg) and birth length (G, 36.4 +/- 3.5 cm vs P, 37.9 +/- 3.5 cm) were significantly different between the 2 groups (P = .047 and .028, respectively). There were no differences in the day of life on which lipid injection was started, the lipid dose, or the timing of TG measurements. The incidence of hypertriglyceridemia was significantly higher in the P period (G, 3/50 vs P, 19/72; P = .004). Administration of the same lipid formulation in plastic bags compared with glass containers is associated with higher rates of hypertriglyceridemia. The poorer clearance of lipids could be due to a higher proportion of large-diameter fat globules in plastic bags compared with those in glass containers.

  14. [Clinical outcomes and economic analysis of two ovulation induction protocols in patients undergoing repeated IVF/ICSI cycles].

    Science.gov (United States)

    Chen, Xiao; Geng, Ling; Li, Hong

    2014-04-01

    To compare the clinical outcomes and cost-effectiveness of luteal phase down-regulation with gonadotrophin-releasing hormone (GnRH) agonist protocol and GnRH antagonist protocol in patients undergoing repeated in vitro fertilization and intracytoplasmic sperm injection (IVF-ICSI) cycles. A retrospective analysis of clinical outcomes and costs was conducted among 198 patients undergoing repeated IVF-ICSI cycles, including 109 receiving luteal phase down-regulation with GnRH agonist protocol (group A) and 89 receiving GnRH antagonist protocol (group B). The numbers of oocytes retrieved and good embryos, clinical pregnancy rate, abortion rate, the live birth rate, mean total cost, and the cost-effective ratio were compared between the two groups. In patients undergoing repeated IVF-ICSI cycles, the two protocols produced no significant differences in the number of good embryos, clinical pregnancy rate, abortion rate, or twin pregnancy rate. Compared with group B, group A had better clinical outcomes though this difference was not statistically significant. The number of retrieved oocytes was significantly greater and live birth rate significantly higher in group A than in group B (9.13=4.98 vs 7.11=4.74, and 20.2% vs 9.0%, respectively). Compared with group B, group A had higher mean total cost per cycle but lower costs for each oocyte retrieved (2729.11 vs 3038.60 RMB yuan), each good embryo (8867.19 vs 9644.85 RMB yuan), each clinical pregnancy (77598.06 vs 96139.85 RMB yuan). For patients undergoing repeated IVF/ICSI cycle, luteal phase down-regulation with GnRH agonist protocol produces good clinical outcomes with also good cost-effectiveness in spite an unsatisfactory ovarian reserve.

  15. Massive Preperitoneal Hematoma after a Subcutaneous Injection

    Directory of Open Access Journals (Sweden)

    Hideki Katagiri

    2016-01-01

    Full Text Available Preperitoneal hematomas are rare and can develop after surgery or trauma. A 74-year-old woman, receiving systemic anticoagulation, developed a massive preperitoneal hematoma after a subcutaneous injection of teriparatide using a 32-gauge, 4 mm needle. In this patient, there were two factors, the subcutaneous injection of teriparatide and systemic anticoagulation, associated with development of the hematoma. These two factors are especially significant, because they are widely used clinically. Although extremely rare, physicians must consider this potentially life-threatening complication after subcutaneous injections, especially in patients receiving anticoagulation.

  16. Epidemiological studies of German patients injected with Ra-224

    International Nuclear Information System (INIS)

    Mays, C.W.; Spiess, H.

    1983-01-01

    The health of 898 patients who received repeated injections of short-lived 224 Ra after World War II, mainly for the treatment of tuberculosis and ankylosing spondylitis has been followed. As of 1980, 53 of these patients had developed bone sarcoma vs only 0.2 cases expected naturally. Two patients with bone sarcoma subsequently developed an additional bone sarcoma. No new bone sarcomas have been reported since the end of 1974. For the patients in each category, the tumor rate at every year after 224 Ra injection was calculated by dividing the yearly number of bone sarcomas by the number of patients whose follow-up extended to that year. This corrected for the effects of death and incomplete follow-up. The yearly tumor rates were then summed to obtain the cumulative tumor rate. Dividing by the average skeletal dose in rads yielded the cumulative risk. The cumulative tumor risk was about 200 bone sarcomas/10 6 person rad of average skeletal dose and, with the dosimetric assumptions used, was not statistically different for (a) juveniles vs adults, (b) males vs females, or (c) TB patients vs spondylitic patients

  17. Oxygen injection facility

    International Nuclear Information System (INIS)

    Ota, Masamoto; Hirose, Yuki

    1998-01-01

    A compressor introduces air as a starting material and sends it to a dust removing device, a dehumidifying device and an adsorption/separation system disposed downstream. The facility of the present invention is disposed in the vicinity of an injection point and installed in a turbine building of a BWR type reactor having a pipeline of a feedwater system to be injected. The adsorbing/separation system comprises an adsorbing vessel and an automatic valve, and the adsorbing vessel is filled with an adsorbent for selectively adsorbing nitrogen. Zeolite is used as the adsorbent. Nitrogen in the air passing through the adsorbing vessel is adsorbed and removed under a pressurized condition, and a highly concentrated oxygen gas is formed. The direction of the steam of the adsorbed nitrogen is changed by an opening/closing switching operation of an automatic valve and released to the atmosphere (the pressure is released). Generated oxygen gas is stored under pressure in a tank, and injected to the pipeline of the feedwater system by an oxygen injection conduit by way of a flow rate control valve. In the adsorbing vessel, steps of adsorption, separation and storage under pressure are repeated successively. (I.N.)

  18. Enhanced appetitive conditioning following repeated pretreatment with d-amphetamine.

    Science.gov (United States)

    Harmer, C J; Phillips, G D

    1998-07-01

    The behavioural response to psychomotor stimulants is augmented with repeated exposure to these drugs. Enhanced stimulated dopamine overflow within the nucleus accumbens and amygdala has been found to accompany this behavioural sensitization. In the present experiment, rats received 2 mg/kg d-amphetamine or 1 ml/kg physiological saline once per day for 5 days. Five days later, a behavioural assay confirmed that prior repeated d-amphetamine treatment markedly enhanced the locomotor activating effects of a d-amphetamine (0.5 mg/kg, i.p.) challenge. Training on a Pavlovian conditioning task began six days subsequently. In Stage 1, a stimulus (light or tone, S-) was presented negatively correlated with a sucrose reward. In Stage 2, presentation of the alternative counterbalanced stimulus (light or tone, S+) was paired with the availability of a 10% sucrose solution. There were no differences between the two groups in their response to the the S- stimulus. However, sensitized animals showed a selective enhancement in the acquisition of conditioned responding to S+, relative to vehicle-injected controls. No differences in behaviour were recorded during the prestimulus periods, nor during presentations of sucrose. Levels of activity within the operant chamber extraneous to alcove approach were also similar in both groups of animals. The conditioned instrumental efficacy of S+, relative to S- was assessed in Stage 3, in which stimulus availability was made contingent on a novel lever-pressing response. Both groups showed a similar preference for the S+ over the S- stimulus. Hence, rats sensitized by prior repeated d-amphetamine showed enhanced appetitive Pavlovian conditioning, without subsequent effect on conditioned reward efficacy. These data are discussed in light of possible changes in mesoamygdaloid dopamine functioning.

  19. Epidural steroid injection in patients with lumbosacral radiculopathy in Abuja, Nigeria

    Directory of Open Access Journals (Sweden)

    Ahidjo A Kawu

    2012-01-01

    Full Text Available Objective : This prospective-controlled observational study looked at well-matched patients with spinal pain and radicular symptoms, caused by lumbar intervertebral disc herniation to compare the short-term clinical outcome of transforaminal and interlaminar epidural steroid injection (ESI in a resource challenged tertiary institution in Nigeria. Materials and Methods : 49 patients with radicular symptoms who were matched for age, symptom duration, magnetic resonance imaging findings, and pre-injection revised Oswentry Disability Index (ODI score and Visual Analogue Scale (VAS were assigned into ESI technique. The ODI and VAS score were analyzed immediately after an injection and upon follow-up (average 178.5 days, also with the need for repeated injections and surgical interventions over a 1-year follow-up interval. Result: In the transforaminal group (25 patients, there was a statistically significant improvement in the ODI scores from before the injection (ODI mean 62.4 to immediately after the injection (ODI mean 24.4, P < 0.01, and upon follow-up (ODI mean 20.8, P < 0.01. 9 patients (18.4% required 1 or 2 repeated injections, 3 (6.1% patients underwent surgery and 2 (4% patients lost to follow-up. In the interlaminar group (24 patients, there was a statistically significant improvement in the ODI scores from before the injection (ODI mean 60.7 to immediately after the injection (ODI mean 30.1, P < 0.01, but not upon follow-up (ODI mean 43.2, P = 0.09. 11 (22.4% patients required 1 or 2 repeated injection, 4 (8% patients underwent surgery and 3 (6.1% patients were lost to follow-up. There is an average of 2 fold improvement of transforaminal ESI over interlaminar ESI in a 40 point scale of ODI score on follow-up, which was statistically significant (P < 0.01. The VAS showed similar pattern with the ODI scores in the study. Conclusion : Transforaminal ESI to treat symptomatic lumbar disc herniation resulted in better short-term pain

  20. Efficacy of intravitreal Ranibizumab injection for choroidal neovascularization secondary to pathologic myopia

    Directory of Open Access Journals (Sweden)

    Li-Hong Cui

    2016-03-01

    Full Text Available AIM:To observe the efficacy and safety of intravitreal Ranibizumab injection in patiens with choroidal neovascularization(CNVsecondary to pathologic myopia.METHODS:In this retrospective and comparative study,24 patients(25 eyeswith CNV secondary to pathologic myopia were enrolled. All patients were assessed by examinations of ETDRS visual acuity chart, preplaced-mirror ophthalmoscopy, fundus fluorescein angiography(FFA, indocyanine green angiography(ICGAand optical coherence tomography(OCT. Patiens received intravitreally injected ranibizumab 0.5mg(0.05mL. Treatments were repeated if the follow-up indicated that it was necessary. The follow-up periods were 4~10mo. Best corrected visual acuity(BCVA, central macular thickness(CMTand leakage of CNV before and after the treatment were compared. RESULTS:No local or systemic complications occurred in any patients during the treatment or follow-up. The average time of injection was 1.52. The mean BCVA was 23.93±12.46 letters before the therapy. In the last follow-up, the mean BCVA was 40.63±7.25 letters, improved by 14.27±9.36 letters and the difference was statically significant(t=5.74, Pt=3.96, PCONCLUSION:Intravitreal ranibizumab injection for CNV secondary to pathologic myopia is safe and effective, and this treatment can improve visual acuity, reduce retina edema and leakage of CNV.

  1. Diagnostics and Identification of Injection Duration of Common Rail Diesel Injectors

    Directory of Open Access Journals (Sweden)

    Krogerus Tomi R.

    2018-02-01

    Full Text Available In this paper, we study the diagnostics and identification of injection duration of common rail (CR diesel pilot injectors of dual-fuel engines. In these pilot injectors, the injected volume is small and the repeatability of the injections and identification of the drifts of the injectors are important factors, which need to be taken into account in achieving good repeatability (shot-to-shot with every cylinder and therefore a well-balanced engine and reduced overall wear. A diagnostics method based on analysis of CR pressure signal with experimental verification results is presented. Using the developed method, the relative duration of injection events can be identified. In the method, the pressure signal during the injection is first extracted after the control of each injection event. After that, the signal is normalized and filtered. Then a derivative of the filtered signal is calculated. Change in the derivative of the filtered signal larger than a predefined threshold indicates an injection event which can be detected and its relative duration can be identified. The efficacy of the proposed diagnostics method is presented with the experimental results, which show that the developed method detects drifts in injection duration and the magnitude of drift. According to the result, ≥ 10 μs change (2%, 500 μs in injection time can be identified.

  2. Diagnostics and Identification of Injection Duration of Common Rail Diesel Injectors

    Science.gov (United States)

    Krogerus, Tomi R.; Huhtala, Kalevi J.

    2018-02-01

    In this paper, we study the diagnostics and identification of injection duration of common rail (CR) diesel pilot injectors of dual-fuel engines. In these pilot injectors, the injected volume is small and the repeatability of the injections and identification of the drifts of the injectors are important factors, which need to be taken into account in achieving good repeatability (shot-to-shot with every cylinder) and therefore a well-balanced engine and reduced overall wear. A diagnostics method based on analysis of CR pressure signal with experimental verification results is presented. Using the developed method, the relative duration of injection events can be identified. In the method, the pressure signal during the injection is first extracted after the control of each injection event. After that, the signal is normalized and filtered. Then a derivative of the filtered signal is calculated. Change in the derivative of the filtered signal larger than a predefined threshold indicates an injection event which can be detected and its relative duration can be identified. The efficacy of the proposed diagnostics method is presented with the experimental results, which show that the developed method detects drifts in injection duration and the magnitude of drift. According to the result, ≥ 10 μs change (2%, 500 μs) in injection time can be identified.

  3. Subcutaneous Injection of Adalimumab Trial compared with Control (SCIATiC): a randomised controlled trial of adalimumab injection compared with placebo for patients receiving physiotherapy treatment for sciatica.

    Science.gov (United States)

    Williams, Nefyn H; Jenkins, Alison; Goulden, Nia; Hoare, Zoe; Hughes, Dyfrig A; Wood, Eifiona; Foster, Nadine E; Walsh, David A; Carnes, Dawn; Sparkes, Valerie; Hay, Elaine M; Isaacs, John; Konstantinou, Kika; Morrissey, Dylan; Karppinen, Jaro; Genevay, Stephane; Wilkinson, Clare

    2017-10-01

    Biological treatments such as adalimumab (Humira ® ; AbbVie Ltd, Maidenhead, UK) are antibodies targeting tumour necrosis factor alpha, released from ruptured intervertebral discs, which might be useful in sciatica. Recent systematic reviews concluded that they might be effective, but that a definitive randomised controlled trial was needed. Usual care in the NHS typically includes a physiotherapy intervention. To test whether or not injections of adalimumab plus physiotherapy are more clinically effective and cost-effective than injections of saline plus physiotherapy for patients with sciatica. Pragmatic, parallel-group, randomised controlled trial with blinded participants and clinicians, and an outcome assessment and statistical analysis with concurrent economic evaluation and internal pilot. Participants were referred from primary care and musculoskeletal services to outpatient physiotherapy clinics. Adults with persistent symptoms of sciatica of 1-6 months' duration and with moderate to high levels of disability. Eligibility was assessed by research physiotherapists according to clinical criteria for diagnosing sciatica. After a second eligibility check, trial participants were randomised to receive two doses of adalimumab (80 mg and then 40 mg 2 weeks later) or saline injections. Both groups were referred for a course of physiotherapy. Outcomes were measured at the start, and after 6 weeks' and 6 months' follow-up. The main outcome measure was the Oswestry Disability Index (ODI). Other outcomes: leg pain version of the Roland-Morris Disability Questionnaire, Sciatica Bothersomeness Index, EuroQol-5 Dimensions, 5-level version, Hospital Anxiety and Depression Scale, resource use, risk of persistent disabling pain, pain trajectory based on a single question, Pain Self-Efficacy Questionnaire, Tampa Scale of Kinesiophobia and adverse effects. To detect an effect size of 0.4 with 90% power, a 5% significance level for a two-tailed t -test and 80% retention

  4. Injection practice in Kaski district, Western Nepal: a community perspective.

    Science.gov (United States)

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, Pathiyil Ravi; Kumar, Vikash K C; Maskey, Manisha; Jha, Nisha

    2015-04-29

    Previous studies have shown that unsafe injection practice is a major public health problem in Nepal but did not quantify the problem. The present community-based study was planned to: 1) quantify injection usage, 2) identify injection providers, 3) explore differences, if any, in injection usage and injection providers, and 4) study and compare people's knowledge and perception about injections between the urban and rural areas of Kaski district. A descriptive, cross-sectional mixed-methods study was conducted from July to November 2012, using a questionnaire based survey and focus group discussions (FGDs). A semi-structured questionnaire advocated by the World Health Organization was modified and administered to household heads and injection receivers in selected households and the FGDs were conducted using a topic guide. The district was divided into urban and rural areas and 300 households from each area were selected. Twenty FGDs were held. In 218 households (36.33%) [99 in urban and 119 in rural] one or more members received at least one injection. During the three month recall period, 258 subjects (10.44%) reported receiving injection(s) with a median of two injections. The average number of injections per person per year was calculated to be 2.37. Health care workers (34.8%), staff of medical dispensaries (37.7%), physicians (25.2%), and traditional healers (2.3%) were consulted by the respondents for their basic health care needs and for injections. Compared to urban respondents, more rural respondents preferred injections for fever (p injections due to injections being perceived by them as being powerful, fast-acting, and longer lasting than oral pills. More than 82% of respondents were aware of, and named, at least one disease transmitted by using unsterile syringes during injection administration or when syringes are shared between people. Less preference for injections and high awareness about the association between injections and injection

  5. Safety and efficacy of repeated injections of botulinum toxin A in peripheral neuropathic pain (BOTNEP): a randomised, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Attal, Nadine; de Andrade, Daniel C; Adam, Frédéric; Ranoux, Danièle; Teixeira, Manoel J; Galhardoni, Ricardo; Raicher, Irina; Üçeyler, Nurcan; Sommer, Claudia; Bouhassira, Didier

    2016-05-01

    Data from previous studies suggest that botulinum toxin A has analgesic effects against peripheral neuropathic pain, but the quality of the evidence is low. We aimed to assess the safety and efficacy of repeated administrations of botulinum toxin A in patients with neuropathic pain. We did a randomised, double-blind, placebo-controlled trial at two outpatient clinics in France (Clinical Pain Centre, Ambroise Paré Hospital, APHP, Boulogne-Billancourt, and Neurological Centre, Hôpital Dupuytren, Limoges) and one in Brazil (Neurological Department, Hospital das Clínicas da FMUSP, São Paulo). Patients aged 18-85 years with peripheral neuropathic pain were randomly assigned (1:1) by block randomisation, according to a centralised schedule, to receive two subcutaneous administrations of botulinum toxin A (up to 300 units) or placebo, 12 weeks apart. All patients and investigators were masked to treatment assignment. The primary outcome was the efficacy of botulinum toxin A versus placebo, measured as the change from baseline in self-reported mean weekly pain intensity over the course of 24 weeks from the first administration. The primary efficacy analysis was a mixed-model repeated-measures analysis in the intention-to-treat population. This trial is registered with ClinicalTrials.gov, NCT01251211. Between Oct 2, 2010, and Aug 2, 2013, 152 patients were enrolled, of whom 68 were randomly assigned (34 per group), and 66 (37 [56%] men) were included in the primary analysis (34 in the botulinum toxin A group and 32 in the placebo group). Botulinum toxin A reduced pain intensity over 24 weeks compared with placebo (adjusted effect estimate -0·77, 95% CI -0·95 to -0·59; pbotulinum toxin A group and 17 (53%) of those in the placebo group (p=1·0). Severe pain was experienced by ten (29%) participants in the botulinum toxin A group and 11 (34%) in the placebo group (p=0·8). Two administrations of botulinum toxin A, each of which comprised several injections, have a

  6. Changes in risk of immediate adverse reactions to iodinated contrast media by repeated administrations in patients with hepatocellular carcinoma.

    Science.gov (United States)

    Fujiwara, Naoto; Tateishi, Ryosuke; Akahane, Masaaki; Taguri, Masataka; Minami, Tatsuya; Mikami, Shintaro; Sato, Masaya; Uchino, Koji; Uchino, Kouji; Enooku, Kenichiro; Kondo, Yuji; Asaoka, Yoshinari; Yamashiki, Noriyo; Goto, Tadashi; Shiina, Shuichiro; Yoshida, Haruhiko; Ohtomo, Kuni; Koike, Kazuhiko

    2013-01-01

    To elucidate whether repeated exposures to iodinated contrast media increase the risk of adverse reaction. We retrospectively reviewed 1,861 patients with hepatocellular carcinoma who visited authors' institution, a tertiary referral center, between 2004 and 2008. We analyzed cumulative probability of adverse reactions and risk factors. We categorized all symptoms into hypersensitivity reactions, physiologic reactions, and other reactions, according to the American College of Radiology guidelines, and evaluated each category as an event. We estimated the association between hazard for adverse reactions and the number of cumulative exposures to contrast media. We also evaluated subsequent contrast media injections and adverse reactions. There were 23,684 contrast media injections in 1,729 patients. One hundred and thirty-two patients were excluded because they were given no contrast media during the study period. Adverse reactions occurred in 196 (0.83%) patients. The cumulative incidence at 10(th), 20(th), and 30(th) examination was 7.9%, 15.2%, and 24.1%, respectively. Presence of renal impairment was found to be one of risk factors for adverse reactions. The estimated hazard of overall adverse reaction gradually decreased until around 10(th) exposure and rose with subsequent exposures. The estimated hazard of hypersensitivity showed V-shaped change with cumulative number of exposures. The estimated hazard of physiologic reaction had a tendency toward decreasing and that of other reaction had a tendency toward increasing. Second adverse reaction was more severe than the initial in only one among 130 patients receiving subsequent injections. Repeated exposures to iodinated contrast media increase the risk of adverse reaction.

  7. Reductions in HIV/STI Incidence and Sharing of Injection Equipment among Female Sex Workers Who Inject Drugs: Results from a Randomized Controlled Trial

    Science.gov (United States)

    Strathdee, Steffanie A.; Abramovitz, Daniela; Lozada, Remedios; Martinez, Gustavo; Rangel, Maria Gudelia; Vera, Alicia; Staines, Hugo; Magis-Rodriguez, Carlos; Patterson, Thomas L.

    2013-01-01

    Background We evaluated brief combination interventions to simultaneously reduce sexual and injection risks among female sex workers who inject drugs (FSW-IDUs) in Tijuana and Ciudad Juarez, Mexico during 2008–2010, when harm reduction coverage was expanding rapidly in Tijuana, but less so in Juarez. Methods FSW-IDUs ≥18 years reporting sharing injection equipment and unprotected sex with clients within the last month participated in a randomized factorial trial comparing four brief, single-session conditions combining either an interactive or didactic version of a sexual risk intervention to promote safer sex in the context of drug use, and an injection risk intervention to reduce sharing of needles/injection paraphernalia. Women underwent quarterly interviews and testing for HIV, syphilis, gonorrhea, Chlamydia and Trichomonas, blinding interviewers and assessors to assignment. Poisson regression with robust variance estimation and repeated measures ordinal logistic regression examined effects on combined HIV/STI incidence and receptive needle sharing frequency. Findings Of 584 initially HIV-negative FSW-IDUs, retention was ≥90%. After 12 months, HIV/STI incidence decreased >50% in the interactive vs. didactic sex intervention (Tijuana:AdjRR:0.38,95% CI:0.16–0.89; Juarez: AdjRR:0.44,95% CI:0.19–0.99). In Juarez, women receiving interactive vs. didactic injection risk interventions decreased receptive needle-sharing by 85% vs. 71%, respectively (p = 0.04); in Tijuana, receptive needle sharing declined by 95%, but was similar in active versus didactic groups. Tijuana women reported significant increases in access to syringes and condoms, but Juarez women did not. Interpretation After 12 months in both cities, the interactive sexual risk intervention significantly reduced HIV/STI incidence. Expanding free access to sterile syringes coupled with brief, didactic education on safer injection was necessary and sufficient for achieving robust, sustained

  8. Safety of Repeated Yttrium-90 Radioembolization

    International Nuclear Information System (INIS)

    Lam, Marnix G. E. H.; Louie, John D.; Iagaru, Andrei H.; Goris, Michael L.; Sze, Daniel Y.

    2013-01-01

    Purpose: Repeated radioembolization (RE) treatments carry theoretically higher risk of radiation-induced hepatic injury because of the liver’s cumulative memory of previous exposure. We performed a retrospective safety analysis on patients who underwent repeated RE. Methods: From 2004 to 2011, a total of 247 patients were treated by RE. Eight patients (5 men, 3 women, age range 51–71 years) underwent repeated treatment of a targeted territory, all with resin microspheres (SIR-Spheres; Sirtex, Lane Cove, Australia). Adverse events were graded during a standardized follow-up. In addition, the correlation between the occurrence of RE-induced liver disease (REILD) and multiple variables was investigated in univariate and multivariate analyses in all 247 patients who received RE. Results: Two patients died shortly after the second treatment (at 84 and 107 days) with signs and symptoms of REILD. Both patients underwent whole liver treatment twice (cumulative doses 3.08 and 2.66 GBq). The other 6 patients demonstrated only minor toxicities after receiving cumulative doses ranging from 2.41 to 3.88 GBq. All patients experienced objective tumor responses. In the whole population, multifactorial analysis identified three risk factors associated with REILD: repeated RE (p = 0.036), baseline serum total bilirubin (p = 0.048), and baseline serum aspartate aminotransferase (p = 0.043). Repeated RE proved to be the only independent risk factor for REILD in multivariate analysis (odds ratio 9.6; p = 0.002). Additionally, the administered activity per target volume (in GBq/L) was found to be an independent risk factor for REILD, but only in whole liver treatments (p = 0.033). Conclusion: The risk of REILD appears to be elevated for repeated RE. Objective tumor responses were observed, but establishment of safety limits will require improvement in dosimetric measurement and prediction

  9. Safety of Repeated Yttrium-90 Radioembolization

    Energy Technology Data Exchange (ETDEWEB)

    Lam, Marnix G. E. H.; Louie, John D. [Stanford University School of Medicine, Division of Interventional Radiology (United States); Iagaru, Andrei H.; Goris, Michael L. [Stanford University School of Medicine, Division of Nuclear Medicine (United States); Sze, Daniel Y., E-mail: dansze@stanford.edu [Stanford University School of Medicine, Division of Interventional Radiology (United States)

    2013-10-15

    Purpose: Repeated radioembolization (RE) treatments carry theoretically higher risk of radiation-induced hepatic injury because of the liver's cumulative memory of previous exposure. We performed a retrospective safety analysis on patients who underwent repeated RE. Methods: From 2004 to 2011, a total of 247 patients were treated by RE. Eight patients (5 men, 3 women, age range 51-71 years) underwent repeated treatment of a targeted territory, all with resin microspheres (SIR-Spheres; Sirtex, Lane Cove, Australia). Adverse events were graded during a standardized follow-up. In addition, the correlation between the occurrence of RE-induced liver disease (REILD) and multiple variables was investigated in univariate and multivariate analyses in all 247 patients who received RE. Results: Two patients died shortly after the second treatment (at 84 and 107 days) with signs and symptoms of REILD. Both patients underwent whole liver treatment twice (cumulative doses 3.08 and 2.66 GBq). The other 6 patients demonstrated only minor toxicities after receiving cumulative doses ranging from 2.41 to 3.88 GBq. All patients experienced objective tumor responses. In the whole population, multifactorial analysis identified three risk factors associated with REILD: repeated RE (p = 0.036), baseline serum total bilirubin (p = 0.048), and baseline serum aspartate aminotransferase (p = 0.043). Repeated RE proved to be the only independent risk factor for REILD in multivariate analysis (odds ratio 9.6; p = 0.002). Additionally, the administered activity per target volume (in GBq/L) was found to be an independent risk factor for REILD, but only in whole liver treatments (p = 0.033). Conclusion: The risk of REILD appears to be elevated for repeated RE. Objective tumor responses were observed, but establishment of safety limits will require improvement in dosimetric measurement and prediction.

  10. Chaos synchronization communication using extremely unsymmetrical bidirectional injections.

    Science.gov (United States)

    Zhang, Wei Li; Pan, Wei; Luo, Bin; Zou, Xi Hua; Wang, Meng Yao; Zhou, Zhi

    2008-02-01

    Chaos synchronization and message transmission between two semiconductor lasers with extremely unsymmetrical bidirectional injections (EUBIs) are discussed. By using EUBIs, synchronization is realized through injection locking. Numerical results show that if the laser subjected to strong injection serves as the receiver, chaos pass filtering (CPF) of the system is similar to that of unidirectional coupled systems. Moreover, if the other laser serves as the receiver, a stronger CPF can be obtained. Finally, we demonstrate that messages can be extracted successfully from either of the two transmission directions of the system.

  11. The effects of injection of bovine vaccine into a human digit: a case report

    Directory of Open Access Journals (Sweden)

    Ricketts David M

    2005-10-01

    Full Text Available Abstract Background The incidence of needlestick injuries in farmers and veterinary surgeons is significant and the consequences of such an injection can be serious. Case presentation We report accidental injection of bovine vaccine into the base of the little finger. This resulted in increased pressure in the flexor sheath causing signs and symptoms of ischemia. Amputation of the digit was required despite repeated surgical debridement and decompression. Conclusion There have been previous reports of injection of oil-based vaccines into the human hand resulting in granulomatous inflammation or sterile abscess and causing morbidity and tissue loss. Self-injection with veterinary vaccines is an occupational hazard for farmers and veterinary surgeons. Injection of vaccine into a closed compartment such as the human finger can have serious sequelae including loss of the injected digit. These injuries are not to be underestimated. Early debridement and irrigation of the injected area with decompression is likely to give the best outcome. Frequent review is necessary after the first procedure because repeat operations may be required.

  12. Assessing Uncertainty and Repeatability in Time-Lapse VSP Monitoring of CO2 Injection in a Brine Aquifer, Frio Formation, Texas (A Case Study)

    Energy Technology Data Exchange (ETDEWEB)

    Nazari, Siamak [Univ. of California, Berkeley, CA (United States). Dept. of Civil and Environmental Engineering; Daley, Thomas M. [Lawrence Berkeley National Lab. (LBNL), Berkeley, CA (United States). Earth Sciences Division

    2013-02-07

    This study was done to assess the repeatability and uncertainty of time-lapse VSP response to CO2 injection in the Frio formation near Houston Texas. A work flow was built to assess the effect of time-lapse injected CO2 into two Frio brine reservoir intervals, the ‘C’ sand (Frio1) and the ‘Blue sand’ (Frio2). The time-lapse seismic amplitude variations with sensor depth for both reservoirs Frio1 and Frio2 were computed by subtracting the seismic response of the base survey from each of the two monitor seismic surveys. Source site 1 has been considered as one of the best sites for evaluating the time-lapse response after injection. For site 1, the computed timelapse NRMS levels after processing had been compared to the estimated time-lapse NRMS level before processing for different control reflectors, and for brine aquifers Frio1, and Frio2 to quantify detectability of amplitude difference. As the main interest is to analyze the time-lapse amplitude variations, different scenarios have been considered. Three different survey scenarios were considered: the base survey which was performed before injection, monitor1 performed after the first injection operation, and monitor2 which was after the second injection. The first scenario was base-monitor1, the second was basemonitor2, and the third was monitor1-monitor2. We considered three ‘control’ reflections above the Frio to assist removal of overburden changes, and concluded that third control reflector (CR3) is the most favorable for the first scenario in terms of NRMS response, and first control reflector (CR1) is the most favorable for the second and third scenarios in terms of NRMS response. The NRMS parameter is shown to be a useful measure to assess the effect of processing on time-lapse data. The overall NRMS for the Frio VSP data set was found to be in the range of 30% to 80% following basic processing. This could be considered as an estimated baseline in assessing the utility

  13. Pilot cohort study of endoscopic botulinum neurotoxin injection in Parkinson's disease.

    Science.gov (United States)

    Triadafilopoulos, George; Gandhy, Rita; Barlow, Carrolee

    2017-11-01

    Gastrointestinal symptoms, such as dysphagia, postprandial bloating, and defecatory straining are common in Parkinson's Disease (PD) and they impact quality of life. Endoscopic botulinum neurotoxin (BoNT) injection has been used in the treatment of dysphagia, gastroparesis and chronic anismus. To examine the feasibility, safety and efficacy of endoscopically delivered BoNT injection to distal esophagus, pylorus or anal canal aiming at relieving regional gastrointestinal symptoms in patients with PD. This is a retrospective open cohort pilot study to assess the clinical response to endoscopic BoNT injection on selected PD patients with symptoms and identifiable abnormalities on high-resolution manometry and wireless motility capsule, to generate early uncontrolled data on feasibility, tolerability, safety and efficacy. Baseline symptoms and response to therapy were assessed by questionnaires. Fourteen PD patients (10 M:4 F), mean age 73 (range: 62-93) were treated. Three patients had esophageal Botox for ineffective esophageal motility (IEM) (n = 1), esophago-gastric junction outlet obstruction (EGJOO) & IEM (n = 1), and diffuse esophageal spasm (DES) (n = 1). Nine patients were treated with pyloric BoNT injection for gastroparesis with mean gastric transit time of 21.2 h; range 5.2-44.2 h. Two patients received anal Botox for defecatory dyssynergia ((Type I) (n = 1) and overlap (slow-transit and dyssynergic) constipation (n = 1). Endoscopic BoNT injection (100-200 units) was well tolerated and there were no significant adverse events. Endoscopic BoNT injection to esophagus, pylorus or anal canal is safe, well-tolerated and leads to symptomatic improvement that lasts up to several months. The procedure can be repeated as needed and combined with other therapies. Copyright © 2017 Elsevier Ltd. All rights reserved.

  14. Repeated treatment with nitric oxide synthase inhibitor attenuates learned helplessness development in rats and increases hippocampal BDNF expression.

    Science.gov (United States)

    Stanquini, Laura Alves; Biojone, Caroline; Guimarães, Francisco Silveira; Joca, Sâmia Regiane

    2017-11-20

    Nitric oxide synthase (NOS) inhibitors induce antidepressant-like effects in animal models sensitive to acute drug treatment such as the forced swimming test. However, it is not yet clear if repeated treatment with these drugs is required to induce antidepressant-like effects in preclinical models. The aim of this study was to test the effect induced by acute or repeated (7 days) treatment with 7-nitroindazole (7-NI), a preferential inhibitor of neuronal NOS, in rats submitted to the learned helplessness (LH) model. In addition, we aimed at investigating if 7-NI treatment would increase brain-derived neurotrophic factor (BDNF) protein levels in the hippocampus, similarly to the effect of prototype antidepressants. Animals were submitted to a pre-test (PT) session with inescapable footshocks or habituation (no shocks) to the experimental shuttle box. Six days later they were exposed to a test with escapable footshocks. Independent groups received acute (a single injection after PT or before test) or repeated (once a day for 7 days) treatment with vehicle or 7-NI (30 mg/kg). Repeated, but not acute, treatment with 7-NI attenuated LH development. The effect was similar to repeated imipramine treatment. Moreover, in an independent experimental group, only repeated treatment with 7-NI and imipramine increased BDNF protein levels in the hippocampus. The results suggest the nitrergic system could be a target for the treatment of depressive-like conditions. They also indicate that, similar to the positive control imipramine, the antidepressant-like effects of NOS inhibition could involve an increase in hippocampal BDNF levels.

  15. A protocol for the retina surgeon's safe initial intravitreal injections.

    Science.gov (United States)

    Frenkel, Ronald E P; Haji, Shamim A; La, Melvin; Frenkel, Max P C; Reyes, Angela

    2010-11-10

    To determine the safety of a surgeon's initial consecutive intravitreal injections using a specific protocol and to review the complications that may be attributed to the injection procedure. A retrospective chart review. Fifty-nine patients (30 females, 29 males) received intravitreal injections of pegaptanib, bevacizumab, or ranibizumab as part of their treatment for neovascular age-related macular degeneration. The average patient age was 80 years. Twenty-two patients were diagnosed with or suspected of having glaucoma. Each patient received an average of 5.8 injections. The charts of 59 patients who received a total of 345 intravitreal injections (104 pegaptanib, 74 bevacizumab, 167 ranibizumab) were reviewed. All injections were performed in an office-based setting. Povidone-iodine, topical antibiotics, and eye speculum were used as part of the pre injection procedure. Vision and intraocular pressure were evaluated immediately following each injection. Incidence of post injection complications, including but not limited to endophthalmitis, retinal detachment, traumatic cataract, and vitreous hemorrhage. There were no cases of endophthalmitis, toxic reactions, traumatic cataracts, retinal detachment, or vitreous hemorrhage. There was one case each of lid swelling, transient floaters, retinal pigment epithelial tear, corneal edema, and corneal abrasion. There were five cases of transient no light perception following pegaptanib injections. The incidence of serious complications was very low for the intravitreal injections given. A surgeon's initial intravitreal injections may be performed with a very high degree of safety using this protocol.

  16. The effects of intratendinous and retrocalcaneal intrabursal injections of corticosteroid on the biomechanical properties of rabbit Achilles tendons.

    Science.gov (United States)

    Hugate, Ronald; Pennypacker, Jason; Saunders, Marnie; Juliano, Paul

    2004-04-01

    The use of corticosteroid injections in the treatment of retrocalcaneal bursitis is controversial. We assessed the effects of corticosteroid injections, both within the tendon substance and into the retrocalcaneal bursa, on the biomechanical properties of rabbit Achilles tendons. The systemic effects of bilateral corticosteroid injections were also studied. The rabbits were divided into three treatment groups. The rabbits in Group I received injections of corticosteroid into the Achilles tendon on the left side and injections of normal saline solution into the Achilles tendon on the right, those in Group II received injections of corticosteroid into the retrocalcaneal bursa on the left side and injections of saline solution into the Achilles tendon on the right, and those in Group III received injections of corticosteroid into the Achilles tendon on the left side and injections of corticosteroid into the retrocalcaneal bursa on the right. These injections were given weekly for three weeks. At four weeks after the final injection, the tendons were harvested and were tested biomechanically to determine failure load, midsubstance strain and total strain, modulus of elasticity, failure stress, and total energy absorbed. The site of failure was also documented. The groups were compared according to the location of the injections, the type of injection (steroid or saline solution), and the total systemic load of steroid. Specimens from limbs that had received intratendinous injections of corticosteroid showed significantly decreased failure stress compared with those from limbs that had received intratendinous injections of saline solution (p = 0.008). Specimens from limbs that had received intrabursal injections of corticosteroid demonstrated significantly decreased failure stress (p = 0.05), significantly decreased total energy absorbed (p = 0.017), and significantly increased total strain (p = 0.049) compared with specimens from limbs that had received intratendinous

  17. Compatibility and Stability of VARUBI (Rolapitant) Injectable Emulsion Admixed with Intravenous Granisetron Hydrochloride.

    Science.gov (United States)

    Wu, George; Powers, Dan; Yeung, Stanley; Chen, Frank; Neelon, Kelly

    2018-01-01

    Prophylaxis or therapy with a combination of a neurokinin 1 (NK-1) receptor antagonist (RA), a 5-hydroxytryptamine- 3 (5-HT3) RA, and dexamethasone is recommended by international antiemesis guidelines for the prevention of chemotherapy-induced nausea and vomiting for patients receiving highly emetogenic chemotherapy and for select patients receiving moderately emetogenic chemotherapy. VARUBI (rolapitant) is a substance P/NK-1 RA that was recently approved by the U.S. Food and Drug Administration as an injectable emulsion in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including, but not limited to, highly emetogenic chemotherapy. Granisetron Hydrochloride Injection USP is one of the 5-HT3 RAs indicated for the prevention of nausea and/or vomiting associated with initial and repeat courses of emetogenic cancer therapy, including high-dose cisplatin. Herein, we describe the physical and chemical compatibility and stability of VARUBI (rolapitant) injectable emulsion (166.5 mg/92.5 mL [1.8 mg/mL], equivalent to 185 mg of rolapitant hydrochloride) admixed with Granisetron Hydrochloride Injection USP (1.0 mg/mL, equivalent to 1.12 mg/mL hydrochloride). Binary admixtures of VARUBI injectable emulsion and Granisetron Hydrochloride Injection USP were prepared and stored in VARUBI ready-to-use glass vials and in four types of commonly used intravenous administration (tubing) sets. Evaluation of the physical and chemical compatibility and stability of the admixtures in the VARUBI ready-to-use vials stored at room temperature (20°C to 25°C) under fluorescent light and under refrigeration (2°C to 8°C protected from light) was conducted at 0, 1, 6, 24, and 48 hours, and that of the admixtures in the intravenous tubing sets was evaluated at 0, 2, and 6 hours of storage at 20°C to 25°C. Physical stability was evaluated by visual examination

  18. Experiment on performance of upper head injection system with ROSA-II

    International Nuclear Information System (INIS)

    1978-05-01

    Of the total 10 ROSA-II/UHI performance tests, 6 were reported previously. The rest are presented and discussion is made on the effects of heat generation in the core and UHI injection and repeatability of experiments. In addition, the following are described: (1) Pressure spikes observed in the upper head after sudden stoppage of UHI injection, and (2) discharge flow oscillation possibly due to UHI water injection into the upper plenum. (auth.)

  19. Prevalence of injections and knowledge of safe injections among rural residents in Central China.

    Science.gov (United States)

    Yan, Y W; Yan, J; Zhang, G P; Gao, Z L; Jian, H X

    2007-08-01

    Abuse of the injection services, namely unnecessary injections and unsafe injections, exists extensively in developing countries. Unsafe injection practices contribute to the transmission of blood-borne pathogens. The aims of this study were to survey the prevalence of injections and knowledge of injection safety among the rural residents in Jingzhou district, Hubei, China and to provide scientific data for developing a health educational programme. A retrospective cross-sectional study was conducted in 12 villages, which were selected from the Jingzhou district by the random sampling method. 50 rural residents were interviewed per village using a questionnaire. Among the 595 residents studied, 192 had received at least one injection in the past three months, with an injection prevalence of 32.3 percent and an average of 0.93 injections. 90.3 percent of the rural residents knew that unsafe injections could transmit the following blood-borne pathogens: human immunodeficiency virus (74.4 percent), hepatitis B virus (55.8 percent) and hepatitis C virus (22.9 percent). Logistic regression analysis showed that the residents' age, educational level and residential area were important factors in influencing their knowledge about injection safety. The results indicated that the injection prevalence was high among rural residents in the study area, and their knowledge regarding injection safety should be further improved.

  20. Variceal recurrence, rebleeding and survival after injection ...

    African Journals Online (AJOL)

    This study tested the validity of the hypothesis that eradication of oesophageal varices by repeated injection sclerotherapy would reduce recurrent variceal bleeding and death from bleeding oesophageal varices in a high risk cohort of patients with portal hypertension and cirrhosis. Patients and Methods: 306 alcoholic ...

  1. Treating malfunction filtering bleb with repeated needling combined with adjunctive 5-FU after glaucoma filtration surgery

    Directory of Open Access Journals (Sweden)

    Yi Liu

    2013-07-01

    Full Text Available AIM: To evaluate the therapeutic efficacy of a repeated bleb needling technique combined with subconjunctival injection of 5-FU in eyes with previous glaucoma surgery that had malfunctional filtering blebs. METHODS: A retrospective review of 34 consecutive patients(34 eyesof repeated bleb needling combined with subconjunctival injection of 5-FU in eyes, which had malfunctional filtering blebs after previous glaucoma surgery in our hospital from March 2009 to February 2013 was performed. The intraocular pressures(IOP, shapes of filtering blebs and complications after surgery were analyzed. RESULTS: There was significant reduction of mean IOP from 35.51mmHg to 14.43mmHg(PCONCLUSION: Repeated needling with adjunctive 5-FU proved a highly effective, safe alternative to treat malfunctional filtering blebs after previous glaucoma surgery.

  2. Botulinum Neurotoxin Injections

    Science.gov (United States)

    ... botulinum neurotoxin as much art as it is science. It is in your best interest to locate the most well-trained and experienced doctor you can find. Before making an appointment to receive botulinum neuro toxin injections, ask the office personnel which doctor ...

  3. Porous media heat transfer for injection molding

    Science.gov (United States)

    Beer, Neil Reginald

    2016-05-31

    The cooling of injection molded plastic is targeted. Coolant flows into a porous medium disposed within an injection molding component via a porous medium inlet. The porous medium is thermally coupled to a mold cavity configured to receive injected liquid plastic. The porous medium beneficially allows for an increased rate of heat transfer from the injected liquid plastic to the coolant and provides additional structural support over a hollow cooling well. When the temperature of the injected liquid plastic falls below a solidifying temperature threshold, the molded component is ejected and collected.

  4. Target injection and engagement for neutron generation at 1 Hz

    International Nuclear Information System (INIS)

    Komeda, Osamu; Mori, Yoshitaka; Nishimura, Yasuhiko

    2013-01-01

    Target injection is a key technology to realizing inertial fusion energy. Here we present the first demonstration of target injection and neutron generation. We injected more than 600 spherical deuterated polystyrene (C 8 D 8 ) bead targets during 10 minutes at 1 Hz. After the targets fell for a distance of 18 cm, we applied the synchronized laser-diode-pumped ultra-intense laser HAMA and successfully generated neutrons repeatedly. The result is a step toward fusion power and also suggests possible industrial neutron sources. (author)

  5. Injectable biomaterials for adipose tissue engineering

    International Nuclear Information System (INIS)

    Young, D A; Christman, K L

    2012-01-01

    Adipose tissue engineering has recently gained significant attention from materials scientists as a result of the exponential growth of soft tissue filler procedures being performed within the clinic. While several injectable materials are currently being marketed for filling subcutaneous voids, they often face limited longevity due to rapid resorption. Their inability to encourage natural adipose formation or ingrowth necessitates repeated injections for a prolonged effect and thus classifies them as temporary fillers. As a result, a significant need for injectable materials that not only act as fillers but also promote in vivo adipogenesis is beginning to be realized. This paper will discuss the advantages and disadvantages of commercially available soft tissue fillers. It will then summarize the current state of research using injectable synthetic materials, biopolymers and extracellular matrix-derived materials for adipose tissue engineering. Furthermore, the successful attributes observed across each of these materials will be outlined along with a discussion of the current difficulties and future directions for adipose tissue engineering. (paper)

  6. Optimal dose and injection duration (injection rate) of contrast material for depiction of hypervascular hepatocellular carcinomas by multidetector CT

    International Nuclear Information System (INIS)

    Yanaga, Yumi; Awai, Kazuo; Nakayama, Yoshiharu; Nakaura, Takeshi; Tamura, Yoshitaka; Yamashita, Yasuyuki; Funama, Yoshinori; Aoyama, Masahito; Asada, Naoki

    2007-01-01

    The aim of this study was to investigate the optimal dose and injection duration of contrast material (CM) for depicting hypervascular hepatocellular carcinomas (HCCs) during the hepatic arterial phase with multidetector row computed tomography (CT). The study population consisted of 71 patients with hypervascular HCCs. After unenhanced scans, the first (early arterial phase, or EAP), second (late arterial phase, or LAP), and third (equilibrium phase) scanning was started at 30, 43, and 180 s after injection of contrast material (CM). During a 33-s period, patients with a body weight ≤50 kg received 100 ml of non-ionic CM with an iodine concentration of 300 mgI/ml; patients whose body weight was >50 kg received 100 ml of CM with an iodine concentration of 370 mgI/ml. First, we measured enhancement in the abdominal aorta and tumor-to-liver contrast (TLC) during the EAP and LAP. Next, to investigate the relation between aortic enhancement and TLC during the LAP, two radiologists visually assessed the conspicuity of hypervascular HCCs during the LAP using a 3-point scale: grade 1, poor; grade 2, fair; grade 3, excellent. Finally, to examine the effect of the CM dose and injection duration on aortic enhancement during the EAP, we simulated aortic enhancement curves using test bolus data obtained for 10 HCC patients and the method of Fleischmann and Hittmair. A relatively strong correlation was observed between aortic enhancement during the EAP and TLC during the LAP (correlation coefficient r=0.75, P 280 HU for aortic enhancement simulations during EAP, the injection duration should be <25 s for patients receiving a CM dose of 1.7 ml/kg with 300 mgI/ml iodine and <30 s for those receiving 2.0 ml/kg. For excellent depiction of hypervascular HCCs during the hepatic arterial phase, the injection duration should be <25 s in patients receiving a CM dose of 1.7 ml/kg with 300 mgI/ml iodine and <30 s for patients receiving 2.0 ml/kg. (author)

  7. Changes in risk of immediate adverse reactions to iodinated contrast media by repeated administrations in patients with hepatocellular carcinoma.

    Directory of Open Access Journals (Sweden)

    Naoto Fujiwara

    Full Text Available BACKGROUND: To elucidate whether repeated exposures to iodinated contrast media increase the risk of adverse reaction. MATERIALS AND METHODS: We retrospectively reviewed 1,861 patients with hepatocellular carcinoma who visited authors' institution, a tertiary referral center, between 2004 and 2008. We analyzed cumulative probability of adverse reactions and risk factors. We categorized all symptoms into hypersensitivity reactions, physiologic reactions, and other reactions, according to the American College of Radiology guidelines, and evaluated each category as an event. We estimated the association between hazard for adverse reactions and the number of cumulative exposures to contrast media. We also evaluated subsequent contrast media injections and adverse reactions. RESULTS: There were 23,684 contrast media injections in 1,729 patients. One hundred and thirty-two patients were excluded because they were given no contrast media during the study period. Adverse reactions occurred in 196 (0.83% patients. The cumulative incidence at 10(th, 20(th, and 30(th examination was 7.9%, 15.2%, and 24.1%, respectively. Presence of renal impairment was found to be one of risk factors for adverse reactions. The estimated hazard of overall adverse reaction gradually decreased until around 10(th exposure and rose with subsequent exposures. The estimated hazard of hypersensitivity showed V-shaped change with cumulative number of exposures. The estimated hazard of physiologic reaction had a tendency toward decreasing and that of other reaction had a tendency toward increasing. Second adverse reaction was more severe than the initial in only one among 130 patients receiving subsequent injections. CONCLUSION: Repeated exposures to iodinated contrast media increase the risk of adverse reaction.

  8. Influence of repeated infusion of capsaicin-contained red pepper sauce on esophageal secondary peristalsis in humans.

    Science.gov (United States)

    Liu, T T; Yi, C H; Lei, W Y; Hung, X S; Yu, H C; Chen, C L

    2014-10-01

    The transient receptor potential vanilloid 1 has been implicated as a target mediator for heartburn perception and modulation of esophageal secondary peristalsis. Our aim was to determine the effect of repeated esophageal infusion of capsaicin-contained red pepper sauce on heartburn perception and secondary peristalsis in healthy adults. Secondary peristalsis was performed with mid-esophageal injections of air in 15 healthy adults. Two separate protocols including esophageal infusion with saline and capsaicin-contained red pepper sauce and 2 consecutive sessions of capsaicin-contained red pepper sauce were randomly performed. After repeated infusion of capsaicin-contained red pepper sauce, the threshold volume to activate secondary peristalsis was significantly increased during slow (p sauce enhanced heartburn perception (p sauce infusion (p = 0.007). Acute infusion of capsaicin-contained red pepper sauce significantly increased pressure wave amplitudes of distal esophagus during slow (p = 0.003) and rapid air injections (p = 0.01), but repeated infusion of capsaicin-contained red pepper sauce significantly decreased pressure wave amplitude of distal esophagus during slow (p = 0.0005) and rapid air injections (p = 0.003). Repeated esophageal infusion of capsaicin appears to attenuate heartburn perception and inhibit distension-induced secondary peristalsis in healthy adults. These results suggest capsaicin-sensitive afferents in modulating sensorimotor function of secondary peristalsis in human esophagus. © 2014 John Wiley & Sons Ltd.

  9. Repeated Exposition to Mercury (II Chloride Enhances Susceptibility to S. schenckii sensu stricto Infection in Mice

    Directory of Open Access Journals (Sweden)

    Alexander Batista-Duharte

    2018-05-01

    Full Text Available Sporotrichosis is a subcutaneous mycosis that has re-emerged in several tropical and subtropical regions over the last decades. Growing findings suggest that the interplay of host, pathogen, and environment has a determinant effect on the diversity, local distribution, and virulence of Sporothrix schenckii sensu lato, the etiologic agent. Among the environmental factors, we have studied the potential role of repeated exposures to mercury (Hg, a known immunotoxic xenobiotic that is widely used in gold mining regions where sporotrichosis outbreaks are frequently reported. In this study, male Swiss mice received subcutaneous injections of either 300 or 1200 µg/kg of mercury (II chloride (HgCl2 for 14 days, three times a week. A control group was injected with the vehicle Phosphate Buffered Saline (PBS. Treatment with HgCl2 impaired several immunologic parameters that are involved in host response to Sporothrix infection, such as the production of TNFα, IL-1, and nitric oxide by macrophages, and Th1/Th2/Th17 populations and their respective cytokines. The consequences of these effects on the host resistance to S. schenckii infection were subsequently evaluated. Hg-exposed mice exhibited a higher fungal load in the fungal inoculation site associated to systemic dissemination to spleen and liver on 14 days post-infection and a higher production of specific IgG1 and mild reduction of IgG2a. These findings suggest that repeated exposition to Hg enhances susceptibility to S. schenckii infection in mice and can be a factor associated to sporotrichosis outbreaks in endemic and highly Hg-polluted areas.

  10. Repeatability of tumour hypoxia imaging using [{sup 18}F]EF5 PET/CT in head and neck cancer

    Energy Technology Data Exchange (ETDEWEB)

    Silvoniemi, Antti [University of Turku, Turku PET Centre (Finland); Turku University Hospital, Department of Otorhinolaryngology - Head and Neck Surgery (Finland); Suilamo, Sami [Turku University Hospital, Department of Oncology and Radiotherapy (Finland); Turku University Hospital, Department of Medical Physics (Finland); Laitinen, Timo; Forsback, Sarita; Solin, Olof [University of Turku, Turku PET Centre (Finland); Loeyttyniemi, Eliisa [University of Turku, Department of Biostatistics, Turku (Finland); Vaittinen, Samuli [Turku University Hospital, Department of Pathology (Finland); Saunavaara, Virva [University of Turku, Turku PET Centre (Finland); Turku University Hospital, Department of Medical Physics (Finland); Groenroos, Tove J.; Minn, Heikki [University of Turku, Turku PET Centre (Finland); Turku University Hospital, Department of Oncology and Radiotherapy (Finland)

    2018-02-15

    Hypoxia contributes to radiotherapy resistance and more aggressive behaviour of several types of cancer. This study was designed to evaluate the repeatability of intratumour uptake of the hypoxia tracer [{sup 18}F]EF5 in paired PET/CT scans. Ten patients with newly diagnosed head and neck cancer (HNC) received three static PET/CT scans before chemoradiotherapy: two with [{sup 18}F]EF5 a median of 7 days apart and one with [{sup 18}F]FDG. Metabolically active primary tumour volumes were defined in [{sup 18}F]FDG images and transferred to co-registered [{sup 18}F]EF5 images for repeatability analysis. A tumour-to-muscle uptake ratio (TMR) of 1.5 at 3 h from injection of [{sup 18}F]EF5 was used as a threshold representing hypoxic tissue. In 10 paired [{sup 18}F]EF5 PET/CT image sets, SUVmean, SUVmax, and TMR showed a good correlation with the intraclass correlation coefficients of 0.81, 0.85, and 0.87, respectively. The relative coefficients of repeatability for these parameters were 15%, 17%, and 10%, respectively. Fractional hypoxic volumes of the tumours in the repeated scans had a high correlation using the Spearman rank correlation test (r = 0.94). In a voxel-by-voxel TMR analysis between the repeated scans, the mean of Pearson correlation coefficients of individual patients was 0.65. The mean (± SD) difference of TMR in the pooled data set was 0.03 ± 0.20. Pretreatment [{sup 18}F]EF5 PET/CT within one week shows high repeatability and is feasible for the guiding of hypoxia-targeted treatment interventions in HNC. (orig.)

  11. Safety and PK/PD correlation of TV-1106, a recombinant fused human albumin-growth hormone, following repeat dose administration to monkeys.

    Science.gov (United States)

    Ashkenazi, Nurit; Rosenstock, Moti; Hallak, Hussein; Bassan, Merav; Rasamoelisolo, Michele; Leuschner, Jost; Shinar, Doron

    TV-1106 is a recombinant human albumin genetically fused to growth hormone which is intended to reduce the frequency of injections for GH therapy users. We report the safety, tolerability, pharmacokinetics and pharmacodynamics of repeated subcutaneous injections of TV-1106 in Cynomolgus monkeys. Cynomolgus monkeys received four weekly subcutaneous injections of 0, 5, 10 or 20mg/kg TV-1106 and were monitored for safety signals throughout the study. Serum levels of TV-1106 and insulin-like growth factor 1 (IGF-1) were assayed. Treated animals showed no adverse effects or histopathological changes. TV-1106 serum concentrations showed sustained exposure to the drug. Exposure increased in a dose-dependent manner with peak concentrations at approximately 24h post-dosing and elimination half-lives in the range of 12 to 24h. IGF-1 serum concentrations were elevated throughout the entire study duration, indicative of the pharmacological response. There was a clear correlation between change in IGF-1 levels and dose or exposure to TV-1106. The safety, pharmacokinetic and pharmacodynamic findings support the further development of TV-1106 as a once-weekly administered treatment for patients with GHD. Copyright © 2016 Elsevier Ltd. All rights reserved.

  12. Repeated maternal intramuscular or intraamniotic erythromycin incompletely resolves intrauterine Ureaplasma parvum infection in a sheep model of pregnancy.

    Science.gov (United States)

    Kemp, Matthew W; Miura, Yuichiro; Payne, Matthew S; Watts, Rory; Megharaj, Smruthi; Jobe, Alan H; Kallapur, Suhas G; Saito, Masatoshi; Spiller, O Brad; Keelan, Jeffrey A; Newnham, John P

    2014-08-01

    Ureaplasma spp are the most commonly isolated microorganisms in association with preterm birth. Maternal erythromycin administration is a standard treatment for preterm prelabor rupture of membranes. There is little evidence of its effectiveness in eradicating Ureaplasma spp from the intrauterine cavity and fetus. We used a sheep model of intrauterine Ureaplasma spp infection to investigate the efficacy of repeated maternal intramuscular and intraamniotic erythromycin treatment to eradicate such an infection. Thirty ewes with singleton pregnancies received an intraamniotic injection of 10(7) color change units of erythromycin-sensitive Ureaplasma parvum serovar 3 at 55 days' gestation. At 116 days' gestation, 28 ewes with viable fetuses were randomized to receive (1) intraamniotic and maternal intramuscular saline solution treatment (n = 8), (2) single intraamniotic and repeated maternal intramuscular erythromycin treatment (n = 10), or (3) single maternal intramuscular and repeated intraamniotic erythromycin treatment (n = 10). Fetuses were surgically delivered at 125 days' gestation. Treatment efficacy was assessed by culture, quantitative polymerase chain reaction, and histopathologic evaluation. Animals treated with intraamniotic erythromycin had significantly less viable U parvum serovar 3 in the amniotic fluid at delivery. However, neither combination of maternal intramuscular and intraamniotic erythromycin treatment successfully cleared U parvum serovar 3 from the amniotic fluid or fetal tissues. Three de novo erythromycin-resistant U parvum isolates were identified in erythromycin-treated animals. Erythromycin treatment, given both to the ewe and into the amniotic cavity, fails to eradicate intrauterine and fetal U parvum serovar 3 infection and may lead to development of erythromycin resistant U parvum. Copyright © 2014 Mosby, Inc. All rights reserved.

  13. Self-injection is a success

    DEFF Research Database (Denmark)

    Jensen, Jonna Gintberg; Høi, Henriette Brahe

    these people have so far received injections from their own doctor. Many of the 29 feel healthy, are on the labor market and live a normal life. Therefore, it may be a recurring nuisance having to consult their physician monthly to get the injection. On this background, it is believed that self......-injection will increase the individual's quality of life. For that reason this project on quality assurance of the 29 citizens current quality of life, if they want training for self-administration in our hospital unit, and follow-up contact about how self-injections are going on. Method for data generation: Data...... out qualitative interviews Transcription of interview material Follow-up telephone interviews Analysis (Steiner Kvale's three operational levels) Significant findings: Causes of training for self-administration is desired. Family doctor injects quickly – which gives bruising, and may bleed profusely...

  14. Direct injection of {sup 188}Re-microspheres in the treatment of hepatocellular carcinoma. Compared with traditional percutaneous ethanol injection: an animal study

    Energy Technology Data Exchange (ETDEWEB)

    Lin, Y.C.; Lee, J.C.; Huang, Y.S. [Dept. of Veterinary Medicine, National Chung-Hsing Univ., Taichung (Taiwan); Dept. of Nuclear Medicine (Taiwan); Tsai, S.C. [Show Chwan Memorial Hospital (Taiwan); Hung, G.U. [Changhua Christian Hospital, Changhua (Taiwan); Lin, W.Y. [Taichung Veterans General Hospital, Taichung (Taiwan)

    2005-07-01

    The aim of this study was to compare the therapeutic efficacies of direct intratumoural injection of {sup 188}Re microspheres (DIRM) and direct intratumoural injection of ethanol (DIE) in rabbits bearing liver tumours. Materials and methods: Fifteen rabbits bearing liver tumours were divided into three groups: group 1 received DIE, group 2 received DIRM, and group 3 (control) received saline. Tumour size was measured by liver sonography before injection, as well as 2, 4, 8, and 12 weeks after injection. Survival time was calculated from the day of treatment to three months after treatment by Kaplan-Meier survival analysis. Results: The mean survival time was 68{+-}9.8 days for the rabbits in the DIRM group, 55.8{+-}11.8 days for the DIE group, and 38.8{+-}6.2 days for the control group. Conclusion: The rabbits survived longer in the DIRM group than in the DIE group although there is no statistical significance. We believe the DIRM method has a good potential to be an alternative to DIE for the treatment of liver tumours. (orig.)

  15. Economic evaluation of an e-mental health intervention for patients with retinal exudative diseases who receive intra-ocular anti-VEGF injections (E-PsEYE): protocol for a randomised controlled trial.

    NARCIS (Netherlands)

    van der Aa, HPA; van Rens, G.H.M.B.; Verbraak, F.D.; Bosscha, M; Koopmanschap, M.A.; Comijs, H.C.; Cuijpers, P.; van Nispen, R.M.A.

    2017-01-01

    Introduction Because of the great potential of vascular endothelial growth factor inhibitors (anti-VEGF) for retinal exudative diseases, an increased number of patients receives this treatment. However, during this treatment, patients are subjected to frequent invasive intravitreal injections, and

  16. Flow Injection and Atomic Absorption Spectrometry (FI-AAS) -

    DEFF Research Database (Denmark)

    Hansen, Elo Harald

    1996-01-01

    One of the advantages of the flow injection (FI) concept is that it is compatible with virtually all detection techniques. Being a versatile vehicle for enhancing the performance of the individual detection devices, the most spectacular results have possibly been obtained in conjunction with atomic...... the point of sample injection/introduction to the point of detection. Hence, in FI-fAAS this feature allows not only to obtain improved repeatability but also improved accuracy, and because the wash to sample ratio is high it permits the handling of samples with elevated salt contents - which...

  17. Stability of heterodyne terahertz receivers

    OpenAIRE

    Kooi, J. W.; Baselmans, J. J. A.; Baryshev, A.; Schieder, R.; Hajenius, M.; Gao, J. R.; Klapwijk, T. M.; Voronov, B.; Gol'tsman, G.

    2006-01-01

    In this paper we discuss the stability of heterodyne terahertz receivers based on small volume NbN phonon cooled hot electron bolometers (HEBs). The stability of these receivers can be broken down in two parts: the intrinsic stability of the HEB mixer and the stability of the local oscillator (LO) signal injection scheme. Measurements show that the HEB mixer stability is limited by gain fluctuations with a 1/f spectral distribution. In a 60 MHz noise bandwidth this results in an Allan varian...

  18. A three-barrel repeating pneumatic pellet injector for plasma fueling of the Joint European Torus

    International Nuclear Information System (INIS)

    Combs, S.K.; Milora, S.L.; Baylor, L.R.; Foust, C.R.; Gethers, F.E.; Sparks, D.O.

    1987-01-01

    Pellet fueling, the injection of frozen hydrogen isotope pellets at high velocity, has been used to improve plasma performance in various tokamak experiments. In one recent experiment, the repeating pneumatic hydrogen pellet injector was used on the Tokamak Fusion Test Reactor (TFTR). This machine gun-like device, which was developed at the Oak Ridge National Laboratory (ORNL) with an objective of steady-state fueling applications, was characterized by a fixed pellet size and a maximum repetition rate of 4 to 6 Hz for several seconds. It was used to deliver deuterium pellets at speeds ranging from 1.0 to 1.5 km/s into TFTR plasma discharges. In the first experiments, injection of single, large (nominal 4-mm-diam) pellets provided high plasma densities in TFTR (1.8 x 10 14 cm -3 on axis). After a conversion to smaller (nominal 2.7-mm-diam) pellets, the pellet injector was operated in the repeating mode to gradually increase the plasma density, injecting up to five pellets on a single machine pulse. This resulted in central plasma densities approaching 4 x 10 14 cm -3 and n tau values of 1.4 x 10 14 cm -3 s. For plasma fueling applications on the Joint European Torus (JET), a pellet injector fashioned after the prototype repeating pneumatic design has been developed. The versatile injector features three repeating guns in a common vacuum enclosure; the guns provide pellets that are 2.7, 4.0, and 6.0 mm in diameter and can operate independently at repetition rates of 5, 2.5, and 1 Hz, respectively. The injector has been installed on JET. A description of the equipment is presented, emphasizing the differences from the original repeating device. Performance characteristics of the three pneumatic guns are also included

  19. A protocol for the retina surgeon’s safe initial intravitreal injections

    Directory of Open Access Journals (Sweden)

    Ronald EP Frenkel

    2010-11-01

    Full Text Available Ronald EP Frenkel1,2, Shamim A Haji1,2, Melvin La1, Max PC Frenkel1, Angela Reyes11Eye Research Foundation, Stuart, FL, USA; 2East Florida Eye Institute, Stuart, FL, USAPurpose: To determine the safety of a surgeon’s initial consecutive intravitreal injections using a specific protocol and to review the complications that may be attributed to the injection procedure.Design: A retrospective chart review.Participants: Fifty-nine patients (30 females, 29 males received intravitreal injections of pegaptanib, bevacizumab, or ranibizumab as part of their treatment for neovascular age-related macular degeneration. The average patient age was 80 years. Twenty-two patients were diagnosed with or suspected of having glaucoma. Each patient received an average of 5.8 injections.Methods: The charts of 59 patients who received a total of 345 intravitreal injections (104 pegaptanib, 74 bevacizumab, 167 ranibizumab were reviewed. All injections were performed in an office-based setting. Povidone–iodine, topical antibiotics, and eye speculum were used as part of the pre injection procedure. Vision and intraocular pressure were evaluated immediately following each injection.Main outcome measures: Incidence of post injection complications, including but not limited to endophthalmitis, retinal detachment, traumatic cataract, and vitreous hemorrhage.Results: There were no cases of endophthalmitis, toxic reactions, traumatic cataracts, retinal detachment, or vitreous hemorrhage. There was one case each of lid swelling, transient floaters, retinal pigment epithelial tear, corneal edema, and corneal abrasion. There were five cases of transient no light perception following pegaptanib injections.Conclusion: The incidence of serious complications was very low for the intravitreal injections given. A surgeon’s initial intravitreal injections may be performed with a very high degree of safety using this protocol.Keywords: intravitreal injection, post injection

  20. Botulinum toxin A injections and occupational therapy in children with unilateral spastic cerebral palsy: a randomized controlled trial.

    Science.gov (United States)

    Lidman, Git; Nachemson, Ann; Peny-Dahlstrand, Marie; Himmelmann, Kate

    2015-08-01

    To investigate the effects of repeated botulinum toxin A (BoNT-A) injections combined with occupational therapy, including a splint, compared with occupational therapy alone on hand function in children with unilateral spastic cerebral palsy (USCP), in all International Classification of Functioning, Disability and Health (ICF) domains. This was a randomized controlled study, population-based and evaluator-blinded for primary outcome (October 2004 to September 2010). Twenty children (14 males; median age 3y 1mo) with USCP, recruited at a rehabilitation centre in Sweden, were assigned to one of two parallel groups using concealed allocation. In the course of one year, 10 children received occupational therapy, while 10 received repeated BoNT-A plus occupational therapy (BoNT-A/OT). Primary outcome (Assisting Hand Assessment [AHA]), and secondary outcome measures (range of movement [ROM], and Canadian Occupational Performance Measure), were measured at baseline, 3, 6, 9, and 12 months. AHA revealed a superior effect in the BoNT-A/OT group at 12 months: 6 out of 10 improved compared with 1 out of 10 in the occupational therapy group (poccupational therapy alone for bimanual performance in young children with USCP. Active ROM and goal performance improved in both groups. © 2015 Mac Keith Press.

  1. Serial office-based steroid injections for treatment of idiopathic subglottic stenosis.

    Science.gov (United States)

    Hoffman, Matthew R; Coughlin, Adam R; Dailey, Seth H

    2017-11-01

    Current treatment options for idiopathic subglottic stenosis include endoscopic interventions, resection, and tracheotomy. Recently, serial office-based steroid injections were proposed as an alternative that may stabilize or induce regression of airway stenosis without the need for repeated operations. Procedure completion rate, pain, complications, effect on stenosis, time since the last operation, and limitations have not been described. Retrospective case series. Retrospective series of 19 patients undergoing serial office-based steroid injection for idiopathic subglottic stenosis. Outcome measures included completion rate, procedure-related pain scores, complications, percentage of airway stenosis, and time since the last operative intervention. Procedure completion rate was 98.8%. Average pain score during the procedure was 2.3 ± 1.7 on a 10-point scale. There were no immediate complications. One patient underwent awake tracheotomy 8 days after her second injection and was later decannulated. Average stenosis decreased from 35% ± 15% to 25% ± 15% (n = 16; P = .086) over the first of three injections and 40% ± 15% to 25% ± 10% to 20% ± 10% (n = 8; P = .002) for those patients completing two sets of three injections. Fourteen of 17 patients undergoing at least three injections have not returned to the operating room since the first injection. Office-based steroid injection represents a promising new treatment pathway for a disease that requires long-term management, offering a purely pharmacologic approach to a disorder that has traditionally been approached from a mechanical perspective. It is safe, well tolerated, and effective. Furthermore, it may help patients and physicians avoid repeated trips to the operating room and the associated risks. 4. Laryngoscope, 127:2475-2481, 2017. © 2017 The American Laryngological, Rhinological and Otological Society, Inc.

  2. Optimal and safe treatment of spider leg veins measuring less than 1.5 mm on skin type IV patients, using repeated low-fluence Nd:YAG laser pulses after polidocanol injection.

    Science.gov (United States)

    Moreno-Moraga, Javier; Hernández, Esteban; Royo, Josefina; Alcolea, Justo; Isarría, M Jose; Pascu, Mihail Lucian; Smarandache, Adriana; Trelles, Mario

    2013-05-01

    Treatment of micro-veins of less than 1.5 mm with laser and with chemical sclerosis is technically challenging because of their difficulty to remedy. Laser treatment is even more difficult when dark phototypes are involved.Three groups of 30 patients each, skin type IV, and vessels measuring less than 1.5 mm in diameter, were enrolled for two treatment sessions 8 weeks apart: group A, polidocanol (POL) micro-foam injection; group B, Nd:YAG laser alone; and group C, laser after POL injection. Repeated 8-Hz low-fluence pulses, moving the hand piece over a 3-cm vein segment with an average of five laser passes maximum and with a total time irradiation of 1 s were used. Sixteen weeks after the second treatment, statistically, degree of clearance after examining photographs and patients satisfaction index, plotted on a visual analogue scale and comparing results of all three groups, results were significantly better for group C (psafe and satisfactory in 96 % of patients using low-fluence laser pulses with a total cumulative energy in the 3 cm venous segment, lower than that of conventional treatment. Very few and transient complications were observed. POL foam injection followed by laser pulses is safe and efficient for vein treatment in dark-skinned patients.

  3. Under eye infraorbital injection technique: the best value in facial rejuvenation.

    Science.gov (United States)

    Shetty, Rashmi

    2014-03-01

    The use of fillers in esthetic rejuvenation or reshaping has been well established and is one of toughest techniques for beginners due to segmental attachments and proximity to important anatomical structures in the infraorbital area making it difficult to achieve smooth esthetic results. To make filling easy, smooth, and repeatable, anatomical points were marked through specific surface measurements. Patients were injected with 0.5-1 mL of hyaluronic acid filler using the identified anatomical point. All patients treated have achieved restoration of the ogee curve with no bruising and minimal downtime with results lasting for 12-36 months. The results of the study suggest the use of single repeatable injection at the crucial point and if required at multiple identified anatomical points along the ligamental attachment to satisfy the esthetic outcome of the patient. Injection of filler at infraorbital points could instantly lift the face up, elevating the point of shadow and shifting the point of highest light reflection to the ideal malar point. © 2014 Wiley Periodicals, Inc.

  4. Analysis of air return alternatives for CRS-type open volumetric receiver

    International Nuclear Information System (INIS)

    Marcos, Ma. Jesus; Romero, Manuel; Palero, Silvia

    2004-01-01

    Even though air-cooled receivers provide substantial benefits, such as low inertia and quick sun-following dispatchability, and the volumetric effect leads to designs with aperture areas similar to those used in molten salt or water/steam receivers, some concern persists regarding absorber durability, reduction of radiation losses and improvement of the air return ratio (ARR). The paper focuses on this last issue, since the ARR is a source of significant receiver losses in current designs. Today's scaled-up receivers claim values between 45 and 70% for ARR, which means, in terms of energy loss, between 5 and 15%. As a consequence of ARR and the radiation loss stemming from high working temperatures, open volumetric receivers efficiencies below 75% are reported at temperatures usable by the power block. Those values may be acceptable for a first demonstration plant, but are categorically not competitive for commercial schemes in which receiver efficiency should approach 90%. This paper discusses the impact of several geometrical properties of the absorber and air injection system used. The study was performed by CFD with the FLUENT code. The assessment considered such alternatives as modularity of the air return system (HITREC receiver concept), outer ring injection with air curtain effect or cavity aperture (with and without secondary concentrator). A detailed analysis reveals that some parts of the receiver aperture achieve an ARR above 90% at well-selected operating conditions, but average values hardly surpass 70%. Therefore, a careful design should keep in mind important variables such as the effects of receiver edge and lateral wind, as well as air injection angle

  5. Failure of botulinum toxin injection for neurogenic detrusor overactivity: Switch of toxin versus second injection of the same toxin.

    Science.gov (United States)

    Peyronnet, Benoit; Castel-Lacanal, Evelyne; Manunta, Andréa; Roumiguié, Mathieu; Marque, Philippe; Rischmann, Pascal; Gamé, Xavier

    2015-12-01

    To evaluate the efficacy of a second injection of the same toxin versus switching to a different botulinum toxin A after failure of a first detrusor injection in patients with neurogenic detrusor overactivity. The charts of all patients who underwent detrusor injections of botulinum toxin A (either abobotulinumtoxinA or onabotulinumtoxinA) for the management of neurogenic detrusor overactivity at a single institution were retrospectively reviewed. Patients in whom a first detrusor injection had failed were included in the present study. They were managed by a second injection of the same toxin at the same dosage or by a new detrusor injection using a different botulinum toxin A. Success was defined as a resolution of urgency, urinary incontinence and detrusor overactivity in a patient self-catheterizing seven times or less per 24 h. A total of 58 patients were included for analysis. A toxin switch was carried out in 29 patients, whereas the other 29 patients received a reinjection of the same toxin at the same dose. The success rate was higher in patients who received a toxin switch (51.7% vs. 24.1%, P = 0.03). Patients treated with a switch from abobotulinumtoxinA to onabotulinumtoxinA and those treated with a switch from onabotulinumtoxinA to abobotulinumtoxinA had similar success rates (52.9% vs. 50%, P = 0.88). After failure of a first detrusor injection of botulinum toxin for neurogenic detrusor overactivity, a switch to a different toxin seems to be more effective than a second injection of the same toxin. The replacement of onabotulinumtoxin by abobotulinumtoxin or the reverse provides similar results. © 2015 The Japanese Urological Association.

  6. The biological effects of radium-224 injected into dogs

    International Nuclear Information System (INIS)

    Muggenburg, B.A.; Hahn, F.F.; Boecker, B.B.

    1996-01-01

    A life-span study was conducted in 128 beagle dogs to determine the biological effects of intravenously injected 224 Ra chloride. The 224 Ra chloride was prepared by the same method used for intravenous injections in humans who were treated for ankylosing spondylitis and tuberculosis. Thus the results obtained from dogs can be compared directly to the population of treated humans, both for the elucidation of the effect of exposure rate and for comparison with other radionuclides for which data for humans are unavailable. Using equal numbers of males and females, the dogs were injected with one of four levels of 224 Ra resulting in initial body burdens of approximately 13, 40, 120 or 350 kBq of 224 Ra kg -1 body mass. A control group of dogs was injected with diluent only. All dogs were divided further into three groups for which the amount of injected 224 Ra (half-life of 3.62 days) or diluent was given in a single injection or divided equally into 10 or 50 weekly injections. As a result of these three injection schedules, the accumulation of dose from the injected 224 Ra was distributed over approximately 1, 3 or 12 months. Each injection schedule included four different injection levels resulting in average absorbed α-particle doses to bone of 0.1, 0.3, 1 and 3 Gy, respectively. The primary early effect observed was a hematological dyscrasia in the dogs receiving either of the two highest injection levels. The effect was most severe in the dogs receiving a single injection of 224 Ra and resulted in the death of three dogs injected at the highest level. The late-occurring biological effects were tumors. Bone tumors were the most common followed by tumors in the nasal mucosa. 52 refs., 8 figs., 8 tabs

  7. Closure of shallow underground injection wells

    International Nuclear Information System (INIS)

    Veil, J.A.; Grunewald, B.

    1993-01-01

    Shallow injection wells have long been used for disposing liquid wastes. Some of these wells have received hazardous or radioactive wastes. According to US Environmental Protection Agency (EPA) regulations, Class IV wells are those injection wells through which hazardous or radioactive wastes are injected into or above an underground source of drinking water (USDW). These wells must be closed. Generally Class V wells are injection wells through which fluids that do not contain hazardous or radioactive wastes are injected into or above a USDW. Class V wells that are responsible for violations of drinking water regulations or that pose a threat to human health must also be closed. Although EPA regulations require closure of certain types of shallow injection wells, they do not provide specific details on the closure process. This paper describes the regulatory background, DOE requirements, and the steps in a shallow injection well closure process: Identification of wells needing closure; monitoring and disposal of accumulated substances; filling and sealing of wells; and remediation. In addition, the paper describes a major national EPA shallow injection well enforcement initiative, including closure plan guidance for wells used to dispose of wastes from service station operations

  8. The effects of acute multiple intraperitoneal injections of the GABAB receptor agonist baclofen on food intake in rats.

    Science.gov (United States)

    Patel, Sunit M; Ebenezer, Ivor S

    2008-12-28

    This study was undertaken to examine the effects of acute repeated administration of the GABA(B) receptor agonist baclofen on food intake in rats. In Experiment 1, the effects of repeated intraperitoneal (i.p.) injections of the GABA(B) receptor agonist baclofen (1 and 2 mg/kg) at 2 h intervals were investigated on food intake in non-deprived male Wistar rats. Both doses of baclofen significantly increased food intake after the 1st injection (PGABA(B) receptor agonists on food intake and energy homeostasis.

  9. Keratopathy and pachymetric changes after photorefractive keratectomy and vitrectomy with silicone oil injection

    DEFF Research Database (Denmark)

    Buch, H; Vesti Nielsen, N

    2000-01-01

    We present a man who, after bilateral excimer laser photorefractive keratectomy (PRK) for high myopia in the right eye, had repeated retinal detachment surgery with lensectomy and injection of silicone oil. Visual acuity fluctuated in accordance with significant central corneal thickness diurnal...... variation. The case illustrates the possibility of PRK as a predisposing factor for keratopathy after retinal detachment surgery with silicone injection in an aphakic eye....

  10. Effectiveness of HIV prevention social marketing with injecting drug users.

    Science.gov (United States)

    Gibson, David R; Zhang, Guili; Cassady, Diana; Pappas, Les; Mitchell, Joyce; Kegeles, Susan M

    2010-10-01

    Social marketing involves applying marketing principles to promote social goods. In the context of health behavior, it has been used successfully to reduce alcohol-related car crashes, smoking among youths, and malaria transmission, among other goals. Features of social marketing, such as audience segmentation and repeated exposure to prevention messages, distinguish it from traditional health promotion programs. A recent review found 8 of 10 rigorously evaluated social marketing interventions responsible for changes in HIV-related behavior or behavioral intentions. We studied 479 injection drug users to evaluate a community-based social marketing campaign to reduce injection risk behavior among drug users in Sacramento, California. Injecting drugs is associated with HIV infection in more than 130 countries worldwide.

  11. Vapocoolant Anesthesia for Cosmetic Facial Rejuvenation Injections: A Randomized, Prospective, Split-Face Trial.

    Science.gov (United States)

    Zeiderman, Matthew R; Kelishadi, Shahrooz Sean; Tutela, John Paul; Rao, Arun; Chowdhry, Saeed; Brooks, Ronald M; Wilhelmi, Bradon J

    2018-01-01

    Background: Minimally invasive cosmetic procedures are the most commonly performed aesthetic techniques by plastic surgeons. Patients are interested in a pain-free experience. Surgeons desire patient satisfaction and time-efficient utilization of office staff and resources. Clinical evidence exists for use of vapocoolant technology to reduce pain associated with intravenous cannulation in the pediatric population and in hemodialysis patients. Applying vapocoolant technology to facial rejuvenation is a novel approach to decrease pain associated with neurotoxin or filler injection. Methods: A randomized, prospective study was conducted, testing 15 subjects receiving filler injections and another 15 patients receiving neurotoxin injections using a split-face model. The vapocoolant spray used was composed of a 95:5 ratio of 1,1,1,3,3-pentafluoropropane and 1,1,1,2-tetrafluoroethane. Within each group, individual patients randomly received injection (filler or neurotoxin) alone versus injection (filler or neurotoxin) plus vapocoolant on an equivalent half of his or her face. An independent examiner recorded from each patient on a scale of 1 to 10 perceived pain for injection alone versus injection plus vapocoolant spray. Results were calculated as a percentage change of pain scores experienced after injection for each person between the control (nonvapocoolant) and treatment (vapocoolant) sides of the face. Results: Vapocoolant spray at the time of cosmetic facial injections leads to a 59% decrease in perceived pain score with neurotoxin injections (range, 0%-100% change) and 64% decrease in perceived pain score with filler injections (range, 0%-100% change). These results were statistically significant with P reduces pain associated with facial rejuvenation procedures.

  12. Comparison of hyaluronic acid and PRP intra-articular injection with combined intra-articular and intraosseous PRP injections to treat patients with knee osteoarthritis.

    Science.gov (United States)

    Su, Ke; Bai, Yuming; Wang, Jun; Zhang, Haisen; Liu, Hao; Ma, Shiyun

    2018-05-01

    The aim of this study was to evaluate the benefit provided by intraosseous infiltration combined with intra-articular injection of platelet-rich plasma to treat mild and moderate stages of knee joint degeneration (Kellgren-Lawrence score II-III) compared with other treatments, specifically intra-articular injection of PRP and of HA. Eighty-six patients with grade II to grade III knee OA according to the Kellgren-Lawrence classification were randomly assigned to intra-articular combined with intraosseous injection of PRP (group A), intra-articular PRP (group B), or intra-articular HA (group C). Patients in group A received intra-articular combined with intraosseous injection of PRP (administered twice, 2 weeks apart). Patients in group B received intra-articular injection of PRP every 14 days. Patients in group C received a series of five intra-articular injections of HA every 7 days. All patients were evaluated using the Visual Analogue Scale (VAS) and Western Ontario and McMaster Universities (WOMAC) score before the treatment and at 1, 3, 6, 12, and 18 months after treatment. There were significant improvements at the end of the 1st month. Notably, group A patients had significantly superior VAS and WOMAC scores than were observed in groups B and C. The VAS scores were similar in groups B and group C after the 6th month. Regarding the WOMAC scores, groups B and C differed at the 1st, 3rd, 6th, and 12th months; however, no significant difference was observed at the 18th month. The combination of intraosseous with intra-articular injections of PRP resulted in a significantly superior clinical outcome, with sustained lower VAS and WOMAC scores and improvement in quality of life within 18 months.

  13. Intraocular Pressure Increases After Intraarticular Knee Injection With Triamcinolone but Not Hyaluronic Acid.

    Science.gov (United States)

    Taliaferro, Kevin; Crawford, Alexander; Jabara, Justin; Lynch, Jonathan; Jung, Edward; Zvirbulis, Raimonds; Banka, Trevor

    2018-03-09

    with osteoarthritis of the knee who were suitable candidates for either a steroid injection or hyaluronic acid injection were included in the study. Exclusion criteria included previous glaucoma surgery, previous corneal injury precluding use of a Tono-Pen, current acute or chronic steroid use, and diagnosis of glaucoma other than primary open-angle. Patients with elevated intraocular pressure at the 1-week timepoint were invited to return at 1 month for repeat measurement; however, only five of nine (55.6%) were able to do so. The mean age of the total population was 64.1 ± 11.65 years. There were 46 (74%) women and 16 men. Patient in the hyaluronic acid injection group were younger than the triamcinolone group, 59.5 ± 11.7 versus 68.7 ± 9.7 years of age (p hyaluronic acid (2.79 ± 9.9 mm Hg versus -0.14 ± 2.96 mm Hg; mean difference 2.93 mm Hg; 95% confidence interval, -0.71 to 6.57 mm Hg; p = 0.12). More patients who received triamcinolone injections developed an increase in intraocular pressure > 7 mm than did those who received hyaluronic acid (29% [nine of 29] versus 0% [zero of 31]; p = 0.002). Of the nine patients who developed elevated intraocular pressure after a triamcinolone injection, five returned for reevaluation 1 month later, and four of them had pressures that remained elevated > 7 mm Hg from baseline. There appears to be an associated intraocular pressure elevation found in patients who have undergone a triamcinolone injection of the knee. Further larger scale randomized investigations are warranted to determine the longevity of this pressure elevation as well as long-term clinical implications, including optic nerve damage and visual field loss. Level II, therapeutic study.

  14. Necrotizing Soft Tissue Fasciitis after Intramuscular Injection

    Directory of Open Access Journals (Sweden)

    Angelica Abbate

    2018-01-01

    Full Text Available Necrotizing soft tissue fasciitis (NSTIs or necrotizing fasciitis is an infrequent and serious infection. Herein, we describe the clinical course of a female patient who received a diagnosis of NSTIs after gluteus intramuscular injection. We also report the results of our review of published papers from 1997 to 2017. Since now, 19 cases of NSTIs following intramuscular injections have been described. We focus on the correlation between intramuscular injection and NSTIs onset, especially in immunosuppressed patients treated with corticosteroids, suffering from chronic diseases or drug addicted. Intramuscular injections can provoke severe tissue trauma, representing local portal of infection, even if correctly administrated. Otherwise, it is important not to inject drug in subcutaneous, which is a less vascularized area and therefore more susceptible to infections. Likewise, a proper injecting technique and aspiration prior to injection seem to be valid measure to prevent intra-arterial or para-arterial drug injection with the consequent massive inflammatory reaction. Necrosis at the infection site appears to be independent of the drug, and it is a strong additional risk factor for NSTIs.

  15. A randomized clinical trial on comparison of corticosteroid injection with or without splinting versus saline injection with or without splinting in patients with lateral epicondylitis

    Directory of Open Access Journals (Sweden)

    Mohammad Ali Tahririan

    2014-01-01

    Full Text Available Background: Lateral epicondylitis is a common problem affecting 1-3% of the population. There has been much debate about the best treatment modality for this condition. There is, however, no conclusive evidence in support of any of the proposed treatment modalities. In this trial, we have studied the effect of corticosteroid injection (with or without splinting with normal saline injection (with or without splinting. Materials and Methods: In this double-blind, randomized clinical trial, individuals were randomly assigned to either of four treatment groups and received either 40 mg depomedrol injection alone, 40 mg depomedrol injection with splinting, normal saline injection alone, or normal saline injection with splinting. They were evaluated using the visual analog scale (VAS at weeks 2, 4 and 24 and with the Oxford elbow scale (OES at 24 weeks. Results: A total of 79 patients were participated in the study. The corticosteroid injection groups had better pain relief as measured by VAS at 2 and 4 weeks compared with the two saline injection groups. Mean VAS difference at week 0 versus week 2 was 4.5 ± 0.9 and 2.8 ± 0.6 in corticosteroid injection groups and saline injection groups respectively (P < 0.01 but at 24 weeks, there was only moderate benefit reported for the group which received steroid injection and splinting (P < 0.01 compared to the saline injection groups. The saline injection groups reported better improvement in OES scores (20.1 ± 3.7 at the end of the trial compared corticosteroid injection groups (16.1 ± 2.9 (P < 0.05. Conclusion: Our results indicate that despite the clear pain reduction benefit associated with steroid injection in short term, this benefit in comparison with normal saline injection fades by the 24 th week of follow-up.

  16. Chaos-pass filtering in injection-locked semiconductor lasers

    International Nuclear Information System (INIS)

    Murakami, Atsushi; Shore, K. Alan

    2005-01-01

    Chaos-pass filtering (CPF) of semiconductor lasers has been studied theoretically. CPF is a phenomenon which occurs in laser chaos synchronization by injection locking and is a fundamental technique for the extraction of messages at the receiver laser in chaotic communications systems. We employ a simple theory based on driven damped oscillators to clarify the physical background of CPF. The receiver laser is optically driven by injection from the transmitter laser. We have numerically investigated the response characteristics of the receiver when it is driven by periodic (message) and chaotic (carrier) signals. It is thereby revealed that the response of the receiver laser in the two cases is quite different. For the periodic drive, the receiver exhibits a response depending on the signal frequency, while the chaotic drive provides a frequency-independent synchronous response to the receiver laser. We verify that the periodic and chaotic drives occur independently in the CPF response, and, consequently, CPF can be clearly understood in the difference of the two drives. Message extraction using CPF is also examined, and the validity of our theoretical explanation for the physical mechanism underlying CPF is thus verified

  17. Repeated Intramuscular-dose Toxicity Test of Water-soluble Carthami Flos (WCF Pharmacopuncture in Sprague-Dawley Rats

    Directory of Open Access Journals (Sweden)

    Yoo-min Choi

    2015-03-01

    Full Text Available Objectives: Water-soluble carthami flos (WCF is a new mixture of Carthami flos (CF pharmacopuncture. We conducted a 4-week toxicity test of repeated intramuscular injections of WCF in Sprague-Dawley rats. Methods: Forty male and 40 female rats were divided into 4 groups of 10 male and 10 female SD rats: The control group received 0.5 mL/animal/day of normal saline whereas the three experimental groups received WCF at doses of 0.125, 0.25, and 0.5 mL/animal/day, respectively. For 4 weeks, the solutions were injected into the femoral muscle of the rats alternating from side to side. Clinical signs, body weights, and food consumption were observed; opthalmological examinations and urinalyses were performed. On day 29, blood samples were taken for hematological and clinical chemistry analyses. Then, necropsy was conducted in all animals to observe weights and external and histopathological changes in the bodily organs. All data were tested using a statistical analysis system (SAS. Results: No deaths were observed. Temporary irregular respiration was observed in male rats of the experimental group for the first 10 days. Body weights, food consumptions, opthalmological examinations, urinalyses, clinical chemistry analyses, organ weights and necropsy produced no findings with toxicological meaning. In the hematological analysis, delay of prothrombin time (PT was observed in male rats of the 0.25- and the 0.5-mL/animal/day groups. In the histopathological test, a dose-dependent inflammatory cell infiltration into the fascia and panniculitis in perimuscular tissues was observed in all animals of the experimental groups. However, those symptoms were limited to local injection points. No toxicological meanings, except localized changes, were noted. Conclusion: WCF solution has no significant toxicological meaning, but does produce localized symptoms. No observed adverse effect level (NOAEL of WCF in male and female rats is expected for doses over 0.5 mL/animal/day.

  18. 'Chaos' in superregenerative receivers

    International Nuclear Information System (INIS)

    Commercon, Jean-Claude; Badard, Robert

    2005-01-01

    The superregenerative principle has been known since the early 1920s. The circuit is extremely simple and extremely sensitive. Today, superheterodyne receivers generally supplant superregenerative receivers in most applications because there are several undesirable characteristics: poor selectivity, reradiation, etc. Superregenerative receivers undergo a revival in recent papers for wireless systems, where low cost and very low power consumption are relevant: house/building meters (such as water, energy, gas counter), personal computer environment (keyboard, mouse), etc. Another drawback is the noise level which is higher than that of a well-designed superheterodyne receiver; without an antenna input signal, the output of the receiver hears in an earphone as a waterfall noise; this sound principally is the inherent input noise amplified and detected by the circuit; however, when the input noise is negligible with respect of an antenna input signal, we are faced to an other source of 'noise' self-generated by the superregenerative working. The main objective of this paper concerns this self-generated noise coming from an exponential growing followed by a re-injection process for which the final state is a function of the phase of the input signal

  19. 21 CFR 522.1820 - Pituitary luteinizing hormone for injection.

    Science.gov (United States)

    2010-04-01

    ....1820 Section 522.1820 Food and Drugs FOOD AND DRUG ADMINISTRATION, DEPARTMENT OF HEALTH AND HUMAN... hypofunction in cattle, horses, swine, sheep, and dogs. (2) Preferably given by intravenous injection, it may....5 mg, and dogs, 1.0 mg. Treatment may be repeated in 1 to 4 weeks, or as indicated. (3) Federal law...

  20. Prognostic factors after intra-articular hyaluronic acid injection in ankle osteoarthritis.

    Science.gov (United States)

    Han, Seung Hwan; Park, Do Young; Kim, Tae Hun

    2014-07-01

    The goal of this study was to identify baseline prognostic factors of outcome in ankle osteoarthritis patients after intra-articular hyaluronic acid injection. Patients with ankle osteoarthritis who received hyaluronic acid injection therapy were retrospectively reviewed. Each patient received weekly intra-articular hyaluronic acid injections (2 mL) for 3 weeks. Six predictors including gender, age, symptom duration, radiographic osteoarthritis stage, radiographic subchondral cyst, and fracture history were evaluated. Visual analogue scale (VAS) and patient satisfaction were evaluated as outcome measures. These predictors and outcome measurements were included in a logistic regression model for statistical analysis. Total of 40 consecutive patients (21 male, 19 female) were included in this study. Mean age was 60.6. Average follow up period was 13 months. The mean VAS recorded 3, 6, and 12 months after the first injection was 3.6 (SD 2.54, phyaluronic acid injection for ankle osteoarthritis is a safe and effective treatment, careful selection of patients should be made according to the above prognostic predictors.

  1. Radiotracer injections through microfilters

    International Nuclear Information System (INIS)

    Huber, H.; Maschek, G.; Pichler, R.; Giesen, I.; Hatzl-Griesenhofer, M.; Maschek, W.

    2002-01-01

    Full text: Problems with the injection of radiotracers ( 99m Tc-HAMS, 99m Tc-DPD) to infants when administered through polar-filter-protected venous pathways caused us to get a closer look of what happens to a tracer in such a system. We simulated injections of the tracers mainly used at our institution in an in-vitro array and measured full and empty tracer syringes, filters (0.2 μm micropores) and the post-filter receptacle of the radioactivity. We calculated the percentage of filter-trapped activity and of activity in the receptacle. For several tracers we repeated this process with a neutral filter of the same pore size to get a comparison between the behavior in polarized and electrically inert filters. In general injection of a soluble radiotracer through a polar filter system means a dose loss in the filter of about 10 %, up to the tracer molecule size of IgG-antibodies. Suspended tracers, which consist of comparatively large particles, like RES- or pulmonary perfusion markers, are blocked by the filter, as can be foreseen with a particle size of >> 0.2 μm. DMSA and DPD (a biphosphonate), although both being soluble and rather small molecules, were blocked by the polar filter to a high extent, and by the neutral filter to a much lower, almost neglectable degree. The conclusions are: if possible avoid any use of a filter in your tracer injection pathway. Never use a filter with bone scan or DMSA applications. When doing uptake calculations you have to add the filter counts to the empty syringe value in the formula. If you cannot avoid to inject the radiotracer through a filter you have to replace the filter afterwards and treat the used filter as radioactive waste. The polarity of the filter material might severely affect retention of radiotracer in the filter. (author)

  2. Treatment of the Infection after Fat Injection

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2015-01-01

    Full Text Available For recent years, use of autologous fat injection has increased significantly in facial contouring surgery. Along with such increase in use, complications like atypical mycoplasma infection have been also on the increasing trend. The authors report two cases of Mycobacterium chelonae infection that occurred after autologous fat injection. Patients were treated as infection that resistant to common antibiotics and results were negative to routine culture and Gram staining. Acid-fast bacillus stain, polymerase chain reaction (PCR test and mycobacterial cultures were conducted for diagnosis under suspicion of atypical mycoplasma infection. Then, combination antibiotics therapy, surgical treatment, and steroid injection were performed for treatment. Both patients were diagnosed with Mycobacterium chelonae in PCR test. They were positive to mycobacterial cultures. Combination antibiotics therapy was repeated to improvement of symptom. However, they could not be free from side effects such as deformation in facial contour, scar and pigmentation even after full recovery. When chronic wound infections after autologous fat injection, we must suspect atypical or mycobacterial infection and conduct examinations for a early diagnosis and proper antibiotic therapy that is effective to the nontuberculous mycobacteria.

  3. A system for accurate and automated injection of hyperpolarized substrate with minimal dead time and scalable volumes over a large range

    Science.gov (United States)

    Reynolds, Steven; Bucur, Adriana; Port, Michael; Alizadeh, Tooba; Kazan, Samira M.; Tozer, Gillian M.; Paley, Martyn N. J.

    2014-02-01

    Over recent years hyperpolarization by dissolution dynamic nuclear polarization has become an established technique for studying metabolism in vivo in animal models. Temporal signal plots obtained from the injected metabolite and daughter products, e.g. pyruvate and lactate, can be fitted to compartmental models to estimate kinetic rate constants. Modeling and physiological parameter estimation can be made more robust by consistent and reproducible injections through automation. An injection system previously developed by us was limited in the injectable volume to between 0.6 and 2.4 ml and injection was delayed due to a required syringe filling step. An improved MR-compatible injector system has been developed that measures the pH of injected substrate, uses flow control to reduce dead volume within the injection cannula and can be operated over a larger volume range. The delay time to injection has been minimized by removing the syringe filling step by use of a peristaltic pump. For 100 μl to 10.000 ml, the volume range typically used for mice to rabbits, the average delivered volume was 97.8% of the demand volume. The standard deviation of delivered volumes was 7 μl for 100 μl and 20 μl for 10.000 ml demand volumes (mean S.D. was 9 ul in this range). In three repeat injections through a fixed 0.96 mm O.D. tube the coefficient of variation for the area under the curve was 2%. For in vivo injections of hyperpolarized pyruvate in tumor-bearing rats, signal was first detected in the input femoral vein cannula at 3-4 s post-injection trigger signal and at 9-12 s in tumor tissue. The pH of the injected pyruvate was 7.1 ± 0.3 (mean ± S.D., n = 10). For small injection volumes, e.g. less than 100 μl, the internal diameter of the tubing contained within the peristaltic pump could be reduced to improve accuracy. Larger injection volumes are limited only by the size of the receiving vessel connected to the pump.

  4. Fluconazole and intrathecal injection of amphotericin B for treating cryptococcal meningitis

    Institute of Scientific and Technical Information of China (English)

    Shiguang Wen; Jian Yin; Shaosen Qin; Meiping Wen; Xiaoyan Zhang; Dongke Chen

    2006-01-01

    intracranial hypertension,were used at the same time of administration. When cryptococcus of cerebrospinal fluid was negative, patients received the secondary therapy at anaphase. The drug withdrawal was not performed untill ink smear of cerebrospinal fluid was negative for 3 successive cultures. ③ Evaluative criteria: Evaluative criteria were classified into 4 styles: Cure: Clinical symptoms and physical signs disappeared and ink smear of cerebrospinal fluid was negative for 3 successful cultures; Improvement: Clinical symptoms and physical signs were improved remarkably, amount of cerebrospinal fluid was decreased, and ink smear was not negative; inefficiency and death.MAIN OUTCOME MEASURE: Clinical effects and poor responses of intrathecal injection of amphotericin B and fluconazole treatment.RESULTS: Among 8 patients with cryptococcal meningitis, one died due to ntracranial hypertension combining with cerebral hernia, and others were returned visit at 1 year after drug withdrawal. ① Clinical effects: Among 8patients with cryptococcal meningitis, 4 were cured, 3 were improved, and one died. There was no relapse case. ② Results of mycological examination: After first intrathecal injection of 4 improved patients, the amount of cryptococcus of cerebrospinal fluid was decreased 20%-30%; in addition, after intrathecal injection for twice or three times, the amount was decreased 33%-50%. ③ Improvement of intracranial hypertension: Seven patients had the intracranial hypertension. After intrathecal injection for twice or three times, pressure of cerebrospinal fluid was decreased below 2 451.75 Pa, and the clinical symptoms were relieved remarkably. ④Poor responses: After intrathecal injection, patients had headache, nausea, emesis and pain of lower limb.Especially, 2 cases had transient paraplegia of both lower limbs, one had retention of urine, and two had conscious disturbance.CONCLUSrON: Controlling intracranial hypertension with repeatedly piercing waist and

  5. Home-Made Micro Valve for Determining Malachite Green Dye by Flow Injection Analysis

    Directory of Open Access Journals (Sweden)

    Amal Saadoon Majeed

    2017-07-01

    Full Text Available The research is included studying and designing micro flow injection system which is characterized with rapidity, simplicity, and low cost for the determination of green malachite dye. The study of flow rate of carrier stream, repeatability, dispersion coefficient, and calibration graph are conducted. It is found that the optimum conditions for the determination of mentioned dye are flow rate 4.200 mL/min, sampling rate 102 sample/h, limit of detection 0.05 ppm, linear range (0.05-18.00 ppm with linearity (R2=0.9700, RSD is 0.355, the repeatability for seven successive injections is studied for the two concentrations 5 ppm and 12 ppm, and the dispersion coefficient values are 1.73 and 1.28 at the two concentrations 2 ppm and 9 ppm respectively.

  6. PLT neutral injection ignitron accelerating supply

    International Nuclear Information System (INIS)

    Ashcroft, D.L.; Murray, J.G.; Newman, R.A.; Peterson, F.L.

    1975-11-01

    A phase-controlled rectifier was designed for the accelerating supply on the PLT Neutral Beam Injection system at PPPL. The rectifier must furnish 70 amperes at up to 50 KV for 300 milliseconds, with a duty cycle of up to 10 percent. Protection of the injectors requires the supply to withstand repeated crowbarring. The rectifying element selected to satisfy these requirements was a commercially-available ignitron, installed in a supporting frame and using firing circuits and controls designed by PPPL

  7. PLT neutral injection ignitron accelerating supply

    International Nuclear Information System (INIS)

    Ashcroft, D.L.; Murray, J.G.; Newman, R.A.; Peterson, F.L.

    1976-03-01

    A phase-controlled rectifier has been designed for the accelerating supply on the PLT Neutral Beam Injection system at PPPL. The rectifier must furnish 70 amperes at up to 50 KV for 300 milliseconds, with a duty cycle of up to 10 percent. Protection of the injectors requires the supply to withstand repeated crowbarring. The rectifying element selected to satisfy these requirements was a commercially-available ignitron, installed in a supporting frame and using firing circuits and controls designed by PPPL

  8. Effect of prostaglandin E2 injection on the structural properties of the rat patellar tendon

    Directory of Open Access Journals (Sweden)

    Ferry Scott T

    2012-01-01

    Full Text Available Abstract Background Increased tendon production of the inflammatory mediator prostaglandin E2 (PGE2 has been suggested to be a potential etiologic agent in the development of tendinopathy. Repeated injection of PGE2 into tendon has been proposed as a potential animal model for studying treatments for tendinopathy. In contrast, nonsteroidal anti-inflammatory drugs (NSAIDs which inhibit PGE2 production and are commonly prescribed in treating tendinopathy have been shown to impair the healing of tendon after acute injury in animal models. The contradictory literature suggests the need to better define the functional effects of PGE2 on tendon. Our objective was to characterize the effects of PGE2 injection on the biomechanical and biochemical properties of tendon and the activity of the animals. Our hypothesis was that weekly PGE2 injection to the rat patellar tendon would lead to inferior biomechanical properties. Methods Forty rats were divided equally into four groups. Three groups were followed for 4 weeks with the following peritendinous injection procedures: No injection (control, 4 weekly injections of saline (saline, 4 weekly injections of 800 ng PGE2 (PGE2-4 wks. The fourth group received 4 weekly injections of 800 ng PGE2 initially and was followed for a total of 8 weeks. All animals were injected bilaterally. The main outcome measurements included: the structural and material properties of the patellar tendon under tensile loading to failure, tendon collagen content, and weekly animal activity scores. Results The ultimate load of PGE2-4 wks tendons at 4 weeks was significantly greater than control or saline group tendons. The stiffness and elastic modulus of the PGE2 injected tendons at 8 weeks was significantly greater than the control or saline tendons. No differences in animal activity, collagen content, or mean fibril diameter were observed between groups. Conclusions Four weekly peritendinous injections of PGE2 to the rat patellar

  9. Incidence of plantar fascia ruptures following corticosteroid injection.

    Science.gov (United States)

    Kim, Chul; Cashdollar, Michael R; Mendicino, Robert W; Catanzariti, Alan R; Fuge, LaDonna

    2010-12-01

    Plantar fasciitis is commonly treated with corticosteroid injections to decrease pain and inflammation. Therapeutic benefits often vary in terms of efficacy and duration. Rupture of the plantar fascia has been reported as a possible complication following corticosteroid injection. A retrospective chart review of 120 patients who received corticosteroid injection for plantar fasciitis was performed at the authors' institution to determine the incidence of plantar fascia rupture. The plantar fascia rupture was diagnosed clinically and confirmed with magnetic resonance imaging. Various factors were analyzed, including the number of injections, interval between injections, body mass index (BMI), and activity level. Four patients (2.4%) consequently experienced plantar fascia rupture following an average of 2.67 injections. The average BMI of these patients was 38.6 kg/m². The authors conclude that corticosteroid injection therapy appears to be a safe and effective form of nonoperative treatment with minimal complications and a relatively low incident of plantar fascia rupture.

  10. Possibilities of nontoxic autonomous thyroid nodules treatment by percutaneous ethanol injection

    Directory of Open Access Journals (Sweden)

    Anđelković Zoran

    2011-01-01

    Full Text Available Background/Aim. According to the current principles, autonomous functional thyroid nodules are treated by surgery or by radioiodin therapy. Ultrasound guided percutaneous ethanol injection into solid tumors of the soft tissues was a starting point in attempts to treat the thyroid nodules by the same method. The aim of the study was to assess the efficiency of percutaneous injection in treating solitary, nontoxic, autonomous thyroid nodules of up to 15 mL volume. Methods. In 25 patients with solitary nontoxic autonomous thyroid nodules diagnosed by tehnetium-99m scanning as an intensive area having a complete supremacy in the paranodal tissue, an ultrasound guided percutaneous ethanol injection was applied. The procedure was carried out repeatedly once a week until the reduction in nodule size to 50% of the initial size was achieved. Results. An average size of the nodule before curing was 9.68 ± 5.01 mL. An average quantity of the injected ethanol was 9.52 ± 5.08 mL, ie 1.06 ± 0.48 mL/mg of the tissue. The regression of the nodule size in the successfully (Δvol% u = - 57.09 ± 13.75%, p < 0.001 and partly successfully cured (Δvol du = -48.45 ± 14.35%, p < 0.05 was statistically significant compared to the size before the treatment. After ceasing ethanol injection, 18 months later, a further size regression (Δvol% = -79.20 ± 9.89% compared to the initial one (p < 0.001 was noticed. Soon, after the procedure was finished, a statistically significant concentration increase of Thyroid Stimulating Hormone (TSH was noticed compared to the initial values (0.18 ± 0.16 vs 0.34 ± 0.31 mU/L, p < 0.01. According to the given criteria, in two female patients satisfactory results were not achieved, but, a year later, in one of them the nodule was not seen by repeated scintigram. The number and frequency of side effects were insignificant. Conclusion. Repeated percutaneous ethanol injections into nontoxic solitary autonomous thyroid nodules result in

  11. Method of controlling injection of oxygen into hydrogen-rich fuel cell feed stream

    Science.gov (United States)

    Meltser, Mark Alexander; Gutowski, Stanley; Weisbrod, Kirk

    2001-01-01

    A method of operating a H.sub.2 --O.sub.2 fuel cell fueled by hydrogen-rich fuel stream containing CO. The CO content is reduced to acceptable levels by injecting oxygen into the fuel gas stream. The amount of oxygen injected is controlled in relation to the CO content of the fuel gas, by a control strategy that involves (a) determining the CO content of the fuel stream at a first injection rate, (b) increasing the O.sub.2 injection rate, (c) determining the CO content of the stream at the higher injection rate, (d) further increasing the O.sub.2 injection rate if the second measured CO content is lower than the first measured CO content or reducing the O.sub.2 injection rate if the second measured CO content is greater than the first measured CO content, and (e) repeating steps a-d as needed to optimize CO consumption and minimize H.sub.2 consumption.

  12. Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal.

    Science.gov (United States)

    Gyawali, Sudesh; Rathore, Devendra S; Kc, Bhuvan; Shankar, P Ravi

    2013-01-03

    Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a) to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b) to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. A descriptive cross-sectional mixed type (qualitative and quantitative) survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. The in-charges (eight males, two females) who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable) injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal training in waste management. Certain safe injection

  13. Study of status of safe injection practice and knowledge regarding injection safety among primary health care workers in Baglung district, western Nepal

    Directory of Open Access Journals (Sweden)

    Gyawali Sudesh

    2013-01-01

    Full Text Available Abstract Background Unsafe injection practices and injection overuse are widespread in developing countries harming the patient and inviting risks to the health care workers. In Nepal, there is a dearth of documented information about injection practices so the present study was carried out: a to determine whether the selected government health facilities satisfy the conditions for safe injections in terms of staff training, availability of sterile injectable equipment and their proper disposal after use and b to assess knowledge and attitudes of healthcare workers in these health care facilities with regard to injection safety. Methodology A descriptive cross-sectional mixed type (qualitative and quantitative survey was carried out from 18th May to 16th June 2012. In-depth interviews with the in-charges were conducted using a semi-structured questionnaire. Observation of the health facilities using a structured observation tool was done. The data were analysed manually by summarizing, tabulating and presenting in various formats. Results The in-charges (eight males, two females who participated in the study ranged in age from 30 to 50 years with a mean age of 37.8 years. Severe infection followed by pain was the most important cause for injection use with injection Gentamicin being most commonly prescribed. New single use (disposable injections and auto-disable syringes were used to inject curative drugs and vaccines respectively. Sufficient safety boxes were also supplied to dispose the used syringe. All health care workers had received full course of Hepatitis B vaccine and were knowledgeable about at least one pathogen transmitted through unsafe injection practices. Injection safety management policy and waste disposal guideline was not available for viewing in any of the facilities. The office staff who disposed the bio-medical wastes did so without taking any safety measures. Moreover, none of these staff had received any formal

  14. Human factors engineering and design validation for the redesigned follitropin alfa pen injection device.

    Science.gov (United States)

    Mahony, Mary C; Patterson, Patricia; Hayward, Brooke; North, Robert; Green, Dawne

    2015-05-01

    To demonstrate, using human factors engineering (HFE), that a redesigned, pre-filled, ready-to-use, pre-asembled follitropin alfa pen can be used to administer prescribed follitropin alfa doses safely and accurately. A failure modes and effects analysis identified hazards and harms potentially caused by use errors; risk-control measures were implemented to ensure acceptable device use risk management. Participants were women with infertility, their significant others, and fertility nurse (FN) professionals. Preliminary testing included 'Instructions for Use' (IFU) and pre-validation studies. Validation studies used simulated injections in a representative use environment; participants received prior training on pen use. User performance in preliminary testing led to IFU revisions and a change to outer needle cap design to mitigate needle stick potential. In the first validation study (49 users, 343 simulated injections), in the FN group, one observed critical use error resulted in a device design modification and another in an IFU change. A second validation study tested the mitigation strategies; previously reported use errors were not repeated. Through an iterative process involving a series of studies, modifications were made to the pen design and IFU. Simulated-use testing demonstrated that the redesigned pen can be used to administer follitropin alfa effectively and safely.

  15. Repeated oral administration of capsaicin increases anxiety-like ...

    Indian Academy of Sciences (India)

    This study was conducted to examine the psycho-emotional effects of repeated oral exposure to capsaicin, the principal active component of chili peppers. Each rat received 1 mL of 0.02% capsaicin into its oral cavity daily, and was subjected to behavioural tests following 10 daily administrations of capsaicin. Stereotypy ...

  16. Steroid injection for painful shoulder: Usefulness of ultrasound-guided approach

    International Nuclear Information System (INIS)

    Lee, Min Hee

    2004-01-01

    To evaluate the efficacy of steroid injection into the subacromial bursa and biceps tendon sheath for painful shoulders and the usefulness of ultrasound-guided approach. Seventeen shoulders of twelve patients with shoulder pain and limited motion were included, and these patient were clinically diagnosed as a painful arc syndrome. Under ultrasound guidance, steroid injection was performed into the subacormial bursa (13 cases) and biceps tendon sheath (4 cases). In 7 cases, 1 mL of steroid was used while the remaining six patients received a mixture of 1 mL of steroid and 1 ml of lidocaine. Both shoulders of two patients received 0.5 mL of steroid. The location of needle and injection duration of fluid were continuously monitored, and complications such as leakage of steroid were recorded. Medical records were reviewed for the presence of pain relief and increasing range of motion following the injection. On ultrasonogram, the needle within the subacromial bursa and biceps tendon sheath was seen as a linear echogenic structure, and injected fluid was identified. There was neither the leakage of steroid injection nor any other complications. In 16 (94%) of 17 shoulders, there was decreased intensity of shoulder pain while increased range of motion was noted in three patients following the injection. Steroid injection into the subacormial bursa and biceps tendon sheath is effective in treating shoulder pain and limited range of motion of the shoulder, and ultrasound is useful guiding method.

  17. Transvaginal Pelvic Floor Muscle Injection Technique: A Cadaver Study.

    Science.gov (United States)

    Gupta, Priyanka; Ehlert, Michael; Sirls, Larry T; Peters, Kenneth

    Women with pelvic floor dysfunction can have tender areas on vaginal examination, which can be treated with trigger-point injections. There are no publications to evaluate the accuracy of pelvic floor muscle injections. Trigger-point injections were performed on 2 fresh cadaveric pelvises using a curved nasal cannula guide and 7-in spinal needle. This was performed using our standard template of 2 sets of injections at the 1-, 3-, and 5-o'clock positions distally and proximally. The first pelvis was dissected to examine dye penetration. Based on these results, we modified our technique and repeated the injections on the second cadaver. We dissected the second pelvis and compared our findings. The 1-o'clock proximal and distal injections stained the obturator internus and externus near the insertion at the ischiopubic ramus. The 3-o'clock injections stained the midbody of the pubococcygeus and puborectalis. The distal 5-o'clock position was too deep and stained the fat of the ischiorectal space. The proximal 5-o'clock injection stained the area of the pudendal nerve. Our goal at the distal 5-o'clock position was to infuse the iliococcygeus muscle, so we shortened the needle depth from 2 to 1 cm beyond the cannula tip. In our second dissection, the distal 5-o'clock injection again stained only the fat of the ischiorectal space. This is the first study to characterize the distribution of pelvic floor muscle injections in a cadaver model and confirms the ability to deliver medications effectively to the pelvic floor muscles.

  18. Policing behaviors, safe injection self-efficacy, and intervening on injection risks: Moderated mediation results from a randomized trial.

    Science.gov (United States)

    Pitpitan, Eileen V; Patterson, Thomas L; Abramovitz, Daniela; Vera, Alicia; Martinez, Gustavo; Staines, Hugo; Strathdee, Steffanie A

    2016-01-01

    We aim to use conditional or moderated mediation to simultaneously test how and for whom an injection risk intervention was efficacious at reducing receptive needle sharing among female sex workers who inject drugs (FSWs-IDUs) in Mexico. Secondary analysis of data from a randomized trial. A total of 300 FSW-IDUs participated in Mujer Mas Segura in Ciudad Juarez, Mexico, and were randomized to an interactive injection risk intervention or a didactic injection risk intervention. We measured safe injection self-efficacy as the hypothesized mediator and policing behaviors (being arrested and syringe confiscation) as hypothesized moderators. In total, 213 women provided complete data for the current analyses. Conditional (moderated) mediation showed that the intervention affected receptive needle sharing through safe injection self-efficacy among women who experienced syringe confiscation. On average, police syringe confiscation was associated with lower safe injection self-efficacy (p = .04). Among those who experienced syringe confiscation, those who received the interactive (vs. didactic) intervention reported higher self-efficacy, which in turn predicted lower receptive needle sharing (p = .04). Whereas syringe confiscation by the police negatively affected safe injection self-efficacy and ultimately injection risk behavior, our interactive intervention helped to "buffer" this negative impact of police behavior on risky injection practices. The theory-based, active skills building elements included in the interactive condition, which were absent from the didactic condition, helped participants' self-efficacy for safer injection in the face of syringe confiscation. (c) 2015 APA, all rights reserved).

  19. Comparison between neurectomy and botulinum toxin A injection for denervated skeletal muscle.

    Science.gov (United States)

    Tsai, Feng-Chou; Hsieh, Ming-Shium; Chou, Chih-Ming

    2010-08-01

    Neurectomy and botulinum toxin A (BoNT-A) injection cause denervated muscle atrophy, but questions remain about their clinical utility. We investigated time-series alterations of rat muscle weight, functional deficits, signaling pathways, and microscopic structures, to gain an understanding of the clinical implications. Between 2008 and 2009, the maximal calf circumference of patients for calf reduction either by neurectomy or BoNT-A injections were recorded for study. A rat skeletal muscle model was established through repeated or dose-adjusted BoNT-A injections and neurectomy. The survival, apoptosis pathways, functional deficits, and microscopic structures were investigated using Western blot, sciatic functional index (SFI), and transmission electron microscopy (TEM), respectively. The rat muscle weight ratio of the BoNT-A group had recovered to 89.3 +/- 3.8% by week 58, but it never recovered in the neurectomy group. Muscle weight reduction by BoNT-A not only depended on the dose, but additive effects were also obtained through repeated injections. Rat SFI demonstrated rapid recovery in both groups. Molecular expressions showed a coherent and biphasic pattern. p-Akt and apoptosis-inducing factor (AIF) were upregulated significantly, with a peak at 8 weeks in the neurectomy group (p structure disruption and sarcomere discontinuity in the neurectomy and BoNT-A groups, respectively. We demonstrated that denervation induced lasting muscle weight and structural changes of different degrees. Muscle weight reduction by BoNT-A was related to frequency and dose. AIF-mediated caspase-independent apoptosis was significantly different for neurectomy and BoNT-A injection.

  20. CT-guided cervical interlaminar epidural steroid injection for cervical radiculopathy

    International Nuclear Information System (INIS)

    Chen Wei; Wu Chungen; Wu Chaoxian; Cheng Yongde

    2009-01-01

    Objective: To evaluate the safety and effectiveness of CT-guided cervical interlaminar epidural steroid injection for the treatment of cervical radiculopathy. Methods: CT-guided cervical interlaminar epidural steroid injection was performed in 32 patients with cervical radioculopathy, encountered during the period of Dec. 2006 to June 2008, as the patients failed to respond to the conservative treatment in 2 weeks. The clinical data and the imaging findings were retrospectively analyzed. Before and after the procedure, visual analogue scale (VAS) and Odom criteria were used to evaluate the pain of the patient. Results: Three months after the injection, improvement judged by Odom criteria was seen in 28 patients (87.5%), and the mean pain relief value of VAS was 5.88 ± 1.10. No significant difference in effective rate and in VAS score (P>0.05) was found between protrusion group and degenerative group, between the group with the course over 6 months and the group with the course below 6 months, also between the group receiving one injection and the group receiving the second injection. Conclusion: CT-guided fine needle (23 gauge) puncture epidural steroid (Decadron) 'target spot' injection is an ideal alternative for the treatment of cervical radiculopathy, especially for the patients who fails to respond to the conservative treatment. (authors)

  1. Intracoronary Injection of CD34-Cells in Chronic Ischemic Heart Failure

    DEFF Research Database (Denmark)

    Hansen, Morten; Nyby, Sebastian; Eifer Møller, Jacob

    2014-01-01

    Objectives: Seven years ago, the DanCell study was carried out to test the hypothesis of improvement in left ventricular ejection fraction (LVEF) following repeated intracoronary injections of autologous bone marrow-derived stem cells (BMSCs) in patients suffering from chronic ischemic heart...... was significantly associated with survival (hazard ratio: 0.90, 95% CI: 0.82-1.00, p = 0.04). Conclusions: Intracoronary injections of a high number of CD34(+) cells may have a beneficial effect on chronic ischemic heart failure in terms of long-term survival. © 2014 S. Karger AG, Basel....

  2. Towards Development of a Dermal Pain Model: In Vitro Activation of Rat and Human Transient Receptor Potential Ankyrin Repeat 1 and Safe Dermal Injection of o-Chlorobenzylidene Malononitrile to Rat.

    Science.gov (United States)

    Annas, Anita; Berg, Anna-Lena; Nyman, Eva; Meijer, Thomas; Lundgren, Viveka; Franzén, Bo; Ståhle, Lars

    2015-12-01

    During clinical development of analgesics, it is important to have access to pharmacologically specific human pain models. o-Chlorobenzylidene malononitrile (CS) is a selective and potent agonist of the transient receptor potential ankyrin repeat 1 (TRPA1), which is a transducer molecule in nociceptors sensing reactive chemical species. While CS has been subject to extensive toxicological investigations in animals and human beings, its effects on intradermal or subcutaneous injection have not previously been reported. We have investigated the potential of CS to be used as an agonist on TRPA1 in human experimental pain studies. A calcium influx assay was used to confirm the capacity of CS to activate TRPA1 with >100,000 times the selectivity over the transient receptor potential vanilloid receptor 1. CS dose-dependently (EC50 0.9 μM) released calcitonin gene-related peptide in rat dorsal root ganglion cultures, supporting involvement in pain signalling. In a local tolerance study, injection of a single intradermal dose of 20 mM CS to rats resulted in superficial, circular crusts at the injection sites after approximately 4 days. The histopathology evaluation revealed a mild, acute inflammatory reaction in the epidermis and dermis at the intradermal CS injection site 1 day after administration. After 14 days, the epidermal epithelium was fully restored. The symptoms were not considered to be adverse, and it is suggested that doses up to 20 μL of 20 mM CS can be safely administered to human beings. In conclusion, our data support development of a CS human dermal pain model. © 2015 Nordic Association for the Publication of BCPT (former Nordic Pharmacological Society).

  3. Social network-related risk factors for bloodborne virus infections among injection drug users receiving syringes through secondary exchange.

    Science.gov (United States)

    De, Prithwish; Cox, Joseph; Boivin, Jean-François; Platt, Robert W; Jolly, Ann M

    2008-01-01

    Secondary syringe exchange (SSE) refers to the exchange of sterile syringes between injection drug users (IDUs). To date there has been limited examination of SSE in relation to the social networks of IDUs. This study aimed to identify characteristics of drug injecting networks associated with the receipt of syringes through SSE. Active IDUs were recruited from syringe exchange and methadone treatment programs in Montreal, Canada, between April 2004 and January 2005. Information on each participant and on their drug-injecting networks was elicited using a structured, interviewer-administered questionnaire. Subjects' network characteristics were examined in relation to SSE using regression models with generalized estimating equations. Of 218 participants, 126 were SSE recipients with 186 IDUs in their injecting networks. The 92 non-recipients reported 188 network IDUs. Networks of SSE recipients and non-recipients were similar with regard to network size and demographics of network members. In multivariate analyses adjusted for age and gender, SSE recipients were more likely than non-recipients to self-report being HIV-positive (OR=3.56 [1.54-8.23]); require or provide help with injecting (OR=3.74 [2.01-6.95]); have a social network member who is a sexual partner (OR=1.90 [1.11-3.24]), who currently attends a syringe exchange or methadone program (OR=2.33 [1.16-4.70]), injects daily (OR=1.77 [1.11-2.84]), and shares syringes with the subject (OR=2.24 [1.13-4.46]). SSE is associated with several injection-related risk factors that could be used to help focus public health interventions for risk reduction. Since SSE offers an opportunity for the dissemination of important prevention messages, SSE-based networks should be used to improve public health interventions. This approach can optimize the benefits of SSE while minimizing the potential risks associated with the practice of secondary exchange.

  4. Repeated rendezvous treatment of PTBD and ERCP in patients with recurrent obstructive jaundice.

    Science.gov (United States)

    Liu, Yingdi; Meng, Jianyun; Wang, Jianhua; Wang, Zhiqiang; Wang, Xiangdong; Linghu, Enqiang; Li, Wen; Yang, Yunsheng

    2010-01-01

    Repeated applications of rendezvous technique combining percutaneous transhepatic biliary drainage (PTBD) with endoscopic retrograde cholangiopancreatography (ERCP) (PE) in patients with recurrent obstructive jaundice have not been reported. The present study aimed to evaluate treatment effects of this technique in patients who previously received the same rendezvous treatment. Repeated PE rendezvous procedure was performed in 27 patients who received the same procedure previously and had recurrent obstructive jaundice. Twenty-two patients were treated by second-time rendezvous procedure and five patients by third-time. The clinical characteristics and therapeutic effects were retrospectively analyzed. By means of repeated rendezvous technique, 26 patients gained access to the bile duct and were successfully implanted new stents, only one failed with stent implantation. Total serum bilirubin level decreased within one week from 221.89 +/- 64.70 micromol/L to 156.0 +/- 32.2 micromol/L in patients with second-time treatment and from 297.07 +/- 109.12 micromol/L to 238.77 +/- 36.81 micromol/L in patients with third-time treatment. There was no severe complications observed that are associated with repeated PE procedure. Rendezvous procedure of PTBD and ERCP could be used repeatedly and effectively for patients who present recurrent obstructive jaundice after ERCP failure.

  5. Corticosteroid injection in early treatment of lateral epicondylitis.

    Science.gov (United States)

    Newcomer, K L; Laskowski, E R; Idank, D M; McLean, T J; Egan, K S

    2001-10-01

    To analyze whether a corticosteroid injection in combination with rehabilitation early in the course of lateral epicondylitis (LE) alters the outcome up to 6 months after injection compared with a control injection and rehabilitation. Randomized, controlled, double-blind study. Sports medicine center in a tertiary care center. Subjects with a diagnosis of LE whose symptoms had been present less than 4 weeks were included. Subjects were recruited by word of mouth and through advertising. The 39 subjects who were recruited were 18 to 65 years old. 19 subjects were randomized to receive rehabilitation and a sham injection, and 20 were randomized to receive rehabilitation and a corticosteroid injection. At 4 and 8 weeks, they were reevaluated and their treatment programs were modified, if indicated. Outcome measurements were performed at baseline, 4 weeks, 8 weeks, and 6 months, and included a functional pain questionnaire and a visual analogue pain scale. Painless grip strength on the affected side and maximal grip strength bilaterally were measured at baseline, 4 weeks, and 8 weeks. There were no significant differences in outcome between the two groups with the exception of an improvement in the visual analogue pain scale in the corticosteroid group from 8 weeks to 6 months. Outcome measurements in both groups improved significantly over time; more than 80% of subjects reported improvements from baseline to 6 months for all scales. A corticosteroid injection does not provide a clinically significant improvement in the outcome of LE, and rehabilitation should be the first line of treatment in patients with a short duration of symptoms.

  6. Encapsulation of interleukin-2 in murine erythrocytes and subsequent deposition in mice receiving a subcutaneous injection

    International Nuclear Information System (INIS)

    DeLoach, J.R.; Andrews, K.; Sheffield, C.L.

    1988-01-01

    Radiolabeled recombinant human interleukin-2 (IL-2) was successfully encapsulated in both mouse and sheep erythrocytes. Of the added IL-2, 70% was recovered bound to or encapsulated within the carrier cells. Erythrocytes containing IL-2 were stable in vitro and most of the IL-2 remained associated with the cells following a 16-h incubation at 37 degrees C. When carrier erythrocytes containing IL-2 were injected subcutaneously into mice, intact [ 35 S]IL-2 was detectable in a number of tissues 3 days after injection

  7. Biocompatibility of intravitreal injection of human mesenchymal stem cells in immunocompetent rabbits.

    Science.gov (United States)

    Labrador Velandia, Sonia; Di Lauro, Salvatore; Alonso-Alonso, Maria Luz; Tabera Bartolomé, Soraya; Srivastava, Girish Kumar; Pastor, José Carlos; Fernandez-Bueno, Ivan

    2018-01-01

    To evaluate the feasibility, safety, and biocompatibility of intravitreal injection of human mesenchymal stem cells (MSCs) in immunocompetent pigmented rabbits. Thirty-two pigmented rabbits (24 females, 8 males; Chinchilla-New Zealand White) were divided into 8 groups of 4 animals. Commercially prepared human MSCs were injected (0.05 ml) into the post-lens vitreous of the right eyes. Groups 1 and 4 received isotonic medium (Ringer lactate-based), groups 2, 5, 7, and 8 received a low dose of 15 × 10 6 cells/ml. Groups 3 and 6 received a high dose of 30 × 10 6 cells/ml. Clinical signs were evaluated and scored before MSCs injection and weekly for 2 or 6 weeks. Animals were sacrificed at 2 or 6 weeks after injection. Eyes, liver, spleen, and gonads were assessed by histology and by fluorescent in situ hybridization to evaluate survival and extraocular migration of MSCs. There were no relevant clinical findings between control and MSC-injected rabbit eyes at any time point. There were also no relevant histological findings between control and MSC-injected rabbits related to ocular, liver, spleen, or gonad tissues modifications. MSCs survived intravitreally for at least 2 weeks after injection. Extraocular migration of MSCs was not detected. MSCs are safe and well-tolerated when administered intravitreally at a dose of 15 × 10 6 cells/ml in pigmented rabbits. These findings enable future research to explore the intravitreal use of commercially prepared allogenic human MSCs in clinical trials of retinal diseases.

  8. Changes in left ventricular filling patterns after repeated injection of autologous bone marrow cells in heart failure patients

    DEFF Research Database (Denmark)

    Diederichsen, Axel Cosmus Pyndt; Møller, Jacob E; Thayssen, Per

    2010-01-01

    Abstract Objectives. We have previously shown that repeated intracoronary infusion of bone marrow cells (BMSC) did not improve left ventricular (LV) ejection fraction in patients with chronic ischemic heart failure. However, the impact of BMSC therapy on LV diastolic filling has remained uncertain....... Conclusion. In this non-randomised study repeated intracoronary BMSC infusions had a beneficial effect on LV filling in patients with chronic ischemic heart failure. Randomised studies are warranted....

  9. [Effects of repeated firing on microleakage of selective laser melting ceramic crowns].

    Science.gov (United States)

    Zhong, Qun; Peng, Yan; Wu, Xue-Ying; Weng, Jia-Wei

    2016-12-01

    To investigate the effects of repeated firing on microleakage of selective laser melting ceramic crowns. Fifty molars were randomly divided into 2 groups (25 teeth in each group). Teeth in group A received a chamfer finish line preparation, whereas teeth in group B received a shoulder finish line. After SLM metal crowns were fabricated, all the crowns received initial oxidation step, opaque firing, dentin firing and glaze firing, then crowns in each group were randomly divided into 5 sub-groups according to different time of clinical firings. Glass ionomer was applied for bonding. After 5000 thermocycles ranging from 5degrees centigrade to 55degrees centigrade, all the specimens was evaluated by dye penetration and then microleakage was examined under light microscopy. The data were analyzed with SPSS 20.0 software package. Microleakage between all specimens of group A were not statistically significant (P>0.05) whereas that of group B were statistically significant (P<0.05); After the fifth time of clinical firing, microleakage of specimens in group B(B5) were significantly higher than that of group A(A5). Repeated firings had no significant influence on marginal microleakage of SLM ceramic crowns whereas the crowns of chamfer finish lines result in better clinical performance after repeated firings.

  10. Comparative study of radioprotective properties of serotin derivatives repeatedly applied before gamma irradiation

    International Nuclear Information System (INIS)

    Gorelova, N.V.; Antipov, V.V.; Vasin, M.V.

    1977-01-01

    In the experiments on albino mice, the phenomenon of desensitization has been studied by a specific activity and some pharmacologic properties of serotonin, mexamin and 5-acetyloxytryptamine, the time-intervals between injections of the preparations being 5, 30 and 60 minutes, 2, 3, 4, 6, 8 and 24 hours. A correlation has been found between changes in radioprotective and pharmacologic properties (as determined by the accumulation of the dye in the splenic tissue) after repeated administration of mexamin. The phenomenon of desensitization is probably dependent not only on the chemical nature and mechanism of action of the protectors but also on the conditions under which they are repeatedly applied

  11. Resilient children of injection drug users.

    Science.gov (United States)

    Pilowsky, Daniel J; Zybert, Patricia A; Vlahov, David

    2004-11-01

    To examine associations between resilience in children of injection drug users and children's coping strategies, parenting stress, and children's social support. Injection drug-using parents (n=91) and their children aged 6 to 11 (n=117) were recruited in Baltimore (1997-1999). Resilience was defined as scoring in the lowest quartile of the Child Behavior Checklist total psychopathology score. Coping strategies used by resilient and nonresilient children, the extent and types of social support that they received, and the level of parenting stress reported by their parents were compared and contrasted. Rates of depressive, anxiety, and disruptive behavior disorders were 15.4%, 22.2%, and 21.4%, respectively, for the entire sample. Compared with the nonresilient, resilient children were less likely to use two avoidance coping strategies (internalizing [p=.002] and externalizing [p=.017]). The level of actual support received by resilient and nonresilient children did not differ significantly (p=.202). Perceived support was greater among resilient children (as reported by their parents; p parents reported lower parenting stress (p=.042). A significant proportion of children of injection drug users are in need of clinical care. Interventions to help children of substance-abusing parents modify their coping style merit exploration.

  12. Effect Of Pyridoxine Injection In Japanese Quail Eggs On HATCHABILITY, Performance And Some Physiological Parameters

    International Nuclear Information System (INIS)

    ELSAYED, M.A.; WAKWAK, M.M.; MAHROSE, KH.M.

    2010-01-01

    The present study was carried out at the poultry farm found in the Nuclear Research Center, Atomic Energy Authority, Inshas, Sharkia Governorate, Egypt, during January 2009. A total number of two hundreds and seventy five quail eggs were used in an experiment of a completely randomized design to estimate hatchability percentage, chick weight at hatch, growth performance, some blood parameters and carcass traits of Japanese quails as affected by injecting their eggs with pyridoxine. Eggs were divided into 5 groups (55 eggs each); the first group (without injection) was served as control while the second group was injected in the width end of the egg with 500 μl saline. The third, fourth and fifth groups were injected in the width end of the Japanese quail eggs with 40, 80 and 120 μg pyridoxine, respectively, dissolved in 500 μl saline. Hatchability percentage, live body weight, daily body weight gain and some organ weights (liver, gizzard and heart) were studied. At the end of the experiment, blood samples were collected for analyses. It was observed that the groups of quail eggs received 120 μg pyridoxine injection recorded the highest hatchability percent. Chick weight at hatch was non-significantly affected by saline solution injection. The birds hatched from the groups of quail eggs received 120μg pyridoxine recorded the highest live body weight, especially during the 2 nd and 3 rd weeks of age. The daily body weight gain was significantly affected by pyridoxine injection only during the intervals of 1 to 2, 3 to 4 and from 1 to 6 weeks of age. Serum total protein, albumin and globulin concentrations were highly significantly elevated in the birds hatched from the groups of quail eggs received 120μg pyridoxine than other groups. Serum AST activity was highly significantly increased in the birds hatched from the groups of quail eggs received 40 μg pyridoxine than other groups while serum ALT activity and calcium concentration were non

  13. Editorial Commentary: Intra-articular Corticosteroid Injection at the Time of Knee Arthroscopy Is Not Recommended.

    Science.gov (United States)

    Hunt, Timothy J

    2016-01-01

    In a population of Medicare patients undergoing knee arthroscopy, a significant increase in the incidence of postoperative infection at 3 and 6 months was found in patients who received an intra-articular corticosteroid injection at the time of knee arthroscopy compared with a matched control group that did not receive an injection. Intra-articular corticosteroid injection at the time of knee arthroscopy is not recommended. Copyright © 2016 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  14. Pharmacologic injection treatment of comitant strabismus

    Science.gov (United States)

    Debert, Iara; Miller, Joel M.; Danh, Kenneth K.; Scott, Alan B.

    2016-01-01

    Purpose To report the magnitude and stability of corrections in comitant horizontal strabismus achieved by injecting bupivacaine (BPX, optionally with epinephrine) and botulinum A toxin (BTXA) into extraocular muscles of alert adult subjects with electromyographic (EMG) guidance. Subjects & Methods A total of 55 adults with comitant horizontal strabismus participated in a prospective observational clinical series. Of these, 29 previously had undergone 1 or more unsuccessful strabismus surgeries; 4 had undergone other orbital surgeries. Thirty-one patients with esodeviations received BPX injections in a lateral rectus muscle, some with BTXA in the medial rectus; 24 patients with exodeviations received BPX in a medial rectus muscle, some with BTXA in the lateral rectus muscle. A second treatment (BPX, BTXA, or both) was administered to 27 patients who had residual strabismus after the first treatment. Five patients required additional injections. Clinical alignment was measured at 6 months and yearly thereafter through 5 years’ follow-up, with mean follow-up of 28 months. A successful outcome was defined as residual deviation ≤10Δ. Results On average, presenting misalignment of 23.8Δ (13.4°) was reduced at 28 months by 16.0Δ (9.1°), with successful outcomes in 56% of patients. Of patients with initial misalignments ≤25Δ, 66% had successful outcomes, with corrections averaging 13.2Δ (7.5°); of patients with larger misalignments, 40% had successful outcomes, with corrections averaging 20.9Δ (11.8°). Corrected alignments were stable over follow-ups as long as 5 years. Conclusions Injection treatments resulted in stable, clinically significant corrections in comitant horizontal strabismus. Injection provides a low-cost alternative to incisional strabismus surgery, particularly where it is desirable to minimize surgical anesthesia and avoid extraocular scarring. PMID:27079589

  15. The Use of Hyaluronic Acid and Corticosteroid Injections Among Medicare Patients With Knee Osteoarthritis.

    Science.gov (United States)

    Koenig, Karl M; Ong, Kevin L; Lau, Edmund C; Vail, Thomas P; Berry, Daniel J; Rubash, Harry E; Kurtz, Steven; Bozic, Kevin J

    2016-02-01

    Hyaluronic acid (HA) and corticosteroid (CS) injections are frequently used in the management of osteoarthritis (OA) of the knee, despite a lack of strong evidence supporting their efficacy in the literature. The purpose of this study is to evaluate trends in HA and CS usage in Medicare patients over the past 15 years. The Medicare 5% national sample database was used to identify 581,022 patients (representing an estimated 11.6 million) with a diagnosis of knee OA between 1999 and 2013. The percentage of newly diagnosed knee OA patients who received any injection trended from 39% in 1999 to 47% in 2006 and then declined to 37.5% in 2013. However, the mean number of injections per newly diagnosed OA patient nearly doubled from 0.27 to 0.45 for CS and from 0.18 to 0.36 for HA. Among those having both HA and CS injections, 69% had CS as first-line treatment, whereas 31% had HA first. The percentage of newly diagnosed knee OA patients receiving injections peaked in 2007 and then decreased steadily through 2013, as did the proportion of patients receiving HA injections as first-line therapy. However, the number of injections per patient has increased significantly over the past 15 years in both groups. Copyright © 2016 Elsevier Inc. All rights reserved.

  16. The effect of platelet-rich plasma injection on lateral epicondylitis following failed conservative management.

    Science.gov (United States)

    Brkljac, Milos; Kumar, Shyam; Kalloo, Dale; Hirehal, Kiran

    2015-12-01

    We assessed the effect PRP injection on pain and function in patients with lateral epicondylitis where conservative management had failed. We prospectively reviewed 34 patients. The mean follow-up was 26 weeks (range 6-114 weeks). We used the Oxford Elbow Score (OES) and progression to surgery to assess outcomes. 88.2% improved their OES. 8.8% reported symptom progression. One patient had no change. No patients suffered adverse reactions. Two patients underwent an open release procedure. One had the injection repeated. An injection of PRP improves pain and function in patients suffering from LE where conservative management has failed.

  17. TARA beamline and injection system

    International Nuclear Information System (INIS)

    Post, R.S.; Brindza, P.; Coleman, J.W.; Torti, R.P.; Blackfield, D.T.; Goodrich, P.

    1983-01-01

    The TARA beamline for neutral beam injection will permit one to three sources to fire into each plug (60 degree or optional 90 degree injection with respect to the TARA axis) or into each anchor (90 degree injection only). The sources, pre-aimed on their mounting plate at the NB test stand, may be fired into neutralizer ducts or optionally through a magnesium curtain, and the unneutralized fraction is dumped by the TARA fringing field onto a receiver plate. The beamline is housed in a cylindrical tank with the beam axis along the tank diameter at the midplane. The tank will be sorption pumped using LN + T/sub I/ or N/sub B/ and/or e-beam gettering. The beam burial tank contains sed arrays and a thin foil dump which reaches sufficiently high temperatures during the shot to boil out gas between shots

  18. Case Reports of Adipose-derived Stem Cell Therapy for Nasal Skin Necrosis after Filler Injection

    Directory of Open Access Journals (Sweden)

    Ha Min Sung

    2012-01-01

    Full Text Available With the gradual increase of cases using fillers, cases of patients treated by non-medical professionals or inexperienced physicians resulting in complications are also increasing. We herein report 2 patients who experienced acute complications after receiving filler injections and were successfully treated with adipose-derived stem cell (ADSCs therapy. Case 1 was a 23-year-old female patient who received a filler (Restylane injection in her forehead, glabella, and nose by a non-medical professional. The day after her injection, inflammation was observed with a 3×3 cm skin necrosis. Case 2 was a 30-year-old woman who received a filler injection of hyaluronic acid gel (Juvederm on her nasal dorsum and tip at a private clinic. She developed erythema and swelling in the filler-injected area A solution containing ADSCs harvested from each patient's abdominal subcutaneous tissue was injected into the lesion at the subcutaneous and dermis levels. The wounds healed without additional treatment. With continuous follow-up, both patients experienced only fine linear scars 6 months postoperatively. By using adipose-derived stem cells, we successfully treated the acute complications of skin necrosis after the filler injection, resulting in much less scarring, and more satisfactory results were achieved not only in wound healing, but also in esthetics.

  19. Effect of injection time on postictal SPET perfusion changes in medically refractory epilepsy

    Energy Technology Data Exchange (ETDEWEB)

    Avery, R.A.; Corsi, M.; Seibyl, J.P.; Zubal, I.G. [Department of Diagnostic Radiology, Yale University School of Medicine, New Haven, CT (United States); Spencer, S.S.; Spanaki, M.V. [Department of Neurology, Yale University School of Medicine, New Haven, Connecticut (United States)

    1999-08-01

    Single-photon emission tomography (SPET) brain imaging in epilepsy has become an increasingly important noninvasive tool in localizing the epileptogenic site. Ictal SPET demonstrates the highest localization sensitivity as compared with postictal and interictal SPET. While ictal SPET consistently reveals hyperperfusion at the epileptogenic site, postictal SPET reveals either hyper- or hypoperfusion depending on the timing of radiopharmaceutical injection. Much discussion in the literature exists about exactly when the transition from hyper- to hypoperfusion occurs at the epileptogenic site in postictal SPET. The systematic examination of two clinical variables - time of injection from seizure onset and offset - was useful in understanding postictal perfusion changes. Twenty-seven patients with medically refractory epilepsy receiving postictal and interictal SPET scans were studied. Quantitative SPET difference imaging was used to evaluate perfusion changes in relationship to injection time. Perfusion changes were found to reflect the time of injection in relation to seizure onset, but to be somewhat independent of seizure offset. Thus, the majority of patients (8/12, 67%) receiving postictal injections within 100 s after seizure onset demonstrated hyperperfusion, while all patients (15/15, 100%) receiving postictal injections more than 100 s after seizure onset showed hypoperfusion. The explanation of this phenomenon is unknown but the findings appear to parallel known changes in cerebral lactate levels. (orig.) With 2 figs., 2 tabs., 32 refs.

  20. Reinforcement of spinal anesthesia by epidural injection of saline: a comparison of hyperbaric and isobaric tetracaine.

    Science.gov (United States)

    Yamazaki, Y; Mimura, M; Hazama, K; Namiki, A

    2000-04-25

    An epidural injection of saline was reported to extend spinal anesthesia because of a volume effect. The aim of this study was to evaluate the influence of the baricity of spinal local anesthetics upon the extension of spinal anesthesia by epidural injection of saline. Forty patients undergoing elective lower-limb surgery were randomly allocated to four groups of 10 patients each. Group A received no epidural injection after the spinal administration of hyperbaric tetracaine (dissolved in 10% glucose). Group B received an epidural injection of 8 ml of physiological saline 20 min after spinal hyperbaric tetracaine. Group C received no epidural injection after spinal isobaric tetracaine (dissolved in physiological saline). Group D received an epidural injection of 8 ml of saline 20 min after spinal isobaric tetracaine. The level of analgesia was examined by the pinprick method at 5-min intervals. The levels of analgesia 20 min after spinal anesthesia were significantly higher in hyperbaric groups than in isobaric groups [T5 (T2-L2) vs. T7 (T3-12)]. After epidural injection of saline, the levels of analgesia in groups B and D were significantly higher than in groups A and C. The segmental increases after epidural saline injection were 2 (0-3) in group B and 2 (1-7) in group D. Sensation in the sacral area remained 20 min after spinal block in one patient in group D; however, it disappeared after epidural saline injection. In this study, 8 ml of epidural saline extended spinal analgesia. However, there was no difference between the augmenting effect in isobaric and hyperbaric spinal anesthesia. We conclude that the reinforcement of spinal anesthesia by epidural injection of saline is not affected by the baricity of the spinal anesthetic solution used.

  1. Dual fuel injection piggyback controller system

    Science.gov (United States)

    Muji, Siti Zarina Mohd.; Hassanal, Muhammad Amirul Hafeez; Lee, Chua King; Fawzi, Mas; Zulkifli, Fathul Hakim

    2017-09-01

    Dual-fuel injection is an effort to reduce the dependency on diesel and gasoline fuel. Generally, there are two approaches to implement the dual-fuel injection in car system. The first approach is changing the whole injector of the car engine, the consequence is excessive high cost. Alternatively, it also can be achieved by manipulating the system's control signal especially the Electronic Control Unit (ECU) signal. Hence, the study focuses to develop a dual injection timing controller system that likely adopted to control injection time and quantity of compressed natural gas (CNG) and diesel fuel. In this system, Raspberry Pi 3 reacts as main controller unit to receive ECU signal, analyze it and then manipulate its duty cycle to be fed into the Electronic Driver Unit (EDU). The manipulation has changed the duty cycle to two pulses instead of single pulse. A particular pulse mainly used to control injection of diesel fuel and another pulse controls injection of Compressed Natural Gas (CNG). The test indicated promising results that the system can be implemented in the car as piggyback system. This article, which was originally published online on 14 September 2017, contained an error in the acknowledgment section. The corrected acknowledgment appears in the Corrigendum attached to the pdf.

  2. Preface to the injection tables

    International Nuclear Information System (INIS)

    Anon.

    1977-01-01

    Twelve groups of dogs received intravenous injections of various doses of 226 Ra, 239 Pu, 228 Ra, 228 Th, 90 Sr, 241 Am, 249 Cf, or 252 Cf at approximately 17 months of age. The animals were euthanized when death appeared imminent. Data are presented on the calculated radiation dose to the skeleton and pathological changes observed at autopsy

  3. Deliberate, repeated self-administration of metallic mercury injection: case report and review of the literature

    International Nuclear Information System (INIS)

    Givica-Perez, A.; Santana-Montesdeoca, J.M.; Diaz-Sanchez, M.; Martinez-Lagares, F.J.; Castaneda, W.R.

    2001-01-01

    Self-administration of metallic mercury through the intravenous route is rare. This event has been reported in psychiatric patients and in suicide attempts. We report a case of successive intravenous self-injections of mercury demonstrated by plain film radiographs and CT scans of the thorax and abdomen. (orig.)

  4. Subcutaneous injection of kisspeptin-54 acutely stimulates gonadotropin secretion in women with hypothalamic amenorrhea, but chronic administration causes tachyphylaxis.

    Science.gov (United States)

    Jayasena, Channa N; Nijher, Gurjinder M K; Chaudhri, Owais B; Murphy, Kevin G; Ranger, Amita; Lim, Adrian; Patel, Daksha; Mehta, Amrish; Todd, Catriona; Ramachandran, Radha; Salem, Victoria; Stamp, Gordon W; Donaldson, Mandy; Ghatei, Mohammad A; Bloom, Stephen R; Dhillo, Waljit S

    2009-11-01

    Kisspeptin is a critical regulator of normal reproductive function. A single injection of kisspeptin in healthy human volunteers potently stimulates gonadotropin release. However, the effects of kisspeptin on gonadotropin release in women with hypothalamic amenorrhea (HA) and the effects of repeated administration of kisspeptin to humans are unknown. The aim of this study was to determine the effects of acute and chronic kisspeptin administration on gonadotropin release in women with HA. We performed a prospective, randomized, double-blinded, parallel design study. Women with HA received twice-daily sc injections of kisspeptin (6.4 nmol/kg) or 0.9% saline (n = 5 per group) for 2 wk. Changes in serum gonadotropin and estradiol levels, LH pulsatility, and ultrasound measurements of reproductive activity were assessed. On the first injection day, potent increases in serum LH and FSH were observed after sc kisspeptin injection in women with HA (mean maximal increment from baseline within 4 h after injection: LH, 24.0 +/- 3.5 IU/liter; FSH, 9.1 +/- 2.5 IU/liter). These responses were significantly reduced on the 14th injection day (mean maximal increment from baseline within 4 h postinjection: LH, 2.5 +/- 2.2 IU/liter, P < 0.05; FSH, 0.5 +/- 0.5 IU/liter, P < 0.05). Subjects remained responsive to GnRH after kisspeptin treatment. No significant changes in LH pulsatility or ultrasound measurements of reproductive activity were observed. Acute administration of kisspeptin to women with infertility due to HA potently stimulates gonadotropin release, but chronic administration of kisspeptin results in desensitization to its effects on gonadotropin release. These data have important implications for the development of kisspeptin as a novel therapy for reproductive disorders in humans.

  5. Grid laser with modified pro re nata injection of bevacizumab and ranibizumab in macular edema due to branch retinal vein occlusion: MARVEL report no 2.

    Science.gov (United States)

    Narayanan, Raja; Panchal, Bhavik; Stewart, Michael W; Das, Taraprasad; Chhablani, Jay; Jalali, Subhadra; Hasnat Ali, Mohd

    2016-01-01

    The purpose of this study was to prospectively study the efficacy of grid laser combined with intravitreal bevacizumab or ranibizumab in eyes with macular edema due to branch retinal vein occlusion. Treatment-naïve eyes were enrolled to receive injections of ranibizumab or bevacizumab. During the first 6 months, patients were evaluated monthly and injected if the best-corrected visual acuity changed by five or more letters or fluid was noted on spectral domain optical coherence tomography (OCT); during the next 6 months, patients were evaluated bimonthly and injected only if the best-corrected visual acuity decreased by five or more letters with the associated fluid. Grid laser photocoagulation was performed if there was fluid on OCT and was repeated if patients were eligible after a minimum interval of 3 months. The mean numbers of ranibizumab and bevacizumab injections were, respectively, 3.2±1.5 and 3.0±1.4 in the first 6 months and 0.3±0.6 and 0.3±0.6 in the last 6 months. Moreover, 55/75 (73.33%) participants did not receive any injections in the last 6 months. The mean reductions in central retinal thickness at 12 months were 165.67 μm (P<0.001; 95% confidence interval -221.50 to -135.0) in the ranibizumab group and 184.78 μm (P<0.001; 95% confidence interval -246.49 to -140.0) in the bevacizumab group (P=0.079). More patients in the bevacizumab group compared to those in the ranibizumab group required rescue laser at 12 months (20 vs eleven; P=0.06). Bimonthly evaluations after month 6 with very few pro re nata injections were effective in maintaining visual gains achieved during the first 6 months. Grid laser photocoagulation is effective in maintaining the vision even in the presence of fluid on OCT, although it's required more often in patients treated with bevacizumab.

  6. Grid laser with modified pro re nata injection of bevacizumab and ranibizumab in macular edema due to branch retinal vein occlusion: MARVEL report no 2

    Science.gov (United States)

    Narayanan, Raja; Panchal, Bhavik; Stewart, Michael W; Das, Taraprasad; Chhablani, Jay; Jalali, Subhadra; Hasnat Ali, Mohd

    2016-01-01

    Purpose The purpose of this study was to prospectively study the efficacy of grid laser combined with intravitreal bevacizumab or ranibizumab in eyes with macular edema due to branch retinal vein occlusion. Patients and methods Treatment-naïve eyes were enrolled to receive injections of ranibizumab or bevacizumab. During the first 6 months, patients were evaluated monthly and injected if the best-corrected visual acuity changed by five or more letters or fluid was noted on spectral domain optical coherence tomography (OCT); during the next 6 months, patients were evaluated bimonthly and injected only if the best-corrected visual acuity decreased by five or more letters with the associated fluid. Grid laser photocoagulation was performed if there was fluid on OCT and was repeated if patients were eligible after a minimum interval of 3 months. Results The mean numbers of ranibizumab and bevacizumab injections were, respectively, 3.2±1.5 and 3.0±1.4 in the first 6 months and 0.3±0.6 and 0.3±0.6 in the last 6 months. Moreover, 55/75 (73.33%) participants did not receive any injections in the last 6 months. The mean reductions in central retinal thickness at 12 months were 165.67 μm (P<0.001; 95% confidence interval −221.50 to −135.0) in the ranibizumab group and 184.78 μm (P<0.001; 95% confidence interval −246.49 to −140.0) in the bevacizumab group (P=0.079). More patients in the bevacizumab group compared to those in the ranibizumab group required rescue laser at 12 months (20 vs eleven; P=0.06). Conclusion Bimonthly evaluations after month 6 with very few pro re nata injections were effective in maintaining visual gains achieved during the first 6 months. Grid laser photocoagulation is effective in maintaining the vision even in the presence of fluid on OCT, although it’s required more often in patients treated with bevacizumab. PMID:27330272

  7. Antipsychotic Selection for Acute Agitation and Time to Repeat Use in a Psychiatric Emergency Department.

    Science.gov (United States)

    Gomez, Seth; Dopheide, Julie

    2016-11-01

    Early recognition and treatment of agitated patients is essential to avoid violence in the psychiatric emergency department (ED). Antipsychotics have established efficacy in managing agitation, yet little is known about how the choice of initial antipsychotic impacts time to repeat use and length of stay (LOS) in the psychiatric ED. To describe the impact of initial antipsychotic selection on time to repeat use and LOS in the psychiatric ED. A chart review identified 388 cases in which patients were administered an antipsychotic for agitation in the psychiatric ED between July 1 and August 31, 2014. Time to repeat use and LOS were compared for intramuscular (IM) haloperidol, other IM antipsychotics, and oral second-generation antipsychotics (SGAs) using the Kruskal-Wallis or Wilcoxon-Mann-Whitney test. Of the 388 cases, 31% (n=122) required repeat medications. Mean time to repeat use for IM haloperidol was 20.1±18.4 hours, which was not significantly different from mean time to repeat use in the groups receiving other IM antipsychotics or oral SGAs (P=0.35). The mean LOS was 29.7±28.7 hours for IM haloperidol, 30.3±36.9 hours for other IM antipsychotics, and 22.6±28.0 hours for oral SGAs. Significant differences in LOS between repeat and nonrepeat users of IM haloperidol and other IM antipsychotics were observed, but not among those who received oral SGAs. Mean time to repeat use ranged from 14 to 20 hours with IM haloperidol, other IM antipsychotics, and oral SGAs without significant differences in time to repeat use in the 3 different groups. Repeat users of IM antipsychotics had a significantly longer LOS in the ED compared with nonrepeat users of IM antipsychotics. However, patients who were initially administered oral SGAs did not have longer LOS in the ED even if a repeat dose was given.

  8. EFFECT OF SHOCK WAVE THERAPYVERSUS CORTICOSTEROID INJECTION IN MANAGEMENT OFKNEE OSTEOARTHRITIS

    Directory of Open Access Journals (Sweden)

    Ahmed Ebrahim Elerian

    2016-04-01

    Full Text Available Background: knee Osteoarthritis is the most common cause of musculoskeletal pain and disability. Shockwaves have been used as an alternative treatment for musculoskeletal disorders; intra-articular injection of steroid is a common treatment for osteoarthritis of the knee. This study aimed to investigate the efficacy of Shock wave therapy versus Corticosteroid intra articular injection in case of knee osteoarthritis. Methods: Sixty patients were diagnosed mild to moderate knee osteoarthritis; they were included in the study. Their ages were 43:65 years with mean age 50 ± 3.5 years. Patients were divided randomly into three equal groups, group (A received shock wave therapy, group (B received two intra-articular injections of corticosteroid at 1-month intervals and group (C received sham shock wave. The outcome measurements were Western Ontario and McMaster Universities arthritis index (WOMAC values, knee ROM, and pain severity using the visual analogue scale (VAS were recorded. The patients were evaluated for these parameters before allocated in their groups then after 1, 2, and 6months later. Results: compared to sham group there were significant improvement of VAS and ROM of shock wave group and corticosteroid injection group than sham (placebo group (p<0.000, (p<0.006, and 0.02 respectively. Furthermore there was significant improve of shock wave group than corticosteroid injection group where p was <0.000 for VAS, ROM and (WOMAC. Conclusion: The results of this study suggested that shock wave therapy may provide effective modality for relieving pain, increase Range of motion and improve function in knee osteoarthritis patient than intra articular corticosteroid injection.

  9. Multifunction waveform generator for EM receiver testing

    Science.gov (United States)

    Chen, Kai; Jin, Sheng; Deng, Ming

    2018-01-01

    In many electromagnetic (EM) methods - such as magnetotelluric, spectral-induced polarization (SIP), time-domain-induced polarization (TDIP), and controlled-source audio magnetotelluric (CSAMT) methods - it is important to evaluate and test the EM receivers during their development stage. To assess the performance of the developed EM receivers, controlled synthetic data that simulate the observed signals in different modes are required. In CSAMT and SIP mode testing, the waveform generator should use the GPS time as the reference for repeating schedule. Based on our testing, the frequency range, frequency precision, and time synchronization of the currently available function waveform generators on the market are deficient. This paper presents a multifunction waveform generator with three waveforms: (1) a wideband, low-noise electromagnetic field signal to be used for magnetotelluric, audio-magnetotelluric, and long-period magnetotelluric studies; (2) a repeating frequency sweep square waveform for CSAMT and SIP studies; and (3) a positive-zero-negative-zero signal that contains primary and secondary fields for TDIP studies. In this paper, we provide the principles of the above three waveforms along with a hardware design for the generator. Furthermore, testing of the EM receiver was conducted with the waveform generator, and the results of the experiment were compared with those calculated from the simulation and theory in the frequency band of interest.

  10. Post-injection delirium/sedation syndrome in patients with schizophrenia treated with olanzapine long-acting injection, I: analysis of cases

    Directory of Open Access Journals (Sweden)

    Stefaniak Victoria J

    2010-06-01

    Full Text Available Abstract Background An advance in the treatment of schizophrenia is the development of long-acting intramuscular formulations of antipsychotics, such as olanzapine long-acting injection (LAI. During clinical trials, a post-injection syndrome characterized by signs of delirium and/or excessive sedation was identified in a small percentage of patients following injection with olanzapine LAI. Methods Safety data from all completed and ongoing trials of olanzapine LAI were reviewed for possible cases of this post-injection syndrome. Descriptive analyses were conducted to characterize incidence, clinical presentation, and outcome. Regression analyses were conducted to assess possible risk factors. Results Based on approximately 45,000 olanzapine LAI injections given to 2054 patients in clinical trials through 14 October 2008, post-injection delirium/sedation syndrome occurred in approximately 0.07% of injections or 1.4% of patients (30 cases in 29 patients. Symptomatology was consistent with olanzapine overdose (e.g., sedation, confusion, slurred speech, altered gait, or unconsciousness. However, no clinically significant decreases in vital signs were observed. Symptom onset ranged from immediate to 3 to 5 hours post injection, with a median onset time of 25 minutes post injection. All patients recovered within 1.5 to 72 hours, and the majority continued to receive further olanzapine LAI injections following the event. No clear risk factors were identified. Conclusions Post-injection delirium/sedation syndrome can be readily identified based on symptom presentation, progression, and temporal relationship to the injection, and is consistent with olanzapine overdose following probable accidental intravascular injection of a portion of the olanzapine LAI dose. Although there is no specific antidote for olanzapine overdose, patients can be treated symptomatically as needed. Special precautions include use of proper injection technique and a post-injection

  11. Fluoroscopically Guided Sacroiliac Joint Injections: Comparison of the Effects of Intraarticular and Periarticular Injections on Immediate and Short-Term Pain Relief.

    Science.gov (United States)

    Nacey, Nicholas C; Patrie, James T; Fox, Michael G

    2016-11-01

    The purpose of this study was to determine whether intraarticular sacroiliac joint injections provide greater immediate and short-term pain relief than periarticular sacroiliac joint injections do. The records of all fluoroscopically guided sacroiliac joint injections performed over a 4-year period were identified. Patients who received an injection of 0.5 mL of bupivacaine and 0.5 mL (20 mg) of triamcinolone and who had preinjection, immediate, and 1-week postinjection pain scores (0-10 numeric scale) were included. Images from the procedures were retrospectively reviewed by two musculoskeletal radiologists to determine intraarticular or periarticular administration of the injection with discrepancies resolved by consensus. One hundred thirteen injections in 99 patients (65 women, 34 men; mean age, 59.4 years) met the inclusion criteria. There were 55 intraarticular and 58 periarticular injections. The mean preinjection, immediate, and 1-week postinjection pain scores for the intraarticular injections were 6.0, 1.6, and 4.1 and for the periarticular injections were 6.1, 2.0, and 4.2. The mean immediate and 1-week postinjection pain reduction were statistically significant in both groups (p sacroiliac joint injections provide statistically significant immediate and 1-week postinjection pain relief, no significant difference in the degree of pain relief achieved with intraarticular and periarticular injections was noted.

  12. Prescription drug monitoring program data tracking of opioid addiction treatment outcomes in integrated dual diagnosis care involving injectable naltrexone.

    Science.gov (United States)

    Sajid, Ayesha; Whiteman, Aaron; Bell, Richard L; Greene, Marion S; Engleman, Eric A; Chambers, R Andrew

    2016-10-01

    Fourfold increases in opioid prescribing and dispensations over 2 decades in the U.S. has paralleled increases in opioid addictions and overdoses, requiring new preventative, diagnostic, and treatment strategies. This study examines Prescription Drug Monitoring Program (PDMP) tracking as a novel measure of opioid addiction treatment outcomes in a university-affiliated integrated mental health-addiction treatment clinic. Repeated measure parametrics examined PDMP and urine drug screening (UDS) data before and after first injection for all patients (N = 68) who received at least one long-acting naltrexone injection (380 mg/IM) according to diagnostic groupings of having either (i) alcohol (control); (ii) opioid; or (iii) combined alcohol and opioid use disorders. There were no group differences post-injection in treatment days, injections delivered, or treatment service encounters. UDS and PDMP measures of opioid exposures were greater in opioid compared to alcohol-only patients. Post-first injection, UDS's positive for opioids declined (p opioid prescriptions (p Opioid patients without alcohol disorders showed the best outcomes with 50% to 80% reductions in PDMP-measures of opioids, down to levels of alcohol-only patients. This study shows PDMP utility for measuring opioid addiction treatment outcomes, supporting the routine use of PDMPs in clinical and research settings. These findings demonstrate that opioid addiction in patients with complex addictions and mental illnesses comorbidities can show effective treatment responses as measured by PDMP tracking of decreases in opioid prescriptions to those patients. (Am J Addict 2016;25:557-564). © 2016 The Authors. The American Journal on Addictions Published by Wiley Periodicals, Inc. on behalf of The American Academy of Addiction Psychiatry (AAAP).

  13. [Incidence of endophthalmitis after intravitreal injection: is antibioprophylaxis mandatory?].

    Science.gov (United States)

    Ramel, J-C; Bron, A-M; Isaico, R; Meillon, C; Binquet, C; Creuzot-Garcher, C

    2014-04-01

    Endophthalmitis is the most dreaded complication after intravitreal injection. With the rise of antiangiogenics their rate is getting higher each year. The use of antibioprophylaxis is controversial. We tried to evaluate the impact of antibioprophylaxis on intravitreal injection endophthalmitis incidence. All patients who received intravitreal injections between January 2007 and October 2012 were included in this retrospective study. Until June 2012 all patients had antibiotics the days following the injection. From July 2012 the antibiotic was replaced by an antiseptic immediately after the injection. An overall number of 11,450 injections were performed. The overall rate of endophthalmitis was 6/11,450 (0.052%). The incidence of endophthalmitis in the group with antibiotics was 3/10,144 injections (0.03%), 2 were culture proven (0.02%). The incidence in the group without antibiotics was 3/1306 (0.23%). The difference was significant (P=0.024). The incidence of endophthalmitis post-intravitreal injections seems to be lower when using antibiotics. However, a prospective study is mandatory to draw more robust conclusions. Copyright © 2014 Elsevier Masson SAS. All rights reserved.

  14. Exposição repetida à cafeína aumenta a atividade locomotora induzida pelo femproporex em ratos adolescentes e adultos Repeated administration of caffeine increases femproporex-induced locomotor activity in adolescent and adult rats

    Directory of Open Access Journals (Sweden)

    Ana Helena Paro

    2008-09-01

    (postnatal day 60 received i.p. injections of caffeine (CAF (10.0 mg/kg (adolescent N = 24; adult N = 16 or saline (adolescent N = 24; adult N = 16 once daily for ten days. Three days following the last injection each group was subdivided and received a challenge injection of femproporex (2.0 mg/kg, i.p. or saline. Locomotor activity was recorded for 1 hour in 5 - minute intervals. Our results showed that repeated injections of caffeine increased femproporex - induced locomotor activity in adult and adolescent rats.

  15. Intraurethral Injection of Autologous Minced Skeletal Muscle

    DEFF Research Database (Denmark)

    Gräs, Søren; Klarskov, Niels; Lose, Gunnar

    2014-01-01

    noted. CONCLUSIONS: Intraurethral injection of minced autologous muscle tissue is a simple surgical procedure that appears safe and moderately effective in women with uncomplicated stress urinary incontinence. It compares well to a more complicated regenerative strategy using in vitro expanded muscle......PURPOSE: Intraurethral injection of in vitro expanded autologous skeletal muscle derived cells is a new regenerative therapy for stress urinary incontinence. We examined the efficacy and safety of a simpler alternative strategy using freshly harvested, minced autologous skeletal muscle tissue...... with its inherent content of regenerative cells. MATERIALS AND METHODS: A total of 20 and 15 women with uncomplicated and complicated stress urinary incontinence, respectively, received intraurethral injections of minced autologous skeletal muscle tissue and were followed for 1 year. Efficacy was assessed...

  16. Low Non-structured Antiretroviral Therapy Interruptions in HIV-Infected Persons Who Inject Drugs Receiving Multidisciplinary Comprehensive HIV Care at an Outpatient Drug Abuse Treatment Center.

    Science.gov (United States)

    Vallecillo, Gabriel; Mojal, Sergio; Roquer, Albert; Samos, Pilar; Luque, Sonia; Martinez, Diana; Martires, Paula Karen; Torrens, Marta

    2016-05-01

    Continuous HIV treatment is necessary to ensure successful combined antiretroviral therapy (cART). The aim of this study was to evaluate the incidence of patient-initiated non-structured treatment interruptions in HIV-infected persons who inject drugs and who received a multidisciplinary comprehensive program, including medical HIV care, drug-dependence treatment and psychosocial support, at a drug outpatient addiction center. Non-structured treatment interruptions were defined as ≥30 consecutive days off cART without medical indication. During a median follow-up of 53.8 months, 37/132 (28 %) patients experienced the first non-structured treatment interruptions. The cumulative probability of cART interruption at 5 years was 31.2 % (95 % CI 22.4-40.0). Current drug use injection ≥1/day (HR 14.77; 95 % CI 5.90-36.96) and cART naive patients (HR 0.35, 95 % CI 0.14-0.93) were predictive factors for non-structured treatment interruptions. HIV care provided at a drug addiction center is a useful strategy to sustain continuous cART, however, drug abstinence is essential for the long-term maintenance of cART.

  17. The effects of injected solution temperature on intravenous regional anaesthesia.

    Science.gov (United States)

    Paul, D L; Logan, M R; Wildsmith, J A

    1988-05-01

    Ten healthy volunteers received three standard Bier's blocks. Prilocaine 0.5%, 40 ml was injected at a solution temperature of 0 degrees C, 22 degrees C or 37 degrees C. Recordings were made of sensory block, motor block, intravenous pressure, limb temperature and pain on injection. There were no differences between the three treatments in the rate of development or in the quality of block but there was a significant difference in the comfort of injection. Cold solutions caused most, and warm solutions least discomfort.

  18. Injection Drug Use Trajectories Among Migrant Populations: A Narrative Review.

    Science.gov (United States)

    Melo, Jason S; Mittal, Maria Luisa; Horyniak, Danielle; Strathdee, Steffanie A; Werb, Dan

    2018-01-24

    Dual epidemics of injection drug use and blood-borne disease, characterized as "syndemics," are present in a range of settings. Behaviors that drive such syndemics are particularly prevalent among mobile drug-using populations, for whom cross-border migration may pose additional risks. This narrative review aims to characterize the risk factors for injection drug use initiation associated with migration, employing a risk environment framework and focusing on the San Diego-Tijuana border region as the most dynamic example of these phenomena. Based on previous literature, we divide migration streams into three classes: intra-urban, internal, and international. We synthesized existing literature on migration and drug use to characterize how mobility and migration drive the initiation of injection drug use, as well as the transmission of hepatitis and HIV, and to delineate how these might be addressed through public health intervention. Population mixing between migrants and receiving communities and the consequent transmission of social norms about injection drug use create risk environments for injection drug use initiation. These risk environments have been characterized as a result of local policy environments, injection drug use norms in receiving communities, migration-related stressors, social dislocation, and infringement on the rights of undocumented migrants. Policies that exacerbate risk environments for migrants may inadvertently contribute to the expansion of epidemics of injection-driven blood-borne disease. Successful interventions that address emerging syndemics in border regions may therefore need to be tailored to migrant populations and distinguish between the vulnerabilities experienced by different migration classes and border settings.

  19. Experimental optimization of a direct injection homogeneous charge compression ignition gasoline engine using split injections with fully automated microgenetic algorithms

    Energy Technology Data Exchange (ETDEWEB)

    Canakci, M. [Kocaeli Univ., Izmit (Turkey); Reitz, R.D. [Wisconsin Univ., Dept. of Mechanical Engineering, Madison, WI (United States)

    2003-03-01

    Homogeneous charge compression ignition (HCCI) is receiving attention as a new low-emission engine concept. Little is known about the optimal operating conditions for this engine operation mode. Combustion under homogeneous, low equivalence ratio conditions results in modest temperature combustion products, containing very low concentrations of NO{sub x} and particulate matter (PM) as well as providing high thermal efficiency. However, this combustion mode can produce higher HC and CO emissions than those of conventional engines. An electronically controlled Caterpillar single-cylinder oil test engine (SCOTE), originally designed for heavy-duty diesel applications, was converted to an HCCI direct injection (DI) gasoline engine. The engine features an electronically controlled low-pressure direct injection gasoline (DI-G) injector with a 60 deg spray angle that is capable of multiple injections. The use of double injection was explored for emission control and the engine was optimized using fully automated experiments and a microgenetic algorithm optimization code. The variables changed during the optimization include the intake air temperature, start of injection timing and the split injection parameters (per cent mass of fuel in each injection, dwell between the pulses). The engine performance and emissions were determined at 700 r/min with a constant fuel flowrate at 10 MPa fuel injection pressure. The results show that significant emissions reductions are possible with the use of optimal injection strategies. (Author)

  20. Coordinated hybrid automatic repeat request

    KAUST Repository

    Makki, Behrooz

    2014-11-01

    We develop a coordinated hybrid automatic repeat request (HARQ) approach. With the proposed scheme, if a user message is correctly decoded in the first HARQ rounds, its spectrum is allocated to other users, to improve the network outage probability and the users\\' fairness. The results, which are obtained for single- and multiple-antenna setups, demonstrate the efficiency of the proposed approach in different conditions. For instance, with a maximum of M retransmissions and single transmit/receive antennas, the diversity gain of a user increases from M to (J+1)(M-1)+1 where J is the number of users helping that user.

  1. Assessment of complications due to intratympanic injections

    Directory of Open Access Journals (Sweden)

    Yu-Chuan Liu

    2016-03-01

    Full Text Available Objective: The purpose of the study is to report and to analyze the complications following intratympanic injections (ITI of steroids. The occurrence rate of complications at different ITI sites, four quadrants of eardrum, was also compared. Methods: A retrospective clinical review in a medical center. Each patient received ITI twice in a week for 2–3 consecutive weeks as a salvage therapy for sudden sensorineural hearing loss. Post-injection complications, especially transient dizziness and vertigo, were recorded. Patients with acute or chronic vertigo episodes in 1 month were excluded. Results: A total of 59 patients with sudden sensorineural hearing loss and a total of 278 times of ITI were performed in 1 year. The post-injection complications included pain, tongue numbness, transient dizziness, vertigo, tinnitus, and a small persistent perforation. There was no significant difference in the occurrence of these complications between the injections sites on the 4 quadrants of the tympanic membrane. However, there was statistical significance in the post-injection vertiginous episode after IT injections to posterior-inferior quadrant (Q3 and posterior-superior quadrant (Q4 compared to anterior-superior quadrant (Q1 and anterior-inferior quadrant (Q2 (P = 0.0113. Conclusion: IT injection is recommended to be applied to the Q2 since the Q1 and Q4 injections are more likely to induce the adverse effect of tongue numbness, while the Q3 and Q4 areas are more likely to induce post-injection vertigo. Keywords: Intratympanic injection, Sudden deafness, Complications, Vertigo

  2. Deterioration of autoimmune condition associated with repeated injection of dextranomer/hyaluronic acid copolymer: A case report

    Directory of Open Access Journals (Sweden)

    Kazuto Suda

    2016-01-01

    Full Text Available A 6-year-old girl underwent ureterocystoneostomy (UCN because of left flank pain due to delayed onset of ureteral stenosis one and a half years after endoscopic dextranomer/hyaluronic acid copolymer (Deflux injection for the treatment of vesicoureteral reflux (VUR. Histopathological examination indicated chronic inflammation with abundant eosinophils characteristic of a reaction to Deflux. Several autoimmune diseases developed during the treatment for ureteral stenosis. First, 2 weeks prior to the onset of left flank pain, she was diagnosed as having systemic lupus erythematosus. Finally, she died of pulmonary hemorrhage due to thrombotic thrombocytopenic purpura 4 months after UCN. The fatal outcome in this case was suspected to be caused by autoimmune syndrome induced by adjuvants, which in this case was the hyaluronic acid polymer injected into the ureteric orifice for the treatment of VUR.

  3. Glans Penis Augmentation Using Hyaluronic Acid Gel as an Injectable Filler

    OpenAIRE

    Moon, Du Geon; Kwak, Tae Il; Kim, Je Jong

    2015-01-01

    Glans penis augmentation (GPA) has received little attention from experts despite the existence of a subset of patients who may be dissatisfied with a small glans or poor tumescence of the glans during erection. Recently, GPA using an injectable filler or implantation of a graft or filler has been developed. Despite a demanding injection technique and inevitable uneven undulation of the glandular surface, GPA using injectable hyaluronic acid (HA) gel is a novel and useful therapy and an effec...

  4. Spinal CT-guided injections. Clinical applications-limitations

    International Nuclear Information System (INIS)

    Stamatakis, V.; Vlachou, I.; Petrocheilou, G.; Safarika, V.; Geroukis, I.; Petinelli, A.; Stathopoulou, S.; Kokkinis, C.

    2012-01-01

    Full text: Introduction: Chronic spinal pain is an important health issue with serious social and financial consequences. Thus, application of minimal invasive procedures is a popular technique for immediate relief of pain. Objectives and tasks: Our purpose is to present CT guided intraspinal injection of pharmaceutical agents for the relief of persistent pain. Material and methods: Chronic localized or radicular spinal pain may be treated safely and efficiently with injection of various pharmaceutical agents (local anesthetic, opioid analgesic and steroids or combination of these). The possible sites of infiltration include: a) intervertebral joints (facets), b) sacroiliac joints, c)perineural infiltration of the affected nerve roots and d) the epidural space. We will mention the patients choice criteria (combination of clinical symptoms and specific pain evaluation questionnaire) as they are reported in the international bibliography. Finally, we will discuss the repeatability criteria of the method as well as its limitations. Results: CT-guided pharmaceutical agents injection for the relief of persistent spinal pain have an advantage against other methods because of the precision and safety that they offer to the localization and diagnosis of the pain cause. Conclusion: Small complications percentage and satisfactory results have made CT-guided spinal injections a popular technique for chronic back pain relief. In order to apply these techniques the good knowledge of the method, its possibilities and limitations is necessary

  5. A Retrospective Analysis of Cyanoacrylate Injection versus Hemoclip Placement for Bleeding Dieulafoy’s Lesion in Duodenum

    Directory of Open Access Journals (Sweden)

    Yu Jiang

    2018-01-01

    Full Text Available Background. Duodenal Dieulafoy’s lesion (DL is a rare disease that may lead to lethal hemorrhage in the upper gastrointestinal tract. The best technique for endoscopic intervention still remains unclear. In the present study, we performed a retrospective analysis of cyanoacrylate injection versus hemoclip placement for treating bleeding DLs. Materials and Methods. We retrospectively analyzed eighteen patients from three medical centers between October 2008 and February 2016; six patients received cyanoacrylate injection, while hemoclips were placed in 12 patients during the upper gastrointestinal endoscopy. Results. All patients received first endoscopic examination and/or endotherapy within 12 hours of admission to hospital. No difference was observed in the primary hemostasis rate or the recurrent hemorrhage rate between the cyanoacrylate injection (CI group and the hemoclip placement (HP group, except that in one patient from the HP group melena was found three days after the first endotherapy. This patient received cyanoacrylate injection once again. Conclusion. Both cyanoacrylate injection and hemoclip placement are effective in treating duodenal DL, and neither of them causes significant side effects.

  6. Endoscopic ultrasound-guided coil or glue injection in post-cyanoacrylate gastric variceal re-bleed.

    Science.gov (United States)

    Mukkada, Roy J; Antony, Rajesh; Chooracken, Mathew J; Francis, Jose V; Chettupuzha, Antony P; Mathew, Pradeep G; Augustine, Philip; Koshy, Abraham

    2018-04-09

    N-butyl-cyanoacrylate injection is recommended in bleeding/recently bled gastric varices. However, cyanoacrylate injection is associated with re-bleed in 25% to 50% of patients. Endoscopic ultrasound (EUS)-guided coil application is an emerging treatment modality for bleeding gastric varices. The aim of this study was to compare EUS-guided coil application combined with or without cyanoacrylate glue injection to injection alone in post-glue gastric variceal re-bleed. A retrospective analysis of a prospectively maintained database was performed. Thirty patients who re-bled after cyanoacrylate injection and who had EUS-guided coil application to gastric varices were included. The comparison was done with data of 51 patients who had only repeat cyanoacrylate injection. Both groups had a follow up for 12 months. EUS-guided coil application was done under endosonographic guidance. A single coil was placed in 7, two coils in each of 13 patients, three in 5, four in 3, five in one, and 6 coils in one patient. In addition, cyanoacrylate glue injection was given in 15 patients. Eight patients had repeat EUS-guided coil application 1 month later. Re-bleed and mortality were assessed. Coilng: Six out of 30 (20%) patients re-bled during follow up of 9 to 365 days. Three out of 30 (10%) died. One patient died 9 days after the procedure due to acute respiratory distress syndrome, one died 4 months after the procedure due to a re-bleed and one 5 months after the procedure due to spontaneous bacterial peritonitis. Glue only: 26/51 (51%) re-bled during follow up of 45 to 365 days. EUS-guided coil application resulted in significantly less re-bleed than glue-only (Kaplan-Meir survival analysis with log-rank test, z = 5.4, p guided coil application with/without cyanoacrylate injection for the obliteration of gastric varices is effective for post-cyanoacrylate gastric variceal re-bleed.

  7. Axial injection in Orsay superconducting cyclotron

    International Nuclear Information System (INIS)

    Depauw, J.; Kugler, M.F.; Legoff, A.; Potier, J.C.; Richomme, A.; Skowron, R.; Mandrillon, P.; Schapira, J.P.

    1983-01-01

    The compact superconducting cyclotron currently planned at IPN at Orsay is designed for light ion acceleration together with heavy ion acceleration. From the beginning, for this reason, a central geometry able to receive an inflector (to 90deg C) allowing the axial injection of low energy ion beams given by an outer source. The present study is aimed at showing the technical feasibility of theoretical results obtained on axial injection. First experimental study has been made of spatial repartition in three dimensions of electric potential developed by a central geometry of 3 electrodes. Then, the electric study of an electrostatic mirror has been made [fr

  8. Successful treatment of unicameral bone cyst by single percutaneous injection of alpha-BSM.

    Science.gov (United States)

    Thawrani, Dinesh; Thai, Chia Che; Welch, Robert D; Copley, Lawson; Johnston, Charles E

    2009-01-01

    Unicameral bone cyst (UBC) is a benign bone lesion, recognized for its high rate of recurrence and need for repeat procedures to achieve healing. We hypothesized that the osteoconductive material apatitic calcium phosphate (alpha-BSM) could be effective in filling and stimulating resolution of UBC. The purpose of this study was to evaluate clinical and radiographic outcomes of UBC treated by a single injection of alpha-BSM. Thirteen patients (6 male, 7 female) with a mean age of 10.5 years, underwent single percutaneous injection of alpha-BSM for presumed UBC. The aspiration of the cysts was followed by vigorous saline lavage using 2 wide bore needles to disrupt the cyst walls. alpha-BSM "paste" was then injected under fluoroscopic guidance. Radiographs were digitized to measure cystic area (millimeter squares) on 2 orthogonal views. Healing was rated according to a modified Neer outcome grading system. Nine of the 13 patients had had pathologic fractures in the past. Eleven of the 13 patients had had past unsuccessful treatment: multiple steroid injections in 6, curettage and bone grafting in 3, and bone marrow and demineralized bone matrix (Grafton) injection in 2. Five cysts were grade 1 (healed 100%), 6 grade 2 (healed >50%), 2 grade 3 (healed <50% with increased cortical thickness), and none grade 4 (recurrence/enlargement). The average resolution of cystic area in 11/13 cysts was 85.7% at final follow-up of 35.8 months (P=0.0001) with 2.8 mm of average gain in cortical thickness (P=0.0018). None of the 13 lesions required an additional procedure or repeat injection. All patients were clinically asymptomatic at latest follow-up. This is the first study quantifying cyst resolution objectively according to actual decrease in area (millimeter squares). A single injection of alpha-BSM is a safe, minimally invasive and efficacious method to treat UBC in the pediatric population.

  9. Comparison of autologous cell therapy and granulocyte-colony stimulating factor (G-CSF) injection vs. G-CSF injection alone for the treatment of acute radiation syndrome in a non-human primate model

    International Nuclear Information System (INIS)

    Bertho, Jean-Marc; Frick, Johanna; Prat, Marie; Demarquay, Christelle; Dudoignon, Nicolas; Trompier, Francois; Gorin, Norbert-Claude; Thierry, Dominique; Gourmelon, Patrick

    2005-01-01

    Purpose: To compare the efficacy of autologous cell therapy after irradiation combined with granulocyte-colony stimulating factor (G-CSF) injections with G-CSF treatment alone in a heterogeneous model of irradiation representative of an accidental situation. Material and Methods: Non-human primates were irradiated at 8.7 Gy whole-body dose with the right arm shielded to receive 4.8 Gy. The first group of animals received G-CSF (lenograstim) injections starting 6 h after irradiation, and a second group received a combination of G-CSF (lenograstim) injections and autologous expanded hematopoietic cells. Animals were followed up for blood cell counts, circulating progenitors, and bone marrow cellularity. Results: No significant differences were seen between the two treatment groups, whatever the parameter observed: time to leukocyte or platelet recovery and duration and severity of aplasia. Conclusion: Our results indicated that identical recovery kinetic was observed when irradiated animals are treated with G-CSF independently of the reinjection of ex vivo expanded autologous hematopoietic cells. Thus G-CSF injections might be chosen as a first-line therapeutic strategy in the treatment of accidental acute radiation victims

  10. Short- and long-term efficacy of intra-articular injections with betamethasone as part of a treat-to-target strategy in early rheumatoid arthritis

    DEFF Research Database (Denmark)

    Hetland, Merete Lund; Østergaard, Mikkel; Ejbjerg, Bo

    2012-01-01

    To investigate the short-term and long-term efficacy of intra-articular betamethasone injections, and the impact of joint area, repeated injections, MRI pathology, anticyclic citrullinated peptide (CCP) and immunoglobulin M rheumatoid factor (IgM-RF) status in patients with early rheumatoid arthr...

  11. CT-guided percutaneous acetic acid injection therapy for liver metastasis

    International Nuclear Information System (INIS)

    Yu Tongfu; Wang Dehang; Zhuang Zhenwu; Li Linxun; Shi Haibin

    2002-01-01

    Objective: To evaluate the efficacy of CT-guided percutaneous acetic acid injection (PAI) for liver metastasis. Methods: Thirty-five cases (40 lesions) with liver metastasis were treated with PAI. 4-10 ml of 30% acetic acid with 1 ml contrast media was injected into every lesion. PAI was performed twice a week, and repeated for 2 to 3 weeks. Results: The tumors shrunk in 23 lesions, and remained unchanged in 12 lesions. The efficiency was 87.5%. All cases were followed up for 3 months to 3 years. One year survival rates was 62.9% (22 cases), 2 years 40.0% (14 cases), and 3 years 22.9% (8 cases). Conclusion: PAI was an effective therapy for liver metastasis

  12. Oxytocin injections in the postpartal period affect mammary tight junctions in sows

    DEFF Research Database (Denmark)

    Farmer, C.; Lessard, M.; Knight, C. H.

    2017-01-01

    The potential impacts of injecting oxytocin (OXY) to sows in the early postpartum period on the quality of mammary tight junctions, milk composition, and immune status of sows and piglets were studied. Postparturient sows received i.m. injections of either saline (control [CTL]; n = 10) or 75 IU ...

  13. The effect of air-lock technique on pain at the site of intramuscular injection

    Directory of Open Access Journals (Sweden)

    Dilek K. Yilmaz

    2016-03-01

    Full Text Available Objectives: To investigate the effects of air-lock technique (ALT on pain of intramuscular (IM injection delivered to the ventrogluteal and dorsogluteal site (DS. Methods: A randomized controlled trial design was used to assess the pain intensity associated with IM injections administered using 2 different methods and injection sites. Recruitment of patients was carried out between April and August 2013 at the Department of Brain Surgery, Cekirge State Hospital, Bursa, Turkey. The sample comprised 60 patients who developed no complications at the IM site, and had no illness that could affect their perception of pain. The patients were randomly divided into 2 groups of 30 patients. Patients in the first group received injections in the ventrogluteal site (VS, while the DS was used for injections in the second group. Patients in each group received 2 injections, one using ALT and one not using the technique. After each injection, the pain felt by patients during the injection was immediately assessed using a visual analog scale. Results: The mean pain score after injections to the DS by the ALT was 3.30 ± 2.70, while the mean pain score after injections to the VS using the same technique was 2.53 ± 2.52. Conclusion: Although the difference between groups was not significant, the results of the study supported the idea that injections delivered to the VS by ALT are less painful than those delivered to the DS.

  14. Effect of single and repeated injections of selective D2-antagonist clebopride on maternal behavior of albino rats.

    Science.gov (United States)

    Tanaeva, K K; Dobryakova, Yu V; Dubynin, V A; Kamensky, A A

    2012-06-01

    This study examined the effect of clebopride at low concentration that did not modify the motor activity on the parental care in female albino rats. Single injection of the drug attenuated the parental care reactions on postinjection minute 20, but not one day thereafter. The daily injection of the drug during the post partum period (1-6 days) resulted in significantly more pronounced and stable effects. The data obtained substantiated the views on the major contribution of D(2)-receptors in the development of behavioral manifestations of puerperal depression.

  15. Fructose-fed streptozotocin-injected rat: an alternative model for type 2 diabetes.

    Science.gov (United States)

    Wilson, Rachel D; Islam, Md Shahidul

    2012-01-01

    The main objective of the study was to develop an alternative non-genetic rat model for type 2 diabetes (T2D). Six-week-old male Sprague-Dawley rats (190.56 ± 23.60 g) were randomly divided into six groups, namely: Normal Control (NC), Diabetic Control (DBC), Fructose-10 (FR10), Fructose-20 (FR20), Fructose-30 (FR30) and Fructose-40 (FR40) and were fed a normal rat pellet diet ad libitum for 2 weeks. During this period, the two control groups received normal drinking water whilst the fructose groups received 10, 20, 30 and 40% fructose in drinking water ad libitum, respectively. After two weeks of dietary manipulation, all groups except the NC group received a single injection (i.p.) of streptozotocin (STZ) (40 mg/kg b.w.) dissolved in citrate buffer (pH 4.4). The NC group received only a vehicle buffer injection (i.p.). One week after the STZ injection, animals with non-fasting blood glucose levels > 300 mg/dl were considered as diabetic. Three weeks after the STZ injection, the animals in FR20, FR30 and FR40 groups were eliminated from the study due to the severity of diabetes and the FR10 group was selected for the remainder of the 11 weeks experimental period. The significantly (p < 0.05) higher fluid intake, blood glucose, serum lipids, liver glycogen, liver function enzymes and insulin resistance (HOMA-IR) and significantly (p < 0.05) lower body weight, oral glucose tolerance, number of pancreatic β-cells and pancreatic β-cell functions (HOMA-β) of FR10 group demonstrate that the 10% fructose-fed followed by 40 mg/kg of BWSTZ injected rat can be a new and alternative model for T2D.

  16. 'Chaos' in superregenerative receivers

    Energy Technology Data Exchange (ETDEWEB)

    Commercon, Jean-Claude [INSA, Department d' Informatiques, Ba-hat t B. Pascal, 20 Avenue Albert Einsten, 69621 Villeurbaune (France)]. E-mail: jean-claude.commercon@insa-lyon.fr; Badard, Robert [INSA, Department d' Informatiques, Bat B. Pascal, 20 Avenue Albert Einsten, 69621 Villeurbaune (France)]. E-mail: robert.badard@insa-lyon.fr

    2005-02-01

    The superregenerative principle has been known since the early 1920s. The circuit is extremely simple and extremely sensitive. Today, superheterodyne receivers generally supplant superregenerative receivers in most applications because there are several undesirable characteristics: poor selectivity, reradiation, etc. Superregenerative receivers undergo a revival in recent papers for wireless systems, where low cost and very low power consumption are relevant: house/building meters (such as water, energy, gas counter), personal computer environment (keyboard, mouse), etc. Another drawback is the noise level which is higher than that of a well-designed superheterodyne receiver; without an antenna input signal, the output of the receiver hears in an earphone as a waterfall noise; this sound principally is the inherent input noise amplified and detected by the circuit; however, when the input noise is negligible with respect of an antenna input signal, we are faced to an other source of 'noise' self-generated by the superregenerative working. The main objective of this paper concerns this self-generated noise coming from an exponential growing followed by a re-injection process for which the final state is a function of the phase of the input signal.

  17. Finding Balance Between Biological Groundwater Treatment and Treated Injection Water

    Energy Technology Data Exchange (ETDEWEB)

    Carlson, Mark A.; Nielsen, Kellin R.; Byrnes, Mark E.; Simmons, Sally A.; Morse, John J.; Geiger, James B.; Watkins, Louis E.; McFee, Phillip M.; Martins, K.

    2015-01-14

    At the U.S. Department of Energy’s Hanford Site, CH2M HILL Plateau Remediation Company operates the 200 West Pump and Treat which was engineered to treat radiological and chemical contaminants in groundwater as a result of the site’s former plutonium production years. Fluidized bed bioreactors (FBRs) are used to remove nitrate, metals, and volatile organic compounds. Increasing nitrate concentrations in the treatment plant effluent and the presence of a slimy biomass (a typical microorganism response to stress) in the FBRs triggered an investigation of nutrient levels in the system. Little, if any, micronutrient feed was coming into the bioreactors. Additionally, carbon substrate (used to promote biological growth) was passing through to the injection wells, causing biological fouling of the wells and reduced specific injectivity. Adjustments to the micronutrient feed improved microorganism health, but the micronutrients were being overfed (particularly manganese) plugging the injection wells further. Injection well rehabilitation to restore specific injectivity required repeated treatments to remove the biological fouling and precipitated metal oxides. A combination of sulfamic and citric acids worked well to dissolve metal oxides and sodium hypochlorite effectively removed the biological growth. Intensive surging and development techniques successfully removed clogging material from the injection wells. Ultimately, the investigation and nutrient adjustments took months to restore proper balance to the microbial system and over a year to stabilize injection well capacities. Carefully tracking and managing the FBRs and well performance monitoring are critical to balancing the needs of the treatment system while reducing fouling mechanisms in the injection wells.

  18. Differential regulation of proopiomelanocortin (POMC mRNA expression in hypothalamus and anterior pituitary following repeated cyanamide with ethanol administration

    Directory of Open Access Journals (Sweden)

    Kinoshita Hiroshi

    2005-01-01

    Full Text Available Background/Aim. We have investigated proopiomelanocortin (POMC mRNA expression in the arcuate nucleus of the hypothalamus (ARC and the anterior lobe of the pituitary (AL following repeated cyanamide-ethanol reaction (CER. Methods. Adult male Sprague -Dawley rats (250 −290 gr were housed in a temperature and humidity controlled environment with free access to food and water. Four experimental groups were used as follows: saline (as control, cyanamide alone, ethanol alone and ethanol with cyanamide. The animals received daily intraperitoneal injections (i.p. of cyanamide (10mg/kg, 60 min before ethanol dosing with or without ethanol (1g/kg for 5 consecutive days, and were sacrificed 60 min after the last dosing of ethanol. The results were presented as the mean ± SEM for each group. All groups within each data set were compared by one-way ANOVA followed by Fisher PLSD test for multiple comparisons. A value of p<0.05 was considered significant. Results. The POMC mRNA levels in ARC were significantly decreased with cyanamide compared to the control and ethanol alone (p<0.05 and p<0.05 respectively, but increased in AL following repeated CER. Conclusion. We speculate that this differential regulation of POMC mRNA expression may be partially involved in the preventive effects on alcohol intake in response to CER.

  19. Relationship of specific MRI findings to treatment outcomes in patients receiving transforaminal epidural steroid injections

    Energy Technology Data Exchange (ETDEWEB)

    Lechmann, Marco; Rosskopf, Andrea; Ehrmann, Christine; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [University of Zuerich, Department of Radiology, Orthopaedic University Hospital Balgrist, Zuerich (Switzerland)

    2016-12-15

    To determine whether specific MRI findings are related to outcomes after lumbar transforaminal epidural steroid injections (TFESI) and to assess the inter-rater reliability of imaging diagnosis. A prospective outcomes study on 156 consecutive patients with 1-month follow-up outcomes data and MRI within 3 months of TFESI was conducted. Pain levels (numerical rating scale) (NRS) were recorded prior to injection. Overall 'improvement' was determined using the Patients Global Impression of Change (PGIC) scale and NRS data were collected at three time points post injection. Two radiologists independently evaluated all images blinded to treatment outcome for reliability of diagnosis. The Chi-square test compared MRI findings for the senior radiologist to 'improvement'. NRS change scores were compared to MRI findings with the unpaired t-test or ANOVA. Kappa and percent agreement assessed inter-rater agreement of diagnosis. The only abnormality linked to 'improvement' (p = 0.03) and higher NRS change scores (p = 0.0001) at 1 month was the disc herniation morphology 'protrusion + sequestration'. Patients with degeneration by osteophytes (p = 0.034), grade 3 foraminal nerve root compression (p = 0.01) and foraminal/extraforaminal location of herniation (p = 0.014) also had higher 1 month NRS change scores. Reliability of diagnosis was 'fair' to 'substantial' depending on MRI findings. Patients with disc protrusion plus sequestration were significantly more likely to report overall improvement and more pain reduction at 1 month. Higher pain reduction was noted in patients with degeneration by osteophytes, grade 3 foraminal nerve root compression, or foraminal/extraforaminal disc herniation location. (orig.)

  20. Occupational hazards of traditional healers: repeated unprotected blood exposures risk infectious disease transmission.

    Science.gov (United States)

    Audet, Carolyn M; Salato, José; Blevins, Meridith; Silva, Wilson; González-Calvo, Lázaro; Vermund, Sten H; Gaspar, Felisbela

    2016-11-01

    Healers provide support for acute and chronic illnesses in rural Mozambique, such as socially acceptable traditional 'vaccinations' (subcutaneous cuts in the skin to rub herbs directly into the bloody lesion). We aimed to document the frequency of blood exposure by traditional practitioners in Mozambique. We conducted surveys with a simple random sample of 236 traditional healers in Zambézia province. Chi-square and Wilcoxon rank-sum tests were used to compare 'injection' behaviours across districts. Healers treated a median of eight patients in the past month (IQR: 4-15). About 75% conducted 'injections'. These healers 'injected' a median of four patients (IQR: 1-8), used a new razor a median of three times (IQR: 1-8), and almost never used gloves. Lifetime blood exposures among those who provided 'injections' during treatments were estimated to be 1758 over a healer's career. The majority of healers are exposed repeatedly to patient blood. Given the high prevalence of HIV, hepatitis B and C virus, and other blood-borne agents, specific healer practices are an occupational hazard and reuse of razors is risky for their clients. © 2016 John Wiley & Sons Ltd.

  1. Rapid assessment of injection practices in Cambodia, 2002

    Directory of Open Access Journals (Sweden)

    Goldstein Susan

    2005-06-01

    Full Text Available Abstract Background Injection overuse and unsafe injection practices facilitate transmission of bloodborne pathogens such as hepatitis B virus (HBV, hepatitis C virus (HCV, and human immunodeficiency virus (HIV. Anecdotal reports of unsafe and unnecessary therapeutic injections and the high prevalence of HBV (8.0%, HCV (6.5%, and HIV (2.6% infection in Cambodia have raised concern over injection safety. To estimate the magnitude and patterns of such practices, a rapid assessment of injection practices was conducted. Methods We surveyed a random sample of the general population in Takeo Province and convenience samples of prescribers and injection providers in Takeo Province and Phnom Penh city regarding injection-related knowledge, attitudes, and practices. Injection providers were observed administering injections. Data were collected using standardized methods adapted from the World Health Organization safe injection assessment guidelines. Results Among the general population sample (n = 500, the overall injection rate was 5.9 injections per person-year, with 40% of participants reporting receipt of ≥ 1 injection during the previous 6 months. Therapeutic injections, intravenous infusions, and immunizations accounted for 74%, 16% and 10% of injections, respectively. The majority (>85% of injections were received in the private sector. All participants who recalled their last injection reported the injection was administered with a newly opened disposable syringe and needle. Prescribers (n = 60 reported that 47% of the total prescriptions they wrote included a therapeutic injection or infusion. Among injection providers (n = 60, 58% recapped the syringe after use and 13% did not dispose of the used needle and syringe appropriately. Over half (53% of the providers reported a needlestick injury during the previous 12 months. Ninety percent of prescribers and injection providers were aware HBV, HCV, and HIV were transmitted through unsafe

  2. Evaluation of pregnancy rates of Bos indicus cows subjected to different synchronization ovulation protocols using injectable progesterone or an intravaginal device

    Directory of Open Access Journals (Sweden)

    Jefferson Tadeu Campos

    2016-12-01

    Full Text Available This study evaluated the pregnancy rate in Nelore cows (Bos indicus that were subjected to fixed-time artificial insemination (FTAI using different protocols consisting of injectable progesterone (P4 or an intravaginal device (impregnated with P4. Multiparous cows 72-84 months in age, 30-45 days postpartum, were selected on the basis of the absence of a corpus luteum (CL and follicles < 8 mm after transrectal palpation and ultrasound examinations. On a random day of the estrus cycle (D0, the selected animals (n = 135 were randomly assigned to one of three experimental groups (n = 45 each. Group I (injectable P4/FTAI 36 hours received 250 mg of injectable P4 and 2 mg EB on D0; on D7, they received 500 µg of cloprostenol; on D8, 300 IU of eCG and 1 mg of EB were administered; and finally, FTAI was performed 36 hours after the application of EB. Group II (injectable P4/FTAI 48 hours received the same protocol as Group I, except that the FTAI was performed 48 hours after ovulation induction. The animals of Group III (Control/CIDR received a conventional protocol for FTAI using an intravaginal device (D0: P4 and 2 mg EB; D8: device removal, 500 µg cloprostenol, 300 IU eCG, 1 mg EB; and FTAI performed 48 hours after removal of the device. The results showed that cows synchronized with the conventional protocol for FTAI (Control/CIDR had a higher pregnancy rate (60 %, 27/45 than those synchronized with an injectable P4/FTAI 36 hours (33.33 %; 15/45, P = 0.010. However, the group receiving injectable P4 group/FTAI 48 hours had a similar pregnancy rate (48.9 %; 22/45; P = 0.290 when compared to both the group receiving the conventional protocol and that receiving injectable P4/FTAI 36 hours (P = 0.134. Although the injectable P4 may affect pregnancy rate with the FTAI performed in 36 hours, we found similar pregnancy rates from cows inseminated 48 hours after induction ovulation, considering injectable or intravaginal P4. Therefore, we suggest that

  3. Strategies and challenges for safe injection practice in developing countries.

    Science.gov (United States)

    Gyawali, Sudesh; Rathore, Devendra Singh; Shankar, P Ravi; Kumar, Kc Vikash

    2013-01-01

    Injection is one of the important health care procedures used globally to administer drugs. Its unsafe use can transmit various blood borne pathogens. This article aims to review the history and status of injection practices, its importance, interventions and the challenges for safe injection practice in developing countries. The history of injections started with the discovery of syringe in the early nineteenth century. Safe injection practice in developed countries was initiated in the early twentieth century but has not received adequate attention in developing countries. The establishment of "Safe Injection Global Network (SIGN)" was an milestone towards safe injection practice globally. In developing countries, people perceive injection as a powerful healing tool and do not hesitate to pay more for injections. Unsafe disposal and reuse of contaminated syringe is common. Ensuring safe injection practice is one of the greatest challenges for healthcare system in developing countries. To address the problem, interventions with active involvement of a number of stakeholders is essential. A combination of educational, managerial and regulatory strategies is found to be effective and economically viable. Rational and safe use of injections can save many lives but unsafe practice threatens life. Safe injection practice is crucial in developing countries. Evidence based interventions, with honest commitment and participation from the service provider, recipient and community with aid of policy makers are required to ensure safe injection practice.

  4. Soft-tissue effects following /sup 224/Ra injections into humans

    Energy Technology Data Exchange (ETDEWEB)

    Spiess, H; Gerspach, A [Muenchen Univ. (Germany, F.R.). Kinderklinik; Mays, C W

    1978-07-01

    Following the Second World War, repeated intravenous injections of /sup 224/Ra were given to German children and adults for the intended treatment of tuberculosis, ankylosing spondylitis and a few other diseases. We have ascertained the health status of 204 juveniles and 612 adults for whom both dosage and injection span are known. /sup 224/Ra is known as a skeletal-seeker, and has induced malignant bone sarcomas, benign exostoses, tooth breakage, and growth retardation. But because of its short 3.62-day half-life, /sup 224/Ra also decays to an appreciable extent in soft tissues, as do the injected atoms of its decay products. Evidence is presented suggesting that some, but certainly not all, of the observed cases of soft-tissue neoplasms, kidney diseases, liver cirrhosis, and cataracts may be related to the /sup 224/Ra therapy. Of particular interest are the 8 cases of cataracts reported at 14-46 years of age (33 yr average) among the 204 patients injected with /sup 224/Ra as juveniles. Due to the rarity of naturally-occurring cataracts at young ages, perhaps all of these 8 cases can be regarded as induced.

  5. Large volume liquid silicone injection in the upper thighs : a never ending story

    NARCIS (Netherlands)

    Hofer, SOP; Damen, A; Nicolai, JPA

    This report concerns a 26-year-old male-to-female transsexual who had received a large volume liquid silicone injection of unknown grade into her upper lateral thighs to gain female contour. She presented at our outpatient clinic 4 years after the silicone injection with complaints of pain and

  6. Assessment of the safety of injection practices and injection-related procedures in family health units and centers in Alexandria.

    Science.gov (United States)

    Elhoseeny, Taghareed A; Mourad, Juidan K

    2014-08-01

    The Safe Injection Global Network (SIGN) developed an intervention strategy for reducing overuse of injections and promoting the administration of safe injections. Tool C--Revised is designed to assess the safety of the most common procedures that puncture the skin within health services. The aim of the study was to assess injection safety within the primary healthcare facilities in Alexandria using Tool C--Revised. A total of 45 family health units and centers in Alexandria were selected by proportional allocation from the eight regions of Alexandria. The Tool C--Revised of the WHO was used for observation of the entire facility, injection practices and injection-related procedures, and sterilization practices. Interview of different health providers and immediate supervisor of injections was carried out. Indicators that reflect risk included: deficiency of alcohol-based hand rub for cleansing hands (13.3%), compliance with hand wash before preparing a procedure (56.9% before injection practices, 61.3% before phlebotomy, and 67.6% before lancet puncture), and wearing a new pair of gloves before new procedures (48.6% before injection practices, 9.7% for phlebotomy, 11.8% for lancet puncture, and 80% for both intravenous injections and infusions). Enough disposable equipment in all facilities for at least 2 weeks dependent on the statement of the average numbers of procedures per week was shown. Only 38% of the providers had received training regarding injection safety in the last 2 years and 62.5% had completed their three doses of hepatitis B vaccine. Only 42.2% of staffs who handled healthcare waste had access to heavy gloves. Indicators related to injection and injection-related practices that reflect risk to patients include deficiency of alcohol-based hand rub tools, nonadherence to hand hygiene before preparing an injection, and inadequate adherence to using a clean barrier when opening a glass ampule and use of gloves. Indicators that may reflect risk to

  7. Repeated stressor exposure enhances contextual fear memory in a beta-adrenergic receptor-dependent process and increases impulsivity in a non-beta receptor-dependent fashion.

    Science.gov (United States)

    Camp, Robert M; Johnson, John D

    2015-10-15

    Memory formation is promoted by stress via the release of norepinephrine and stimulation of beta-adrenergic receptors (β-ARs). Previous data demonstrate that repeated stressor exposure increases norepinephrine turnover and β-AR signaling within the amygdala, which led to the hypothesis that some stress-induced behavioral changes are likely due to facilitated associative learning. To test this, Fischer rats were exposed to chronic mild stress for four days. On day 5, subjects (including non-stressed controls) were injected with the beta-blocker propranolol or vehicle prior to conditioning in an operant box (animals receive two mild foot shocks) or passive avoidance apparatus (animals received a foot shock upon entry into the dark chamber). Twenty-four hours later, subjects were returned to the operant box for measurement of freezing or returned to the passive avoidance apparatus for measurement of latency to enter the dark chamber. Subjects were also tested in an open field to assess context-independent anxiety-like behavior. Animals exposed to chronic stress showed significantly more freezing behavior in the operant box than did controls, and this exaggerated freezing was blocked by propranolol during the conditioning trial. There was no effect of stress on behavior in the open field. Unexpectedly, retention latency was significantly reduced in subjects exposed to chronic stress. These results indicate that chronic exposure to stress results in complex behavioral changes. While repeated stress appears to enhance the formation of fearful memories, it also results in behavioral responses that resemble impulsive behaviors that result in poor decision-making. Copyright © 2015 Elsevier Inc. All rights reserved.

  8. Modeling the effects of repeated systemic administrations of small activity amounts In radionuclide therapy with beta emitters

    International Nuclear Information System (INIS)

    Calderon, Carlos; Gonzalez, Joaquin; Cepero, Janet; Colom, Camila; Rodriguez, Juan C.

    2008-01-01

    Full text: Good results for radionuclide therapy treatments where repeated short time spaced systemic injection of small activity amounts are given have been reported. Bone marrow and kidneys are usually considered as dose-limiting organs in radionuclide therapy. The treatments in radionuclide therapy with repeated administration could be optimized if irradiation effects in those one might be estimated. Xeno-grafted mice is the often biological model used during the evaluation of candidates for radionuclide therapy. A mathematical model of tumor cell kinetics was combined with another one reported for marrow cell kinetics which allows the calculation of marrow cell survival and proliferation in response to different irradiation schemes. Radionuclide therapy treatment with repeated administrations with radiopharmaceuticals labeled with beta emitters were simulated. The effects on fast-growing and slow-growing tumors were evaluated, as well as radiosensitive and radioresistant tumors. For more realistic estimation of absorbed dose in mice organs the cross-irradiation due to high energy beta particles was included into the MIRD's formula. Tumor and kidneys responses to the irradiation were estimated on the linear-quadratic model framework which was adapted for a multi-exponential dose rate function describing radionuclide therapy treatments with repeated administrations. Published values for murine tumors kinetics, marrows cellular turnover rates and radiosensitivities were used during the calculations. Iso-effective schemes were also determined varying the interval between fractions and the number of administration. For a given tolerated level of thrombocytopenia and absorbed dose in kidneys an optimal regime of radionuclide therapy with repeated administration could be found. The mathematical model presented here allows the prediction of the nadir and duration of thrombocytopenia, the effects on kidneys and the tumor cell response to various treatment schemes

  9. Spiral CT portography: correlation with different injection rate

    International Nuclear Information System (INIS)

    Wu Dong; Zhou Kangrong; Chen Zuwang; Chen Gang; Chen Jin; Chen Huiming

    2000-01-01

    Objective: To choose optimal injection rate in spiral CT portography(CTP) by comparing 3D CTP images using different injection rates. Methods: Thirty-seven patients were randomly divided into 2 groups (11 and 26 cases in each group). Single-level dynamic scan was completed at the first liver hilus, starting at 15s or 30s after initial contrast injection(2 ml/kg) with injection rate 1.5 ml/s (slow group) or 3.0 ml/s (rapid group). The continuous scan were repeated every 5s for 120s or 135s. ROI was used to measure the CT value of the portal vein and the liver parenchyma, respectively, and then the time-density curves were drawn. Spiral CT portography were performed at injection rate of 1.5 ml/s or 3.0 ml/s as the delay time designed described above, including 98 cases in rapid group and 12 cases in slow group. Both MPVR (multi-projection volume reconstruction) and MIP (maximum intensity projection) were employed for reconstruction. All images were ranked according to the grade of portal vein, the different CT value between the portal vein and the liver parenchyma, the edge's definition of blood vessel, the grade of hepatic vein and the display of IVC by 2 radiologists. Results: The maximum density difference in average between the portal vein and the liver parenchyma was 53.4 HU and 83.9 HU, respectively (t = 16.418, P < 0.001) in slow group and rapid one, and the mean reaching time was 80s and 60s, respectively (t = 13.394, P < 0.001). In slow injection group, the average score of MPVR image was 9.3, while it was 12.5 (t = 3.514, P < 0.01) in rapid injection group. Rapid group was better than slow one at the PV-L, the grade of the portal vein, and the edge's definition of blood vessel. Conclusion: Using rapid injection rate (3.0 ml/s), the maximum density difference between the portal vein and the liver parenchyma increases, and the mean reaching time shortens. The quality of 3D CTP image of rapid injection rate (3.0 ml/s) is superior to that of slow injection rate

  10. Two cases of Robertsonian translocations in oligozoospermic males and their consequences for pregnancies induced by intracytoplasmic sperm injection

    NARCIS (Netherlands)

    R.F.A. Weber (Robert); F.J. Los; N.S. den Hollander (Nicolette); M. Dhont; M.H. Pieters; J.O. van Hemel; P.A. in 't Veld

    1997-01-01

    textabstractTwo case histories are presented documenting structural chromosome abnormalities in infertile males. The abnormalities were detected only after application of intracytoplasmic sperm injection (ICSI) was repeatedly unsuccessful or resulted in an abnormal

  11. Sub-Tenon's lidocaine injection improves emergence agitation after ...

    African Journals Online (AJOL)

    Objective: This study aimed to evaluate the effect of a sub-Tenon's lidocaine injection on emergence agitation in children receiving sevoflurane or halothane anaesthesia for strabismus surgery. Design: A prospective, randomised study. Setting: The study setting included a hospital where a surgical team performed ...

  12. Intramuscular versus ultrasound-guided intratenosynovial glucocorticoid injection for tenosynovitis in patients with rheumatoid arthritis

    DEFF Research Database (Denmark)

    Ammitzbøll-Danielsen, Mads; Østergaard, Mikkel; Fana, Viktoria

    2017-01-01

    and tenosynovitis were randomised into two double-blind groups: (A) 'intramuscular group', receiving intramuscular injection of betamethasone and US-guided intratenosynovial isotonic saline injection and (B) 'intratenosynovial group' receiving saline intramuscularly and US-guided intratenosynovial betamethasone......% (2/24) versus 44% (11/25), that is, difference of ?36pp (?58pp to ?13pp), p=0.003. Most US, clinical and patient-reported scores improved more in the 'intratenosynovial group' at all follow-up visits. Conclusions In this randomised double-blind clinical trial, patients with RA and tenosynovitis...

  13. Effect analysis of intradermal hyaluronic acid injection to treat enlarged facial pores.

    Science.gov (United States)

    Qian, Wei; Zhang, Yan-Kun; Hou, Ying; Lyu, Wei; Cao, Qian; Li, Yan-Qi; Fan, Ju-Feng

    2017-08-08

    To investigate the clinical application and efficacy of intradermal injection of low molecular weight hyaluronic acid (LMW-HA) for treating enlarged facial pores. From January 2015 to May 2016, 42 subjects who sought aesthetic treatment underwent intradermal injection of LMW-HA to improve enlarged facial pores. For each treatment, 2.5 mL (25 mg) of LMW-HA was injected into the skin of the full face. The treatment was repeated 2-5 times with an interval of 1 to 1.5 months between consecutive treatments. The postoperative follow-up period was 1 to 6 months. Statistical analysis was used to compare the degree of enlargement of facial pores before and after injection. The clinical efficacy and adverse effects were recorded. The enlarged facial pores before and after treatment were categorized and subjected to the Wilcoxon matched-pairs signed-rank test. The difference was statistically significant (Pinjection sites in the subjects who sought aesthetic treatment. The overall satisfaction rate was 92.8%. Intradermal injection of LMW-HA can significantly improve skin texture, reduce pore size, and enhance skin radiance. The injection technique was simple, safe, and effective and could easily be extended to clinical practice. © 2017 Wiley Periodicals, Inc.

  14. Shenfu injection reduces toxicity of bupivacaine in rats

    Institute of Scientific and Technical Information of China (English)

    王强; 刘艳红; 雷毅; 杨静; 陈绍洋; 陈敏; 熊利泽

    2003-01-01

    Objective To investigate the effects of injecting Shenfu, an extract of traditional Chinese herbal medicines, on the central nervous system (CNS) and the cardiac toxicity of bupivacaine in rats. Methods Sixteen male Sprague-Dawley rats, weighing form 280 to 320 g, were randomly assigned to two groups (n=8 in each group). Animals in the control group received a saline injection 10 ml/kg while animals in the Shenfu group received an injection of Shenfu 10 ml/kg intraperitoneally 30 minutes before intravenous infusion of bupivacaine. Lead Ⅱ of an electrocardiogram (EEG) was continuously monitored after 3 needles were inserted into the skin of both forelimbs and the left hind-leg of each rat. The femoral artery was cannulated for measurement of arterial blood pressure and blood sampling. The femoral vein was cannulated for the infusion of bupivacaine. After baseline measurement (arterial blood pressure, heart rate and arterial blood gas), 0.5% bupivacaine was infused intravenously at a rate of 2 mg*kg-1*min-1 to all animals until asystole occurred. The time of bupivacaine-induced convulsions, arrhythmia and asystole were determined. The dose of bupivacaine was then calculated at the corresponding time point. Results The doses of bupivacaine that induced convulsions, arrhythmia and cardiac arrest were remarkably larger in Shenfu injection-treated animals than in saline-treated rats [convulsions, (10.5±1.9) mg/kg vs (7.2±1.5) mg/kg; arrhythmia (10.5±2.0) mg/kg vs (7.2±1.9) mg/kg; asystole, (32.8±8.5) mg/kg vs (25.0±5.0) mg/kg; P=0.006, 0.009 and 0.044, respectively]. Conclusion The Shenfu injection is able to reduce the toxicity of bupiralaine to CNS and cardiac system in rats.

  15. Repeated cue exposure effects on subjective and physiological indices of chocolate craving

    OpenAIRE

    Van Gucht, Dinska; Vansteenwegen, Debora; Beckers, Tom; Hermans, Dirk; Baeyens, Frank; Van den Bergh, Omer

    2008-01-01

    The aim of this study is to investigate the effects of repeated unreinforced exposure to chocolate cues in persons reporting chocolate craving. Participants in the experimental group (n=40) received 10 consecutive brief exposures to chocolate cues in each of two sessions, separated by 1-3 days. Control participants (n=18) received two exposures at the start and end of each session. Chocolate craving was measured (alternately) through subjective report and the amount of saliva secretion to cho...

  16. Impact of Clinical Practice Guidelines on Use of Intra-Articular Hyaluronic Acid and Corticosteroid Injections for Knee Osteoarthritis.

    Science.gov (United States)

    Bedard, Nicholas A; DeMik, David E; Glass, Natalie A; Burnett, Robert A; Bozic, Kevin J; Callaghan, John J

    2018-05-16

    The efficacy of corticosteroid and hyaluronic acid injections for knee osteoarthritis has been questioned. The purpose of this study was to determine the impact of the American Academy of Orthopaedic Surgeons (AAOS) clinical practice guidelines on the use of these injections in the United States and determine if utilization differed by provider specialty. Patients with knee osteoarthritis were identified within the Humana database from 2007 to 2015, and the percentage of patients receiving a knee injection relative to the number of patients having an encounter for knee osteoarthritis was calculated and was trended for the study period. The impact of each edition of the AAOS clinical practice guidelines on injection use was evaluated with segmented regression analysis. Injection trends were also analyzed relative to the specialty of the provider performing the injection. Of 1,065,175 patients with knee osteoarthritis, 405,101 (38.0%) received a corticosteroid injection and 137,005 (12.9%) received a hyaluronic acid injection. The rate of increase in hyaluronic acid use, per 100 patients with knee osteoarthritis, decreased from 0.15 to 0.07 injection per quarter year (p = 0.02) after the first clinical practice guideline, and the increase changed to a decrease at a rate of -0.12 injection per quarter (p guideline. After the first clinical practice guideline, the rate of increase in utilization of corticosteroids, per 100 patients with knee osteoarthritis, significantly lessened to 0.12 injection per quarter (p guideline, corticosteroid injection use plateaued (p = 0.72). The trend in use of hyaluronic acid injections by orthopaedic surgeons and pain specialists decreased with time following the second-edition clinical practice guideline but did not change for primary care physicians or nonoperative musculoskeletal providers. Subtle but significant changes in hyaluronic acid and corticosteroid injections occurred following the publication of both clinical practice

  17. MR study of acute myocardial infarction with injection of Gd-DOTA (Fifteen patients)

    International Nuclear Information System (INIS)

    Richoz, B.; Delcour, C.; Depelchin, P.; Lenaers, A.; Jacquemin, C.; Gusella, P.; Struyven, J.; Richoz, B.

    1990-01-01

    We studied 15 patients 4 to 8 days after myocardial infarction by using ECG gated MR before and after administration of 0.2 mmol/kg Gd-DOTA. The diagnosis in each patient was confirmed by electrocardiographic criteria, elevated levels of fractionated creatine kinase (CK) isoenzyme, thallium scintigraphy, ventriculography and coronarography. T1-weighted, spin-echo images, were obtained before and immediately after injection of Gd-DOTA and were repeated 15 min later. The site of infarction was visualized in 10 patients as an area of high signal intensity after the injection of Gd-DOTA. Contrast between normal and infarcted myocardium was greatest 15 min after injection. Three patients were excluded because of failure to acquire adequate MR studies. In 2 other patients, the infarct were not detected. Before injection of Gd-DOTA, only 2 infarcts were detected. These results suggest that Gd-DOTA can improve MR visualization and detection of acute myocardial infarction [fr

  18. Safe injection practice among health-care workers in Gharbiya Governorate, Egypt.

    Science.gov (United States)

    Ismail, N A; Aboul Ftouh, A M; El-Shoubary, W H; Mahaba, H

    2007-01-01

    We assessed safe injection practices among 1100 health-care workers in 25 health-care facilities in Gharbiya Governorate. Questionnaires were used to collect information and 278 injections were observed using a standardized checklist. There was a lack of infection control policies in all the facilities and a lack of many supplies needed for safe injection. Proper needle manipulation before disposal was observed in only 41% of injections, safe needle disposal in 47.5% and safe syringe disposal in 0%. Reuse of used syringes and needles was reported by 13.2% of the health-care workers and 66.2% had experienced a needle-stick injury. Only 11.3% had received a full course of hepatitis B vaccination.

  19. Is there a difference in treatment outcomes between epidural injections with particulate versus non-particulate steroids?

    Energy Technology Data Exchange (ETDEWEB)

    Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K. [Orthopedic University Hospital Balgrist, Department of Radiology, Zurich (Switzerland); University of Zurich, Faculty of Medicine, Zurich (Switzerland)

    2017-04-15

    To compare the outcomes of patients after interlaminar computed tomography (CT)-guided epidural injections of the lumbar spine with particulate vs. non-particulate steroids. 531 consecutive patients were treated with CT-guided lumbar interlaminar epidural injections with steroids and local anaesthetics. 411 patients received a particulate steroid and 120 patients received a non-particulate steroid. Pain levels were assessed using the 11-point numerical rating scale (NRS) and overall reported 'improvement' was assessed using the Patients Global Impression of Change (PGIC) at 1 day, 1 week and 1 month post-injection. Descriptive and inferential statistics were applied. Patients receiving particulate steroids had statistically significantly higher NRS change scores (p = 0.0001 at 1 week; p = 0.0001 at 1 month). A significantly higher proportion of patients receiving particulate steroids reported relevant improvement (PGIC) at both 1 week and 1 month post injection (p = 0.0001) and they were significantly less likely to report worsening at 1 week (p = 0.0001) and 1 month (p = 0.017). Patients treated with particulate steroids had significantly greater pain relief and were much more likely to report clinically relevant overall 'improvement' at 1 week and 1 month compared to the patients treated with non-particulate steroids. (orig.)

  20. Is there a difference in treatment outcomes between epidural injections with particulate versus non-particulate steroids?

    International Nuclear Information System (INIS)

    Bensler, Susanne; Sutter, Reto; Pfirrmann, Christian W.A.; Peterson, Cynthia K.

    2017-01-01

    To compare the outcomes of patients after interlaminar computed tomography (CT)-guided epidural injections of the lumbar spine with particulate vs. non-particulate steroids. 531 consecutive patients were treated with CT-guided lumbar interlaminar epidural injections with steroids and local anaesthetics. 411 patients received a particulate steroid and 120 patients received a non-particulate steroid. Pain levels were assessed using the 11-point numerical rating scale (NRS) and overall reported 'improvement' was assessed using the Patients Global Impression of Change (PGIC) at 1 day, 1 week and 1 month post-injection. Descriptive and inferential statistics were applied. Patients receiving particulate steroids had statistically significantly higher NRS change scores (p = 0.0001 at 1 week; p = 0.0001 at 1 month). A significantly higher proportion of patients receiving particulate steroids reported relevant improvement (PGIC) at both 1 week and 1 month post injection (p = 0.0001) and they were significantly less likely to report worsening at 1 week (p = 0.0001) and 1 month (p = 0.017). Patients treated with particulate steroids had significantly greater pain relief and were much more likely to report clinically relevant overall 'improvement' at 1 week and 1 month compared to the patients treated with non-particulate steroids. (orig.)

  1. Are needle-free injections a useful alternative for growth hormone therapy in children? Safety and pharmacokinetics of growth hormone delivered by a new needle-free injection device compared to a fine gauge needle.

    NARCIS (Netherlands)

    Dorr, H.G.; Zabransky, S.; Keller, E.; Otten, B.J.; Partsch, C.J.; Nyman, L.; Gillespie, B.K.; Lester, N.R.; Wilson, A.M.; Hyren, C.; Kuijck, M.A. van; Schuld, P.; Schoenfeld, S.L.

    2003-01-01

    The clinical safety, use and pharmacokinetics of a new needle-free device for delivery of growth hormone (GH) were compared with those of conventional needle injection devices. In an open-label, randomized, 4-period crossover study, 18 healthy adults received single subcutaneous injections of

  2. Evaluation of pain and inflammation associated with hot iron branding and microchip transponder injection in horses.

    Science.gov (United States)

    Lindegaard, Casper; Vaabengaard, Dorte; Christophersen, Mogens T; Ekstøm, Claus T; Fjeldborg, Julie

    2009-07-01

    To compare effects of hot iron branding and microchip transponder injection regarding aversive behavioral reactions indicative of pain and inflammation in horses. 7 adult horses. In a randomized controlled clinical crossover study, behavioral reactions to hot iron branding and microchip transponder injection were scored by 4 observers. Local and systemic inflammation including allodynia were assessed and compared by use of physiologic and biochemical responses obtained repeatedly for the 168-hour study period. Serum cortisol concentration was measured repeatedly throughout the first 24 hours of the study. Sham treatments were performed 1 day before and 7 days after treatments. Hot iron branding elicited a significantly stronger aversive reaction indicative of pain than did microchip transponder injection (odds ratio [OR], 12.83). Allodynia quantified by means of skin sensitivity to von Frey monofilaments was significantly greater after hot iron branding than after microchip transponder injection (OR, 2.59). Neither treatment induced signs of spontaneously occurring pain that were observed during the remaining study period, and neither treatment induced increased serum cortisol concentrations. Comparison with sham treatments indicated no memory of an unpleasant event. The hot iron branding areas had significantly increased skin temperature and swelling (OR, 14.6). Systemic inflammation as measured via serum amyloid A concentration was not detected after any of the treatments. Microchip transponder injection induced less signs of pain and inflammation and did not seem to pose a higher long-term risk than hot iron branding. Consequently, results indicated that hot iron branding does inflict more pain and should be abandoned where possible.

  3. Eosinophils contribute to the resolution of lung-allergic responses following repeated allergen challenge.

    Science.gov (United States)

    Takeda, Katsuyuki; Shiraishi, Yoshiki; Ashino, Shigeru; Han, Junyan; Jia, Yi; Wang, Meiqin; Lee, Nancy A; Lee, James J; Gelfand, Erwin W

    2015-02-01

    Eosinophils accumulate at the site of allergic inflammation and are critical effector cells in allergic diseases. Recent studies have also suggested a role for eosinophils in the resolution of inflammation. To determine the role of eosinophils in the resolution phase of the response to repeated allergen challenge. Eosinophil-deficient (PHIL) and wild-type (WT) littermates were sensitized and challenged to ovalbumin (OVA) 7 or 11 times. Airway inflammation, airway hyperresponsiveness (AHR) to inhaled methacholine, bronchoalveolar lavage (BAL) cytokine levels, and lung histology were monitored. Intracellular cytokine levels in BAL leukocytes were analyzed by flow cytometry. Groups of OVA-sensitized PHIL mice received bone marrow from WT or IL-10(-/-) donors 30 days before the OVA challenge. PHIL and WT mice developed similar levels of AHR and numbers of leukocytes and cytokine levels in BAL fluid after OVA sensitization and 7 airway challenges; no eosinophils were detected in the PHIL mice. Unlike WT mice, sensitized PHIL mice maintained AHR, lung inflammation, and increased levels of IL-4, IL-5, and IL-13 in BAL fluid after 11 challenges whereas IL-10 and TGF-β levels were decreased. Restoration of eosinophil numbers after injection of bone marrow from WT but not IL-10-deficient mice restored levels of IL-10 and TGF-β in BAL fluid as well as suppressed AHR and inflammation. Intracellular staining of BAL leukocytes revealed the capacity of eosinophils to produce IL-10. After repeated allergen challenge, eosinophils appeared not essential for the development of AHR and lung inflammation but contributed to the resolution of AHR and inflammation by producing IL-10. Copyright © 2014 American Academy of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  4. New pellet production and acceleration technologies for high speed pellet injection system 'HIPEL' in large helical device

    International Nuclear Information System (INIS)

    Viniar, I.; Sudo, S.

    1994-12-01

    New technologies of pellet production and acceleration for fueling and diagnostics purposes in large thermonuclear reactors are proposed. The technologies are intended to apply to the multiple-pellet injection system 'HIPEL' for Large Helical Device of NIFS in Japan. The pellet production technology has already been tested in a pipe-gun type pellet injector. It will realize the repeating pellet injection by means of decreasing of the pellet formation time into the pipe-gun barrel. The acceleration technology is based upon a new pump tube operation in two-stage gas gun and also upon a new conception of the allowable pressure acting on a pellet into a barrel. Some preliminary estimations have been made, and principles of a pump tube construction providing for a reliable long term operation in the repeating mode without any troubles from a piston are proposed. (author)

  5. Anesthetic duration of lidocaine with 10% dextran is comparable to lidocaine with 1:160 000 epinephrine after intraosseous injection in the rabbit.

    Science.gov (United States)

    Ito, Emiko; Ichinohe, Tatsuya; Shibukawa, Yoshiyuki; Aida, Hidetaka; Kaneko, Yuzuru

    2007-09-01

    To compare the effects of 10% dextran and epinephrine on intraosseous injection with lidocaine in rabbits. Twenty male Japanese white rabbits were used. The effect of intraosseous injection was evaluated using an electromyogram (EMG) of the digastric muscle after electrical pulp stimulation. Two percent lidocaine alone (L), 2% lidocaine containing 1:80000 epinephrine (LE8), 2% lidocaine containing 1:160 000 epinephrine (LE16), and 2% lidocaine containing 10% dextran (LD) were tested. Electromyogram recordings were repeated before and 30 seconds, 1, 2, 3, 4, 5, 7, 10, 12, 15, and 20 minutes after the intraosseous injection. Thereafter, recordings were repeated every 5 minutes until the EMG recovered to the control value. There was no difference in the onset time between the 4 groups. The order of the duration of maximum effect was LE8 >LE16 = LD >or=L. The order of the duration of anesthesia was LE8 >LE16 = LD >L. Ten percent dextran potentiates local anesthetic effects of 2% lidocaine in intraosseous injection. The potency of 10% dextran is comparable to 1:160 000 epinephrine.

  6. [Ice application for reducing pain associated with goserelin acetate injection].

    Science.gov (United States)

    Ishii, Kaname; Nagata, Chika; Koshizaki, Eiko; Nishiuchi, Satoko

    2013-10-01

    We investigated the effectiveness of using an ice pack for reducing the pain associated with goserelin acetate injection. In this study, 39 patients with prostate cancer and 1 patient with breast cancer receiving hormonal therapy with goserelin acetate were enrolled. All patients completed a questionnaire regarding the use of ice application. We used the numerical rating scale (NRS) to assess the pain associated with injection. The NRS scores indicated that the pain was significantly less with ice application than with the usual method (p application could decrease the duration of pain sensation. Ice application at the injection site is safe and effective for reducing pain.

  7. Rates of fuel discharge as affected by the design of fuel-injection systems for internal-combustion engines

    Science.gov (United States)

    Gelalles, A G; Marsh, E T

    1933-01-01

    Using the method of weighing fuel collected in a receiver during a definite interval of the injection period, rates of discharge were determined, and the effects noted, when various changes were made in a fuel-injection system. The injection system consisted primarily of a by-pass controlled fuel pump and an automatic injection valve. The variables of the system studied were the pump speed, pump-throttle setting, discharge-orifice diameter, injection-valve opening and closing pressures, and injection-tube length and diameter.

  8. Autologous platelet lysate local injections for the treatment of refractory lateral epicondylitis.

    Science.gov (United States)

    Tan, Xun-xiang; Ju, Hai-yang; Yan, Wei; Jiang, Hong-jiang; Su, Jin-ping; Dong, Hua-jun; Wang, Ling-shuang; Zou, De-bao

    2016-01-25

    The purpose of this study was to investigate the efficacy and safety of autologous platelet lysate (APL) local injections in reducing pain and improving function in patients with refractory lateral epicondylitis. A total of 56 patients with refractory lateral epicondylitis were enrolled in this study. All the patients received three injections in one course of treatment. Subjective assessments include visual analog scale (VAS) pain score and Mayo elbow score before injection (baseline) and at 1, 6, and 12 months after injection. Significant differences were observed in VAS and Mayo scores at baseline and at 1, 6, and 12 months after injection. Overall, the injections of APL improved local symptoms and all the patients recovered to normal elbow function with 12 months follow-up. Local injections of APL resulted in favorable clinical outcomes for the treatment of lateral epicondylitis. APL could be clinically effective in the treatment of lateral epicondylitis.

  9. An automatic system for acidity determination based on sequential injection titration and the monosegmented flow approach.

    Science.gov (United States)

    Kozak, Joanna; Wójtowicz, Marzena; Gawenda, Nadzieja; Kościelniak, Paweł

    2011-06-15

    An automatic sequential injection system, combining monosegmented flow analysis, sequential injection analysis and sequential injection titration is proposed for acidity determination. The system enables controllable sample dilution and generation of standards of required concentration in a monosegmented sequential injection manner, sequential injection titration of the prepared solutions, data collecting, and handling. It has been tested on spectrophotometric determination of acetic, citric and phosphoric acids with sodium hydroxide used as a titrant and phenolphthalein or thymolphthalein (in the case of phosphoric acid determination) as indicators. Accuracy better than |4.4|% (RE) and repeatability better than 2.9% (RSD) have been obtained. It has been applied to the determination of total acidity in vinegars and various soft drinks. The system provides low sample (less than 0.3 mL) consumption. On average, analysis of a sample takes several minutes. Copyright © 2011 Elsevier B.V. All rights reserved.

  10. Cardiac lymphoscintigraphy following closed-chest catheter injection of radiolabeled colloid into the myocardium of dogs: concise communication

    International Nuclear Information System (INIS)

    Osbakken, M.D.; Kopiwoda, S.Y.; Swan, A.; Castronovo, F.P.; Strauss, H.W.

    1982-01-01

    A catheter technique for injection of radiolabeled colloids into the myocardium was developed and tested in a series of 15 dogs. A multipurpose angiographic catheter was modified to permit an inner core of PE-50 polyethylene tubing, tipped with a 23-gage needle, to pass through the lumen for intra-myocardial injection of the femoral artery: for the right ventricle, the femoral vein. The catheter advanced under fluoroscopy until the desired surface for injection is reached. The inner core is then extended to lodge the needle in the endocardium. A mixture of Renogratin (to confirm the endocardial injection site) and radiolabeled colloid was injected in up to 6 hr. In three dogs the procedure was repeated 3 or 4 times. From two to five nodes were visible in all animals, irrespective of whether the right or left ventricular myocardium was injected. In two animals the injection was given intravenously, and no nodes were seen. These data suggest that cardiac lymphatic drainage can be studied with a catheter injection method

  11. Two Crosslinking Technologies for Superficial Reticular Dermis Injection: A Comparative Ultrasound and Histologic Study

    OpenAIRE

    Micheels, Patrick; Besse, Stéphanie; Sarazin, Didier

    2017-01-01

    Background: Few hyaluronic acid fillers have been developed for superficial injection. Objective: To compare the diffusion and integration properties of cohesive polydensified matrix and Vycross® technology hyaluronic acid fillers with lidocaine following injection into the superficial reticular dermis. Methods and materials: Two subjects received two injections each of cohesive polydensified matrix and Vycross® hyaluronic acid (0.2mL/site) in the superficial reticular dermis of the buttock u...

  12. Cardiac lymphoscintigraphy following closed-chest catheter injection of radiolabeled colloid into the myocardium of dogs: concise communication

    International Nuclear Information System (INIS)

    Osbakken, M.D.; Kopiwoda, S.Y.; Swan, A.; Castronovo, F.P.; Strauss, H.W.

    1982-01-01

    A catheter technique for injection of radiolabeled colloids into the myocardium was developed and tested in a series of 15 dogs. A multipurpose angiographic catheter was modified to permit an inner core of PE-50 polyethylene tubing, tipped with a 23-gage needle, to pass through the lumen for intra-myocardial injection of radiocolloids. For injection of the left ventricle, the catheter is introduced through the femoral artery: for the right ventricle, the femoral vein. The catheter advanced under fluoroscopy until the desired surface for injection is reached. The inner core is then extended to lodge the needle in the endocardium. A mixture of Renografin (to confirm the endocardial injection site) and radiolabeled colloid was injected in 13 animals. Ten minutes after injection, scintigraphy was begun and continued for up to 6 hr. In three dogs the procedure was repeated 3 or 4 times. From two to five nodes were visible in all animals, irrespective of whether the right or left ventricular myocardium was injected. In two animals the injection was given intravenously, and no nodes were seen. These data suggest that cardiac lymphatic drainage can be studied with a catheter injection method

  13. The relationship of social support concept and repeat mammography among Iranian women.

    Science.gov (United States)

    Farhadifar, Fariba; Taymoori, Parvaneh; Bahrami, Mitra; Zarea, Shamsy

    2015-10-24

    Breast cancer ranks as the first most common cancer among the Iranian women. The regular repeat of mammography with 1-2 year intervals leads to the increased efficiency of early detection of breast cancer. The present study examined the predictors of repeat mammography. It was hypothesized that higher social support is connected with mammography repeat. A cross-sectional study was carried out among 400 women 50 years and older in Sanandaj, Iran. Data was collected by the questionnaire including information on socio demographical variables and measuring social support level. Data was analyzed by SPSS16 software. Multiple logistic regression was used to determine the predictive power of demographic variables and dimensions of social support for repeat mammography. Women aged 50-55 years had three times odds of repeat mammography compared to women aged 56-60 years) OR, 3.02). Married women had greater odds of repeat mammography compared to single women (P women with higher social support was 0.93 times greater than the women with lower social support (OR, 0.93; 95 % CI, 0.91-0.95; P women are less likely repeat mammography than other Asian women. Identifying the associations between perceived social support and repeat mammography may offer detailed information to allow for future study and guide the development of interventions not only for Iranian women but also for similar cultural that received pay too little attention to date in the breast cancer literature.

  14. The concept of "compartment allergy": prilocaine injected into different skin layers

    Directory of Open Access Journals (Sweden)

    Wobser Marion

    2011-04-01

    Full Text Available Abstract We herein present a patient with delayed-type allergic hypersensitivity against prilocaine leading to spreading eczematous dermatitis after subcutaneous injections for local anesthesia with prilocaine. Prilocaine allergy was proven by positive skin testing and subcutaneous provocation, whereas the evaluation of other local anesthetics - among them lidocaine, articaine and mepivacaine - did not exhibit any evidence for cross-reactivity. Interestingly, our patient repeatedly tolerated strictly deep subcutaneous injection of prilocaine in provocation testing while patch and superficial subcutaneous application mounted strong allergic responses. We hypothesize, that lower DC density in deeper cutaneous compartments and/or different DC subsets exhibiting distinct functional immunomodulatory properties in the various layers of the skin may confer to the observed absence of clinical reactivity against prilocaine after deep subcutaneous injection. The term compartment allergy indicates that the route of allergen administration together with the targeted immunologic environment orchestrates on the immunologic outcome: overt T-cell mediated allergy or clinical tolerance.

  15. Treatment of pneumonia in pigs with long-acting injectable tylosin.

    Science.gov (United States)

    Couper, A; Cromie, L; Neeve, S; Pommier, P; Keïta, A; Pagot, E

    2006-12-09

    A blinded, randomised clinical trial was carried out in Brittany, France on three commercial pig farms with a history of pneumonia. Pigs with clinical signs of respiratory disease were randomly allocated to one of two treatment groups; 100 pigs received a single intramuscular injection of a long-acting formulation of tylosin at a dose rate of 20 mg tylosin/kg bodyweight, and 101 pigs received three consecutive daily intramuscular injections of 10 mg tylosin/kg bodyweight. The pigs' rectal temperatures and other clinical variables were recorded at intervals and a scoring system was used to evaluate the results of the treatments. Relapses were recorded for up to nine days after the treatment. There were no statistically significant differences between the two treatments in terms of clinical scores, rectal temperatures, or cure or relapse rates.

  16. Sustained Release of Antibiotics from Injectable and Thermally Responsive Polypeptide Depots

    OpenAIRE

    Adams, Samuel B.; Shamji, Mohammed F.; Nettles, Dana L.; Hwang, Priscilla; Setton, Lori A.

    2009-01-01

    Biodegradable polymeric scaffolds are of interest for delivering antibiotics to local sites of infection in orthopaedic applications, such as bone and diarthrodial joints. The objective of this study was to develop a biodegradable scaffold with ease of drug loading in aqueous solution, while providing for drug depot delivery via syringe injection. Elastin-like polypeptides (ELPs) were used for this application, biopolymers of repeating pentapeptide sequences that were thermally triggered to u...

  17. Hyaluronic Acid Injections for Treatment of Advanced Osteoarthritis of the Knee: Utilization and Cost in a National Population Sample.

    Science.gov (United States)

    Weick, Jack W; Bawa, Harpreet S; Dirschl, Douglas R

    2016-09-07

    The prevalence of knee osteoarthritis is increasing in the aging U.S. The efficacy and cost-effectiveness of the use of hyaluronic acid (HA) injections for the treatment of knee osteoarthritis are debated. In this study, we assessed the utilization and costs of HA injections in the 12 months preceding total knee arthroplasty (TKA) and evaluated the usage of HA injections in end-stage knee osteoarthritis management in relation to other treatments. MarketScan Commercial Claims and Encounters and Medicare Supplemental and Coordination of Benefits databases (Truven Health Analytics) were reviewed to identify patients who underwent TKA from 2005 to 2012. The utilization of patient-specific osteoarthritis-related health care (including medications, corticosteroid injections, HA injections, imaging, and office visits) and payment information were analyzed for the 12 months preceding TKA. A total of 244,059 patients met the inclusion criteria. Of those, 35,935 (14.7%) had ≥1 HA injection in the 12 months preceding TKA. HA injections were responsible for 16.4% of all knee osteoarthritis-related payments, trailing only imaging studies (18.2%), and HA injections accounted for 25.2% of treatment-specific payments, a rate that was higher than that of any other treatment. Patients receiving HA injections were significantly more likely to receive additional knee osteoarthritis-related treatments compared with patients who did not receive HA injections. Despite numerous studies questioning the efficacy and cost-effectiveness of HA injections for osteoarthritis of the knee, HA injections are still utilized for a substantial percentage of patients. Given the paucity of data supporting the effectiveness of HA injections and the current cost-conscious health-care climate, decreasing their use among patients with end-stage knee osteoarthritis may represent a substantial cost reduction that likely does not adversely impact the quality of care. Copyright © 2016 by The Journal of Bone

  18. Interarytenoid muscle botox injection for treatment of adductor spasmodic dysphonia with vocal tremor.

    Science.gov (United States)

    Kendall, Katherine A; Leonard, Rebecca J

    2011-01-01

    Up to one-third of patients presenting with adductor spasmodic dysphonia will have an associated vocal tremor. These patients may not respond fully to treatment using thyroarytenoid (TA) muscle botulinum toxin (Botox) injection. Treatment failures are attributed to the involvement of multiple muscle groups in the tremor. This study evaluates the results of combined interarytenoid (IA) and TA muscle Botox injection in a group of 27 patients with adductor spasmodic dysphonia and vocal tremor and in four patients with severe vocal tremor alone. Patient-satisfaction data were reviewed retrospectively. Pre- and postinjection acoustic data were collected prospectively. Acoustic measures of fundamental frequency and cycle-by-cycle variability in frequency (jitter) and intensity (shimmer) were obtained from 15 patients' sustained vowel productions. Measures were collected after TA muscle injection, alone, and after combined TA and IA (TA+IA) muscle injections. In addition, two experienced voice clinicians blindly assessed tremor severity from recordings made for each patient in the two conditions. Patients were also queried regarding their satisfaction with the results of the injections and whether they desired to continue receiving TA+IA treatment. Significant improvement in all acoustic measures except for % jitter was observed after the TA+IA muscle injections. Listeners identified voice samples after TA+IA muscle injections as demonstrating less tremor in 73% of the paired comparisons. Sixty-seven percent of the patients with spasmodic dysphonia and vocal tremor wished to continue to receive IA muscle injections. Only one patient with severe vocal tremor wished to continue with injections. The addition of an IA muscle Botox injection to the treatment of patients with a combination adductor spasmodic dysphonia and vocal tremor may improve voice outcomes. Copyright © 2011 The Voice Foundation. Published by Mosby, Inc. All rights reserved.

  19. Comparative study of attenuation of the pain caused by propofol intravenous injection, by granisetron, magnesium sulfate and nitroglycerine

    Directory of Open Access Journals (Sweden)

    Dhananjay Kumar Singh

    2011-01-01

    Full Text Available Background: Propofol has the disadvantage of causing pain or discomfort on injection. The aim of the study was to assess the efficacy of pretreatment with various drugs to alleviate the propofol injection pain. Methods: One hundred American Society of Anesthesiology (ASA I and II adults, scheduled for various elective surgical procedures under general anesthesia (GA, were included in the study. They were randomly divided into four groups having 25 patients in each group. Group A received pretreatment with intravenous (i.v. magnesium sulfate, group B received i.v. granisetron, group C received i.v. nitroglycerine and group D was the control group. One-fourth of the total calculated induction dose of propofol was administered over a period of 5 seconds. The patients were asked about the pain on injection. The intensity of pain was assessed using verbal response. A score of 0-3 which corresponds to no, mild, moderate and severe pain was recorded. Results: All the three drugs reduced the incidence and intensity of pain on propofol injection but the order of efficacy in attenuation of pain on the propofol injection was granisetron > nitroglycerine > magnesium sulfate > control. Conclusion: Granisetron was the most effective followed by nitroglycerine and magnesium sulfate in attenuating pain on propofol intravenous injection.

  20. Alopecia with foreign body granulomas induced by Radiesse injection: A case report.

    Science.gov (United States)

    Liu, Ren-Feng; Kuo, Tseng-Tong; Chao, Yen-Yu; Huang, Yu-Huei

    2018-02-26

    Radiesse is a soft tissue filler which has been widely used for cosmetic enhancement. The safety of Radiesse has been thoroughly investigated via numerous studies. A late-onset complication of Radiesse injection consists of foreign body granulomas, with only three case reports in over 10 years of clinical use. Herein, we describe the case of a patient who experienced alopecia with foreign body granulomas at the injection region one month after receiving a Radiesse injection. To our knowledge, this is the first report in the English literature of alopecia as an adverse event associated with Radiesse injection. The present case reminded physicians to evaluate more cautiously the necessity of injecting filler into hair-bearing area for lifting purpose. This procedure may cause foreign body granulomatous reaction, which may result in hair loss at the injection region.

  1. Two cases of Robertsonian translocations in oligozoospermic males and their consequences for pregnancies induced by intracytoplasmic sperm injection

    NARCIS (Netherlands)

    P.A. In't Veld (Peter); R.F.A. Weber (Rob); F.J. Los; N.S. den Hollander (Nicolette); M. Dhont; M.H.E.C. Pieters (Math H. E.); J.O.V. Hemel (Jan O. Van)

    1997-01-01

    textabstractTwo case histories are presented documenting structural chromosome abnormalities in infertile males. The abnormalities were detected only after application of intracytoplasmic sperm injection (ICSI) was repeatedly unsuccessful or resulted in an abnormal pregnancy. A mosaic Robertsonian

  2. Intravitreal injection with ranibizumab combined with triamcinolone acetonide sub-Tenon injection for macular edema due to CRVO

    Directory of Open Access Journals (Sweden)

    Ting-Ting Li

    2015-01-01

    Full Text Available AIM: To evaluate the efficacy of intravitreal injection with Ranibizumab combined with sub-Tenon injection with Triamcinolone acetonide(TAfor macular edema(MEdue to central retinal venous occlusions(CRVO.METHODS:Forty-six patients(46 eyeswere diagnosed ischemic CRVO with significant macular edema by fundus fluorescence-angiography(FFAand optical coherence tomography(OCT. All the patients had panretinal photocoagulation(PRP, a week after the four times therapies. Twenty-three patients(23 eyesin group A were randomly chosen to receive intravitreal injection with ranibizumab(IVR, another 23 patients(23 eyesin group B to treat with both IVR and sub-Tenon injection with TA(PSTT. There was no significant difference on macular edema and best corrected visual activity(BCVAbetween the two groups. The changes in BCVA and central macular thickness(CMTbefore and 1wk; 1, 3, 6mo after treatments were analyzed.RESULTS: One week after the treatment: the BCVA increased while the CMT decreased compared with that of pretreatment in groups A and B(PPPPPP>0.05.CONCLUSION: Not only IVR can decrease ME caused by CRVO and increase the BCVA, but also IVR combined with PSTT can. But combined therapies can be more rapidly and have more positive effect on decreasing the ME and protecting the visual function.

  3. Debiasing egocentrism and optimism biases in repeated competitions

    Directory of Open Access Journals (Sweden)

    Jason P. Rose

    2012-11-01

    Full Text Available When judging their likelihood of success in competitive tasks, people tend to be overoptimistic for easy tasks and overpessimistic for hard tasks (the shared circumstance effect; SCE. Previous research has shown that feedback and experience from repeated-play competitions has a limited impact on SCEs. However, in this paper, we suggest that competitive situations, in which the shared difficulty or easiness of the task is more transparent, will be more amenable to debiasing via repeated play. Pairs of participants competed in, made predictions about, and received feedback on, multiple rounds of a throwing task involving both easy- and hard-to-aim objects. Participants initially showed robust SCEs, but they also showed a significant reduction in bias after only one round of feedback. These and other results support a more positive view (than suggested from past research on the potential for SCEs to be debiased through outcome feedback.

  4. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Results: Safe injection procedures regarding final waste disposal were sufficiently adopted, while measures regarding disposable injection equipment, waste containers, hand hygiene, as well as injection practices were inadequately carried out. Lack of job aid posters that promote safe injection and safe disposal of ...

  5. The choroid plexus response to a repeated peripheral inflammatory stimulus

    Directory of Open Access Journals (Sweden)

    Palha Joana A

    2009-11-01

    Full Text Available Abstract Background Chronic systemic inflammation triggers alterations in the central nervous system that may relate to the underlying inflammatory component reported in neurodegenerative disorders such as multiple sclerosis and Alzheimer's disease. However, it is far from being understood whether and how peripheral inflammation contributes to induce brain inflammatory response in such illnesses. As part of the barriers that separate the blood from the brain, the choroid plexus conveys inflammatory immune signals into the brain, largely through alterations in the composition of the cerebrospinal fluid. Results In the present study we investigated the mouse choroid plexus gene expression profile, using microarray analyses, in response to a repeated inflammatory stimulus induced by the intraperitoneal administration of lipopolysaccharide every two weeks for a period of three months; mice were sacrificed 3 and 15 days after the last lipopolysaccharide injection. The data show that the choroid plexus displays a sustained response to the repeated inflammatory stimuli by altering the expression profile of several genes. From a total of 24,000 probes, 369 are up-regulated and 167 are down-regulated 3 days after the last lipopolysaccharide injection, while at 15 days the number decreases to 98 and 128, respectively. The pathways displaying the most significant changes include those facilitating entry of cells into the cerebrospinal fluid, and those participating in the innate immune response to infection. Conclusion These observations contribute to a better understanding of the brain response to peripheral inflammation and pave the way to study their impact on the progression of several disorders of the central nervous system in which inflammation is known to be implicated.

  6. Stress-induced osteolysis of distal clavicle: imaging patterns and treatment using CT-guided injection

    Energy Technology Data Exchange (ETDEWEB)

    Sopov, V.; Groshar, D. [Dept. of Nuclear Medicine, Technion-Israel Inst. of Technology, Haifa (Israel); Fuchs, D. [Dept. of Orthopaedics, Technion-Israel Inst. of Technology, Haifa (Israel); Bar-Meir, E. [Dept. of Radiology, Technion-Israel Inst. of Technology, Haifa (Israel)

    2001-02-01

    Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has clinical and radiological findings similar to post-traumatic ODC. We describe a case of successful treatment of stress-induced ODC with CT-guided injection of corticosteroid and anesthetic drug into the acromioclavicular joint. (orig.)

  7. Stress-induced osteolysis of distal clavicle: imaging patterns and treatment using CT-guided injection

    International Nuclear Information System (INIS)

    Sopov, V.; Groshar, D.; Fuchs, D.; Bar-Meir, E.

    2001-01-01

    Osteolysis of distal clavicle (ODC) may occur in patients who experience repeated stress or microtrauma to the shoulder. This entity has clinical and radiological findings similar to post-traumatic ODC. We describe a case of successful treatment of stress-induced ODC with CT-guided injection of corticosteroid and anesthetic drug into the acromioclavicular joint. (orig.)

  8. Repeated cue exposure effects on subjective and physiological indices of chocolate craving

    NARCIS (Netherlands)

    van Gucht, D.; Vansteenwegen, D.; Beckers, T.; Hermans, D.; Baeyens, F.; Van den Bergh, O.

    2008-01-01

    The aim of this study is to investigate the effects of repeated unreinforced exposure to chocolate cues in persons reporting chocolate craving. Participants in the experimental group (n ¼ 40) received 10 consecutive brief exposures to chocolate cues in each of two sessions, separated by 1-3 days.

  9. The effects of repeated parenteral administration of chelating agents on the distribution and excretion of uranium

    International Nuclear Information System (INIS)

    Domingo, J.L.; Ortega, A.; Llobet, J.M.; Paternain, J.L.; Corbella, J.

    1989-01-01

    The effects of repeated ip administration of gallic acid, 4,5-dihydroxy-1,3-benzenedisulfonic acid (Tiron), diethylenetriaminepentaacetic acid (DTPA), and 5-aminosalicylic acid (5-AS) on the distribution and excretion of uranium were assessed in male Swiss mice. Only Tiron significantly increased the amount of uranium excreted into urine and feces. A significant decrease in the concentration of uranium in liver, spleen and bone was observed after administration of Tiron, whereas injection of gallic acid or DTPA resulted in a significant decrease in the concentration of the metal in the liver. The results show that Tiron was consistently the most effective chelator of those tested in the treatment of uranium poisoning after repeated daily administration of the metal

  10. Thyroid nodules with nondiagnostic results on repeat fine-needle aspiration biopsy: which nodules should be considered for repeat biopsy or surgery rather than follow-up?

    Energy Technology Data Exchange (ETDEWEB)

    Eun, Na Lae; Chang, Hang Seok; Gweon, Hye Mi; Kim, Jeong Ah; Youk, Ji Hyun; Son, Eun Jun [Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of); Yoo, Mi Ri [Dept. of Radiology, Dongjak Kyunghee Hospital, Seoul (Korea, Republic of); Park, Ah Young [Dept. of Radiology, Korea University Ansan Hospital, Korea University College of Medicine, Ansan (Korea, Republic of); Moon, Hee Jung [Dept. of Radiology and Research Institute of Radiological Science, Severance Hospital, Yonsei University College of Medicine, Seoul (Korea, Republic of)

    2016-07-15

    The goal of this study was to assess the clinicopathologic and ultrasonographic features of thyroid nodules with nondiagnostic results on repeat ultrasonography (US)-guided fineneedle aspiration biopsy (FNAB) according to size and the number of suspicious findings and to determine the proper management of nodules with consecutive nondiagnostic results. This retrospective study included 297 nodules with nondiagnostic results on repeat FNAB that were evaluated by US over the course of at least 12 months of follow-up, a follow-up biopsy, or an operation. We compared clinical and US variables between benign and malignant nodules in thyroid nodules with repeat nondiagnostic results. The comparison of benign and malignant nodules with repeat nondiagnostic results revealed that age, marked hypoechogenicity, irregular or microlobulated margins, microcalcifications, and nonparallel shape were significantly associated with malignancy. Multivariate logistic regression analysis in malignant nodules revealed that microcalcifications and irregular or microlobulated margins were independently associated with malignancy. Among them, only irregular or microlobulated margins were independently significant as a predictor of malignancy in repeatedly nondiagnostic nodules measuring >10 mm. Using receiver operating characteristic analysis, the best cutoff value for the “number of suspicious findings” between benign and malignant nodules was three in nodules of all sizes, three in nodules measuring ≤10 mm, and two in nodules measuring >10 mm. Irregular or microlobulated margins may be the most frequent US features in repeatedly nondiagnostic nodules >10 mm. The presence of “two or more suspicious findings” can be used as the cutoff for distinguishing benign and malignant nodules.

  11. Drug use and AIDS: estimating injection prevalence in a rural state.

    Science.gov (United States)

    Leukefeld, Carl G; Logan, T K; Farabee, David; Clayton, Richard

    2002-01-01

    This paper presents approaches used in one rural U.S. state to describe the level of injecting drug use and to estimate the number of injectors not receiving drug-user treatment. The focus is on two broad areas of estimation that were used to present the prevalence of injecting drug use in Kentucky. The first estimation approach uses available data from secondary data sources. The second approach involves three small community studies.

  12. Granisetron Extended-Release Injection: A Review in Chemotherapy-Induced Nausea and Vomiting.

    Science.gov (United States)

    Deeks, Emma D

    2016-12-01

    An extended-release (ER) subcutaneously injectable formulation of the first-generation 5-HT 3 receptor antagonist granisetron is now available in the USA (Sustol ® ), where it is indicated for the prevention of acute and delayed chemotherapy-induced nausea and vomiting (CINV) following moderately emetogenic chemotherapy (MEC) or anthracycline and cyclophosphamide combination chemotherapy regimens in adults. Granisetron ER is administered as a single subcutaneous injection and uses an erosion-controlled drug-delivery system to allow prolonged granisetron release. Primary endpoint data from phase III studies after an initial cycle of chemotherapy indicate that, when used as part of an antiemetic regimen, granisetron ER injection is more effective than intravenous ondansetron in preventing delayed CINV following highly emetogenic chemotherapy (HEC); is noninferior to intravenous palonosetron in preventing both acute CINV following MEC or HEC and delayed CINV following MEC; and is similar, but not superior, to palonosetron in preventing delayed CINV following HEC. The benefits of granisetron ER were seen in various patient subgroups, including those receiving anthracycline plus cyclophosphamide-based HEC, and (in an extension of one of the studies) over multiple MEC or HEC cycles. Granisetron ER injection is generally well tolerated, with an adverse event profile similar to that of ondansetron or palonosetron. Thus, granisetron ER injection expands the options for preventing both acute and delayed CINV in adults with cancer receiving MEC or anthracycline plus cyclophosphamide-based HEC.

  13. MR cartilage imaging in assessment of the regenerative power of autologous peripheral blood stem cell injection in knee osteoarthritis

    Directory of Open Access Journals (Sweden)

    Khaled A. Ahmad

    2014-09-01

    Conclusion: Limited good level of evidence showed that repeated intra-articular injections of autologous PBSC resulted in an improvement of the quality of articular cartilage repair and physical function as observed by MRI and clinical assessment.

  14. Increased haematopoietic stem cell survival in mice injected with tocopherol after X-irradiation

    International Nuclear Information System (INIS)

    Roy, R.M.; Malick, M.A.; Clark, G.M.

    1982-01-01

    Tocopherol injection (2.5 mg) immediately after irradiation reduced lethality only during bone-marrow syndrome. Endogenous spleen colony count at 8 days after X-radiation were significantly greater in vitamin-E-injected mice compared to noninjected or vehicle-injected animals; however, 59 Fe incorporation into spleen and bone marrow did not suggest enhanced erythropoietic activity in vitamin-E-injected groups at 2, 4, 8 and 10 days following irradiation. Mitotic index and frequency of micronuclei in marrow at 24 hours post irradiation (3 GY) were unaffected by tocopherol injection. The uptake of tritium from injected 3 H-tocopherol suggests that tocopherol has been accumulated in spleens but not marrows of irradiated animals within a few hours. Also tocopherol has no effect on endogenous spleen colony counts if injected after 5 hours nor is there an effect on the seeding efficiency of exogenous bonemarrow cells injected into recipients receiving tocopherol after irradiation. (orig.) [de

  15. The incidence of anticipatory nausea and vomiting after repeat cycle chemotherapy: the effect of granisetron.

    Science.gov (United States)

    Aapro, M. S.; Kirchner, V.; Terrey, J. P.

    1994-01-01

    Anticipatory nausea and vomiting (ANV) after repeated cycles of cytotoxic chemotherapy is thought to be a conditioned response to a conditioning stimulus. Good control of acute and delayed emesis may result in a lower incidence of ANV. We have analysed data from 574 chemotherapy patients who received granisetron as their antiemetic treatment during repeat cycle chemotherapy. Per treatment cycle, less than 10% of patients displayed symptoms of anticipatory nausea and 2% or less had symptoms of anticipatory vomiting. It is concluded that the use of granisetron as an antiemetic during the acute phase of chemotherapy may result in a lower incidence of ANV in patients undergoing repeat cycle chemotherapy. PMID:8180031

  16. The Effect of Impactful Articles on Clinical Practice in the United States: Corticosteroid Injection for Patients with Lateral Epicondylitis.

    Science.gov (United States)

    Fujihara, Yuki; Huetteman, Helen E; Chung, Ting-Ting; Shauver, Melissa J; Chung, Kevin C

    2018-05-01

    Following publication of high-level evidence demonstrating that it is not an effective treatment for lateral epicondylitis, a reduction in the corticosteroid injection rate would be expected. The authors aimed to clarify current clinical practice pattern for lateral epicondylitis and identify factors that influence the introduction of evidence into clinical practice. In this administrative claims analysis, the authors used 2009 to 2015 Truven MarketScan data to extract claims for corticosteroid injection, physical therapy, platelet-rich plasma injection, and surgery for lateral epicondylitis. The authors performed multivariable analysis using a generalized estimating equation model to identify the variables that potentially affect the odds of receiving a given treatment. Among 711,726 claims, the authors found that the odds of receiving a corticosteroid injection increased slightly after publication of contradictory evidence (OR, 1.7; 95 percent CI, 1.04 to 1.11 in 2015). Being male (OR, 1.21; 95 percent CI, 1.19 to 1.23), older (OR, 1.16; 95 percent CI, 1.13 to 1.19), and having managed care insurance (OR, 1.15; 95 percent CI, 1.13 to 1.18) significantly contributed to increased odds of receiving corticosteroid injections. Patients seen at facilities in the South (OR, 1.33; 95 percent CI, 1.30 to 1.36 compared with the Northeast) and by plastic/orthopedic surgeons (OR, 2.48; 95 percent CI, 2.43 to 2.52) also had increased odds of receiving corticosteroid injection. Corticosteroid injection use did not decrease after publication of impactful articles, regardless of provider specialty or other patient-related factors. This finding emphasizes that there are various barriers for even high-level evidence to overcome the inertia of current practice.

  17. Study Protocol- Lumbar Epidural Steroid Injections for Spinal Stenosis (LESS: a double-blind randomized controlled trial of epidural steroid injections for lumbar spinal stenosis among older adults

    Directory of Open Access Journals (Sweden)

    Friedly Janna L

    2012-03-01

    Full Text Available Abstract Background Lumbar spinal stenosis is one of the most common causes of low back pain among older adults and can cause significant disability. Despite its prevalence, treatment of spinal stenosis symptoms remains controversial. Epidural steroid injections are used with increasing frequency as a less invasive, potentially safer, and more cost-effective treatment than surgery. However, there is a lack of data to judge the effectiveness and safety of epidural steroid injections for spinal stenosis. We describe our prospective, double-blind, randomized controlled trial that tests the hypothesis that epidural injections with steroids plus local anesthetic are more effective than epidural injections of local anesthetic alone in improving pain and function among older adults with lumbar spinal stenosis. Methods We will recruit up to 400 patients with lumbar central canal spinal stenosis from at least 9 clinical sites over 2 years. Patients with spinal instability who require surgical fusion, a history of prior lumbar surgery, or prior epidural steroid injection within the past 6 months are excluded. Participants are randomly assigned to receive either ESI with local anesthetic or the control intervention (epidural injections with local anesthetic alone. Subjects receive up to 2 injections prior to the primary endpoint at 6 weeks, at which time they may choose to crossover to the other intervention. Participants complete validated, standardized measures of pain, functional disability, and health-related quality of life at baseline and at 3 weeks, 6 weeks, and 3, 6, and 12 months after randomization. The primary outcomes are Roland-Morris Disability Questionnaire and a numerical rating scale measure of pain intensity at 6 weeks. In order to better understand their safety, we also measure cortisol, HbA1c, fasting blood glucose, weight, and blood pressure at baseline, and at 3 and 6 weeks post-injection. We also obtain data on resource utilization

  18. Comparative study of the novel and conventional injection approach for inferior alveolar nerve block.

    Science.gov (United States)

    Boonsiriseth, K; Sirintawat, N; Arunakul, K; Wongsirichat, N

    2013-07-01

    This study aimed to evaluate the efficacy of anesthesia obtained with a novel injection approach for inferior alveolar nerve block compared with the conventional injection approach. 40 patients in good health, randomly received each of two injection approaches of local anesthetic on each side of the mandible at two separate appointments. A sharp probe and an electric pulp tester were used to test anesthesia before injection, after injection when the patients' sensation changed, and 5 min after injection. This study comprised positive aspiration and intravascular injection 5% and neurovascular bundle injection 7.5% in the conventional inferior alveolar nerve block, but without occurrence in the novel injection approach. A visual analog scale (VAS) pain assessment was used during injection and surgery. The significance level used in the statistical analysis was pinferior alveolar nerve block by the novel injection approach provided adequate anesthesia and caused less pain and greater safety during injection. Copyright © 2012 International Association of Oral and Maxillofacial Surgeons. Published by Elsevier Ltd. All rights reserved.

  19. Clinical therapeutic effects of intravitreal Ranibizumab injection combined laser photocoagulation for macular edema in BRVO

    Directory of Open Access Journals (Sweden)

    Bin Liu

    2014-11-01

    Full Text Available AIM: To evaluate the clinical therapeutic efficacy of intravitreal ranibizumab injection combined grid laser photocoagulation for macular edema secondary to branch retinal vein occlusion(BRVO. METHODS: Forty-two confirmed cases(42 eyeswith macular edema secondary to BRVO were randomized into 3 groups, each group contained 14 eyes. The ranibizumab group was received intravitreal injection of ranibizumab(0.05mL, the laser group was received grid laser photocoagulation, and the combined group was received a second therapy of grid laser photocoagulation after 1wk of the intravitreal injection of ranibizumab. Recorded the best-corrected visual acuity(BCVAand the central macular thickness(CMTpreoperative and at 1, 3, 6mo after therapy. RESULTS: The BCVA and the CMT had no differences among three groups pretherapy(P>0.05. While BCVA was much better and CMT was reduced significantly posttherapy than pretherapy in all three groups(PPP>0.05. While the BCVA was better and the CMT was thinner in the combined group than ranibizumab group and laser group at every time point(PPCONCLUSION: The intravitreal ranibizumab injection combined grid laser photocoagulation is an effective treatment method for the macular edema secondary to BRVO, it is more effective in improving BCVA than intravitreal ranibizumab or grid laser photocoagulation alone.

  20. The absorption and uptake of recombinant human follicle-stimulating hormone through vaginal subcutaneous injections - a pharmacokinetic study

    Science.gov (United States)

    Hsu, Chao-Chin; Kuo, Hsin-Chih; Hsu, Chao-Tien; Gu, Qing

    2009-01-01

    Background Follicle stimulating hormone (FSH) has been routinely used for ovulation induction. Because of rapid clearance of the hormone, FSH is commonly administered by daily intramuscular or subcutaneous injections in in-vitro fertilization (IVF). To reduce the number of visits to the clinic, an intermittent vaginal injection of rhFSH every 3 days employing the concepts of mesotherapy and uterine first-pass effect was invented and has successfully been applied in women receiving IVF treatment. This study was designed to monitor the pharmacokinetic pattern of rhFSH administered vaginally. Methods Twelve healthy women with regular ovulatory cycles were recruited. All volunteers received gonadotrophin-releasing hormone agonist to suppress pituitary function and were assigned to receive single dose recombinant human FSH (rhFSH, Puregon 300) either using conventional abdominal subcutaneous injection or vaginal subcutaneous injection in a randomized cross-over study. Serum samples were collected at pre- scheduled time intervals after injections of rhFSH to determine immunoreactive FSH levels. Pharmacokinetic parameters characterizing rate [maximal plasma concentrations (Cmax) and time of maximal plasma concentrations (tmax)] and extent [area under the plasma concentration-time curve (AUC) and clearance] of absorption of rhFSH were compared. Results Vaginal injection of rhFSH was well tolerated and no drug-related adverse reaction was noted. Our analysis revealed that tmax was significantly earlier (mean 6.67 versus 13.33 hours) and Cmax was significantly higher (mean 17.77 versus 13.96 IU/L) in vaginal versus abdominal injections. The AUC0-∞ was 1640 versus 1134 IU·hour/L in vaginal and abdominal injections, respectively. Smaller plasma elimination rate constant (0.011 versus 0.016 hour-1), longer mean residence time (106.58 versus 70.47 hours), and slower total body clearance (292.2 versus 400.1 mL/hour) were also found in vaginal injection. Conclusion The vaginal

  1. The absorption and uptake of recombinant human follicle-stimulating hormone through vaginal subcutaneous injections - a pharmacokinetic study

    Directory of Open Access Journals (Sweden)

    Kuo Hsin-Chih

    2009-10-01

    Full Text Available Abstract Background Follicle stimulating hormone (FSH has been routinely used for ovulation induction. Because of rapid clearance of the hormone, FSH is commonly administered by daily intramuscular or subcutaneous injections in in-vitro fertilization (IVF. To reduce the number of visits to the clinic, an intermittent vaginal injection of rhFSH every 3 days employing the concepts of mesotherapy and uterine first-pass effect was invented and has successfully been applied in women receiving IVF treatment. This study was designed to monitor the pharmacokinetic pattern of rhFSH administered vaginally. Methods Twelve healthy women with regular ovulatory cycles were recruited. All volunteers received gonadotrophin-releasing hormone agonist to suppress pituitary function and were assigned to receive single dose recombinant human FSH (rhFSH, Puregon 300 either using conventional abdominal subcutaneous injection or vaginal subcutaneous injection in a randomized cross-over study. Serum samples were collected at pre- scheduled time intervals after injections of rhFSH to determine immunoreactive FSH levels. Pharmacokinetic parameters characterizing rate [maximal plasma concentrations (Cmax and time of maximal plasma concentrations (tmax] and extent [area under the plasma concentration-time curve (AUC and clearance] of absorption of rhFSH were compared. Results Vaginal injection of rhFSH was well tolerated and no drug-related adverse reaction was noted. Our analysis revealed that tmax was significantly earlier (mean 6.67 versus 13.33 hours and Cmax was significantly higher (mean 17.77 versus 13.96 IU/L in vaginal versus abdominal injections. The AUC0-∞ was 1640 versus 1134 IU·hour/L in vaginal and abdominal injections, respectively. Smaller plasma elimination rate constant (0.011 versus 0.016 hour-1, longer mean residence time (106.58 versus 70.47 hours, and slower total body clearance (292.2 versus 400.1 mL/hour were also found in vaginal injection

  2. Repeating and non-repeating fast radio bursts from binary neutron star mergers

    Science.gov (United States)

    Yamasaki, Shotaro; Totani, Tomonori; Kiuchi, Kenta

    2018-04-01

    Most fast radio bursts (FRB) do not show evidence of repetition, and such non-repeating FRBs may be produced at the time of a merger of binary neutron stars (BNS), provided that the BNS merger rate is close to the high end of the currently possible range. However, the merger environment is polluted by dynamical ejecta, which may prohibit the radio signal from propagating. We examine this by using a general-relativistic simulation of a BNS merger, and show that the ejecta appears about 1 ms after the rotation speed of the merged star becomes the maximum. Therefore there is a time window in which an FRB signal can reach outside, and the short duration of non-repeating FRBs can be explained by screening after ejecta formation. A fraction of BNS mergers may leave a rapidly rotating and stable neutron star, and such objects may be the origin of repeating FRBs like FRB 121102. We show that a merger remnant would appear as a repeating FRB on a time scale of ˜1-10 yr, and expected properties are consistent with the observations of FRB 121102. We construct an FRB rate evolution model that includes these two populations of repeating and non-repeating FRBs from BNS mergers, and show that the detection rate of repeating FRBs relative to non-repeating ones rapidly increases with improving search sensitivity. This may explain why only the repeating FRB 121102 was discovered by the most sensitive FRB search with Arecibo. Several predictions are made, including the appearance of a repeating FRB 1-10 yr after a BNS merger that is localized by gravitational waves and subsequent electromagnetic radiation.

  3. Multiple intravenous injections of allogeneic equine mesenchymal stem cells do not induce a systemic inflammatory response but do alter lymphocyte subsets in healthy horses.

    Science.gov (United States)

    Kol, Amir; Wood, Joshua A; Carrade Holt, Danielle D; Gillette, Jessica A; Bohannon-Worsley, Laurie K; Puchalski, Sarah M; Walker, Naomi J; Clark, Kaitlin C; Watson, Johanna L; Borjesson, Dori L

    2015-04-15

    Intravenous (IV) injection of mesenchymal stem cells (MSCs) is used to treat systemic human diseases and disorders but is not routinely used in equine therapy. In horses, MSCs are isolated primarily from adipose tissue (AT) or bone marrow (BM) and used for treatment of orthopedic injuries through one or more local injections. The objective of this study was to determine the safety and lymphocyte response to multiple allogeneic IV injections of either AT-derived MSCs (AT-MSCs) or BM-derived MSCs (BM-MSCs) to healthy horses. We injected three doses of 25 × 10(6) allogeneic MSCs from either AT or BM (a total of 75 × 10(6) MSCs per horse) into five and five, respectively, healthy horses. Horses were followed up for 35 days after the first MSC infusion. We evaluated host inflammatory and immune response, including total leukocyte numbers, serum cytokine concentration, and splenic lymphocyte subsets. Repeated injection of allogeneic AT-MSCs or BM-MSCs did not elicit any clinical adverse effects. Repeated BM-MSC injection resulted in increased blood CD8(+) T-cell numbers. Multiple BM-MSC injections also increased splenic regulatory T cell numbers compared with AT-MSC-injected horses but not controls. These data demonstrate that multiple IV injections of allogeneic MSCs are well tolerated by healthy horses. No clinical signs or clinico-pathologic measurements of organ toxicity or systemic inflammatory response were recorded. Increased numbers of circulating CD8(+) T cells after multiple IV injections of allogeneic BM-MSCs may indicate a mild allo-antigen-directed cytotoxic response. Safety and efficacy of allogeneic MSC IV infusions in sick horses remain to be determined.

  4. Skin Necrosis with Oculomotor Nerve Palsy Due to a Hyaluronic Acid Filler Injection

    Directory of Open Access Journals (Sweden)

    Jae Il Lee

    2017-07-01

    Full Text Available Performing rhinoplasty using filler injections, which improve facial wrinkles or soft tissues, is relatively inexpensive. However, intravascular filler injections can cause severe complications, such as skin necrosis and visual loss. We describe a case of blepharoptosis and skin necrosis caused by augmentation rhinoplasty and we discuss the patient’s clinical progress. We describe the case of a 25-year-old female patient who experienced severe pain, blepharoptosis, and decreased visual acuity immediately after receiving a filler injection. Our case suggests that surgeons should be aware of nasal vascularity before performing an operation, and that they should avoid injecting fillers at a high pressure and/or in excessive amounts. Additionally, filler injections should be stopped if the patient complains of severe pain, and appropriate measures should be taken to prevent complications caused by intravascular filler injections.

  5. A Cadaveric Study on Sacroiliac Joint Injection

    Science.gov (United States)

    Zou, Yu-Cong; Li, Yi-Kai; Yu, Cheng-Fu; Yang, Xian-Wen; Chen, Run-Qi

    2015-01-01

    The scope of this study was to explore the possibility as well as the feasibility of sacroiliac joint injection following simple X-ray clip location. For the cadaveric study, 10 fixed sacroiliac joint (SIJ) sectional specimens, 4 dried cadaveric pelvises and 21 embalmed adult cadaveric pelvises were dissected, followed by an injection of contrast agent into the joint. The irrigation of the agent was observed through CT scanning. For the radiologic study, 188 CT scans of ankylosing spondylitis patients (143 male, 45 female) were collected from 2010 to 2012, in Nanfang Hospital. What was measured was (1) Distance between the posterior midline and sagittal synovium; (2) Length of the sagittal synovium; (3) Distance between the midpoint of the sagittal synovium and posterior superior iliac spine; and (4) Distance between the superficial skin vertical to the sagittal synovium point were measured. For the practice-based study: 20 patients (17 males and 3 females) with early ankylosing spondylitis, from Nanfang Hospital affiliated with Southern Medical University were recruited, and sacroiliac joint unguided injections were done on the basis of the cadaveric and radiologic study. Only the inferior 1/3rd portion parallel to the posterior midline could be injected into since the superior 2/3rd portion were filled with interosseous ligaments. Thirteen of the 20 patients received successful injections as identified by CT scan using the contrast agent. Sacroiliac joint injection following simple X-ray clip location is possible and feasible if the operation is performed by trained physicians familiar with the sacroiliac joint and its surrounding anatomic structures. PMID:25692437

  6. Bladder base/trigone injection is safe and as effective as bladder body injection of onabotulinumtoxinA for idiopathic detrusor overactivity refractory to antimuscarinics.

    Science.gov (United States)

    Kuo, Hann-Chorng

    2011-09-01

    The purpose of this study was to evaluate the efficacy and safety of onabotulinumtoxinA injections at bladder base/trigone and compare with injections at bladder body or bladder body/trigone for the treatment of idiopathic detrusor overactivity (IDO) refractory to antimuscarinics. A single blind, randomized, paralleled, actively controlled trial was performed in patients with urodynamically proven IDO who failed antimuscarinic therapy. Patients were randomly assigned to receive intravesical injections of 100 U of onabotulinumtoxinA into three different bladder sites. All treatments were evaluated by voiding diary variables, urgency severity score, urodynamic studies, and patient perception of bladder condition. Long-term success rates over 12 months were also determined. Among the patients, 37 were randomized to injections in the bladder body, 35 into the bladder body/trigone, and 33 into the bladder base/trigone. Successful results were reported in 76 (72%) patients at 3 months: 26 (70%) in the bladder body group, 26 (74%) in the bladder body/trigone group, and 24 (73%) in the bladder base/trigone group. There were no significant differences in success rates, changes in urgency and urgency incontinence episodes, urodynamic variables, or long-term success rates among the three subgroups. The incidence of adverse events was similar among three groups. No vesicoureteral reflux was noted in all patients with or without involving trigone injection. Intravesical onabotulinumtoxinA injection is an effective treatment for IDO regardless of the bladder injection site. Bladder base/trigone injection is as safe and effective as bladder body injections with or without trigone involvement. Copyright © 2011 Wiley-Liss, Inc.

  7. The John N. Insall Award: Do Intraarticular Injections Increase the Risk of Infection After TKA?

    Science.gov (United States)

    Bedard, Nicholas A; Pugely, Andrew J; Elkins, Jacob M; Duchman, Kyle R; Westermann, Robert W; Liu, Steve S; Gao, Yubo; Callaghan, John J

    2017-01-01

    Infection after total knee arthroplasty (TKA) can result in disastrous consequences. Previous research regarding injections and risk of TKA infection have produced conflicting results and in general have been limited by small cohort size. The purpose of this study was to evaluate if intraarticular injection before TKA increases the risk of postoperative infection and to identify if time between injection and TKA affect the risk of TKA infection. The Humana data set was reviewed from 2007 to 2014 for all patients who received a knee injection before TKA. Current Procedural Terminology (CPT) codes and laterality modifiers were used to identify patients who underwent knee injection followed by ipsilateral TKA. Postoperative infection within 6 months of TKA was identified using International Classification of Diseases, 9 th Revision/CPT codes that represent two infectious endpoints: any postoperative surgical site infection (encompasses all severities of infection) and operative intervention for TKA infection (surrogate for deep TKA infection). The injection cohort was stratified into 12 subgroups by monthly intervals out to 12 months corresponding to the number of months that had elapsed between injection and TKA. Risk of postoperative infection was compared between the injection and no injection cohorts. In total, 29,603 TKAs (35%) had an injection in the ipsilateral knee before the TKA procedure and 54,081 TKA cases (65%) did not. The PearlDiver database does not currently support line-by-line output of patient data, and so we were unable to perform a multivariate analysis to determine whether other important factors may have varied between the study groups that might have had a differential influence on the risk of infection between those groups. However, the Charlson Comorbidity index was no different between the injection and no injection cohorts (2.9 for both) suggesting similar comorbidity profiles between the groups. The proportion of TKAs developing any

  8. Repeated intraperitoneal injections of liposomes containing phosphatidic acid and cardiolipin reduce amyloid-β levels in APP/PS1 transgenic mice

    DEFF Research Database (Denmark)

    Ordóñez-Gutiérrez, Lara; Re, Francesca; Bereczki, Erika

    2015-01-01

    , it was hypothesized that shifting this equilibrium towards the blood by enhancing peripheral clearance might reduce Aβ levels in the brain: the 'sink effect'. We tested this hypothesis by intraperitoneally injecting APP/PS1 transgenic mice with small unilamellar vesicles containing either phosphatidic acid...... Aβ may be therapeutically relevant in AD. FROM THE CLINICAL EDITOR: Intraperitoneal injection of small unilamellar vesicles containing phosphatidic acid or cardiolipin significantly reduced the amount of amyloid-beta (Aß) peptide in the plasma in a rodent model. Brain levels of Aß were also affected...

  9. Systematic assessment of microneedle injection into the mouse cornea.

    Science.gov (United States)

    Matthaei, Mario; Meng, Huan; Bhutto, Imran; Xu, Qingguo; Boelke, Edwin; Hanes, Justin; Jun, Albert S

    2012-06-20

    Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. A mean corneal area of 5.0 ± 1.4 mm(2) (mean ± SD) and 7.7 ± 1.4 mm(2) was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively of total corneal area involved.

  10. Will a single periarticular lidocaine-corticosteroid injection improve the clinical efficacy of intraarticular hyaluronic acid treatment of symptomatic knee osteoarthritis?

    Science.gov (United States)

    Ertürk, Cemil; Altay, Mehmet Akif; Altay, Nuray; Kalender, Ali Murat; Öztürk, İbrahim Avşin

    2016-11-01

    A local injection of corticosteroid-lidocaine into the periarticular soft tissue structures is used commonly for rapid pain relief. It is hypothesized that knee pain associated with knee osteoarthritis would be relieved quickly and effectively in patients receiving intraarticular hyaluronic acid combined with a periarticular lidocaine-corticosteroid injection. To test this hypothesis, the clinical effect of the combined treatment with hyaluronic acid injection alone in patients with symptomatic knee osteoarthritis as compared in this prospective single-blinded randomized trial. This study included 70 patients. Group 1 (n = 35) received intraarticular hyaluronic acid injections only, whereas group 2 (n = 35) received intraarticular hyaluronic acid injections combined with a single local injection of corticosteroid-lidocaine. Injections were administered to the most painful areas of the anterior or posterior medial condyle of the femur or tibia. The outcome was measured by independent assessors (blinded to treatment) using a linear VAS pain scale and WOMAC and HSS knee scores. Assessments were performed at baseline and at 1, 3, 6, 12, 26, and 52 weeks. During the first 3 weeks, group 2 patients showed significantly better all scores than did group 1 patients (p hyaluronic acid alone in patients with knee osteoarthritis and can be considered a useful adjunctive treatment modality. This combined method may provide early return to patient's daily activity. Therapeutic study, Level I.

  11. [Crosslinking sodium hyaluronate gel with different ratio of molecular weight for subcutaneous injection: animal experimental study and clinical trials subcutaneous injection].

    Science.gov (United States)

    Ran, Weizhi; Wang, Xiaoli; Hu, Yuefei; Gao, Songying; Yang, Yahong; Sun, Jian; Sun, Shuming; Liu, Zhongmei; Wang, Jiangling

    2015-05-01

    To investigate the biocompatibility and degradation rate of crosslinking sodium hyaluronate gel with different ratio of molecular weight, so as to choose the effective, safe and totally degraded hyaluronate gel for aesthetic injection. (1) Compound colloid was formed by cross-linking the divinyl sulphone and sodium hyaluronate with different molecular weight (4 x 10(5), 8 x 10(5), 10 x 10(5), 12 x 10(5)). (2) Healthy level KM mice was randomly divided into two groups to receive hyaluronic acid gel or liquid injection. Each group was subdivided into three subgroup to receive hyaluronic acid with different molecular weight. The biocompatibility and degradation rate, of hyaluronate were observed at 7, 90, 180 days after injection. At the same time, different molecular weight of sodium hyaluronate gel is sealed or exposed respectively under the low temperature preservation to observe its natural degradation rate. (3) The most stable colloid was selected as aesthetic injector for volunteers to observe the aesthetic effect. The sodium hyaluronate gel with molecular of 4 x 10(5) was completely degraded 90 days later. The sodium hyaluronate gel with molecular of 8 x 10(5) was completely degraded 180 days later. The sodium hyaluronate gel with molecular of 10 x 10(5) was degraded to 90.0% after 180 days. The sodium hyaluronate liquid can be degraded completely within 7 days. The colloid could be kept for at least 12 months when sealed under low temperature, but was totally degraded when exposed for I d. Sodium hyaluronate gel with molecular 10 x 10(5) was confirmed to be kept for at least 6 months in animal experiment and clinical trials. Under the same condition of material ratio, the higher the molecular weight is, the lower the degradation rate is. But the liquidity of gel is not good for injection when molecular weight is too large. It suggests that Sodium hyaluronate gel with molecular 10 x 10(5) maybe the best choice in cosmetic injections.

  12. Intravitreal triamcinolone acetonide injections in the treatment of retinal vein occlusions.

    Science.gov (United States)

    Roth, Daniel B; Cukras, Catherine; Radhakrishnan, Ravi; Feuer, William J; Yarian, David L; Green, Stuart N; Wheatley, Harold M; Prenner, Jonathan

    2008-01-01

    To report the visual acuity response after intravitreal triamcinolone injection in patients with macular edema due to retinal vein occlusions. Retrospective nonrandomized interventional series of 172 consecutive patients with macular edema due to retinal vein occlusions who were treated with intravitreal triamcinolone acetonide injection. Patients underwent Snellen visual acuity testing and ophthalmoscopic examination at baseline and 1, 3, 6, and 12 months after intravitreal triamcinolone acetonide injection. All subtypes of retinal vein occlusions showed significant improvements in mean visual acuity 1 month after injection. This improvement in visual acuity was maintained over the 12-month period for all but the central retinal vein occlusion group. Seventy-one (41.3%) of the 172 patients received more than one intravitreal triamcinolone injection for unresolved or recurrent macular edema. This study demonstrates a benefit associated with intravitreal triamcinolone acetonide injection for retinal vein occlusions that was maintained by patients with branch retinal vein occlusions and hemiretinal vein occlusions over a 12-month period. Visual acuity improvement was not maintained in patients with central retinal vein occlusions with this course of treatment.

  13. Assessment of MRI Contrast Agent Kinetics via Retro-Orbital Injection in Mice: Comparison with Tail Vein Injection.

    Science.gov (United States)

    Wang, Fang; Nojima, Masanori; Inoue, Yusuke; Ohtomo, Kuni; Kiryu, Shigeru

    2015-01-01

    It is not known whether administration of contrast agent via retro-orbital injection or the tail vein route affects the efficiency of dynamic contrast-enhanced magnetic resonance imaging (MRI). Therefore, we compared the effects of retro-orbital and tail vein injection on the kinetics of the contrast agent used for MRI in mice. The same group of nine healthy female mice received contrast agent via either route. An extracellular contrast agent was infused via the tail vein and retro-orbital vein, in random order. Dynamic contrast-enhanced MRI was performed before and after administering the contrast agent. The contrast effects in the liver, kidney, lung, and myocardium were assessed. The average total times of venous puncture and mounting of the injection system were about 10 and 4 min for the tail vein and retro-orbital route, respectively. For all organs assessed, the maximum contrast ratio occurred 30 s after administration and the time course of the contrast ratio was similar with either routes. For each organ, the contrast ratios correlated strongly; the contrast ratios were similar. The retro-orbital and tail vein routes afforded similar results in terms of the kinetics of the contrast agent. The retro-orbital route can be used as a simple efficient alternative to tail vein injection for dynamic contrast-enhanced MRI of mice.

  14. Novel Treatment of Chronic Bladder Pain Syndrome and Other Pelvic Pain Disorders by OnabotulinumtoxinA Injection.

    Science.gov (United States)

    Jhang, Jia-Fong; Kuo, Hann-Chorng

    2015-06-18

    Chronic pelvic pain (CPP) is defined as pain in the pelvic organs and related structures of at least 6 months' duration. The pathophysiology of CPP is uncertain, and its treatment presents challenges. Botulinum toxin A (BoNT-A), known for its antinociceptive, anti-inflammatory, and muscle relaxant activity, has been used recently to treat refractory CPP with promising results. In patients with interstitial cystitis/bladder pain syndrome, most studies suggest intravesical BoNT-A injection reduces bladder pain and increases bladder capacity. Repeated BoNT-A injection is also effective and reduces inflammation in the bladder. Intraprostatic BoNT-A injection could significantly improve prostate pain and urinary frequency in the patients with chronic prostatitis/chronic pelvic pain syndrome. Animal studies also suggest BoNT-A injection in the prostate decreases inflammation in the prostate. Patients with CPP due to pelvic muscle pain and spasm also benefit from localized BoNT-A injections. BoNT-A injection in the pelvic floor muscle improves dyspareunia and decreases pelvic floor pressure. Preliminary studies show intravesical BoNT-A injection is useful in inflammatory bladder diseases such as chemical cystitis, radiation cystitis, and ketamine related cystitis. Dysuria is the most common adverse effect after BoNT-A injection. Very few patients develop acute urinary retention after treatment.

  15. Haemopoiesis-enhancing effects of repeatedly administered carboxymethylglucan in mice exposed to fractionated irradiation

    International Nuclear Information System (INIS)

    Hofer, M.; Pospisil, M.; Pipalova, I.; Hola, J.

    1995-01-01

    Carboxymethylglucan (CMG), a water-soluble glucan derivative, enhanced the number of granulocytes in the peripheral blood as well as other indices of haemopoietic recovery (total cellularity and the number of granulocyte-macrophage progenitor cells in femoral marrow, spleen weight) investigated after fractionated gamma-irradiation of mice (five doses of 2 Gy each, or three, four and five doses of 3 Gy each given at 24 hours' intervals). An increased liver weight and a more pronounced anaemia found in the CMG-treated mice suggested that also inflammatory side effects were evoked by repeated CMG administration. On the other hand, the development of tolerance, i.e., a decreased effectiveness of CMG treatment on repeated administration did not seem to play a major role under the experimental conditions studied because the protective effects of CMG increased with the increasing number of CMG injections. (author) 2 figs., 16 refs

  16. Injection therapy for chronic prostatitis: A retrospective analysis of 77 cases

    Directory of Open Access Journals (Sweden)

    Attila Toth

    2018-03-01

    Full Text Available Objective: To compare pre- and post-therapy symptom scores reported on the National Institute of Health Chronic Prostatitis Symptom Index (NIHCPSI after trans-rectal antibiotic injections therapy for men suffering from chronic prostatitis. Materials and methods: Retrospective analysis of NIHCPSI symptom scores obtained from chart reviews of 77 treated males suffering from chronic prostatitis before and after trans rectal injections for the treatment of chronic prostatitis. Results: Most patients reported a 40% to 60% improvement in symptom scores. In subgroups comparing scores in patients with less than 5 injections, the improvement was less than in patients who received 10 or more injections. Patients’ responses after a shorter (3 months follow up showed better pain scores than patient’s scores after longer, over one-year or more, follow- up periods. Conclusion: Our findings show that direct antibiotic injection for chronic prostatitis is a viable addition to standard therapies. Improvements in symptom scores are long lasting. Discomfort is minimal and side effects are rare and avoidable

  17. Comparison of radiological changes in humans exposed to radium and in beagle dogs injected with radium

    International Nuclear Information System (INIS)

    Morgan, J.P.; Kirsh, J.E.; Pool, R.R.

    1982-01-01

    Data from MIT and New Jersey studies were combined with data from the Center for Human Radiobiology, Argonne National Laboratory, to create a material of 2259 persons occupationaly exposed to radium. The population studied consisted of radium-dial painters, radium chemists, and persons who had received radium in past years in attempts to treat various medical conditions. Within a colony of beagle dogs at the LEHR, UCD, which received eight semi-monthly injections of 226 Ra were 28 dogs that received a dosage of 80 to 130 times maximum permissible skeletal burden for man (0.1 μCi 226 Ra). The intravenous injections of 226 Ra began at 435 days of age

  18. Lens subluxation after plasmin and SF6 injections in rabbit eyes.

    Directory of Open Access Journals (Sweden)

    Wei-Chi Wu

    Full Text Available To investigate the rate of lens subluxation following plasmin and/or SF6 injections in eyes, and whether a subsequent elevated level of vascular endothelial growth factor (VEGF and vitreous tap would aggravate subluxation.Four groups of rabbits were used. Group 1 received an intravitreal injection (IVI of plasmin and SF6 in the right eye; group 2 received an IVI of plasmin in the right eye; group 3 received an IVI of SF6 in the right eye; and group 4 received an IVI of balanced salt solution in the right eye. After treatment, IVIs of VEGF were given and vitreous tap was performed three times, followed by clinical observation of lens subluxation and scanning electronic microscope evaluation of the zonular fibers.After IVIs of plasmin and SF6, and VEGF and vitreous tap had been performed one to three times, lens subluxation was noted in 0%, 43%, 71%, 71%, and 86% of the eyes in group 1. After IVIs of plasmin, VEGF, and vitreous tap had been performed one to three times, lens subluxation was noted in 11%, 22%, 44%, 44%, and 67% of the eyes in group 2. The eyes in group 3 and 4 did not show signs of lens subluxation after VEGF IVIs and vitreous tap. Histology confirmed zonular fiber damage in the eyes treated with plasmin.The incidence of lens subluxation increased following plasmin injections in the eyes, and this was aggravated by the subsequent high VEGF level in the eyes and vitreous tapping. Zonular fibers were disrupted following plasmin treatment. These effects should be kept in mind when using plasmin enzymes in patients with vitreoretinal abnormalities.

  19. Deep Friction Massage Versus Steroid Injection in the Treatment of Lateral Epicondylitis.

    Science.gov (United States)

    Yi, Rosemary; Bratchenko, Walter W; Tan, Virak

    2018-01-01

    The aim of the study was to determine the efficacy of deep friction massage in the treatment of lateral epicondylitis by comparing outcomes with a control group treated with splinting and therapy and with an experimental group receiving a local steroid injection. A randomized clinical trial was conducted to compare outcomes after recruitment of consecutive patients presenting with lateral epicondylitis. Patients were randomized to receive one of 3 treatments: group 1: splinting and stretching, group 2: a cortisone injection, or group 3: a lidocaine injection with deep friction massage. Pretreatment and posttreatment parameters of visual analog scale (VAS) pain ratings, Disabilities of the Arm, Shoulder and Hand (DASH) scores, and grip strength were measured. Outcomes were measured at early follow-up (6-12 weeks) and at 6-month follow-up. There was a significant improvement in VAS pain score in all treatment groups at early follow-up. DASH score and grip strength improved in the cortisone injection group and the deep friction massage group at early follow-up; these parameters did not improve in the splinting and stretching group. At 6-month follow-up, only patients in the deep friction massage group demonstrated a significant improvement in all outcome measures, including VAS pain score, DASH score, and grip strength. Deep friction massage is an effective treatment for lateral epicondylitis and can be used in patients who have failed other nonoperative treatments, including cortisone injection.

  20. Behavioral cross-sensitization between testosterone and fenproporex in adolescent and adult rats.

    Science.gov (United States)

    Conceição, C Q; Engi, S A; Cruz, F C; Planeta, C S

    2017-11-17

    The abuse of psychoactive drugs is considered a global health problem. During the last years, a relevant number of studies have investigated the relationship between anabolic-androgenic steroids (AAS) and other psychoactive drugs. AAS, such as testosterone, can cause a dependence syndrome that shares many features with the classical dependence to psychoactive substances. Pre-clinical evidence shows that there are interactions between testosterone and psychoactive drugs, such as cocaine. However, few studies have been performed to investigate the effect of repeated testosterone treatment on behavioral effects of amphetamine derivatives, such as fenproporex. The purpose of the present study was to investigate the effects of repeated testosterone administration on fenproporex-induced locomotor activity in adolescent and adult rats. Adolescent male Wistar rats were injected with testosterone (10 mg/kg sc for 10 days). After 3 days, animals received an acute injection of fenproporex (3.0 mg/kg ip) and the locomotor activity was recorded during 40 min. Thirty days later, the same animals received the same treatment with testosterone followed by a fenproporex challenge injection as described above. Our results demonstrated that repeated testosterone induced behavioral sensitization to fenproporex in adolescent but not in adult rats. These findings suggest that repeated AAS treatment might increase the dependence vulnerability to amphetamine and its derivatives in adolescent rats.

  1. The ''injection problem'' for quasiparallel shocks

    International Nuclear Information System (INIS)

    Zank, G. P.; Rice, W. K. M.; le Roux, J. A.; Cairns, I. H.; Webb, G. M.

    2001-01-01

    For a particle to be accelerated diffusively at a shock by the first-order Fermi acceleration mechanism, the particle must be sufficiently energetic that it can scatter across all the micro- and macrostructure of the shock, experiencing compression between the converging upstream and downstream states. This is the well-known ''injection problem.'' Here the interaction of ions with the ramp of a quasiparallel shock is investigated. Some ions incident on the shock experience specular reflection, caused either by the cross-shock electrostatic potential or by mirroring as the magnetic field is bent and compressed through the ramp. Scattering of reflected ions by self-generated and pre-existing turbulence in the region upstream of the shock then acts to trap backstreaming ions and return them to the ramp, where some experience further reflections. Such repeated reflections and scattering energize a subpopulation of ions up to energies sufficiently large that they can be diffusively shock accelerated. Two ion distributions are considered: pickup ions which are assumed to be described by a shell distribution, are thermal solar wind ions which may be described by a kappa distribution. Injection efficiencies are found analytically to be very high for pickup ions and much lower for thermal solar wind ions, suggesting that this injection mechanism, stochastic reflected ion or SRI acceleration, is a natural precursor for the acceleration of the anomalous cosmic ray component at a quasiparallel shock. While significantly less efficient, SRI acceleration is also viable for thermal solar wind ions described by a kappa distribution

  2. Botulinum toxin type A injections for the management of muscle tightness following total hip arthroplasty: a case series

    Directory of Open Access Journals (Sweden)

    Delanois Ronald E

    2009-08-01

    Full Text Available Abstract Background Development of hip adductor, tensor fascia lata, and rectus femoris muscle contractures following total hip arthroplasties are quite common, with some patients failing to improve despite treatment with a variety of non-operative modalities. The purpose of the present study was to describe the use of and patient outcomes of botulinum toxin injections as an adjunctive treatment for muscle tightness following total hip arthroplasty. Methods Ten patients (14 hips who had hip adductor, abductor, and/or flexor muscle contractures following total arthroplasty and had been refractory to physical therapeutic efforts were treated with injection of botulinum toxin A. Eight limbs received injections into the adductor muscle, 8 limbs received injections into the tensor fascia lata muscle, and 2 limbs received injection into the rectus femoris muscle, followed by intensive physical therapy for 6 weeks. Results At a mean final follow-up of 20 months, all 14 hips had increased range in the affected arc of motion, with a mean improvement of 23 degrees (range, 10 to 45 degrees. Additionally all hips had an improvement in hip scores, with a significant increase in mean score from 74 points (range, 57 to 91 points prior to injection to a mean of 96 points (range, 93 to 98 at final follow-up. There were no serious treatment-related adverse events. Conclusion Botulinum toxin A injections combined with intensive physical therapy may be considered as a potential treatment modality, especially in difficult cases of muscle tightness that are refractory to standard therapy.

  3. A case study of lightning, whistlers, and associated ionospheric effects during a substorm particle injection event

    International Nuclear Information System (INIS)

    Rodriguez, J.V.; Inan, U.S.; Li, Y.Q.; Holzworth, R.H.; Smith, A.J.; Orville, R.E.; Rosenberg, T.J.

    1992-01-01

    Simultaneous ground-based observations of narrowband and broadband VLF radio waves and of cloud-to-ground lightning were made at widely spaced locations during the 1987 Wave-Induced Particle Precipitation (WIPP) campaign, conducted from Wallops Island, Virginia. Based on these observations, the first case study has been made of the relationships among located cloud-to-ground (CG) lightning flashes, whistlers, and associated ionospheric effects during a substorm particle injection event. This event took place 2 days after the strongest geomagnetic storm of 1987, during a reintensification in geomagnetic activity that did not affect the high rate of whistlers observed at Faraday Station, Antarctica. At the time of the injection event, several intense nighttime thunderstorms were located over Long Island and the coast of New England, between 400 km northwest and 600 km north of the region geomagnetically conjugate to Faraday. About two thirds of the CG flashes that were detected in these thunderstorms during the hour following the injection event onset were found to be causatively associated with whistlers received at Faraday. During the same period the amplitude of the 24.0-kHz signal from the NAA transmitter in Cutler, Maine, propagating over the thunderstorm centers toward Wallops Island was repeatedly perturbed in a manner characteristic of previously reported VLF signatures of transient and localized ionization enhancements at D region altitudes. Though such enhancements may have been caused by whistler-induced bursts electron precipitation from the magnetosphere, the data in this case are insufficient to establish a clear connection between the NAA amplitude perturbations and the Faraday Station whistlers. In view of the proximity of the NAA great circle path to the storm center, having the lower ionosphere by intense radiation from lightning may also have played a role in the observed VLF perturbations

  4. Mediastinal lymphoscintigraphy after intraperitoneal injection of 99mTc-HSA-D

    International Nuclear Information System (INIS)

    Kawahara, Hidejirou; Hirai, Katsuya; Aoki, Teruaki; Takayama, Sumio; Mori, Yutaka

    1998-01-01

    An intraperitoneal injection tube was inserted into the abdominal cavity (right subphrenic lesion 3, left subphrenic lesion 3, Douglas pouch 3) in patients with recurrent gastric cancer and those receiving non curative resection. 99m Tc-HSA-D, 1 ml (740 MBq) was administered through the tube. After the injection, lymph flow dynamics was observed with a scinticamera. In the subphrenic injection group, there was no significant difference in the mediastinal lymphography between right and left subphrenic injection. In that group, mediastinal lymphography had been observed promptly after the administration. However, in the Douglas injection group, until 99m Tc-HSA-D reached the diaphragm no mediastinal lymphography was observed. The HSA-D count in the peripheral blood increased in the Douglas injection group but it remained low in the subphrenic injection group. Therefore it is conceivable that the main pathway was the diaphragm lymphatic system between the intraabdominal lymphatic system and the mediastinal lymphatic system. And intraperitoneal administration of the anticancer agent may not only have a sufficiently effect on the intraabdominal lymphatic system but also on the mediastinal lymphatic system. Especially subphrenic injection is very useful because concentration of the agent in peripheral blood may be held at a low level. (author)

  5. [Neuroprotective effect of naloxone in brain damage caused by repeated febrile seizure].

    Science.gov (United States)

    Shan, Ying; Qin, Jiong; Chang, Xing-zhi; Yang, Zhi-xian

    2004-04-01

    The brain damage caused by repeated febrile seizure (FS) during developing age is harmful to the intellectual development of children. So how to decrease the related damage is a very important issue. The main purpose of the present study was to find out whether the non-specific opiate antagonist naloxone at low dose has the neuroprotective effect on seizure-induced brain damage. Warm water induced rat FS model was developed in this study. Forty-seven rats were randomly divided into two groups: normal control group (n = 10) and hyperthermic seizure groups (n = 37). The latter was further divided into FS control group (n = 13) and naloxone-treated group (n = 24). The dose of naloxone is different in two naloxone-treated groups (12/each group), in one group the dose was 1 mg/kg, in the other one 2 mg/kg. Seven febrile seizures were induced in each rat of hyperthermic seizure groups with the interval of 2 days. The rats were weighed and injected intraperitoneally with naloxone once the FS occurred in naloxone-treated group, while the rats of the other groups were injected with 0.9% sodium chloride. Latency, duration and grade of FS in different groups were observed and compared. HE-staining and the electron microscopy (EM) were used to detect the morphologic and ultrastructural changes of hippocampal neurons. In naloxone-treated group, the rats' FS duration and FS grade (5.02 +/- 0.63, 2.63 +/- 0.72) were significantly lower (t = 5.508, P seizure, it could lighten the brain damage resulted from repeated FS to some extent.

  6. The Timing of Hip Arthroscopy After Intra-articular Hip Injection Affects Postoperative Infection Risk.

    Science.gov (United States)

    Wang, Dean; Camp, Christopher L; Ranawat, Anil S; Coleman, Struan H; Kelly, Bryan T; Werner, Brian C

    2017-11-01

    To evaluate the association of preoperative intra-articular hip injection with surgical site infection after hip arthroscopy. A large administrative database was used to identify all patients undergoing hip arthroscopy from 2007 to 2015 within a single private insurer and from 2005 to 2012 within Medicare in the United States. Those that received an ipsilateral preoperative intra-articular hip injection were identified. The patients were then divided into the following groups based on the interval between preoperative injection and ipsilateral hip arthroscopy: (1) 12 months) of preoperative hip injection. Patients developing a surgical site infection within 6 months following hip arthroscopy were identified using International Classification of Diseases, Ninth Revision, and Current Procedural Terminology codes associated with infection. Groups were compared using a multivariate logistic regression analysis to control for age, gender, body mass index, smoking status, alcohol usage, and multiple medical comorbidities including diabetes mellitus, hemodialysis use, inflammatory arthritis, and peripheral vascular disease. In total, 19% of privately insured and 6% of Medicare patients received a hip injection within 12 months of hip arthroscopy. The overall infection rate in privately insured and Medicare patients was 1.19% and 1.10%, respectively. Preoperative hip injection within 3 months of surgery was associated with a significantly higher risk of postoperative infection versus controls (2.16%, odds ratio [OR] 6.1, P arthroscopy increased when preoperative intra-articular hip injections were given within 3 months of surgery. Level III, retrospective comparative study. Copyright © 2017 Arthroscopy Association of North America. Published by Elsevier Inc. All rights reserved.

  7. A Unified Model for Repeating and Non-repeating Fast Radio Bursts

    International Nuclear Information System (INIS)

    Bagchi, Manjari

    2017-01-01

    The model that fast radio bursts (FRBs) are caused by plunges of asteroids onto neutron stars can explain both repeating and non-repeating bursts. If a neutron star passes through an asteroid belt around another star, there would be a series of bursts caused by a series of asteroid impacts. Moreover, the neutron star would cross the same belt repetitively if it were in a binary with the star hosting the asteroid belt, leading to a repeated series of bursts. I explore the properties of neutron star binaries that could lead to the only known repeating FRB so far (FRB121102). In this model, the next two epochs of bursts are expected around 2017 February 27 and 2017 December 18. On the other hand, if the asteroid belt is located around the neutron star itself, then a chance fall of an asteroid from that belt onto the neutron star would lead to a non-repeating burst. Even a neutron star grazing an asteroid belt can lead to a non-repeating burst caused by just one asteroid plunge during the grazing. This is possible even when the neutron star is in a binary with the asteroid-hosting star, if the belt and the neutron star orbit are non-coplanar.

  8. A Unified Model for Repeating and Non-repeating Fast Radio Bursts

    Energy Technology Data Exchange (ETDEWEB)

    Bagchi, Manjari, E-mail: manjari@imsc.res.in [The Institute of Mathematical Sciences (IMSc-HBNI), 4th Cross Road, CIT Campus, Taramani, Chennai 600113 (India)

    2017-04-01

    The model that fast radio bursts (FRBs) are caused by plunges of asteroids onto neutron stars can explain both repeating and non-repeating bursts. If a neutron star passes through an asteroid belt around another star, there would be a series of bursts caused by a series of asteroid impacts. Moreover, the neutron star would cross the same belt repetitively if it were in a binary with the star hosting the asteroid belt, leading to a repeated series of bursts. I explore the properties of neutron star binaries that could lead to the only known repeating FRB so far (FRB121102). In this model, the next two epochs of bursts are expected around 2017 February 27 and 2017 December 18. On the other hand, if the asteroid belt is located around the neutron star itself, then a chance fall of an asteroid from that belt onto the neutron star would lead to a non-repeating burst. Even a neutron star grazing an asteroid belt can lead to a non-repeating burst caused by just one asteroid plunge during the grazing. This is possible even when the neutron star is in a binary with the asteroid-hosting star, if the belt and the neutron star orbit are non-coplanar.

  9. Concentration of plutonium in hair following intravenous injection

    International Nuclear Information System (INIS)

    Toohey, R.E.; Cacic, C.G.; Oldham, R.D.; Larsen, R.P.

    1979-01-01

    The concentration of plutonium has been determined along the length of the hair of a female subject who received 11.1 kBq (0.3 μCi) of 239 Pu by intravenous injection in 1945. The subject succumbed to her preexisting illness 518 days post-injection. The growth rate of hair given for females in ICRP is 0.36 mm/day, and so a half-length of 43 +- 9 mm corresponds to a half-time of 120 +- 25 days. However, since plutonium was found in the most distal portion of the hair, an average growth rate of at least 280 mm/518 days, or 0.54 mm/ day is indicated for this individual. This value yields a half-time of 80 +- 20 days for the long-lived component of plutonium concentration in the hair and therefore also in the blood. This half-time is in excellent agreement with that of 88 +- 13 days found for the plutonium injection cases

  10. Repeatability of Cryogenic Multilayer Insulation

    Science.gov (United States)

    Johnson, W. L.; Vanderlaan, M.; Wood, J. J.; Rhys, N. O.; Guo, W.; Van Sciver, S.; Chato, D. J.

    2017-12-01

    Due to the variety of requirements across aerospace platforms, and one off projects, the repeatability of cryogenic multilayer insulation (MLI) has never been fully established. The objective of this test program is to provide a more basic understanding of the thermal performance repeatability of MLI systems that are applicable to large scale tanks. There are several different types of repeatability that can be accounted for: these include repeatability between identical blankets, repeatability of installation of the same blanket, and repeatability of a test apparatus. The focus of the work in this report is on the first two types of repeatability. Statistically, repeatability can mean many different things. In simplest form, it refers to the range of performance that a population exhibits and the average of the population. However, as more and more identical components are made (i.e. the population of concern grows), the simple range morphs into a standard deviation from an average performance. Initial repeatability testing on MLI blankets has been completed at Florida State University. Repeatability of five Glenn Research Center (GRC) provided coupons with 25 layers was shown to be +/- 8.4% whereas repeatability of repeatedly installing a single coupon was shown to be +/- 8.0%. A second group of 10 coupons has been fabricated by Yetispace and tested by Florida State University, the repeatability between coupons has been shown to be +/- 15-25%. Based on detailed statistical analysis, the data has been shown to be statistically significant.

  11. Evaluation of the effects of botulinum toxin A injections when used to improve ease of care and comfort in children with cerebral palsy whom are non-ambulant: a double blind randomized controlled trial

    Directory of Open Access Journals (Sweden)

    Thorley Megan

    2012-08-01

    Full Text Available Abstract Background Children with cerebral palsy (CP whom are non-ambulant are at risk of reduced quality of life and poor health status. Severe spasticity leads to discomfort and pain. Carer burden for families is significant. This study aims to determine whether intramuscular injections of botulinum toxin A (BoNT-A combined with a regime of standard therapy has a positive effect on care and comfort for children with CP whom are non-ambulant (GMFCS IV/V, compared with standard therapy alone (cycle I, and whether repeated injections with the same regime of adjunctive therapy results in greater benefits compared with a single injecting episode (cycle II. The regime of therapy will include serial casting, splinting and/or provision of orthoses, as indicated, combined with four sessions of goal directed occupational therapy or physiotherapy. Method/design This study is a double blind randomized controlled trial. Forty participants will be recruited. In cycle I, participants will be randomized to either a treatment group who will receive BoNT-A injections into selected upper and/or lower limb muscles, or a control group who will undergo sham injections. Both groups will receive occupational therapy and /or physiotherapy following injections. Groups will be assessed at baseline then compared at 4 and 16 weeks following injections or sham control. Parents, treating clinicians and assessors will be masked to group allocation. In cycle II, all participants will undergo intramuscular BoNT-A injections to selected upper and/or lower limb muscles, followed by therapy. The primary outcome measure will be change in parent ratings in identified areas of concern for their child’s care and comfort, using the Canadian Occupational Performance Measure (COPM. Secondary measures will include the Care and Comfort Hypertonicity Scale (ease of care, the Cerebral Palsy Quality of Life Questionnaire (CP QoL–Child (quality of life, the Caregiver Priorities and Child

  12. Repeated E-Book Reading and Its Contribution to Learning New Words among Kindergartners

    Science.gov (United States)

    Korat, Ofra; Kozlov-Peretz, Olla; Segal-Drori, Ora

    2017-01-01

    The contribution of repeated e-book reading with and without word explanation support and its effect on receptive and expressive word learning among preschoolers was examined. Seventy-eight kindergartners were randomly divided into an experimental and a control group. The experimental group received two individual reading sessions of an e-book…

  13. Potentials and limitations of histone repeat sequences for phylogenetic reconstruction of Sophophora.

    Science.gov (United States)

    Baldo, A M; Les, D H; Strausbaugh, L D

    1999-11-01

    Simplified DNA sequence acquisition has provided many new data sets that are useful for phylogenetic reconstruction, including single- and multiple-copy nuclear and organellar genes. Although transcribed regions receive much attention, nontranscribed regions have recently been added to the repertoire of sequences suitable for phylogenetic studies, especially for closely related taxa. We evaluated the efficacy of a small portion of the histone repeat for phylogenetic reconstruction among Drosophila species. Histone repeats in invertebrates offer distinct advantages similar to those of widely used ribosomal repeats. First, the units are tandemly repeated and undergo concerted evolution. Second, histone repeats include both highly conserved coding and variable intergenic regions. This composition facilitates application of "universal" primers spanning potentially informative sites. We examined a small region of the histone repeat, including the intergenic spacer segments of coding regions from the divergently transcribed H2A and H2B histone genes. The spacer (about 230 bp) exists as a mosaic with highly conserved functional motifs interspersed with rapidly diverging regions; the former aid in alignment of the spacer. There are no ambiguities in alignment of coding regions. Coding and noncoding regions were analyzed together and separately for phylogenetic information. Parsimony, distance, and maximum-likelihood methods successfully retrieve the corroborated phylogeny for the taxa examined. This study demonstrates the resolving power of a small histone region which may now be added to the growing collection of phylogenetically useful DNA sequences.

  14. Tennis elbow: role of local steroid injection.

    Science.gov (United States)

    Ahmed, Gulzar Saeed; Ali, Muhammad; Trago, Imtiaz Ahmed

    2012-01-01

    Tennis elbow is a condition, characterised by pain and tenderness over the lateral epicondyle of the humerus, and pain on resisted dorsiflexion of the wrist, middle finger, or both. The aim of this randomised controlled trial was to investigate the short term efficacy of local steroid injection compared with oral and topical NSAIDs. Sixty patients (45 male and 15 female) were included in the study. The mean age was 42 years for men and 40 years for women. They were placed in group A and B (30 cases each). Group A received local steroid injection (triamcinolone 20 mg mixed with lignocaine 2% 1 cc) and topical NSAID cream application (diclofenac diethylammonium) twice a day, tab. diclofenac sodium 50 mg twice a day for 3 weeks. Group B received tab diclofenac 50 mg twice a day and, topical NSAID cream application twice a day for 3 weeks. Assessment of patients was made 3 times; first at the start of the study, 2nd time after 6 weeks, and 3rd time after 12 weeks. A blinded assessor rated the elbow complaints of the patients at resisted dorsiflexion of wrist using VAS (0 = no severity, 1-3 mild, 4-6 moderate, 7-9 sever, 10 = maximum severity). At six weeks, 22 (73.33%) patient in group A had no pain as compared to 7 (23.33%) patients in group B who were pain free (p < 0.0001, chi2 = 38.75). At 12 weeks 27 (90%) patients in group A were pain free compared to group B in which 7 (23.33%) patients were pain free (p < 0.0001, chi2 = 27.56). In patients with tennis elbow, the use of local steroid injection in combination with topical and oral NSAIDs is superior to the use of combination of topical and oral NSAIDs. Better results with combination therapy using local steroid injection may be limited to the short term.

  15. Alteration of Skin Mechanical Properties in Patients Undergoing Botulinum Toxin Type A Injections of Forehead Rhytides.

    Science.gov (United States)

    Min, Peiru; Zhang, Zheng; Grassetti, Luca; Perdanasari, Aurelia Trisliana; Torresetti, Matteo; Pu, Zheming; Zhang, Yan; Han, Sheng; Marsili, Riccardo; Zhang, Yi Xin; di Benedetto, Giovanni; Lazzeri, Davide

    2016-06-01

    Although application of botulinum toxin type A (BTX-A) for the treatment of forehead rhytides has become very popular, the effects of its intramuscular injections on the skin mechanical properties remain unclear. We prospectively investigated the alterations in the mechanical properties of the skin of patients who received intramuscular injections of botulinum toxin A (BTX-A) for forehead rhytides and compared two injection doses. Of the 42 enrolled patients, one randomly assigned half received intramuscular injections of two units (group I), and the other half received four units (group II) of BTX-A in each injection point. The baseline and post-treatment skin mechanical parameters, including gross elasticity (R2), net elasticity (R5), viscoelastic ratio (R6) and biological elasticity (R7), were measured using the Cutometer(®) and compared. Treatment with BTX-A resulted in significant overall alterations in the mechanical properties of skin at the injection sites of both treatment groups during the 16-week period, and no significant differences were observed between groups. Significant decreases in biological elasticity, net elasticity and viscoelasticity properties were observed at 2 weeks follow-up and began to recover at that time. All of the skin mechanical properties recovered to baseline levels by 16 weeks of follow-up in both dosage groups, which indicates that the higher dosage (4 units) did not delay relapse compared to the two-unit dosage. We concluded that intramuscular injections of BTX-A significantly regulated the gross elasticity, net elasticity, functional elasticity and viscoelastic elasticity at the injection point over a radius of 1.5 cm at 2, 4 and 8 weeks follow-up. The alteration in the skin measurements had completely diminished by the 16-week follow-up. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or

  16. Randomised, prospective, non-blinded pilot study comparing the effect of intramuscular steroid injections and intralesional steroid injections in the management of tennis elbow

    Science.gov (United States)

    Tahir, Hasan; Biro, Izolda; Donnelly, Simon; Greenwood, Mandy

    2016-01-01

    Background Tennis elbow is an overuse injury affecting people performing repetitive forearm movements. It is a soft tissue disorder that causes significant disability and pain. The aim of the study was to establish that an intramuscular steroid injection is effective in the short-term pain relief and functional improvement of tennis elbow. The severity of pain at the injection site was monitored to determine whether the intramuscular injection is better tolerated than the intralesional injection. Methods and results 19 patients, who had no treatment for tennis elbow in the preceding 3 months, were recruited from Whipps Cross University Hospital, London, and were randomised to receive either 80 mg of intramuscular Depo-Medrone or 40 mg of intralesional Depo-Medrone injection. Blinding proved difficult as the injection sites differed and placebo arms were not included in the study. A Patient-Rated Tennis Elbow Evaluation (PRTEE) Questionnaire and a 10-point Likert scale were used to assess primary outcome. Six weeks after the treatment, there was a reduction in pain, improvement in function and total PRTEE scores in both intramuscular and intralesional groups (p=0.008) using a 95% CI for mean treatment difference of −26 to +16 points. A statistically significant result (p=0.001) in favour of intramuscular causing less pain at the injection site was noted. Conclusion Non-inferiority of intramuscular to intralesional injections was not confirmed; however, the intramuscular injection proved to be effective in reducing tennis elbow-related symptoms and was found less painful at the site of injection at the time of administration. Trial registration number EUDRACT Number: 2010-022131-11. REC Number: 10/H0718/76 (NRES, Central London REC 1). PMID:28879024

  17. Deployment Repeatability

    Science.gov (United States)

    2016-04-01

    evaluating the deployment repeatability builds upon the testing or analysis of deployment kinematics (Chapter 6) and adds repetition. Introduction...material yield or failure during a test. For the purposes of this chapter, zero shift will refer to permanent changes in the structure, while reversible ...the content of other chapters in this book: Gravity Compensation (Chapter 4) and Deployment Kinematics and Dynamics (Chapter 6). Repeating the

  18. The effect and complication of botulinum toxin type a injection with serial casting for the treatment of spastic equinus foot.

    Science.gov (United States)

    Lee, Sook Joung; Sung, In Young; Jang, Dae Hyun; Yi, Jin Hwa; Lee, Jin Ho; Ryu, Ju Seok

    2011-06-01

    To identify the effect of serial casting combined with Botulinum toxin type A (BTX-A) injection on spastic equinus foot. Twenty-nine children with cerebral palsy who had equinus foot were recruited from the outpatient clinic of Rehabilitation Medicine. The children were divided into 2 groups, one of which received serial casting after BTX-A injection, and the other which only received BTX-A injection. Serial casting started 3 weeks after the BTX-A injection, and was changed weekly for 3 times. Spasticity of the ankle joint was evaluated using the modified Ashworth scale (MAS), and the modified Tardieu scale (MTS). Gait pattern was measured using the physician's rating scale (PRS). The degree of ankle dorsiflexion and the MAS improved significantly until 12 weeks following the BTX-A injection in the serial casting group (pcasting. Our study demonstrated that the effect of BTX-A injection with serial casting was superior and lasted longer than the effect of BTX-A injection only in patients with spastic equinus foot. We therefore recommend BTX-A injection with serial casting for the treatment of equinus foot. However, physicians must also consider the possible complications associated with serial casting.

  19. Factors Associated with the Use of Hyaluronic Acid and Corticosteroid Injections among Patients with Radiographically Confirmed Knee Osteoarthritis: A Retrospective Data Analysis.

    Science.gov (United States)

    Lapane, Kate L; Liu, Shao-Hsien; Dubé, Catherine E; Driban, Jeffrey B; McAlindon, Timothy E; Eaton, Charles B

    2017-02-01

    Despite the rapid proliferation of hyaluronate (HA) and corticosteroid (CO) injections and clinical guidelines regarding their use in osteoarthritis (OA), information on the characteristics of people receiving these injections is scarce. We describe the use of injections among adults with radiographically confirmed knee OA and identify factors associated with injection use. We used publicly available data from the Osteoarthritis Initiative (OAI), an international collaboration sponsored by the National Institutes of Health, and included participants with ≥1 radiographically confirmed knee OA (Kellgren-Lawrence grade ≥2 [definite osteophytes and possible joint space narrowing (JSN) on anteroposterior weight-bearing radiograph]) at baseline. We matched 415 participants who received at least 1 HA and/or CO injection during the 6-month interval before 1 of the first 7 annual follow-up assessments to 1841 injection nonusers by randomly selecting a study visit to match the distribution observed in the injection users. Multinomial logistic regression models were used for identifying factors associated with injection use, including sociodemographic and clinical/functional factors. Eighteen percent of the 2256 patients identified as having knee OA had received at least 1 injection (years 1-7, 16.9%, 13.7%, 16.6%, 13.5%, 15.9%, 13.5%, and 9.9%, respectively), most commonly with CO (68.4%). HA and CO were more commonly injected in those with a higher annual household income (adjusted odds ratio [aOR] [95% CI] with HA, US ≥$50,000 vs injection may be associated with higher socioeconomic positioning and indicators of greater disease severity in patients with knee OA. Copyright © 2017. Published by Elsevier Inc.

  20. Reconfigurable multiport EPON repeater

    Science.gov (United States)

    Oishi, Masayuki; Inohara, Ryo; Agata, Akira; Horiuchi, Yukio

    2009-11-01

    An extended reach EPON repeater is one of the solutions to effectively expand FTTH service areas. In this paper, we propose a reconfigurable multi-port EPON repeater for effective accommodation of multiple ODNs with a single OLT line card. The proposed repeater, which has multi-ports in both OLT and ODN sides, consists of TRs, BTRs with the CDR function and a reconfigurable electrical matrix switch, can accommodate multiple ODNs to a single OLT line card by controlling the connection of the matrix switch. Although conventional EPON repeaters require full OLT line cards to accommodate subscribers from the initial installation stage, the proposed repeater can dramatically reduce the number of required line cards especially when the number of subscribers is less than a half of the maximum registerable users per OLT. Numerical calculation results show that the extended reach EPON system with the proposed EPON repeater can save 17.5% of the initial installation cost compared with a conventional repeater, and can be less expensive than conventional systems up to the maximum subscribers especially when the percentage of ODNs in lightly-populated areas is higher.

  1. Determination of a safe INR for joint injections in patients taking warfarin.

    Science.gov (United States)

    Bashir, M A; Ray, R; Sarda, P; Li, S; Corbett, S

    2015-11-01

    With an increase in life expectancy in 'developed' countries, the number of elderly patients receiving joint injections for arthritis is increasing. There are legitimate concerns about an increased risk of thromboembolism if anticoagulation is stopped or reversed for such an injection. Despite being a common dilemma, the literature on this issue is scarce. We undertook 2,084 joint injections of the knee and shoulder in 1,714 patients between August 2008 and December 2013. Within this cohort, we noted 41 patients who were taking warfarin and followed them immediately after joint injection in the clinic or radiology department, looking carefully for complications. Then, we sought clinical follow-up, correspondence, and imaging evidence for 4 weeks, looking for complications from these joint injections. We recorded International Normalised Ratio (INR) values before injection. No complications were associated with the procedure after any joint injection. The radiologists who undertook ultrasound-guided injections to shoulders re-scanned the joints looking for haemarthroses: they found none. A similar outcome was noted clinically after injections in the outpatient setting. With a mean INR of 2.77 (range, 1.7-5.5) and a maximum INR within this group of 5.5, joint injections to the shoulder and knee can be undertaken safely in primary or secondary care settings despite the patient taking warfarin.

  2. Botulinum neurotoxin type A injections for vaginismus secondary to vulvar vestibulitis syndrome.

    Science.gov (United States)

    Bertolasi, Laura; Frasson, Emma; Cappelletti, Jee Yun; Vicentini, Silvana; Bordignon, Monia; Graziottin, Alessandra

    2009-11-01

    To investigate whether botulinum neurotoxin type A improves vaginismus and study its efficacy with repeated treatments. Outpatients were referred because standard cognitive-behavioral and medical treatment for vaginismus and vulvar vestibular syndrome failed. From this group, we prospectively recruited consecutive women (n=39) whose diagnostic electromyogram (EMG) recordings from the levator ani muscle showed hyperactivity at rest and reduced inhibition during straining. These women were followed for a mean (+/-standard deviation) of 105 (+/-50) weeks. Recruited patients underwent repeated cycles of botulinum neurotoxin type A injected into the levator ani under EMG guidance and EMG monitoring thereafter. At enrollment and 4 weeks after each cycle, women were asked about sexual intercourse; underwent EMG evaluation and examinations to grade vaginal resistance according to Lamont; and completed a visual analog scale (VAS) for pain, the Female Sexual Function Index Scale, a quality-of-life questionnaire (Short-Form 12 Health Survey), and bowel and bladder symptom assessment. At 4 weeks after the first botulinum neurotoxin type A cycle, the primary outcome measures (the possibility of having sexual intercourse, and levator ani EMG hyperactivity) both improved, as did the secondary outcomes, Lamont scores, VAS, Female Sexual Function Index Scales, Short-Form 12 Health Survey, and bowel-bladder symptoms. These benefits persisted through later cycles. When follow-up ended, 63.2% of the patients completely recovered from vaginismus and vulvar vestibular syndrome, 15.4% still needed reinjections (censored), and 15.4% had dropped out. Botulinum neurotoxin type A is an effective treatment option for vaginismus secondary to vulvar vestibular syndrome refractory to standard cognitive-behavioral and medical management. After patients received botulinum neurotoxin type A, their sexual activity improved and reinjections provided sustained benefits. III.

  3. Systematic assessment of microneedle injection into the mouse cornea

    Directory of Open Access Journals (Sweden)

    Matthaei Mario

    2012-06-01

    Full Text Available Abstract Background Corneal intrastromal injection is an important mode of gene-vector application to subepithelial layers. In a mouse model, this procedure is substantially complicated by the reduced corneal dimensions. Furthermore, it may be difficult to estimate the corneal area reached by the volume of a single injection. This study aimed to investigate intrastromal injections into the mouse cornea using different microneedles and to quantify the effect of injecting varying volumes. A reproducible injection technique is described. Methods Forty eyes of 20 129 Sv/J mice were tested. India ink was intrastromally injected using 30° beveled 33 G needles, tri-surface 25° beveled 35 G needles, or hand-pulled and 25° beveled glass needles. Each eye received a single injection of a volume of 1 or 2 μL. Corneoscleral buttons were fixed and flat mounted for computer-assisted quantification of the affected corneal area. Histological assessment was performed to investigate the intrastromal location of the injected dye. Results A mean corneal area of 5.0 ±1.4 mm2 (mean ± SD and 7.7 ±1.4 mm2 was covered by intrastromal injections of 1 and 2 μL, respectively. The mean percentage of total corneal area reached ranged from 39% to 53% for 1 μL injections, and from 65% to 81% for 2 μL injections. Injections using the 33 G needles tended to provide the highest distribution area. Perforation rates were 8% for 30° beveled 33 G needles and 44% for tri-surface beveled 35 G needles. No perforation was observed with glass needle; however, intrastromal breakage of needle tips was noted in 25% of these cases. Conclusions Intracorneal injection using a 30° beveled 33 G needle was safe and effective. The use of tri-surface beveled 35 G needles substantially increased the number of corneal perforations. Glass needles may break inside the corneal stroma. Injections of 1 μL and 2 μL resulted in an overall mean of 49% and 73% respectively

  4. Association between continuous peripheral i.v. infusion of 3% sodium chloride injection and phlebitis in adults.

    Science.gov (United States)

    Meng, Lina; Nguyen, Cherwyn M; Patel, Samit; Mlynash, Michael; Caulfield, Anna Finley

    2018-03-01

    One institution's experience with use of peripheral i.v. (PIV) catheters for prolonged infusions of 3% sodium chloride injection at rates up to 100 mL/hr is described. A prospective, observational, 13-month quality assurance project was conducted at an academic medical center to evaluate frequencies of patient and catheter phlebitis among adult inpatients who received both an infusion of 3% sodium chloride injection for a period of ≥4 hours through a dedicated PIV catheter and infusions of routine-care solutions (RCSs) through separate PIV catheters during the same hospital stay. Sixty patients received PIV infusions through a total of 291 catheters during the study period. The majority of patients (78%) received infusions of 3% sodium chloride injection for intracranial hypertension, with 30% receiving such infusions in the intensive care unit. Phlebitis occurred in 28 patients (47%) during infusions of 3% sodium chloride and 26 patients (43%) during RCS infusions ( p = 0.19). Catheter phlebitis occurred in 73 catheters (25%), with no significant difference in the frequencies of catheter phlebitis with infusion of 3% sodium chloride versus RCSs (30% [32 of 106 catheters]) versus 22% [41 of 185 catheters]), p = 0.16). Patient and catheter phlebitis rates were not significantly different with infusions of 3% sodium chloride injection versus RCSs, suggesting that an osmolarity cutoff value of 900 mOsm/L for peripheral infusions of hypertonic saline solutions may not be warranted. Copyright © 2018 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  5. Resveratrol ameliorates depressive-like behavior in repeated corticosterone-induced depression in mice.

    Science.gov (United States)

    Ali, Syed Hamid; Madhana, Rajaram Mohanrao; K V, Athira; Kasala, Eshvendar Reddy; Bodduluru, Lakshmi Narendra; Pitta, Sathish; Mahareddy, Jalandhar Reddy; Lahkar, Mangala

    2015-09-01

    A mouse model of depression has been recently developed by exogenous corticosterone (CORT) administration, which has shown to mimic HPA-axis induced depression-like state in animals. The present study aimed to examine the antidepressant-like effect and the possible mechanisms of resveratrol, a naturally occurring polyphenol of phytoalexin family, on depressive-like behavior induced by repeated corticosterone injections in mice. Mice were injected subcutaneously (s.c.) with 40mg/kg corticosterone (CORT) chronically for 21days. Resveratrol and fluoxetine were administered 30min prior to the CORT injection. After 21-days treatment with respective drugs, behavioral and biochemical parameters were estimated. Since brain derived neurotrophic factor (BDNF) has been implicated in antidepressant activity of many drugs, we also evaluated the effect of resveratrol on BDNF in the hippocampus. Three weeks of CORT injections in mice resulted in depressive-like behavior, as indicated by the significant decrease in sucrose consumption and increase in immobility time in the forced swim test and tail suspension test. Further, there was a significant increase in serum corticosterone level and a significant decrease in hippocampus BDNF level in CORT-treated mice. Treatment of mice with resveratrol significantly ameliorated all the behavioral and biochemical changes induced by corticosterone. These results suggest that resveratrol produces an antidepressant-like effect in CORT-induced depression in mice, which is possibly mediated by rectifying the stress-based hypothalamic-pituitary-adrenal (HPA) axis dysfunction paradigm and upregulation of hippocampal BDNF levels. Copyright © 2015 Elsevier Inc. All rights reserved.

  6. A Three-arm Randomized Clinical Trial Comparing Continuous Femoral Plus Single-injection Sciatic Peripheral Nerve Blocks versus Periarticular Injection with Ropivacaine or Liposomal Bupivacaine for Patients Undergoing Total Knee Arthroplasty.

    Science.gov (United States)

    Amundson, Adam W; Johnson, Rebecca L; Abdel, Matthew P; Mantilla, Carlos B; Panchamia, Jason K; Taunton, Michael J; Kralovec, Michael E; Hebl, James R; Schroeder, Darrell R; Pagnano, Mark W; Kopp, Sandra L

    2017-06-01

    Multimodal analgesia is standard practice for total knee arthroplasty; however, the role of regional techniques in improved perioperative outcomes remains unknown. The authors hypothesized that peripheral nerve blockade would result in lower pain scores and opioid consumption than two competing periarticular injection solutions. This three-arm, nonblinded trial randomized 165 adults undergoing unilateral primary total knee arthroplasty to receive (1) femoral catheter plus sciatic nerve blocks, (2) ropivacaine-based periarticular injection, or (3) liposomal bupivacaine-based periarticular injection. Primary outcome was maximal pain during postoperative day 1 (0 to 10, numerical pain rating scale) in intention-to-treat analysis. Additional outcomes included pain scores and opioid consumption for postoperative days 0 to 2 and 3 months. One hundred fifty-seven study patients received peripheral nerve block (n = 50), ropivacaine (n = 55), or liposomal bupivacaine (n = 52) and reported median maximal pain scores on postoperative day 1 of 3, 4, and 4.5 and on postoperative day 0 of 1, 4, and 5, respectively (average pain scores for postoperative day 0: 0.6, 1.7, and 2.4 and postoperative day 1: 2.5, 3.5, and 3.7). Postoperative day 1 median maximal pain scores were significantly lower for peripheral nerve blockade compared to liposomal bupivacaine-based periarticular injection (P = 0.016; Hodges-Lehmann median difference [95% CI] = -1 [-2 to 0]). After postanesthesia care unit discharge, postoperative day 0 median maximal and average pain scores were significantly lower for peripheral nerve block compared to both periarticular injections (ropivacaine: maximal -2 [-3 to -1]; P bupivacaine: maximal -3 [-4 to -2]; P bupivacaine over ropivacaine in periarticular injections for total knee arthroplasty.

  7. Induration at Injection or Infusion Site May Reduce Bioavailability of Parenteral Phenobarbital Administration.

    Science.gov (United States)

    Nakayama, Hirokazu; Echizen, Hirotoshi; Ogawa, Ryuichi; Akabane, Atsuya; Kato, Toshiaki; Orii, Takao

    2017-06-01

    Phenobarbital is well tolerated and effective for controlling agitation or preventing convulsion at the end of life. No information is available concerning parenteral bioavailability of phenobarbital when induration develops at the injection or infusion site. We investigated whether induration at injection or infusion site is related to phenobarbital bioavailability via parenteral routes of continuous subcutaneous infusion and intermittent subcutaneous or intramuscular injection. A retrospective analysis was conducted on the medical data obtained from 18 patients who received chronic subcutaneous or intramuscular injections of phenobarbital for the prevention of convulsions and underwent plasma concentration monitoring of the drug. Patients whose concomitant medications were altered during the observation periods were excluded from the analysis. Comparisons were performed for concentration/dose (C/D) ratios obtained from patients with induration at injection or infusion sites (induration group, n = 6) and those without induration (noninduration group, n = 12). P phenobarbital may be reduced when induration develops at the injection or infusion site in patients treated parenterally by continuous subcutaneous infusion or intramuscular injection.

  8. Mesotherapy and phosphatidylcholine injections: historical clarification and review.

    Science.gov (United States)

    Rotunda, Adam M; Kolodney, Michael S

    2006-04-01

    Mesotherapy was originally conceived in Europe as a method of utilizing cutaneous injections containing a mixture of compounds for the treatment of local medical and cosmetic conditions. Although mesotherapy was traditionally employed for pain relief, its cosmetic applications, particularly fat and cellulite removal, have recently received attention in the United States. Another treatment for localized fat reduction, which was popularized in Brazil and uses injections of phosphatidylcholine, has been erroneously considered synonymous with mesotherapy. Despite their attraction as purported "fat-dissolving" injections, the safety and efficacy of these novel cosmetic treatments remain ambiguous to most patients and physicians. To distinguish mesotherapy from phosphatidylcholine injections by reviewing their history and the relevant experimental or clinical findings. A comprehensive search of Medline indexed literature and conference proceedings. All the published studies evaluating the clinical efficacy of traditional mesotherapy currently originate from Europe. These reports focus primarily on musculoskeletal pain and vascular disease, rather than cosmetic applications. Although experimental data suggest that a number of traditional mesotherapy ingredients may theoretically reduce fat, these effects have not been supported in peer-reviewed studies. An increasing number of reports demonstrate that subcutaneous injections of a formula containing phosphatidylcholine combined with its emulsifier, deoxycholate, are effective in removing small collections of adipose tissue. Cell lysis, resulting from the detergent action of deoxycholate, may account for this clinical effect. Mesotherapy is distinct from a method of treating adipose tissue with subcutaneous injections of deoxycholate alone or in combination with phosphatidylcholine. Additional clinical and experimental studies are necessary to more definitively establish the safety and efficacy of these treatments.

  9. Repeat pregnancy in women with HIV infection in Latin America and the Caribbean

    Science.gov (United States)

    Megazzini, Karen; Melo, Victor Hugo; Coelho, Débora Fernandes; Watts, D. Heather; Krauss, Margot; Gouvea, Maria Isabel; Duarte, Geraldo; Losso, Marcelo H.; Siberry, George K.

    2016-01-01

    Intended and unintended pregnancies occur frequently among HIV-infected women. We evaluated the occurrence of repeat pregnancy and characteristics associated with this outcome among HIV-infected women in Latin America and the Caribbean who were participating in the National Institute of Child Health and Human Development (NICHD) International Site Development Initiative (NISDI). Of the 1342 HIV-infected pregnant women enrolled in NISDI, 124 (9.2%) had one or more repeat pregnancies on study. Median time between the index delivery and date of conception of the subsequent pregnancy was 1.4 years (range 0.1–5.7). Younger age [odds ratio (OR)=1.07, 95% confidence interval (CI): 1.04–1.11 per one-year decrease in age], hospitalization during the index pregnancy or up to 6 months postpartum [OR=2.0, 95% CI: 1.2–3.4], and poor index pregnancy outcome (stillbirth or spontaneous/therapeutic abortion) [OR=3.4, 95% CI: 1.4–8.4] were associated with increased occurrence of repeat pregnancy in multivariable analysis. Among women with repeat pregnancies, the proportion receiving antiretroviral treatment (versus prophylaxis) increased from 39.4% at the time of the index pregnancy to 81.8% at the time of the repeat pregnancy (ppregnancy planning and prevention of unintended pregnancies. PMID:26288031

  10. Regulatory controls and slurry fracture injection

    International Nuclear Information System (INIS)

    Dusseault, M. B.; Bilak, R. A.

    1997-01-01

    The technological and regulatory framework necessary for the safe operation of solid waste disposal using slurry fracture injection (SFI) in Saskatchewan and Alberta was studied. Seven current SFI sites were used as the source of experience. Regular audits of volumes, continuous pressure recording, careful deformation monitoring and analysis, and repeated evaluation of reservoir properties were considered to be the essential features. In the case of toxic wastes, microseismic monitoring and regular well interference or tracer tests might be additional measures used to increase confidence in the containment method. Given the recent introduction of SFI technology, guarding against over-regulation was recommended to allow SFI to operate under the most effective operating conditions, and to preserve its attractiveness as an environmentally attractive and safe waste disposal alternative. 5 refs., 3 tabs., 4 figs

  11. Factors Associated with Therapeutic Efficacy of Intravesical OnabotulinumtoxinA Injection for Overactive Bladder Syndrome.

    Directory of Open Access Journals (Sweden)

    Sheng-Mou Hsiao

    Full Text Available To analyze the predictors of therapeutic efficacy after intravesical botulinum toxin A injection for overactive bladder syndrome (OAB refractory to antimuscarinic therapy.All consecutively OAB patients, who visited the urologic outpatient clinics of a medical center and refractory to antimuscarinic treatment, were prospectively enrolled. All enrolled patients received intravesical injection of 100 U onabotulinumtoxinA (Botox. The Global Response Assessment (GRA score ≥ 2 at 3 months after Botox injection was defined as a successful treatment, otherwise failed.Overall, 89 patients received intravesical injection. Eighty patients, including 42 men and 38 women, had received follow-up at 3 months. The overall success rate was 63.8%. The global response assessment, urgency severity score, urgency, urgency urinary incontinence and frequency episodes, and functional bladder capacity improved after treatment. However, post-void residual volume (PVR increased, and voiding efficiency (VE decreased after treatment. Female gender (odds ratio = 3.75 was the only independent factor associated with the success. Female gender (coefficient = 0.74, low baseline overactive bladder symptoms score (coefficient = -0.12 and the presence of OAB-wet (coefficient = 0.79 were independent factors associated with therapeutic efficacy (i.e., GRA score. VE (odds ratio = 0.062 was the only predictor for a large PVR at 3 months. The optimum cutoff value of VE was <87% with the area under the ROC curve being 0.64 (sensitivity = 63.8%, specificity = 57.1%.The therapeutic effects of Botox can persist till 6 months after treatment. Female gender, low overactive bladder symptoms score and OAB-wet are associated better therapeutic efficacy, and low baseline VE is associated with large PVR. These findings can serve as an initial guide or assist in consultation regarding the treatment of OAB patients with Botox injection.ClinicalTrials.gov NCT01657409.

  12. Risk factors associated with injection initiation among drug users in Northern Thailand

    Directory of Open Access Journals (Sweden)

    Suriyanon Vinai

    2006-03-01

    Full Text Available Abstract Background Circumstances surrounding injection initiation have not been well addressed in many developing country contexts. This study aimed to identify demographic factors, sexual behaviors and drug use characteristics related to injection initiation among drug users in northern Thailand. Methods A cross-sectional survey was conducted among 2,231 drug users admitted to the Northern Drug Treatment Center in Mae Rim, Chiang Mai, Thailand, between February 1, 1999 and December 31, 2000. A multiple logistic regression was employed to identify the independent effects from potential risk factors of transition into injection. Results After controlling for other covariates, being 20 years of age or older, single, ever receiving education, urban residence, and having a history of smoking or incarceration were significantly associated with higher likelihood of injection initiation. Multiple sex partners and an experience of sex abuse were associated with an increased risk of injection initiation. Comparing to those whose first drug was opium, individuals using heroin as their initiation drug had greater risk of injection initiation; conversely, those taking amphetamine as their first drug had less risk of injection initiation. Age of drug initiation was negatively associated with the risk of injection initiation: the older the age of drug initiation, the less the risk of injection initiation. Conclusion Injection initiation was related to several demographic factors, sexual behaviors and drug use characteristics. Understanding these factors will benefit the design of approaches to successfully prevent or delay transition into injection.

  13. Study of four weeks repeated-dose toxic test of Sweet Bee Venom in rats Original Articles

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    Kwon Hae-Yon

    2011-03-01

    Full Text Available Objectives: This study was performed to analyse four weeks repeated -dose toxicity of Sweet Bee Venom (SBV-pure melittin, the major component of honey bee venom in rats. Methods: All experiments were conducted under the regulations of Good Laboratory Practice (GLPat Biotoxtech Company, a non-clinical study authorized institution. Male and female rats of 5 weeks old were chosen for the pilot study of four weeks repeated-dose toxicity and was injected at the level of 0.56 mg/kg body weight (eighty times higher than the clinical application dosage as the high dosage, followed by 0.28 and 0.14 mg/kg as midium and low dosage, respectively. Equal amount of normal saline was injected as the control group every day for four weeks. Results: 1. No mortality was witnessed in all of the experiment groups. 2. All experiment groups appealed pain sense in the treating time compared to the control group, and side effects such as hyperemia and movement disorder were observed around the area of injection in all experiment groups, and the higher dosage in treatment, the higher occurrence in side effects. 3. Concerning weight measurement, neither male nor female groups showed significant changes compared to the control group. 4. Concerning to the CBC and biochemistry, all experiment groups didn't show any significant changes compared to the control group. 5. Concerning weight measurement of organs, experiment groups didn't show any significant changes compared to the control group. 6. To verify abnormalities of organs and tissues, those such as cerebellum, cerebrum, liver, lung, kidney,and spinal cords were removed and we conducted histologocal observation with H-E staining.Concerning the histologocal observation of liver tissues, some fatty changes were observed around portal vein in 0.56 mg/kg experiment group. But another organs were not detected in any abnormalities. 7. The proper high dosage of SBV for the thirteen weeks repeated test in rats may be 0.28 mg

  14. 18F-FDG PET/CT Findings Following Repeated Intramuscular Injections of "Site Enhancement Oil" in the Upper Extremities

    DEFF Research Database (Denmark)

    Dejanović, Danijela; Loft, Annika

    2017-01-01

    We present the findings on F-FDG PET/CT in a 50-year-old man known to self-administer intramuscular injections with site enhancement oil in the upper extremities. PET images show diffuse pathological high FDG uptake in soft tissue of the upper arms and in scanned portions of the forearms. On the CT...

  15. Impact of injection therapy on retinal patients with diabetic macular edema or retinal vein occlusion.

    Science.gov (United States)

    Sivaprasad, Sobha; Oyetunde, Sesan

    2016-01-01

    An important factor in the choice of therapy is the impact it has on the patient's quality of life. This survey aimed to understand treatment burden, treatment-related anxiety and worry, and practical issues such as appointment attendance and work absence in patients receiving injection therapy for diabetic macular edema (DME) or retinal vein occlusion (RVO). A European sample of 131 retinal patients completed a detailed questionnaire to elucidate the impact of injection therapy on individuals with DME or RVO. RVO and DME greatly impact a patient's quality of life. An intensive injection regimen and the requirements for multiple hospital visits place a large practical burden on the patient. Each intravitreal injection appointment (including travel time) was reported to take an average of 4.5 hours, with a total appointment burden over 6 months of 13.5 hours and 20 hours for RVO and DME patients, respectively. This creates a significant burden on patient time and may make appointment attendance difficult. Indeed, 53% of working patients needed to take at least 1 day off work per appointment and 71% of patients required a carer's assistance at the time of the injection appointment, ~6.3 hours per injection. In addition to practical issues, three-quarters of patients reported experiencing anxiety about their most recent injection treatment, with 54% of patients reporting that they were anxious for at least 2 days prior to the injection. Patients' most desired improvement to their treatment regimen was to have fewer injections and to require fewer appointments, to achieve the same visual results. Patients' quality of life is clearly very affected by having to manage an intensive intravitreal injection regimen, with a considerable treatment burden having a large negative effect. Reducing the appointment burden to achieve the same visual outcomes and the provision of additional support for patients to attend appointments would greatly benefit those receiving intravitreal

  16. Personalized Video Feedback and Repeated Task Practice Improve Laparoscopic Knot-Tying Skills: Two Controlled Trials.

    Science.gov (United States)

    Abbott, Eduardo F; Thompson, Whitney; Pandian, T K; Zendejas, Benjamin; Farley, David R; Cook, David A

    2017-11-01

    Compare the effect of personalized feedback (PF) vs. task demonstration (TD), both delivered via video, on laparoscopic knot-tying skills and perceived workload; and evaluate the effect of repeated practice. General surgery interns and research fellows completed four repetitions of a simulated laparoscopic knot-tying task at one-month intervals. Midway between repetitions, participants received via e-mail either a TD video (demonstration by an expert) or a PF video (video of their own performance with voiceover from a blinded senior surgeon). Each participant received at least one video per format, with sequence randomly assigned. Outcomes included performance scores and NASA Task Load Index (NASA-TLX) scores. To evaluate the effectiveness of repeated practice, scores from these trainees on a separate delayed retention test were compared against historical controls who did not have scheduled repetitions. Twenty-one trainees completed the randomized study. Mean change in performance scores was significantly greater for those receiving PF (difference = 23.1 of 150 [95% confidence interval (CI): 0, 46.2], P = .05). Perceived workload was also significantly reduced (difference = -3.0 of 20 [95% CI: -5.8, -0.3], P = .04). Compared with historical controls (N = 93), the 21 with scheduled repeated practice had higher scores on the laparoscopic knot-tying assessment two weeks after the final repetition (difference = 1.5 of 10 [95% CI: 0.2, 2.8], P = .02). Personalized video feedback improves trainees' procedural performance and perceived workload compared with a task demonstration video. Brief monthly practice sessions support skill acquisition and retention.

  17. Longterm outcome of Macroplatique injection for treatment of vesicoureteral reflux in children

    Directory of Open Access Journals (Sweden)

    Elrahmany A. Mohamed

    2014-01-01

    Full Text Available Background: This study examined our experience with one year follow-up of 20 cases of vesicoureteric reflux in children after treatment with Macroplastique ® injection. Patient and Methods: A total of 20 children (31 ureters with primary grades II to V vesicoureteral reflux were treated with subureteral Macroplastique ® injection from 2010 to 2011 and followed for an average of 12 months (range 3 to 24. Vesicoureteral reflux was grade II in 3, III in 7, IV in 9 and V in 12 ureters. Each child underwent pre-operative voiding cystourethrography, abdominopelvic ultrasound, urine analysis/culture, S. creatinine and CBC. Dimercapto-succinic acid scan (DMSA scan and magnetic resonance urography (MRU were done in some patients. Voiding cystourethrography at 3 months was done to rule out persistent reflux. Results: Overall, reflux was corrected in 11 (35.5% ureters and 9 (45% children after a single injection. With repeat injection, reflux was corrected in 16 (51.6% ureters and 11 (55% children, reflux improved/downgrade in 4 (12.9% ureters and 2 (10% children. Correction by grade was 100%, 100%, 9.7%, 9.7% for grades II to V, respectively. There were no surgical complications. None of the cured patients had recurrent reflux during follow-up. There were 9 (45% children who required open ureteral re-implantation for failed injection. Conclusion: Sub-ureteral Macroplastique ® injection therapy could be a primary treatment for low grade VUR (grade III or less in children because it is simple, safe, effective, less invasive, decreased.

  18. Programmable DNA-binding proteins from Burkholderia provide a fresh perspective on the TALE-like repeat domain.

    Science.gov (United States)

    de Lange, Orlando; Wolf, Christina; Dietze, Jörn; Elsaesser, Janett; Morbitzer, Robert; Lahaye, Thomas

    2014-06-01

    The tandem repeats of transcription activator like effectors (TALEs) mediate sequence-specific DNA binding using a simple code. Naturally, TALEs are injected by Xanthomonas bacteria into plant cells to manipulate the host transcriptome. In the laboratory TALE DNA binding domains are reprogrammed and used to target a fused functional domain to a genomic locus of choice. Research into the natural diversity of TALE-like proteins may provide resources for the further improvement of current TALE technology. Here we describe TALE-like proteins from the endosymbiotic bacterium Burkholderia rhizoxinica, termed Bat proteins. Bat repeat domains mediate sequence-specific DNA binding with the same code as TALEs, despite less than 40% sequence identity. We show that Bat proteins can be adapted for use as transcription factors and nucleases and that sequence preferences can be reprogrammed. Unlike TALEs, the core repeats of each Bat protein are highly polymorphic. This feature allowed us to explore alternative strategies for the design of custom Bat repeat arrays, providing novel insights into the functional relevance of non-RVD residues. The Bat proteins offer fertile grounds for research into the creation of improved programmable DNA-binding proteins and comparative insights into TALE-like evolution. © The Author(s) 2014. Published by Oxford University Press on behalf of Nucleic Acids Research.

  19. A prospective randomized trial of different supplementary local anesthetic techniques after failure of inferior alveolar nerve block in patients with irreversible pulpitis in mandibular teeth.

    Science.gov (United States)

    Kanaa, Mohammad D; Whitworth, John M; Meechan, John Gerard

    2012-04-01

    The objective of this study was to compare the efficacy of supplementary repeat inferior alveolar nerve block with 2% lidocaine and epinephrine, buccal infiltration with 4% articaine with epinephrine, intraligamentary injection, or intraosseous injection (both with 2% lidocaine with epinephrine) after failed inferior alveolar nerve block (IANB) for securing pain-free treatment in patients experiencing irreversible pulpitis in mandibular permanent teeth. This randomized clinical trial included 182 patients diagnosed with irreversible pulpitis in mandibular teeth. Patients received 2.0 mL of 2% lidocaine with 1:80,000 epinephrine as an IANB injection. Patients who did not experience pain-free treatment received randomly 1 of 4 supplementary techniques, namely repeat lidocaine IANB (rIANB), articaine buccal infiltration (ABI), lidocaine intraligamentary injection (PDL), or lidocaine intraosseous injection (IO). Successful pulp anesthesia was considered to have occurred when no response was obtained to the maximum stimulation (80 reading) of the pulp tester, at which time treatment commenced. Treatment was regarded as being successfully completed when it was associated with no pain. Data were analyzed by χ(2) and Fisher exact tests. Of the 182 patients, 122 achieved successful pulpal anesthesia within 10 minutes after initial IANB injection; 82 experienced pain-free treatment. ABI and IO allowed more successful (pain-free) treatment (84% and 68%, respectively) than rIANB or PDL supplementary techniques (32% and 48%, respectively); this was statistically significant (P = .001). IANB injection alone does not always allow pain-free treatment for mandibular teeth with irreversible pulpitis. Supplementary buccal infiltration with 4% articaine with epinephrine and intraosseous injection with 2% lidocaine with epinephrine are more likely to allow pain-free treatment than intraligamentary and repeat IANB injections with 2% lidocaine with epinephrine for patients experiencing

  20. Study of the Effects of Intravenous Injection of Hyoscine on Parturition (Labor

    Directory of Open Access Journals (Sweden)

    H Bekhradi Nasab

    2006-01-01

    Full Text Available Introduction: Despite wide use of hyoscine by midwives and doctors as an adjunct to labor, the obstetrics literature contains few references to the effect of this drug. This study was a double blinded, randomized controlled trial of primigravidas in Iran to determine the effects of hyoscine intravenous injection on parturition (labor. Methods:One hundred primigravidas in uncomplicated spontaneous labor with cervical dilation less than 4 cm and cervical effacement < 50% were randomly assigned into two groups; the experimental group ( N = 50 receiving 20 mg hyoscine and the control group ( N = 50 receiving placebo, with predetermined codes injected at the beginning of the active phase of labor. The groups were compared for labor progress, fetal tachycardia and bradycardia after 0.5 and 1h of injection, Apgar score and birth weight. Statistical methods for normally distributed variables included 2- tailed student T test and chi- square analysis. The accepted level of significance was p < 0.05. Results:The two groups were similar in respect to maternal age, gestational age , initial cervical effacement & dilation and mean birth weight. The mean change in the cervical effacement and dilation after 1 & 2 h of injection was significantly higher in those receiving hyoscine (p< 0.0001. There was a significant difference in the duration of active phase and second stage of labor in the two groups ( p < 0.0001 . Fetal tachycardia and bradycardia occurred more frequently in patients in the hyoscine group as compared to the control group but the difference was not significant. The difference between the mean first and fifth- minute Apgar score was not significant, too. Conclusion: This small study suggests the benefits of a single dose of hyoscine for labor progress and represents the first attempt to evaluate this medication. However, larger randomized studies are needed to establish the efficacy, safety, and optimal dose of hyoscine .

  1. The cost-effectiveness of CT-guided sacroiliac joint injections: a measure of QALY gained.

    Science.gov (United States)

    Bydon, Mohamad; Macki, Mohamed; De la Garza-Ramos, Rafael; Youssef, Mina; Gokaslan, Ziya L; Meleka, Sherif; Bydon, Ali

    2014-10-01

    The purpose of this study is to estimate the total cost and the quality of life years (QALY) gained for computer tomography (CT)-guided sacroiliac joint (SIJ) injections. The cost per QALY gained for the procedure is the primary end-point of this study. In our 1-year prospective institutional study, we gathered 30 patients undergoing CT-guided SIJ injections for degenerative changes at the SIJ space. Patient-reported outcomes included both the US population-based EQ-5D (EuroQol) index score and the EQ-visual analog scale (VAS). The EQ-5D is based on mobility, self-care, usual activities, pain/discomfort, and anxiety depression. Utility expenditures were based on hospital charges at our institution. All 30 patients had one pre-injection physician visit followed by 43 initial injections (13 bilateral). Each patient underwent one CT scan, and three patients required additional plain films. In the 1 year following the injections, 26 physician visits were documented. Five patients required repeat CT-guided injections. Total 1-year cost for all 30 patients was $34 874·00. Mean decrease in EQ-VAS was 0·60 (P  =  0·187). The mean 1-year gain of 0·58 EQ-5D QALY reached statistical significance (P sacroiliac injections was $2004·29. In one of the first cost analyses of CT-guided sacroiliac injections, we found that the procedure improves pain and activities of daily living. The cost per QALY gained by CT-guided sacroiliac injections falls well below the threshold cost of 1 QALY, suggesting that the procedure is strongly cost-effective.

  2. Plantar fascia calcification a sequelae of corticosteroid injection in the treatment of recalcitrant plantar fasciitis.

    Science.gov (United States)

    Fox, Thomas Peter; Oliver, Govind; Wek, Caesar; Hester, Thomas

    2013-08-16

    We report the case of a 72-year-old woman suffering with severe plantar fasciitis who received a therapeutic corticosteroid injection. Two-and-a-half years after the injection she developed a small calcified lump under the skin which subsequently caused ulceration and infection. She went on to develop a diabetic foot infection requiring an extended course of intravenous antibiotics.

  3. Polydimethylsiloxane Injection Laryngoplasty for Unilateral Vocal Fold Paralysis: Long-Term Results.

    Science.gov (United States)

    Mattioli, Francesco; Bettini, Margherita; Botti, Cecilia; Busi, Giulia; Tassi, Sauro; Malagoli, Andrea; Molteni, Gabriele; Trebbi, Marco; Luppi, Maria Pia; Bergamini, Giuseppe; Presutti, Livio

    2017-07-01

    To analyze the long-term objective, perceptive, and subjective outcomes after endoscopic polydimethylsiloxane (PDMS) injection laryngoplasty in unilateral vocal fold paralysis. A retrospective study carried out between January 2008 and January 2012. Head and Neck Department, University Hospital of Modena, Modena, Italy. This was a retrospective analysis of 26 patients with unilateral vocal fold paralysis who underwent endoscopic injection of PDMS under general anesthesia. A voice evaluation protocol was performed for all patients, which included videolaryngostroboscopy, maximum phonation time, fundamental frequency, analysis of the harmonic structure of the vowel /a/ and the word /aiuole/, Grade of Dysphonia, Instability, Roughness, Breathiness, Asthenia, and Strain scale, and Voice Handicap Index. The protocol was performed before surgery, in the immediate postoperative period, and at least 3 years after surgery. The mean follow-up period was 73 months (range 39-119 months). The statistical analysis showed a significant improvement (P injection laryngoplasty with PDMS guarantees long-lasting effects over time. No complications were reported in our series. Injection laryngoplasty with PDMS can be considered to be a minimally invasive and safe technique for the treatment of unilateral vocal fold paralysis. Moreover, it allows very good and stable results to be obtained over time, avoiding repeated treatments and improving the quality of life of the patients. Copyright © 2017 The Voice Foundation. Published by Elsevier Inc. All rights reserved.

  4. Repeated stress exposure causes strain-dependent shifts in the behavioral economics of cocaine in rats

    NARCIS (Netherlands)

    Groblewski, Peter A.; Zietz, Chad; Willuhn, Ingo; Phillips, Paul E. M.; Chavkin, Charles

    2015-01-01

    Cocaine-experienced Wistar and Wistar Kyoto (WKY) rats received four daily repeated forced swim stress sessions (R-FSS), each of which preceded 4-hour cocaine self-administration sessions. Twenty-four hours after the last swim stress, cocaine valuation was assessed during a single-session threshold

  5. Effects of acute or repeated paroxetine and fluoxetine treatment on affective behavior in male and female adolescent rats

    Science.gov (United States)

    Amodeo, Leslie R.; Greenfield, Venuz Y.; Humphrey, Danielle E.; Varela, Veronica; Pipkin, Joseph A.; Eaton, Shannon E.; Johnson, Jelesa D.; Plant, Christopher P.; Harmony, Zachary R.; Wang, Li; Crawford, Cynthia A.

    2015-01-01

    Rationale The SSRI antidepressant fluoxetine is one of the few drugs that is effective at treating depression in adolescent humans. In contrast, the SSRI paroxetine has limited efficacy and is more at risk for inducing suicidal behavior. Objective The purpose of the present study was to more fully characterize the differential actions of paroxetine and fluoxetine. Methods In Experiment 1, male and female rats were injected with paroxetine (2.5 or 10 mg/kg), fluoxetine (10 mg/kg), or vehicle for 10 days starting on postnatal day (PD) 35, and affective behaviors were assessed using sucrose preference and elevated plus maze tasks. A separate set of rats were used to examine monoamine levels. In Experiment 2, rats were injected with paroxetine (2.5, 5 or 10 mg/kg), fluoxetine (5, 10 or 20 mg/kg), or vehicle during the same time frame as Experiment 1 and anxiety-like behaviors were measured using elevated plus maze, light/dark box, and acoustic startle. Results Repeated SSRI treatment failed to alter sucrose preference, although both paroxetine and fluoxetine reduced time spent in the open arms of the elevated plus maze and light compartment of the light/dark box. Paroxetine, but not fluoxetine, enhanced acoustic startle and interfered with habituation. Serotonin turnover was decreased by both acute and repeated fluoxetine treatment but unaltered by paroxetine administration. Discussion These results show that repeated treatment with paroxetine and fluoxetine has dissociable actions in adolescent rats. In particular, paroxetine, but not fluoxetine, increases acoustic startle at low doses and may increase sensitivity to environmental stressors. PMID:26141193

  6. Spine epidural and sacroiliac joints injections – when and how to perform

    International Nuclear Information System (INIS)

    D’Orazio, Federico; Gregori, Lorenzo Maria; Gallucci, Massimo

    2015-01-01

    Highlights: • Image guided interventions focused to administer drugs inside the epidural space are effective in reducing the perceived spinal pain, but their efficacy seems to be limited in time. • To treat spinal pain with image guided interventions is safe and repeatable. • Sacroiliac dysfunction is a common cause of sciatica-like pain which can be treated with CT-guided interventions (both steroids and pulsed RF denervation). - Abstract: Objectives: To review the state-of-the-art of image – guided techniques used to treat painful syndromes of the lower back, their indications, how they should be performed, their related risks and the expected results. Methods: We describe the actual standards about image-guided infiltrative therapies both on spine and on sacroiliac joints. Results: Both spinal epidural and sacroiliac injections appear useful in a large percentage of treated patients to get control of the perceived pain. Performing these therapies under CT or fluoroscopic guidance is the best and safest way to obtain satisfactory results because it is possible to target the use of drugs directly to the involved painful structures. Conclusions: Image-guided injections of the epidural space and of the sacroiliac joints are effective techniques for the treatment of pain; their effectiveness is sometimes not lasting for long periods of time but considering the low associated risk when performed by trained personnel, they can be easily repeated

  7. Spine epidural and sacroiliac joints injections – when and how to perform

    Energy Technology Data Exchange (ETDEWEB)

    D’Orazio, Federico, E-mail: federico.dorazio@gmail.com; Gregori, Lorenzo Maria, E-mail: lollog@hotmail.it; Gallucci, Massimo, E-mail: massimo.gallucci@cc.univaq.it

    2015-05-15

    Highlights: • Image guided interventions focused to administer drugs inside the epidural space are effective in reducing the perceived spinal pain, but their efficacy seems to be limited in time. • To treat spinal pain with image guided interventions is safe and repeatable. • Sacroiliac dysfunction is a common cause of sciatica-like pain which can be treated with CT-guided interventions (both steroids and pulsed RF denervation). - Abstract: Objectives: To review the state-of-the-art of image – guided techniques used to treat painful syndromes of the lower back, their indications, how they should be performed, their related risks and the expected results. Methods: We describe the actual standards about image-guided infiltrative therapies both on spine and on sacroiliac joints. Results: Both spinal epidural and sacroiliac injections appear useful in a large percentage of treated patients to get control of the perceived pain. Performing these therapies under CT or fluoroscopic guidance is the best and safest way to obtain satisfactory results because it is possible to target the use of drugs directly to the involved painful structures. Conclusions: Image-guided injections of the epidural space and of the sacroiliac joints are effective techniques for the treatment of pain; their effectiveness is sometimes not lasting for long periods of time but considering the low associated risk when performed by trained personnel, they can be easily repeated.

  8. Declining trend in the use of repeat computed tomography for trauma patients admitted to a level I trauma center for traffic-related injuries

    Energy Technology Data Exchange (ETDEWEB)

    Psoter, Kevin J., E-mail: kevinp2@u.washington.edu [Department of Epidemiology, University of Washington, Box 357236, Seattle, WA 98195 (United States); Roudsari, Bahman S., E-mail: roudsari@u.washington.edu [Department of Radiology, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Graves, Janessa M., E-mail: janessa@u.washington.edu [Department of Pediatrics, Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Mack, Christopher, E-mail: cdmack@uw.edu [Harborview Injury Prevention and Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States); Jarvik, Jeffrey G., E-mail: jarvikj@u.washington.edu [Department of Radiology and Department of Neurological Surgery, Comparative Effectiveness, Cost and Outcomes Research Center, University of Washington, 325 Ninth Avenue, Box 359960, Seattle, WA 98104 (United States)

    2013-06-15

    Objective: To evaluate the trend in utilization of repeat (i.e. ≥2) computed tomography (CT) and to compare utilization patterns across body regions for trauma patients admitted to a level I trauma center for traffic-related injuries (TRI). Materials and Methods: We linked the Harborview Medical Center trauma registry (1996–2010) to the billing department data. We extracted the following variables: type and frequency of CTs performed, age, gender, race/ethnicity, insurance status, injury mechanism and severity, length of hospitalization, intensive care unit (ICU) admission and final disposition. TRIs were defined as motor vehicle collisions, motorcycle, bicycle and pedestrian-related injuries. Logistic regression was used to evaluate the association between utilization of different body region repeat (i.e. ≥2) CTs and year of admission, adjusting for patient and injury-related characteristics that could influence utilization patterns. Results: A total of 28,431 patients were admitted for TRIs over the study period and 9499 (33%) received repeat CTs. From 1996 to 2010, the proportion of patients receiving repeat CTs decreased by 33%. Relative to 2000 and adjusting for other covariates, patients with TRIs admitted in 2010 had significantly lower odds of undergoing repeat head (OR = 0.61; 95% CI: 0.49–0.76), pelvis (OR = 0.37; 95% CI: 0.27–0.52), cervical spine (OR = 0.23; 95% CI: 0.12–0.43), and maxillofacial CTs (OR = 0.24; 95% CI: 0.10–0.57). However, they had higher odds of receiving repeat thoracic CTs (OR = 1.86; 95% CI: 1.02–3.38). Conclusion: A significant decrease in the utilization of repeat CTs was observed in trauma patients presenting with traffic-related injuries over a 15-year period.

  9. Injection, injectivity and injectability in geothermal operations: problems and possible solutions. Phase I. Definition of the problems

    Energy Technology Data Exchange (ETDEWEB)

    Vetter, O.J.; Crichlow, H.B.

    1979-02-14

    The following topics are covered: thermodynamic instability of brine, injectivity loss during regular production and injection operations, injectivity loss caused by measures other than regular operations, heat mining and associated reservoir problems in reinjection, pressure maintenance through imported make-up water, suggested solutions to injection problems, and suggested solutions to injection problems: remedial and stimulation measures. (MHR)

  10. Dextrose prolotherapy and corticosteroid injection into rat Achilles tendon.

    Science.gov (United States)

    Martins, C A Q; Bertuzzi, R T; Tisot, R A; Michelin, A F; do Prado, J M; Stroher, A; Burigo, M

    2012-10-01

    To assess the mechanical behavior and the histology of collagen fibers after prolotherapy with 12.5% dextrose into rat Achilles tendons and to compare with those of corticosteroid treatment. Out of 60 adult female Wistar rats (70 tendons), 15 received 12.5% dextrose (group I); 15 were treated with corticosteroid injection (group II); and 15 were given 0.9% saline injection (group III), all into the right Achilles tendon, whereas 13 animals received no injections (group IV). Three doses of each substance (groups I, II, and III) were given at a 5-day interval. Collagen fiber color was quantitatively assessed in three samples from each group and in five samples from the control group using picrosirius red staining under polarized and nonpolarized light. Twelve tendons from each group treated with the test substance and 20 tendons from the control group were submitted to the tensile strength test. There was no statistical difference across the groups with respect to maximum load at failure (n.s.) and absorbed energy (n.s.). With respect to tendon rupture, there was no difference between the myotendinous and the tendinous regions (n.s.). However, hematoxylin-eosin staining revealed statistical significance in lymphocytic inflammatory infiltrate (P = 0.008) and in parallel fiber orientation (P = 0.003) when comparing groups to the control group, without significance for either neovascularization (n.s.) or the presence of fibroblasts (n.s.). Likewise, there was no significant difference between the percentage of mature (n.s.) and immature (n.s.) fibers. Dextrose was not deleterious to the tendinous tissue, as it did not change the mechanical and histological properties of Achilles tendons in rats. The data obtained in this study may help clinicians in their daily work as they suggest that injections of 12.5% dextrose caused no harm to the tendons, although the clinical importance in humans still needs to be defined.

  11. Intravitreal injection of perfluoropropane for the treatment of vitreomacular traction

    Directory of Open Access Journals (Sweden)

    Xiao-Ping Wan

    2013-07-01

    Full Text Available AIM: To study the efficacy of a single intravitreal injection of perfluoropropane(C3F8in releasing vitreomacular traction. METHODS: Twelve eyes of 12 consecutive patients with vitreomacular traction received a single intravitreal injection of 0.3mL 100%(C3F8were retrospectively analyzed. The best corrected vision acuity and the neural epithelium thickness of central macular were observed. RESULTS: One month following treatment, vitreomacular traction was released in 5 eyes(42%, mean final visual acuity(VAimproved 0.04 and mean central foveal thickness decreased by 69μm. The vision acuity before and after treatment were 0.20±0.07, 0.25±0.04 respectively.CONCLUSION: Intravitreal C3F8 injection could offer a minimally invasive alternative to pars plana vitrectomy in patients with vitreomacular traction.

  12. Same day injections of Tc-99m methoxy isobutyl isonitrile (hexamibi) for myocardial tomographic imaging: Comparison between rest-stress and stress-rest injection sequences

    International Nuclear Information System (INIS)

    Taillefer, R.; Gagnon, A.; Laflamme, L.; Leveille, J.; Phaneuf, D.C.

    1989-01-01

    It has been shown that both rest and stress 99m Tc-hexamibi myocardial perfusion imaging can be performed on the same day using two different doses injected within few h (the first one at rest followed by a second at stress). In order to evaluate and compare 2 sequences (rest-stress and stress-rest) of 99m Tc-hexamibi injections performed the same day, 18 patients with either abnormal 201 Tl myocardial scan or abnormal coronary angiography were studied with 2 99m Tc-hexamibi injections protocols. The rest-stress study was performed as follows: 7 mCi 99m Tc-hexamibi was injected at rest. Single photon emission computed tomography (SPECT) was performed 60 min later. Immediately after the rest study, patients were injected at peak stress with 25 mCi 99m Tc-hexamibi. Tomographic imaging was repeated 1 h later. Patients were submitted to the stress-rest protocol within 3 days. Tomographic imaging was done 1 h after a 7 mCi injection at stress. This study was followed by an injection of 25 mCi 99m Tc-hexamibi at rest, a tomographic study was performed 60 min later. Myocardial sections were reconstructed in horizontal long, vertical long, and short axes. Data analysis also included polar map representation. A total of 324 segments were interpreted blind by 3 observers, there was an agreement in 283/324 (87.3%) segments between the 2 protocols. However, 24 segments (7.4%) judged ischemic on rest-stress were called scars on stress-rest. In three patients, myocardial segments were judged normal on the rest image of the rest-stress protocol while they were found abnormal (false positive images) on the stress-rest sequence. Stress images from both protocols were judged similar in 17 patients. In conclusion, when using a short time interval (less than 2 h) between two 99m Tc-hexamibi injections, it is preferable to do a rest-stress sequence since the rest image performed initially represents a true rest study, which is not necessarily the case with the stress-rest sequence

  13. Repeated dose intramuscular injection of the CIMAvax-EGF vaccine in Sprague Dawley rats induces local and systemic toxicity.

    Science.gov (United States)

    Mancebo, A; Casacó, A; González, B; Ledón, N; Sorlozabal, J; León, A; Gómez, D; González, Y; Bada, A M; González, C; Arteaga, M E; Ramírez, H; Fuentes, D

    2012-05-09

    CIMAvax-EGF consists of a human recombinant epidermal growth factor (EGF), coupled to P64k, a recombinant carrier protein from N. meningitis, and Montanide ISA 51 as adjuvant. The vaccine immunization induces a specific antibody production, inhibiting the EGF/EGF-R interaction through EGF deprivation. The objective of this study was to assess the CIMAvax-EGF toxicity in Sprague Dawley rats after intramuscular administration of repeated doses (6 months) and at the same time to determine if rat is a relevant species for studying CIMAvax-EGF vaccine. Rats were randomly distributed into four groups: control, Montanide ISA 51, treated with 1× and 15× of human total dose of the antigen. Animals were immunized weekly during 9 weeks, plus 9 immunizations every 14 days. Rats were inspected daily for clinical signs. Body weight, food consumption, and rectal temperature were measured during the administration of doses. Blood samples were collected for hematological, serum biochemical determinations and EGF titles at the beginning, three months and at the end of experimentation. Gross necropsy and histological examination of tissues were performed on animals at the end of the assay. Vaccine provoked the apparition of antibodies against EGF in the rats, demonstrating rat species relevance in these studies. Body weight gain, food and water consumption were not affected. CIMAvax-EGF and Montanide ISA 51 produced local damage at the administration site, showing multiple cysts and granulomas. Both vaccine-treated groups showed neutrophil elevation, besides an AST increase probably related to the damage at the administration site. Rectal temperature was found to be significantly higher in 15× treated group after immunizations, probably induced by the inflammatory process at the injection site. In summary, the clinical pathology findings together with the body temperature results, appear to be caused by the inflammatory reaction at the administration site of the vaccine, mainly

  14. Contrast medium injected into juvenile bone cysts to analyze interior morphology and guide intracavity corticosteroid treatment

    International Nuclear Information System (INIS)

    Rosenborg, M.; Karlsson, A.; Hirsch, G.; Mortensson, W.

    1992-01-01

    In connection with treating juvenile bone cysts with intracavital corticosteroid injections, the interior cyst anatomy was analyzed at cystography in 13 children aged 4 to 15 years. Only 4 children had a true unicameral cyst; the others had 2 or more cysts or had compartments with free or restricted communication to the main cyst. Cysts and compartments which had not been reached by steroids may continue to grow. Optimum treatment may therefore require injections at different sites guided by cystography. Neither conventional criteria of cyst activity nor repeated bone scintigraphy 3 months after treatment could predict whether the treatment would lead to final healing. (orig.)

  15. Contrast medium injected into juvenile bone cysts to analyze interior morphology and guide intracavity corticosteroid treatment

    Energy Technology Data Exchange (ETDEWEB)

    Rosenborg, M.; Karlsson, A.; Hirsch, G.; Mortensson, W. (Karolinska Inst., St. Goeran' s Children' s Hospital, Stockholm (Sweden). Depts. of Pediatric Radiology, Pediatric Surgery, and Hospital Physics)

    1992-05-01

    In connection with treating juvenile bone cysts with intracavital corticosteroid injections, the interior cyst anatomy was analyzed at cystography in 13 children aged 4 to 15 years. Only 4 children had a true unicameral cyst; the others had 2 or more cysts or had compartments with free or restricted communication to the main cyst. Cysts and compartments which had not been reached by steroids may continue to grow. Optimum treatment may therefore require injections at different sites guided by cystography. Neither conventional criteria of cyst activity nor repeated bone scintigraphy 3 months after treatment could predict whether the treatment would lead to final healing. (orig.).

  16. Expansion of protein domain repeats.

    Directory of Open Access Journals (Sweden)

    Asa K Björklund

    2006-08-01

    Full Text Available Many proteins, especially in eukaryotes, contain tandem repeats of several domains from the same family. These repeats have a variety of binding properties and are involved in protein-protein interactions as well as binding to other ligands such as DNA and RNA. The rapid expansion of protein domain repeats is assumed to have evolved through internal tandem duplications. However, the exact mechanisms behind these tandem duplications are not well-understood. Here, we have studied the evolution, function, protein structure, gene structure, and phylogenetic distribution of domain repeats. For this purpose we have assigned Pfam-A domain families to 24 proteomes with more sensitive domain assignments in the repeat regions. These assignments confirmed previous findings that eukaryotes, and in particular vertebrates, contain a much higher fraction of proteins with repeats compared with prokaryotes. The internal sequence similarity in each protein revealed that the domain repeats are often expanded through duplications of several domains at a time, while the duplication of one domain is less common. Many of the repeats appear to have been duplicated in the middle of the repeat region. This is in strong contrast to the evolution of other proteins that mainly works through additions of single domains at either terminus. Further, we found that some domain families show distinct duplication patterns, e.g., nebulin domains have mainly been expanded with a unit of seven domains at a time, while duplications of other domain families involve varying numbers of domains. Finally, no common mechanism for the expansion of all repeats could be detected. We found that the duplication patterns show no dependence on the size of the domains. Further, repeat expansion in some families can possibly be explained by shuffling of exons. However, exon shuffling could not have created all repeats.

  17. A microfabricated electroosmotic pump coupled to a gas-diffusion microchip for flow injection analysis of ammonia

    International Nuclear Information System (INIS)

    Zhu, Zaifang; Lu, Joann J.; Liu, Shaorong; Almeida, M. Inês G. S.; Kolev, Spas D.; Pu, Qiaosheng

    2015-01-01

    We have microfabricated two functional components toward developing a microchip flow injection analysis (FIA) system, i.e., an open-channel electroosmotic pump and a gas-diffusion chip, consisting of two microfabricated glass wafers and a porous polytetrafluoroethylene membrane. This is the first application of gas-diffusion separation in a microchip FIA system. To demonstrate the feasibility of using these two components for performing gas-diffusion FIA, we have incorporated them together with a regular FIA injection valve and a capillary electrophoresis absorbance detector in a flow injection system for determination of ammonia in environmental water samples. This system has a limit of detection of 0.10 mg L −1 NH 3 , with a good repeatability (relative standard deviation of less than 5 % for 4.0 mg L −1 NH 3 ). Parameters affecting its performance are also discussed. (author)

  18. assessment of injection of liquid rhizobial inoculum and traditional inoculation of soybean under furrow and drip irrigation

    International Nuclear Information System (INIS)

    Janat, M.; Kurdali, F.

    2008-01-01

    Soybean in naturally N 2 -fixing legume, but it needs artificial inoculation with appropriate strains of rhizobia when introduced to land not previously cultivated to the crop. As soybean is being introduced to Syria, inoculation with Bradyrhizobium japonicum is essential to ensure effective biological nitrogen fixation by the crop. The question is: what is the most effective mean of inoculation?. As Syria is a water-short country, we examined the possibility of applying the rhizobial inoculant in irrigation system (Biofertigation) in contrast with the conventional seed pelleting application. In a 2 year experiment at a research station near Damascus, we compared seed pelleting of the inoculant under furrow and drip irrigation, with repeated inoculation by injection of a liquid culture rhizobial inoculum through the drip system. Drip irrigation enhanced N 2 fixation by soybean regardless of inoculation technique ad repeated inoculation. Injection of the liquid rhizobial inoculum through drip irrigation system was shown to enhances the acquisition of atmospheric N 2 and improve N 2 fixation by soybean.(author)

  19. Dynamic computed tomography after bolus injection and infusion of perfluorooctylbromide (PFOB)

    International Nuclear Information System (INIS)

    Adam, G.; Guenther, R.W.; Goertz, H.; Schiffer, C.

    1992-01-01

    We investigated the enhancement of the liver, the spleen, and of induced abscesses and the abdominal vessels after administration of 3 g/kg bodyweight Perfluoroocytlbromide (PFOB) on an animal model. Twenty-one rabbits each received the contrast medium as bolus injection and as slow infusion over half an hour. CT was performed between 2 and 48 hours after contrast medium application. Peak enhancement of the liver, the spleen and the liver abscess membrane was found between 24 and 48 hours after PFOB administration, independently of the application mode. Peak enhancement of the abdominal aorta and the IVC was observed within two hours after bolus injection. In this rabbit model PFOB permits best delineation of the vessels after bolus injection within the first two hours, while CT imaging of the liver, the spleen and the liver abscess membrane is best between 24 and 48 hours after contrast medium application, independent of the injection velocity. (orig.) [de

  20. Lumbar facet syndrome - Lumbar facet joint injection and low back pain

    International Nuclear Information System (INIS)

    Acevedo Gonzalez, Juan Carlos; Jimenez Hakim, Enrique; Rodriguez, Jose Maria; Hakim Daccach, Fernando; Quinonez, German; Rodriguez Munera, Andres

    2004-01-01

    The authors conducted a retrospective study lo evaluate the effectiveness of injection therapy in the lumbar zygapophysial joints with anesthetics and steroids in patients with persisting low back pain and lumbar facer syndrome. Thirty-seven patients with low back pain who reported immediate relief of their pain after controlled blocks into the facet joints between the fourth and fifth lumbar vertebrae and the fifth lumbar and first sacral vertebrae were evaluated. Outcome was evaluated using the visual analog pain scales. All outcome measures were repeated at eight days and six weeks alter controlled injection. At six-week follow-up examination 83,7% of thirty-seven patients experienced a good response to controlled blocks of the lumbar zygaphyseal (facet) joints. Good result is the pain relief of 50% or more. Fifteen patients experienced a good response with pain relief of eight points or more in the VAS

  1. Rugged Large Volume Injection for Sensitive Capillary LC-MS Environmental Monitoring

    Directory of Open Access Journals (Sweden)

    Hanne Roberg-Larsen

    2017-08-01

    Full Text Available A rugged and high throughput capillary column (cLC LC-MS switching platform using large volume injection and on-line automatic filtration and filter back-flush (AFFL solid phase extraction (SPE for analysis of environmental water samples with minimal sample preparation is presented. Although narrow columns and on-line sample preparation are used in the platform, high ruggedness is achieved e.g., injection of 100 non-filtrated water samples did not result in a pressure rise/clogging of the SPE/capillary columns (inner diameter 300 μm. In addition, satisfactory retention time stability and chromatographic resolution were also features of the system. The potential of the platform for environmental water samples was demonstrated with various pharmaceutical products, which had detection limits (LOD in the 0.05–12.5 ng/L range. Between-day and within-day repeatability of selected analytes were <20% RSD.

  2. Adaptive Injection-locking Oscillator Array for RF Spectrum Analysis

    International Nuclear Information System (INIS)

    Leung, Daniel

    2011-01-01

    A highly parallel radio frequency receiver using an array of injection-locking oscillators for on-chip, rapid estimation of signal amplitudes and frequencies is considered. The oscillators are tuned to different natural frequencies, and variable gain amplifiers are used to provide negative feedback to adapt the locking band-width with the input signal to yield a combined measure of input signal amplitude and frequency detuning. To further this effort, an array of 16 two-stage differential ring oscillators and 16 Gilbert-cell mixers is designed for 40-400 MHz operation. The injection-locking oscillator array is assembled on a custom printed-circuit board. Control and calibration is achieved by on-board microcontroller.

  3. The leucine-rich repeat structure.

    Science.gov (United States)

    Bella, J; Hindle, K L; McEwan, P A; Lovell, S C

    2008-08-01

    The leucine-rich repeat is a widespread structural motif of 20-30 amino acids with a characteristic repetitive sequence pattern rich in leucines. Leucine-rich repeat domains are built from tandems of two or more repeats and form curved solenoid structures that are particularly suitable for protein-protein interactions. Thousands of protein sequences containing leucine-rich repeats have been identified by automatic annotation methods. Three-dimensional structures of leucine-rich repeat domains determined to date reveal a degree of structural variability that translates into the considerable functional versatility of this protein superfamily. As the essential structural principles become well established, the leucine-rich repeat architecture is emerging as an attractive framework for structural prediction and protein engineering. This review presents an update of the current understanding of leucine-rich repeat structure at the primary, secondary, tertiary and quaternary levels and discusses specific examples from recently determined three-dimensional structures.

  4. Cluster endophthalmitis following multiple intravitreal bevacizumab injections from a single use vial

    Directory of Open Access Journals (Sweden)

    Perwez Khan

    2016-01-01

    Full Text Available The risk of endophthalmitis is always a concern when an intraocular procedure is performed. Intravitreal injection is a frequently used method for therapeutic management of many diseases, affecting the posterior segment of the eye. Hence, it is important to assess the risk of complications, especially endophthalmitis. Most studies conducted concentrate on risk assessment from single use from single drug vial. The present article reports the occurrence of cluster endophthalmitis following multiple intravitreal bevacizumab injections from a single vial. Intravitreal injection of bevacizumab was administered to eight eyes of eight patients. Administered dose was prepared from single 4-ml vial of bevacizumab and was injected in the eye, after patient preparation and under aseptic conditions. The procedure was repeated for the remaining patients, thereby imparting multiple pricks in the same vial. Four of the eight patients reported to the hospital on the 3rd day after injection with complaints of pain, watering, and diminution of vision. Two patients reported the following day with similar complaints. Two patients who did not report by the 4th day were contacted and recalled for an examination. All the patients were thoroughly examined using slit lamp biomicroscopy and indirect ophthalmoscopy. Six out of eight were clinically diagnosed to have endophthalmitis and were administered intravitreal antibiotics. The present report highlights possibility of microbial contamination of the drug vial or during compounding process. However, from the present incident, we are encouraged to stay vigilant and wary of contamination

  5. Shenfu injection provides protection for perinatal asphyxia in neonates

    Directory of Open Access Journals (Sweden)

    Yu Jiang

    2016-03-01

    Full Text Available This study aimed to investigate the efficacy of shenfu injection for the protection of neonates with asphyxia. Eighty neonates with asphyxia were randomly divided into two groups, treatment group and control group (n=40. Both groups received interventions such as ventilation, oxygen, and circulation support. Treatment group was administrated with shenfu injection additionally. Serum levels of creatine kinase, alanine aminotransferase, aspartate aminotransferase, creatinine, and neuron-specific enolase were significantly lower but the oxygenation index was significantly higher in treatment group on day 7 and day 14. The neurobehavioral score was significantly higher in treatment group than in control group. On the 14th day, the survival rate of treatment group (77.5% was higher than that of control group (55%. Shenfu injection could protect the function of the brain, heart, lung, liver and kidney by attenuating ischemia reperfusion after severe asphyxia resuscitation, improve neurobehavioral ability and increase the survival of neonates.

  6. Effect of repeated freezing-thawing on the Achilles tendon of rabbits.

    Science.gov (United States)

    Chen, Lianxu; Wu, Yanping; Yu, Jiakuo; Jiao, Zhaode; Ao, Yingfang; Yu, Changlong; Wang, Jianquan; Cui, Guoqing

    2011-06-01

    The increased use of allograft tissue in the reconstruction of anterior cruciate ligament has brought more focus to the effect of storage and treatment on allograft. The purpose of this study was to observe the effect of histology and biomechanics on Achilles tendon in rabbits through repeated freezing-thawing before allograft tendon transplantation. Rabbit Achilles tendons were harvested and processed according to the manufacture's protocol of tissue bank, and freezing-thawing was repeated three times (group 1) and ten times (group 2). Those received only one cycle were used as controls. Then, tendons in each group were selected randomly to make for histological observations and biomechanics test. Histological observation showed that the following changes happened as the number of freezing-thawing increased: the arrangement of tendon bundles and collagen fibrils became disordered until ruptured, cells disrupted and apparent gaps appeared between tendon bundle because the formation of ice crystals. There were significant differences between the experimental and control groups in the values of maximum load, energy of maximum load and maximum stress, whereas no significant differences existed in other values such as stiffness, maximum strain, elastic modulus, and energy density. Therefore, repeated freezing-thawing had histological and biomechanical effect on Achilles tendon in rabbits before allograft tendon transplantation. This indicates that cautions should be taken in the repeated freezing-thawing preparation of allograft tendons in clinical application.

  7. Investigation of a Quadruplex-Forming Repeat Sequence Highly Enriched in Xanthomonas and Nostoc sp.

    Directory of Open Access Journals (Sweden)

    Charlotte Rehm

    Full Text Available In prokaryotes simple sequence repeats (SSRs with unit sizes of 1-5 nucleotides (nt are causative for phase and antigenic variation. Although an increased abundance of heptameric repeats was noticed in bacteria, reports about SSRs of 6-9 nt are rare. In particular G-rich repeat sequences with the propensity to fold into G-quadruplex (G4 structures have received little attention. In silico analysis of prokaryotic genomes show putative G4 forming sequences to be abundant. This report focuses on a surprisingly enriched G-rich repeat of the type GGGNATC in Xanthomonas and cyanobacteria such as Nostoc. We studied in detail the genomes of Xanthomonas campestris pv. campestris ATCC 33913 (Xcc, Xanthomonas axonopodis pv. citri str. 306 (Xac, and Nostoc sp. strain PCC7120 (Ana. In all three organisms repeats are spread all over the genome with an over-representation in non-coding regions. Extensive variation of the number of repetitive units was observed with repeat numbers ranging from two up to 26 units. However a clear preference for four units was detected. The strong bias for four units coincides with the requirement of four consecutive G-tracts for G4 formation. Evidence for G4 formation of the consensus repeat sequences was found in biophysical studies utilizing CD spectroscopy. The G-rich repeats are preferably located between aligned open reading frames (ORFs and are under-represented in coding regions or between divergent ORFs. The G-rich repeats are preferentially located within a distance of 50 bp upstream of an ORF on the anti-sense strand or within 50 bp from the stop codon on the sense strand. Analysis of whole transcriptome sequence data showed that the majority of repeat sequences are transcribed. The genetic loci in the vicinity of repeat regions show increased genomic stability. In conclusion, we introduce and characterize a special class of highly abundant and wide-spread quadruplex-forming repeat sequences in bacteria.

  8. Investigation of a Quadruplex-Forming Repeat Sequence Highly Enriched in Xanthomonas and Nostoc sp.

    Science.gov (United States)

    Rehm, Charlotte; Wurmthaler, Lena A; Li, Yuanhao; Frickey, Tancred; Hartig, Jörg S

    2015-01-01

    In prokaryotes simple sequence repeats (SSRs) with unit sizes of 1-5 nucleotides (nt) are causative for phase and antigenic variation. Although an increased abundance of heptameric repeats was noticed in bacteria, reports about SSRs of 6-9 nt are rare. In particular G-rich repeat sequences with the propensity to fold into G-quadruplex (G4) structures have received little attention. In silico analysis of prokaryotic genomes show putative G4 forming sequences to be abundant. This report focuses on a surprisingly enriched G-rich repeat of the type GGGNATC in Xanthomonas and cyanobacteria such as Nostoc. We studied in detail the genomes of Xanthomonas campestris pv. campestris ATCC 33913 (Xcc), Xanthomonas axonopodis pv. citri str. 306 (Xac), and Nostoc sp. strain PCC7120 (Ana). In all three organisms repeats are spread all over the genome with an over-representation in non-coding regions. Extensive variation of the number of repetitive units was observed with repeat numbers ranging from two up to 26 units. However a clear preference for four units was detected. The strong bias for four units coincides with the requirement of four consecutive G-tracts for G4 formation. Evidence for G4 formation of the consensus repeat sequences was found in biophysical studies utilizing CD spectroscopy. The G-rich repeats are preferably located between aligned open reading frames (ORFs) and are under-represented in coding regions or between divergent ORFs. The G-rich repeats are preferentially located within a distance of 50 bp upstream of an ORF on the anti-sense strand or within 50 bp from the stop codon on the sense strand. Analysis of whole transcriptome sequence data showed that the majority of repeat sequences are transcribed. The genetic loci in the vicinity of repeat regions show increased genomic stability. In conclusion, we introduce and characterize a special class of highly abundant and wide-spread quadruplex-forming repeat sequences in bacteria.

  9. Risk of Injection-Site Abscess among Infants Receiving a Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in Kenya

    Science.gov (United States)

    Burton, Deron C.; Bigogo, Godfrey M.; Audi, Allan O.; Williamson, John; Munge, Kenneth; Wafula, Jackline; Ouma, Dominic; Khagayi, Sammy; Mugoya, Isaac; Mburu, James; Muema, Shadrack; Bauni, Evasius; Bwanaali, Tahreni; Feikin, Daniel R.; Ochieng, Peter M.; Mogeni, Ondari D.; Otieno, George A.; Olack, Beatrice; Kamau, Tatu; Van Dyke, Melissa K.; Chen, Robert; Farrington, Paddy; Montgomery, Joel M.; Breiman, Robert F.; Scott, J. Anthony G.; Laserson, Kayla F.

    2015-01-01

    There is a theoretical risk of adverse events following immunization with a preservative-free, 2-dose vial formulation of 10-valent-pneumococcal conjugate vaccine (PCV10). We set out to measure this risk. Four population-based surveillance sites in Kenya (total annual birth cohort of 11,500 infants) were used to conduct a 2-year post-introduction vaccine safety study of PCV10. Injection-site abscesses occurring within 7 days following vaccine administration were clinically diagnosed in all study sites (passive facility-based surveillance) and, also, detected by caregiver-reported symptoms of swelling plus discharge in two sites (active household-based surveillance). Abscess risk was expressed as the number of abscesses per 100,000 injections and was compared for the second vs first vial dose of PCV10 and for PCV10 vs pentavalent vaccine (comparator). A total of 58,288 PCV10 injections were recorded, including 24,054 and 19,702 identified as first and second vial doses, respectively (14,532 unknown vial dose). The risk ratio for abscess following injection with the second (41 per 100,000) vs first (33 per 100,000) vial dose of PCV10 was 1.22 (95% confidence interval [CI] 0.37–4.06). The comparator vaccine was changed from a 2-dose to 10-dose presentation midway through the study. The matched odds ratios for abscess following PCV10 were 1.00 (95% CI 0.12–8.56) and 0.27 (95% CI 0.14–0.54) when compared to the 2-dose and 10-dose pentavalent vaccine presentations, respectively. In Kenya immunization with PCV10 was not associated with an increased risk of injection site abscess, providing confidence that the vaccine may be safely used in Africa. The relatively higher risk of abscess following the 10-dose presentation of pentavalent vaccine merits further study. PMID:26509274

  10. Behavioral cross-sensitization between testosterone and fenproporex in adolescent and adult rats

    Directory of Open Access Journals (Sweden)

    C.Q. Conceição

    2017-11-01

    Full Text Available The abuse of psychoactive drugs is considered a global health problem. During the last years, a relevant number of studies have investigated the relationship between anabolic-androgenic steroids (AAS and other psychoactive drugs. AAS, such as testosterone, can cause a dependence syndrome that shares many features with the classical dependence to psychoactive substances. Pre-clinical evidence shows that there are interactions between testosterone and psychoactive drugs, such as cocaine. However, few studies have been performed to investigate the effect of repeated testosterone treatment on behavioral effects of amphetamine derivatives, such as fenproporex. The purpose of the present study was to investigate the effects of repeated testosterone administration on fenproporex-induced locomotor activity in adolescent and adult rats. Adolescent male Wistar rats were injected with testosterone (10 mg/kg sc for 10 days. After 3 days, animals received an acute injection of fenproporex (3.0 mg/kg ip and the locomotor activity was recorded during 40 min. Thirty days later, the same animals received the same treatment with testosterone followed by a fenproporex challenge injection as described above. Our results demonstrated that repeated testosterone induced behavioral sensitization to fenproporex in adolescent but not in adult rats. These findings suggest that repeated AAS treatment might increase the dependence vulnerability to amphetamine and its derivatives in adolescent rats.

  11. Intra-osseous injection of donor mesenchymal stem cell (MSC) into the bone marrow in living donor kidney transplantation; a pilot study.

    Science.gov (United States)

    Lee, Hyunah; Park, Jae Berm; Lee, Sanghoon; Baek, Soyoung; Kim, HyunSoo; Kim, Sung Joo

    2013-04-11

    Mesenchymal stem cells (MSCs) are multi-potent non-hematopoietic progenitor cells possessing an immune-regulatory function, with suppression of proliferation of activated lymphocytes. In this study, adult living donor kidney transplantation (LDKT) recipients were given MSCs derived from the donor bone marrow to evaluate the safety and the feasibility of immunological changes related to the intra-osseous injection of MSC into the bone marrow. MSCs were derived from negative HLA cross-match donors. Donor bone marrow was harvested 5 weeks prior to KT. At the time of transplantation, 1 x 106 cell/kg of donor MSC was directly injected into the bone marrow of the recipient's right iliac bone. Patients' clinical outcomes, presence of mixed chimerism by short tandem repeat polymerase chain reaction, analysis of plasma FoxP3 mRNA and cytokine level, and mixed lymphocyte reaction (MLR) were performed. Seven patients enrolled in this study and received donor MSC injections simultaneously with LDKT. The median age of recipients was 36 years (32 ~ 48). The number of HLA mismatches was 3 or less in 5 and more than 3 in 2. No local complications or adverse events such as hypersensitivity occurred during or after the injection of donor MSC. There was no graft failure, but the biopsy-proven acute rejections were observed in 3 recipients during the follow-up period controlled well with steroid pulse therapy (SPT). The last serum creatinine was a median of 1.23 mg/dL (0.83 ~ 2.07). Mixed chimerism was not detected in the peripheral blood of the recipients at 1 and 8 week of post-transplantation. Donor-specific lymphocyte or T cell proliferation and Treg priming responses were observed in some patients. Plasma level of IL-10, a known mediator of MSC-induced immune suppression, increased in the patients with Treg induction. Donor MSC injection into the iliac bone at the time of KT was feasible and safe. A possible correlation was observed between the induction of inhibitory

  12. Choice of intra-articular injection in treatment of knee osteoarthritis: platelet-rich plasma, hyaluronic acid or ozone options.

    Science.gov (United States)

    Duymus, Tahir Mutlu; Mutlu, Serhat; Dernek, Bahar; Komur, Baran; Aydogmus, Suavi; Kesiktas, Fatma Nur

    2017-02-01

    This study was performed to compare the efficacy of treatment in three groups of patients with knee osteoarthritis (OA) given an intra-articular injection of platelet-rich plasma (PRP), hyaluronic acid (HA) or ozone gas. A total of 102 patients with mild-moderate and moderate knee OA who presented at the polyclinic with at least a 1-year history of knee pain and VAS score ≥4 were randomly separated into three groups. Group 1 (PRP group) received intra-articular injection of PRP × 2 doses, Group 2 (HA group) received a single dose of HA, and Group 3 (Ozone group) received ozone × four doses. Weight-bearing anteroposterior-lateral and Merchant's radiographs of both knees were evaluated. WOMAC and VAS scores were applied to all patients on first presentation and at 1, 3, 6 and 12 months. At the end of the 1st month after injection, significant improvements were seen in all groups. In the 3rd month, the improvements in WOMAC and VAS scores were similar in Groups 1 and 2, while those in Group 3 were lower (p injections, as the application alone was sufficient to provide at least 12 months of pain-free daily living activities. Therapeutic study, Level I.

  13. Multiple PRP injections are more effective than single injections and hyaluronic acid in knees with early osteoarthritis: a randomized, double-blind, placebo-controlled trial.

    Science.gov (United States)

    Görmeli, Gökay; Görmeli, Cemile Ayşe; Ataoglu, Baybars; Çolak, Cemil; Aslantürk, Okan; Ertem, Kadir

    2017-03-01

    To compare the effectiveness of intraarticular (IA) multiple and single platelet-rich plasma (PRP) injections as well as hyaluronic acid (HA) injections in different stages of osteoarthritis (OA) of the knee. A total of 162 patients with different stages of knee OA were randomly divided into four groups receiving 3 IA doses of PRP, one dose of PRP, one dose of HA or a saline injection (control). Then, each group was subdivided into two groups: early OA (Kellgren-Lawrence grade 0 with cartilage degeneration or grade I-III) and advanced OA (Kellgren-Lawrence grade IV). The patients were evaluated before the injection and at the 6-month follow-ups using the EuroQol visual analogue scale (EQ-VAS) and International Knee Documentation Committee (IKDC) subjective scores. Adverse events and patient satisfaction were recorded. There was a statistically significant improvement in the IKDC and EQ-VAS scores in all the treatment groups compared with the control group. The knee scores of patients treated with three PRP injections were significantly better than those patients of the other groups. There was no significant difference in the scores of patients injected with one dose of PRP or HA. In the early OA subgroups, significantly better clinical results were achieved in the patients treated with three PRP injections, but there was no significant difference in the clinical results of patients with advanced OA among the treatment groups. The clinical results of this study suggest IA PRP and HA treatment for all stages of knee OA. For patients with early OA, multiple (3) PRP injections are useful in achieving better clinical results. For patients with advanced OA, multiple injections do not significantly improve the results of patients in any group. I.

  14. Repeated anaesthesia with isoflurane and medetomidine-midazolam-fentanyl in guinea pigs and its influence on physiological parameters.

    Directory of Open Access Journals (Sweden)

    Sabrina Schmitz

    Full Text Available Repeated anaesthesia may be required in experimental protocols and in daily veterinary practice, but anaesthesia is known to alter physiological parameters in GPs (Cavia porcellus, GPs. This study investigated the effects of repeated anaesthesia with either medetomidine-midazolam-fentanyl (MMF or isoflurane (Iso on physiological parameters in the GP. Twelve GPs were repeatedly administered with MMF or Iso in two anaesthesia sets. One set consisted of six 40-min anaesthesias, performed over 3 weeks (2 per week; the anaesthetic used first was randomized. Prior to Iso anaesthesia, atropine was injected. MMF anaesthesia was antagonized with AFN (atipamezole-flumazenil-naloxone. Abdominally implanted radio-telemetry devices recorded the mean arterial blood pressure (MAP, heart rate (HR and core body temperature continuously. Additionally, respiratory rate, blood glucose and body weight were assessed. An operable state could be achieved and maintained for 40 min in all GPs. During the surgical tolerance with MMF, the GPs showed a large MAP range between the individuals. In the MMF wake- up phase, the time was shortened until the righting reflex (RR returned and that occurred at lower MAP and HR values. Repeated Iso anaesthesia led to an increasing HR during induction (anaesthesias 2-6, non-surgical tolerance (anaesthesias 3-6 and surgical tolerance (anaesthesias 4, 6. Both anaesthetics may be used repeatedly, as repeating the anaesthesias resulted in only slightly different physiological parameters, compared to those seen with single anaesthesias. The regular atropine premedication induced HR increases and repeated MMF anaesthesia resulted in a metabolism increase which led to the faster return of RR. Nevertheless, Iso's anaesthesia effects of strong respiratory depression and severe hypotension remained. Based on this increased anaesthesia risk with Iso, MMF anaesthesia is preferable for repeated use in GPs.

  15. Rate of Post-traumatic Endophthalmitis with or without Injection of Balanced Salt Solution

    Directory of Open Access Journals (Sweden)

    Nasrin Rafati

    2013-01-01

    Full Text Available Purpose: In a study complementing a previous multicenter randomized clinical trial on prophylactic injection of intraocular antibiotics during primary repair of penetrating eye injuries (PEIs, we sought to determine whether needle entrance and injection of balanced salt solution (BSS, per se, could increase the rate of acute post-traumatic bacterial endophthalmitis (APBE. Methods: Patients randomized to the BSS injection arm (n=167 of the Traumatic Endophthalmitis Trial, and eligible patients who had refused enrollment and received no intraocular injections during primary repair (n=111 were compared for the development of APBE. Results: APBE occurred in 8 of 167 (4.8% eyes in the BSS group and in 5 of 111 (4.5% eyes in the non-injection group (P=0.91. Retained intraocular foreign bodies were present in 46 eyes including 25 (15% eyes in the BSS injection group and 21 (18.9% eyes in the non-injection group (P=0.38. Logistic regression analysis showed no significant difference between BSS injected and non-injected eyes in terms of APBE (P=0.69. However, the presence of intraocular foreign bodies was strongly associated with the risk of endophthalmitis (P<0.001, OR=14.1, 95% CI: 4.1-48.5. Conclusion: Needle entrance and intraocular injection of BSS during primary repair of PEIs does not increase the risk of APBE.

  16. Testosterone Injection

    Science.gov (United States)

    ... typical male characteristics. Testosterone injection works by supplying synthetic testosterone to replace the testosterone that is normally ... as a pellet to be injected under the skin.Testosterone injection may control your symptoms but will ...

  17. Low noise cryogenic receiver for spectroscopic applications in mm-wave radioastronomy at 230 GHz

    International Nuclear Information System (INIS)

    Pagani, L.; Ruffie, G.; Beaudin, G.; Gheudin, M.; Deschamps, A.

    1986-01-01

    A new cooled mm-wave receiver is presented. This receiver has been in operation since October 1985 with a 2.5 m Cassegrain telescope located at the Plateau de Bure in the French Alps. It is tunable from 210 to 240 GHz and has a DSB system noise temperature of 360 K and a 600 MHz instantaneous bandwidth. The receiver is composed of a local oscillator (klystron frequency tripler) and a Schottky diode mixer with a cooled FET amplifier. Quasi-optical techniques are used for signal injection. A computer-controlled microprocessor drives the whole system and performs calibration and frequency tuning of the receiver. The different parts of the receiver, frequency tripler, quasi-optical techniques, mixer, FET amplifier, and microprocessor, are described. 13 references

  18. Nicolau Syndrome after Intramuscular Injection of Non-Steroidal Anti-Inflammatory Drugs (NSAID

    Directory of Open Access Journals (Sweden)

    Mehmet Dadaci

    2015-01-01

    Full Text Available Nicolau syndrome is a rare complication of intramuscular injection that leads to local ischemic necrosis of the skin and adipose tissue. In this paper, we discuss etiologies, risk factors, and treatment options for gluteal Nicolau syndrome referring to patients treated in our hospital. Our study includes 17 women who visited our clinic with symptoms of gluteal necrosis secondary to intramuscular injection. The following variables were taken into account: injection site, drug administered, frequency of injections, the person who administered the injections, needle size, and needle tip color. Magnetic resonance images obtained in the aftermath of intramuscular injection application were carefully analyzed for presence of necrosis, cyst formation and the thickness of the gluteal fat tissue layer. Drugs that had been received in intramuscular injection were exclusively non-steroidal anti-inflammatory drugs. Mean patient BMI was 41.8 (all patients were considered as obese, and mean gluteal fat thickness was 54 mm. Standard length of needles (3.8 cm had been used in procedures. The wounds were treated with primary closure in 11 patients and with local flap therapy in 6 patients. The observed necrosis was a consequence of misplaced gluteal injection, where drugs were injected into the adipose tissue instead of the muscle due to the extreme thickness of the fat layer, on one hand, and the inappropriate length of standard needles, on the other hand. Intramuscular injection should be avoided in obese patients whenever possible: if it is necessary, proper injection technique should be used.

  19. Hysteresis of magnetostructural transitions: Repeatable and non-repeatable processes

    Science.gov (United States)

    Provenzano, Virgil; Della Torre, Edward; Bennett, Lawrence H.; ElBidweihy, Hatem

    2014-02-01

    The Gd5Ge2Si2 alloy and the off-stoichiometric Ni50Mn35In15 Heusler alloy belong to a special class of metallic materials that exhibit first-order magnetostructural transitions near room temperature. The magnetic properties of this class of materials have been extensively studied due to their interesting magnetic behavior and their potential for a number of technological applications such as refrigerants for near-room-temperature magnetic refrigeration. The thermally driven first-order transitions in these materials can be field-induced in the reverse order by applying a strong enough field. The field-induced transitions are typically accompanied by the presence of large magnetic hysteresis, the characteristics of which are a complicated function of temperature, field, and magneto-thermal history. In this study we show that the virgin curve, the major loop, and sequentially measured MH loops are the results of both repeatable and non-repeatable processes, in which the starting magnetostructural state, prior to the cycling of field, plays a major role. Using the Gd5Ge2Si2 and Ni50Mn35In15 alloys, as model materials, we show that a starting single phase state results in fully repeatable processes and large magnetic hysteresis, whereas a mixed phase starting state results in non-repeatable processes and smaller hysteresis.

  20. Hysteresis of magnetostructural transitions: Repeatable and non-repeatable processes

    International Nuclear Information System (INIS)

    Provenzano, Virgil; Della Torre, Edward; Bennett, Lawrence H.; ElBidweihy, Hatem

    2014-01-01

    The Gd 5 Ge 2 Si 2 alloy and the off-stoichiometric Ni 50 Mn 35 In 15 Heusler alloy belong to a special class of metallic materials that exhibit first-order magnetostructural transitions near room temperature. The magnetic properties of this class of materials have been extensively studied due to their interesting magnetic behavior and their potential for a number of technological applications such as refrigerants for near-room-temperature magnetic refrigeration. The thermally driven first-order transitions in these materials can be field-induced in the reverse order by applying a strong enough field. The field-induced transitions are typically accompanied by the presence of large magnetic hysteresis, the characteristics of which are a complicated function of temperature, field, and magneto-thermal history. In this study we show that the virgin curve, the major loop, and sequentially measured MH loops are the results of both repeatable and non-repeatable processes, in which the starting magnetostructural state, prior to the cycling of field, plays a major role. Using the Gd 5 Ge 2 Si 2 and Ni 50 Mn 35 In 15 alloys, as model materials, we show that a starting single phase state results in fully repeatable processes and large magnetic hysteresis, whereas a mixed phase starting state results in non-repeatable processes and smaller hysteresis

  1. Revisiting the TALE repeat.

    Science.gov (United States)

    Deng, Dong; Yan, Chuangye; Wu, Jianping; Pan, Xiaojing; Yan, Nieng

    2014-04-01

    Transcription activator-like (TAL) effectors specifically bind to double stranded (ds) DNA through a central domain of tandem repeats. Each TAL effector (TALE) repeat comprises 33-35 amino acids and recognizes one specific DNA base through a highly variable residue at a fixed position in the repeat. Structural studies have revealed the molecular basis of DNA recognition by TALE repeats. Examination of the overall structure reveals that the basic building block of TALE protein, namely a helical hairpin, is one-helix shifted from the previously defined TALE motif. Here we wish to suggest a structure-based re-demarcation of the TALE repeat which starts with the residues that bind to the DNA backbone phosphate and concludes with the base-recognition hyper-variable residue. This new numbering system is consistent with the α-solenoid superfamily to which TALE belongs, and reflects the structural integrity of TAL effectors. In addition, it confers integral number of TALE repeats that matches the number of bound DNA bases. We then present fifteen crystal structures of engineered dHax3 variants in complex with target DNA molecules, which elucidate the structural basis for the recognition of bases adenine (A) and guanine (G) by reported or uncharacterized TALE codes. Finally, we analyzed the sequence-structure correlation of the amino acid residues within a TALE repeat. The structural analyses reported here may advance the mechanistic understanding of TALE proteins and facilitate the design of TALEN with improved affinity and specificity.

  2. All-photonic quantum repeaters

    Science.gov (United States)

    Azuma, Koji; Tamaki, Kiyoshi; Lo, Hoi-Kwong

    2015-01-01

    Quantum communication holds promise for unconditionally secure transmission of secret messages and faithful transfer of unknown quantum states. Photons appear to be the medium of choice for quantum communication. Owing to photon losses, robust quantum communication over long lossy channels requires quantum repeaters. It is widely believed that a necessary and highly demanding requirement for quantum repeaters is the existence of matter quantum memories. Here we show that such a requirement is, in fact, unnecessary by introducing the concept of all-photonic quantum repeaters based on flying qubits. In particular, we present a protocol based on photonic cluster-state machine guns and a loss-tolerant measurement equipped with local high-speed active feedforwards. We show that, with such all-photonic quantum repeaters, the communication efficiency scales polynomially with the channel distance. Our result paves a new route towards quantum repeaters with efficient single-photon sources rather than matter quantum memories. PMID:25873153

  3. Laparoendoscopic transgastric histoacryl injection of gastric varices: a new surgical approach.

    Science.gov (United States)

    Kassem, Mohamed I; El-Haddad, Hani M; El-Bahrawi, Hassan A

    2013-02-01

    Gastric varices (GVs) are a common finding in Egyptian patients with portal hypertension due to cirrhosis or schistosomal hepatic fibrosis. These patients present with an acute attack or history of hematemesis. Endoscopic histoacryl injection is the standard treatment in Egypt; however, because of technical difficulties it is possible to inject only a little amount of this material, as it may endanger the channels of the flexible endoscope. We thought of a new surgical laparoendoscopic technique to obviate the need for repeated endoscopies and complete obliteration of GVs. This study was conducted on 20 patients with portal hypertension and GVs. After the patient was placed under general anesthesia, a small gastrostomy was done in the anterior gastric wall through which a 10-mm trocar was inserted for the laparoscopic camera. Injection of GVs was done via a spinal needle or a central venous line needle inserted directly. Injection of an adequate amount of histoacryl was done under direct vision. This study was conducted from July 2009 to August 2011 on 20 patients with GVs. The age range was from 22 to 56 years, with a mean age of 39.8±7.85 years. There were 14 men (70%) and 6 women (30%). Fourteen patients (70%) showed complete obliteration of GVs after one session of treatment, whereas 6 patients (30%) had unsatisfactory results and were subjected to another session. GVs were completely obliterated after the second session in 4 patients. Two cases of recurrence of GVs were operated on. This new technique enabled us to inject GVs with a suitable amount of glue material under direct vision without harming the endoscope. Use of this procedure is recommended in patients fit for surgery and those who had failed endoscopic injection sclerotherapy.

  4. Characterisation of the clinical and activated T cell response to repeat delayed-type hypersensitivity skin challenges in human subjects, with KLH and PPD, as a potential model to test T cell-targeted therapies.

    Science.gov (United States)

    Belson, Alexandra; Schmidt, Tim; Fernando, Disala; Hardes, Kelly; Scott, Nicola; Brett, Sara; Clark, Deborah; Oliveira, João Joaquim; Davis, Bill; McHugh, Simon; Stone, John

    2016-05-01

    To characterise the delayed-type hypersensitivity (DTH) skin reaction to repeated challenges of keyhole limpet hemocyanin (KLH) and tuberculin purified protein derivative (PPD) in healthy volunteers, as a potential model to test T cell-targeted investigational agents. Forty-nine subjects received either KLH, PPD, or PBS repeat skin challenges, and clinical assessments including induration, erythema and Laser Doppler Imaging. Skin biopsies or suction blisters were taken after challenge to investigate the cellular infiltrate of the challenge site, the T cell activation status, as determined by LAG-3 expression, and, specifically for the blister, the concentrations of inflammatory cytokines. Point estimates, estimates of variation and corresponding 95% confidence intervals were constructed for each type of challenge and timepoint. The DTH response could be measured at 48 and 120 h post-KLH and PPD challenge with induration, erythema and Laser Doppler Imaging, with 48 h post-challenge demonstrating the peak of the response. PPD was well tolerated in subjects after multiple challenges, however, a significant number of KLH-treated subjects demonstrated an injection site reaction 6-7 days following the SC injection. PPD demonstrated a boost effect on the second challenge as measured by increased induration, where as this was not noted consistently for KLH. Compared to unchallenged and PBS control-injected skin, increased T cell numbers were detected in the challenge site by both the skin suction blister and biopsy technique, at either time point following KLH or PPD challenge. Use of the T cell activation marker LAG-3 demonstrated the activated phenotype of these cells. In skin blisters, higher numbers of LAG-3+ T cells were detected at 48 h post-challenge, whereas in the biopsies, similar numbers of LAG-3+ cells were observed at both 48 and 120 h. Analysis of blister T cell subpopulations revealed some differences in phenotypes between the time points and between the CD4

  5. Sideband characterization and atmospheric observations with various 340 GHz heterodyne receivers

    Energy Technology Data Exchange (ETDEWEB)

    Renker, Matthias, E-mail: renker@iap.unibe.ch; Murk, Axel [Institute of Applied Physics, University of Bern, Bern (Switzerland); Rea, Simon P. [STFC Rutherford Appleton Laboratory, Didcot, Oxfordshire (United Kingdom); Emrich, A.; Frisk, U. [OMNISYS Instruments, Västra Frölunda (Sweden)

    2014-08-15

    This paper describes sideband response measurements and atmospheric observations with a double sideband and two Single Sideband (SSB) receiver prototypes developed for the multi-beam limb sounder instrument stratosphere-troposphere exchange and climate monitor radiometer. We first show an advanced Fourier-Transform Spectroscopy (FTS) method for sideband response and spurious signal characterization. We then present sideband response measurements of the different prototype receivers and we compare the results of the SSB receivers with sideband measurements by injecting a continuous wave signal into the upper and lower sidebands. The receivers were integrated into a total-power radiometer and atmospheric observations were carried out. The observed spectra were compared to forward model spectra to conclude on the sideband characteristics of the different receivers. The two sideband characterization methods show a high degree of agreement for both SSB receivers with various local oscillator settings. The measured sideband response was used to correct the forward model simulations. This improves the agreement with the atmospheric observations and explains spectral features caused by an unbalanced sideband response. The FTS method also allows to quantify the influence of spurious harmonic responses of the receiver.

  6. Prostate atypia: does repeat biopsy detect clinically significant prostate cancer?

    Science.gov (United States)

    Dorin, Ryan P; Wiener, Scott; Harris, Cory D; Wagner, Joseph R

    2015-05-01

    While the treatment pathway in response to benign or malignant prostate biopsies is well established, there is uncertainty regarding the risk of subsequently diagnosing prostate cancer when an initial diagnosis of prostate atypia is made. As such, we investigated the likelihood of a repeat biopsy diagnosing prostate cancer (PCa) in patients in which an initial biopsy diagnosed prostate atypia. We reviewed our prospectively maintained prostate biopsy database to identify patients who underwent a repeat prostate biopsy within one year of atypia (atypical small acinar proliferation; ASAP) diagnosis between November 1987 and March 2011. Patients with a history of PCa were excluded. Chart review identified patients who underwent radical prostatectomy (RP), radiotherapy (RT), or active surveillance (AS). For some analyses, patients were divided into two subgroups based on their date of service. Ten thousand seven hundred and twenty patients underwent 13,595 biopsies during November 1987-March 2011. Five hundred and sixty seven patients (5.3%) had ASAP on initial biopsy, and 287 (50.1%) of these patients underwent a repeat biopsy within one year. Of these, 122 (42.5%) were negative, 44 (15.3%) had atypia, 19 (6.6%) had prostatic intraepithelial neoplasia, and 102 (35.6%) contained PCa. Using modified Epstein's criteria, 27/53 (51%) patients with PCa on repeat biopsy were determined to have clinically significant tumors. 37 (36.3%) proceeded to RP, 25 (24.5%) underwent RT, and 40 (39.2%) received no immediate treatment. In patients who underwent surgery, Gleason grade on final pathology was upgraded in 11 (35.5%), and downgraded 1 (3.2%) patient. ASAP on initial biopsy was associated with a significant risk of PCa on repeat biopsy in patients who subsequently underwent definitive local therapy. Patients with ASAP should be counseled on the probability of harboring both clinically significant and insignificant prostate cancer. © 2015 Wiley Periodicals, Inc.

  7. Dextrose Prolotherapy Versus Control Injections in Painful Rotator Cuff Tendinopathy.

    Science.gov (United States)

    Bertrand, Helene; Reeves, Kenneth Dean; Bennett, Cameron J; Bicknell, Simon; Cheng, An-Lin

    2016-01-01

    To compare the effect of dextrose prolotherapy on pain levels and degenerative changes in painful rotator cuff tendinopathy against 2 potentially active control injection procedures. Randomized controlled trial, blinded to participants and evaluators. Outpatient pain medicine practice. Persons (N=73) with chronic shoulder pain, examination findings of rotator cuff tendinopathy, and ultrasound-confirmed supraspinatus tendinosis/tear. Three monthly injections either (1) onto painful entheses with dextrose (Enthesis-Dextrose), (2) onto entheses with saline (Enthesis-Saline), or (3) above entheses with saline (Superficial-Saline). All solutions included 0.1% lidocaine. All participants received concurrent programmed physical therapy. Primary: participants achieving an improvement in maximal current shoulder pain ≥2.8 (twice the minimal clinically important difference for visual analog scale pain) or not. Secondary: improvement in the Ultrasound Shoulder Pathology Rating Scale (USPRS) and a 0-to-10 satisfaction score (10, completely satisfied). The 73 participants had moderate to severe shoulder pain (7.0±2.0) for 7.6±9.6 years. There were no baseline differences between groups. Blinding was effective. At 9-month follow-up, 59% of Enthesis-Dextrose participants maintained ≥2.8 improvement in pain compared with Enthesis-Saline (37%; P=.088) and Superficial-Saline (27%; P=.017). Enthesis-Dextrose participants' satisfaction was 6.7±3.2 compared with Enthesis-Saline (4.7±4.1; P=.079) and Superficial-Saline (3.9±3.1; P=.003). USPRS findings were not different between groups (P=.734). In participants with painful rotator cuff tendinopathy who receive physical therapy, injection of hypertonic dextrose on painful entheses resulted in superior long-term pain improvement and patient satisfaction compared with blinded saline injection over painful entheses, with intermediate results for entheses injection with saline. These differences could not be attributed to a

  8. Nanoparticle encapsulation in red blood cells enables blood-pool magnetic particle imaging hours after injection

    International Nuclear Information System (INIS)

    Rahmer, J; Gleich, B; Borgert, J; Antonelli, A; Sfara, C; Magnani, M; Tiemann, B; Weizenecker, J

    2013-01-01

    Magnetic particle imaging (MPI) is a new medical imaging approach that is based on the nonlinear magnetization response of super-paramagnetic iron oxide nanoparticles (SPIOs) injected into the blood stream. To date, real-time MPI of the bolus passage of an approved MRI SPIO contrast agent injected into the tail vein of living mice has been demonstrated. However, nanoparticles are rapidly removed from the blood stream by the mononuclear phagocyte system. Therefore, imaging applications for long-term monitoring require the repeated administration of bolus injections, which complicates quantitative comparisons due to the temporal variations in concentration. Encapsulation of SPIOs into red blood cells (RBCs) has been suggested to increase the blood circulation time of nanoparticles. This work presents first evidence that SPIO-loaded RBCs can be imaged in the blood pool of mice several hours after injection using MPI. This finding is supported by magnetic particle spectroscopy performed to quantify the iron concentration in blood samples extracted from the mice 3 and 24 h after injection of SPIO-loaded RBCs. Based on these results, new MPI applications can be envisioned, such as permanent 3D real-time visualization of the vessel tree during interventional procedures, bleeding monitoring after stroke, or long-term monitoring and treatment control of cardiovascular diseases. (paper)

  9. Grid laser with modified pro re nata injection of bevacizumab and ranibizumab in macular edema due to branch retinal vein occlusion: MARVEL report no 2

    Directory of Open Access Journals (Sweden)

    Narayanan R

    2016-06-01

    Full Text Available Raja Narayanan,1 Bhavik Panchal,1 Michael W Stewart,2 Taraprasad Das,1 Jay Chhablani,1 Subhadra Jalali,1 Mohd Hasnat Ali3 On behalf of MARVEL study group 1Smt. Kanuri Santhamma Centre for Vitreo Retinal Diseases, L V Prasad Eye Institute, Hyderabad, India; 2Department of Ophthalmology, Mayo Clinic, Jacksonville, FL, USA; 3Department of Biostatistics, L V Prasad Eye Institute, Hyderabad, India Purpose: The purpose of this study was to prospectively study the efficacy of grid laser combined with intravitreal bevacizumab or ranibizumab in eyes with macular edema due to branch retinal vein occlusion.Patients and methods: Treatment-naïve eyes were enrolled to receive injections of ranibizumab or bevacizumab. During the first 6 months, patients were evaluated monthly and injected if the best-corrected visual acuity changed by five or more letters or fluid was noted on spectral domain optical coherence tomography (OCT; during the next 6 months, patients were evaluated bimonthly and injected only if the best-corrected visual acuity decreased by five or more letters with the associated fluid. Grid laser photocoagulation was performed if there was fluid on OCT and was repeated if patients were eligible after a minimum interval of 3 months.Results: The mean numbers of ranibizumab and bevacizumab injections were, respectively, 3.2±1.5 and 3.0±1.4 in the first 6 months and 0.3±0.6 and 0.3±0.6 in the last 6 months. ­Moreover, 55/75 (73.33% participants did not receive any injections in the last 6 months. The mean reductions in central retinal thickness at 12 months were 165.67 µm (P<0.001; 95% ­confidence interval -221.50 to -135.0 in the ranibizumab group and 184.78 µm (P<0.001; 95% confidence interval -246.49 to -140.0 in the bevacizumab group (P=0.079. More patients in the bevacizumab group compared to those in the ranibizumab group required rescue laser at 12 months (20 vs eleven; P=0.06.Conclusion: Bimonthly evaluations after month 6

  10. Fluoroscopically-guided transforaminal epidural steroid injection for the treatment of sciatica due to herniated nucleus pulposus

    International Nuclear Information System (INIS)

    Liu Xiao; Wang Jianhui; Duan Zhaohui; Xu Zhitao; Shu Xiaomin; Qiu Ronghua

    2009-01-01

    Objective: To discuss the therapeutic benefit of fluoroscopically-guided lumbar transforaminal epidural steroid injections (TFESI) in treating patients with sciatica due to a herniated nucleus pulposus. Methods: From October 2004 to November 2007, fluoroscopically-guided lumbar TFESI as performed in 79 patients (41 males and 38 females with a mean age of 45.75 years,ranged from 20 to 70 years) with sciatica due to a herniated nucleus pulposus. Patients had a symptomatic course of disease from 8 weeks to 22 years and showed no response to conservative treatment. The diagnosis was confirmed by computed tomography or magnetic resonance imaging. TFESI was performed at patient's request. Additional injections, up to 3 times, were given with an interval of 7 or 10 days. The injection medicine consisted of 25 mg of prednisolone acetate and (9-14) ml of 0.5% lidocaine. Patients were evaluated by an independent observer and received questionnaires before the initial injection and at 6,12 months after TFESI. Questionnaires included an eleven points visual analog scale (VAS) and a five points patient satisfaction scale. A successful outcome required a patient satisfaction scale score of 3 (very good) or 4(excellent) and a reduction on the VAS score of 2 or more points after TFESI. Pain relief was classified as 'excellent' when the pain was completely resolved or diminished by 5 points or more, as 'good' when a diminution of pain was 2 points or more, as 'fair' and 'poor' when a diminution of pain was 1 point or less, or even an increase in pain. Results: Twenty-nine patients received single injection, 22 patients received two, 15 patients received three and 13 patients received four times of injection, with a mean of 1.96 times per patient. The mean VAS scores were 6.5(ranged 3.5-9.5) before and 3.8(ranged 0-9.5) 6 months after the procedure. Pain relief was graded as excellent in 35 patients (44.3%), good in 26 patients(32.9%), fair in 10 patients(12.7%), and poor in 8

  11. Exercise therapy after ultrasound-guided corticosteroid injections in patients with subacromial pain syndrome

    DEFF Research Database (Denmark)

    Ellegaard, Karen; Christensen, Robin; Rosager, Sara

    2016-01-01

    BACKGROUND: Subacromial pain syndrome (SAPS) accounts for around 50 % of all cases of shoulder pain. The most commonly used treatments are glucocorticosteroid (steroid) injections and exercise therapy; however, despite treatment SAPS patients often experience relapse of their symptoms. Therefore...... the clinical effect of combining steroid and exercise therapy is highly relevant to clarify. The aim of this randomized controlled trial was to investigate if exercise therapy added to steroid injection in patients with SAPS will improve the effect of the injection therapy on shoulder pain. METHODS......: In this two-arm randomized trial running over 26 weeks, patients with unilateral shoulder pain (> 4 weeks) and thickened subacromial bursa (> 2 mm on US) were included. At baseline all participants received two steroid injections into the painful shoulder with an interval of one week. Subsequently they were...

  12. Client satisfaction among participants in a randomized trial comparing oral methadone and injectable diacetylmorphine for long-term opioid-dependency

    Directory of Open Access Journals (Sweden)

    Brissette Suzanne

    2011-07-01

    Full Text Available Abstract Background Substitution with opioid-agonists (e.g., methadone has shown to be an effective treatment for chronic long-term opioid dependency. Patient satisfaction with treatment has been associated with improved addiction treatment outcomes. However, there is a paucity of studies evaluating patients' satisfaction with Opioid Substitution Treatment (OST. In the present study, participants' satisfaction with OST was evaluated at 3 and 12 months. We sought to test the relationship between satisfaction and patients' characteristics, the treatment modality received and treatment outcomes. Methods Data from a randomized controlled trial, the North American Opiate Medication Initiative (NAOMI, conducted in Vancouver and Montreal (Canada between 2005-2008, was analyzed. The NAOMI study compared the effectiveness of oral methadone vs. injectable diacetylmorphine over 12 months. A small sub-group of patients received injectable hydromorphone on a double blind basis with diacetylmorphine. The Client Satisfaction Questionnaire (CSQ-8 was used to measure satisfaction with treatment. CSQ-8 scores, as well as retention and response to treatment, did not differ between those receiving hydromorphone and diacetylmorphine at 3 or 12 months assessments; therefore, these two groups were analyzed together as the 'injectable' treatment group. Results A total of 232 (92% and 237 (94% participants completed the CSQ-8 at 3 and 12 months, respectively. Participants in both groups were highly satisfied with treatment. Independent of treatment group, participants satisfied with treatment at 3 months were more likely to be retained at 12 months. Multivariate analysis indicated that satisfaction was greater among those randomized to the injection group after controlling for treatment effectiveness. Participants who were retained, responded to treatment, and had fewer psychological symptoms were more satisfied with treatment. Finally, open-ended comments were made by

  13. Estimating prognosis at the time of repeat whole brain radiation therapy for multiple brain metastases: The reirradiation score

    Directory of Open Access Journals (Sweden)

    Natalie Logie, MD

    2017-07-01

    Conclusions: In the largest reported cohort to receive repeat WBRT, application of the RPA score was not predictive of MS. The new ReRT score is a simple tool based on readily available clinical information.

  14. A repeatable seismic source for tomography at volcanoes

    Directory of Open Access Journals (Sweden)

    A. Ratdomopurbo

    1999-06-01

    Full Text Available One major problem associated with the interpretation of seismic signals on active volcanoes is the lack of knowledge about the internal structure of the volcano. Assuming a 1D or a homogeneous instead of a 3D velocity structure leads to an erroneous localization of seismic events. In order to derive a high resolution 3D velocity model ofMt. Merapi (Java a seismic tomography experiment using active sources is planned as a part of the MERAPI (Mechanism Evaluation, Risk Assessment and Prediction Improvement project. During a pre-site survey in August 1996 we tested a seismic source consisting of a 2.5 l airgun shot in water basins that were constructed in different flanks of the volcano. This special source, which in our case can be fired every two minutes, produces a repeatable, identical source signal. Using this source the number of receiver locations is not limited by the number of seismometers. The seismometers can be moved to various receiver locations while the source reproduces the same source signal. Additionally, at each receiver location we are able to record the identical source signal several times so that the disadvantage of the lower energy compared to an explosion source can be reduced by skipping disturbed signals and stacking several recordings.

  15. Design of the Injection and extraction system and related machine protection for the Clic Damping Rings

    CERN Document Server

    Apsimon, Robert; Barnes, Mike; Borburgh, Jan; Goddard, Brennan; Papaphilippou, Yannis; Uythoven, Jan

    2014-01-01

    Linear machines such as CLIC have relatively low rates of collision between bunches compared to their circular counterparts. In order to achieve the required luminosity, a very small spot size is envisaged at the interaction point, thus a low emittance beam is needed. Damping rings are essential for producing the low emittances needed for the CLIC main beam. It is crucial that the beams are injected and extracted from the damping rings in a stable and repeatable fashion to minimise emittance blow-up and beam jitter at the interaction point; both of these effects will deteriorate the luminosity at the interaction point. In this paper, the parameters and constraints of the injection and extraction systems are considered and the design of these systems is optimised within this parameter space. Related machine protection is considered in order to prevent damage from potential failure modes of the injection and extraction systems.

  16. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Nermine Mohamed Tawfik Foda

    2017-01-10

    Jan 10, 2017 ... sures regarding disposable injection equipment, waste containers, hand hygiene ... injection practices lead to high prevalence of NSSIs in operating rooms. .... guidelines, the availability of training courses to HCWs, and provi-.

  17. Impact of injection therapy on retinal patients with diabetic macular edema or retinal vein occlusion

    Directory of Open Access Journals (Sweden)

    Sivaprasad S

    2016-05-01

    Full Text Available Sobha Sivaprasad,1 Sesan Oyetunde2 1NIHR Biomedical Research Centre, Moorfields Eye Hospital, London, 2Allergan Holdings Ltd., Marlow, UK Purpose: An important factor in the choice of therapy is the impact it has on the patient’s quality of life. This survey aimed to understand treatment burden, treatment-related anxiety and worry, and practical issues such as appointment attendance and work absence in patients receiving injection therapy for diabetic macular edema (DME or retinal vein occlusion (RVO.Patients and methods: A European sample of 131 retinal patients completed a detailed questionnaire to elucidate the impact of injection therapy on individuals with DME or RVO.Results: RVO and DME greatly impact a patient’s quality of life. An intensive injection regimen and the requirements for multiple hospital visits place a large practical burden on the patient. Each intravitreal injection appointment (including travel time was reported to take an average of 4.5 hours, with a total appointment burden over 6 months of 13.5 hours and 20 hours for RVO and DME patients, respectively. This creates a significant burden on patient time and may make appointment attendance difficult. Indeed, 53% of working patients needed to take at least 1 day off work per appointment and 71% of patients required a carer’s assistance at the time of the injection appointment, ~6.3 hours per injection. In addition to practical issues, three-quarters of patients reported experiencing anxiety about their most recent injection treatment, with 54% of patients reporting that they were anxious for at least 2 days prior to the injection. Patients’ most desired improvement to their treatment regimen was to have fewer injections and to require fewer appointments, to achieve the same visual results.Conclusion: Patients’ quality of life is clearly very affected by having to manage an intensive intravitreal injection regimen, with a considerable treatment burden

  18. Laser fusion: an assessment of pellet injection, tracking and beam pointing

    International Nuclear Information System (INIS)

    Monsler, M.J.

    1978-01-01

    A conceptual design is presented for a target injection and final optical system which can be integrated with a lithium waterfall laser fusion reactor and operate repetitively within the presented tolerances. A high f-number focusing system using coated metal optics at 30 to 60 meters distance is suggested. An intermediate section of the differentially pumped beam tube contains flowing xenon which effectively shields the optics from debris and x rays, allowing the mirrors to operate at least a year without optical degradation. Pellets are injected with a repeating gas gun positioned horizontally just above the laser beam. No pellet trajectory correction is desired or required. Simple tracking of the target using a low power laser illuminator, a position sensing photodetector, and a trajectory prediction scheme are assumed. Two-degree of freedom x-y beam steering is preferred, without focus capability. Both the tracker and the adaptive mirror are placed in the laser building, well away from the fixed final optical mirror which faces the microexplosion

  19. Spine epidural and sacroiliac joints injections--when and how to perform.

    Science.gov (United States)

    D'Orazio, Federico; Gregori, Lorenzo Maria; Gallucci, Massimo

    2015-05-01

    To review the state-of-the-art of image-guided techniques used to treat painful syndromes of the lower back, their indications, how they should be performed, their related risks and the expected results. We describe the actual standards about image-guided infiltrative therapies both on spine and on sacroiliac joints. Both spinal epidural and sacroiliac injections appear useful in a large percentage of treated patients to get control of the perceived pain. Performing these therapies under CT or fluoroscopic guidance is the best and safest way to obtain satisfactory results because it is possible to target the use of drugs directly to the involved painful structures. Image-guided injections of the epidural space and of the sacroiliac joints are effective techniques for the treatment of pain; their effectiveness is sometimes not lasting for long periods of time but considering the low associated risk when performed by trained personnel, they can be easily repeated. Copyright © 2014 Elsevier Ireland Ltd. All rights reserved.

  20. One-minute mental status examination for category fluency is more useful than mini-mental state examination to evaluate the reliability of insulin self-injection in elderly diabetic patients.

    Science.gov (United States)

    Yajima, Ken; Matsushita, Takaya; Sumitomo, Hidetaka; Sakurai, Hirofumi; Katayama, Takashi; Kanno, Kazuo; Sakai, Masashi; Shigeta, Masayuki; Shirabe, Shinichiro; Nakano, Tadasumi; Nishimura, Kazuhiro; Ueki, Akio; Kitaoka, Masafumi

    2014-05-04

    We investigated the factors associated with the reliability of insulin self-injection in elderly diabetic patients receiving insulin therapy. We enrolled diabetic patients aged ≥65 years and receiving insulin therapy, and assessed their cognitive function by the mini-mental state examination and 1-min mental status examination for category fluency. We also observed their technique of insulin self-injection, and evaluated whether or not patients were able to inject insulin by themselves according to nine defined details in terms of insulin self-injection. The predictive factors for the reliability of insulin self-injection were determined by univariate and multivariate logistic regression analysis. There were 278 participants (135 males, 143 females) enrolled in the present study. According to multivariate logistic regression analysis, only the 1-min mental status examination score was found to be a significant independent predictor of the reliability of insulin self-injection (odds ratio 0.75; 95% confidence interval 0.62-0.90; P = 0.002). The 1-min mental status examination for category fluency can be considered more useful than mini-mental state examination to evaluate the reliability of insulin self-injection in elderly diabetic patients receiving insulin therapy.

  1. An unusual delayed complication of paraffin self-injection for penile girth augmentation.

    Science.gov (United States)

    De Siati, Mario; Selvaggio, Oscar; Di Fino, Giuseppe; Liuzzi, Giuseppe; Massenio, Paolo; Sanguedolce, Francesca; Carrieri, Giuseppe; Cormio, Luigi

    2013-12-01

    Penile self-injection of various oils is still carried out among Eastern Europe people for penile girth augmentation despite the potential destructive complications of this practice are well known. Penile reactions to such foreign bodies include scarring, abscess formation, ulceration, and even Fournier's gangrene; voiding problems due to mineral oil self-injection have been reported only once. To our knowledge, we describe the first case of paraffin self-injection for penile girth augmentation presenting with acute urinary retention. A 27-year-old Romanian man presented with severe penile pain and acute urinary retention five years after having practiced repeated penile self-injections of paraffin for penile girth augmentation. The penile shaft was massively enlarged, fibrotic and phymotic; urethral catheterization failed due to severe stricture of the proximal pendulum urethra. The patients refused placement of a suprapubic catheter and underwent immediate penile surgical exploration. The scarred tissue between dartos and Buck's fascia and a fibrotic ring occluding the urethra were removed and the penile skin reconstructed. Pathology confirmed the diagnosis of paraffinoma. The patient resumed normal voiding immediately after catheter removal on second postoperative day; he was very pleased with cosmetic, sexual and voiding results at six weeks, six months and 1 year follow-up. The present report describes a novel complication of penile self-injection for penile girth augmentation. Because of the increasing number of patients seeking penile augmentation, physicians dealing with sexual medicine should pay more attention to such request to prevent the use of non medical treatments that can turn into medical disasters.

  2. Repeat Rifaximin for Irritable Bowel Syndrome: No Clinically Significant Changes in Stool Microbial Antibiotic Sensitivity.

    Science.gov (United States)

    Pimentel, M; Cash, B D; Lembo, A; Wolf, R A; Israel, R J; Schoenfeld, P

    2017-09-01

    Rifaximin has demonstrated efficacy and safety for diarrhea-predominant irritable bowel syndrome (IBS-D). To determine the rifaximin repeat treatment effect on fecal bacterial antibiotic susceptibility. Patients with IBS in Trial 3 (TARGET 3) study who responded to open-label rifaximin 550 mg three times daily for 2 weeks, with symptom recurrence within 18 weeks, were randomized to double-blind treatment: two 2-week repeat courses of rifaximin or placebo, separated by 10 weeks. Prospective stool sample collection occurred before and after open-label rifaximin, before and after the first repeat course, and at the end of the study. Susceptibility testing was performed with 11 antibiotics, including rifaximin and rifampin, using broth microdilution or agar dilution methods. Of 103 patients receiving open-label rifaximin, 73 received double-blind rifaximin (n = 37) or placebo (n = 36). A total of 1429 bacterial and yeast isolates were identified, of which Bacteroidaceae (36.7%) and Enterobacteriaceae (33.9%) were the most common. In the double-blind phase, Clostridium difficile was highly susceptible to rifaximin [minimum inhibitory concentration (MIC) range 0.008-1 µg/mL] and rifampin (MIC range 0.004-0.25 µg/mL). Following double-blind rifaximin treatment, Staphylococcus isolates remained susceptible to rifaximin at all visits (MIC 50 range ≤0.06-32 µg/mL). Rifaximin exposure was not associated with long-term cross-resistance of Bacteroidaceae, Enterobacteriaceae, and Enterococcaceae to rifampin or nonrifamycin antibiotics tested. In this study, short-term repeat treatment with rifaximin has no apparent long-term effect on stool microbial susceptibility to rifaximin, rifampin, and nonrifamycin antibiotics. CLINICALTRIALS. NCT01543178.

  3. An observation of histological evidence on internal organ damages in mice caused by repeated exposures to motorcycle emissions

    Science.gov (United States)

    Wardoyo, Arinto Y. P.; Juswono, Unggul P.; Noor, Johan A. E.

    2017-05-01

    Motor vehicle emissions have been identified as a source of ultrafine particles, which have significant impacts on human health. Repeated and prolonged exposure to ultrafine particles may have a significant association with organ damage. Here, we evaluated the correlation between repeated exposure to ultrafine particles and organ damage in mice. Motorcycle emissions were injected into an exposure chamber with mice for a period of 20 seconds. This treatment was conducted over 10 days. The mice were sacrificed on the 2nd, 4th, 6th, 8th, and 10th days for organ preparations. Based on the results, motorcycle emission exposure caused organ damage in mice, with different severities depending on the organ. The highest damage was found for the lung, followed by the kidney, erythrocytes, and liver.

  4. Acupuncture Injection Combined with Electrokinetic Injection for Polydimethylsiloxane Microfluidic Devices

    Directory of Open Access Journals (Sweden)

    Ji Won Ha

    2017-01-01

    Full Text Available We recently reported acupuncture sample injection that leads to reproducible injection of nL-scale sample segments into a polydimethylsiloxane (PDMS microchannel for microchip capillary electrophoresis. The advantages of the acupuncture injection in microchip capillary electrophoresis include capability of minimizing sample loss and voltage control hardware and capability of introducing sample plugs into any desired position of a microchannel. However, the challenge in the previous study was to achieve reproducible, pL-scale sample injections into PDMS microchannels. In the present study, we introduce an acupuncture injection technique combined with electrokinetic injection (AICEI technique to inject pL-scale sample segments for microchip capillary electrophoresis. We carried out the capillary zone electrophoresis (CZE separation of FITC and fluorescein, and the mixture of 10 μM FITC and 10 μM fluorescein was separated completely by using the AICEI method.

  5. Properties of the chromatin assembled on DNA injected into Xenopus oocytes and eggs

    International Nuclear Information System (INIS)

    Gargiulo, G.; Wasserman, W.; Worcel, A.

    1983-01-01

    The onset of DNA synthesis occurs between 10 and 30 minutes after activation of the egg and thus the transition from nuclease-sensitive to nuclease-resistant supercoils may take place on the newly replicated DNA. To test this possibility, the nonradioactive circular 5-kb DNA carrying the Drosophila histone gene repeat and [α -32 P]dCTP were coinjected into fertilized eggs. Such protocol labels both the injected, replicated heterologous DNA and the replicated endogenous, maternal Xenopus DNA. The labeled, presumably replicated, supercoiled DNA is resistant to micrococcal nuclease as expected. The endogenous, high-molecular-weight Xenopus DNA is degraded to 180-bp nucleosomal DNA. Thus, the nuclease resistance is not a general property of chromatin during the cleavage stage of the Xenopus embryo but is a peculiar feature of the injected DNA. 42 references, 5 figures

  6. Allergic anaphylaxis due to subcutaneously injected heparin

    Directory of Open Access Journals (Sweden)

    Anders Diana

    2013-01-01

    Full Text Available Abstract Heparins are one of the most used class of anticoagulants in daily clinical practice. Despite their widespread application immune-mediated hypersensitivity reactions to heparins are rare. Among these, the delayed-type reactions to s.c. injected heparins are well-known usually presenting as circumscribed eczematous plaques at the injection sites. In contrast, potentially life-threatening systemic immediate-type anaphylactic reactions to heparins are extremely rare. Recently, some cases of non-allergic anaphylaxis could be attributed to undesirable heparin contaminants. A 43-year-old patient developed severe anaphylaxis symptoms within 5–10 minutes after s.c. injection of enoxaparin. Titrated skin prick testing with wheal and flare responses up to an enoxaparin dilution of 1:10.000 indicated a probable allergic mechanism of the enoxaparin-induced anaphylaxis. The basophil activation test as an additional in-vitro test method was negative. Furthermore, skin prick testing showed rather broad cross-reactivity among different heparin preparations tested. In the presented case, history, symptoms, and results of skin testing strongly suggested an IgE-mediated allergic hypersensitivity against different heparins. Therefore, as safe alternative anticoagulants the patient could receive beneath coumarins the hirudins or direct thrombin inhibitors. Because these compounds have a completely different molecular structure compared with the heparin-polysaccharides.

  7. 78 FR 65594 - Vehicular Repeaters

    Science.gov (United States)

    2013-11-01

    ... coordinators estimate the effect on coordination fees? Does the supposed benefit that mobile repeater stations... allow the licensing and operation of vehicular repeater systems and other mobile repeaters by public... email: [email protected] or phone: 202-418- 0530 or TTY: 202-418-0432. For detailed instructions for...

  8. Quantitative Differences Between the First and Second Injection of Contrast Agent in Contrast-Enhanced Ultrasonography of Feline Kidneys and Spleen.

    Science.gov (United States)

    Stock, Emmelie; Vanderperren, Katrien; Haers, Hendrik; Duchateau, Luc; Hesta, Myriam; Saunders, Jimmy H

    2017-02-01

    Contrast-enhanced ultrasound is a valuable and safe technique for the evaluation of organ perfusion. Repeated injections of ultrasound contrast agent are often administered during the same imaging session. However, it remains unclear if quantitative differences are present between the consecutive microbubble injections. Therefore, the first and second injection of contrast agent for the left renal cortex, renal medulla and the splenic parenchyma in healthy cats were compared. A lower peak intensity and area under the curve were observed for the first injection of contrast agent in the feline kidney, both for the renal cortex and medulla, and spleen. Moreover, for the renal cortex, the time-intensity curve was steeper after the second injection. Findings from the present study demonstrate that a second injection of contrast agent provides stronger enhancement. The exact mechanism behind our findings remains unclear; however, saturation of the lung macrophages is believed to play an important role. Copyright © 2016 World Federation for Ultrasound in Medicine & Biology. Published by Elsevier Inc. All rights reserved.

  9. Safety of radiofrequency treatment over human skin previously injected with medium-term injectable soft-tissue augmentation materials: a controlled pilot trial.

    Science.gov (United States)

    Alam, Murad; Levy, Ross; Pajvani, Urvi; Pavjani, Urvi; Ramierez, James A; Guitart, Joan; Veen, Heather; Gladstone, Hayes B

    2006-03-01

    Several soft-tissue augmentation materials are now available for reduction of nasolabial fold creases and perioral rhytides. Nasolabial folds and perioral rhytides can also be improved by skin tightening delivered by non-ablative radiofrequency (RF) treatment. The purpose of this study was to assess the safety of RF treatment over skin areas recently injected with medium-term injectable soft-tissue augmentation materials. Five subjects were assigned to the experimental arm (augmentation materials plus RF) and one to the control arm (augmentation materials alone). Each subject received injections of 0.3 mL of hyaluronic acid derivative (Restylane) and calcium hydroxylapatite (Radiesse) 3 cm apart on the upper inner arm. Two weeks later, two non-overlapping passes of RF (Thermage ThermaCool TC) were delivered at 63.5 setting with medium-fast 1.5 cm2 tip over injected sites in all of the experimental subjects. Punch skin biopsies were obtained 3 days later from each of the two injection sites on each subject. Light microscopy and digital photomicrographs obtained at low, medium, and high power showed no difference between filler materials in experimental and control subjects. In both cases filler was evident at the deep dermal-subcutaneous junction. Nodule formation, foreign body extravasation, or hemorrhage/clot was not observed grossly or histologically. Subjects and physicians did not report any difference in signs and symptoms between the experimental and control arms. Slightly increased transitory pain was noted when RF was delivered over filler versus over normal skin. Applying RF treatment over the same area 2 weeks after deep dermal injection with hyaluronic acid derivatives or calcium hydroxylapatite does not appear to cause gross morphological changes in the filler material or surrounding skin. Further studies with different parameters are necessary to confirm these findings. 2006 Wiley-Liss, Inc.

  10. Tevatron serial data repeater system

    International Nuclear Information System (INIS)

    Ducar, R.J.

    1981-01-01

    A ten megabit per second serial data repeater system has been developed for the 6.28km Tevatron accelerator. The repeaters are positioned at each of the thirty service buildings and accommodate control and abort system communications as well as distribution of the Tevatron time and energy clocks. The repeaters are transparent to the particular protocol of the transmissions. Serial data are encoded locally as unipolar two volt signals employing the self-clocking Manchester Bi-Phase code. The repeaters modulate the local signals to low-power bursts of 50 MHz rf carrier for the 260m transmission between service buildings. The repeaters also demodulate the transmission and restructure the data for local utilization. The employment of frequency discrimination techniques yields high immunity to the characteristic noise spectrum

  11. Short-term outcome after intravitreal ranibizumab injections for the treatment of retinopathy of prematurity.

    Science.gov (United States)

    Castellanos, María Ana Martínez; Schwartz, Shulamit; García-Aguirre, Gerardo; Quiroz-Mercado, Hugo

    2013-07-01

    To evaluate ocular outcome in premature infants treated with intravitreal ranibizumab injections for retinopathy of prematurity (ROP) over a period of 3 years. An interventional case series. Premature infants with high-risk prethreshold or threshold ROP with plus disease received an off label monotherapy with intravitreal injections of ranibizumab. The primary outcome was treatment success defined as regression of neovascularisation (NV) and absence of recurrence. The secondary outcomes were ocular and systemic adverse events and visual acuity. Six eyes were included in the study and treated with intravitreal injections of ranibizumab. All showed complete resolution of NV after a single injection. The anti-angiogenic intravitreal injections allowed for continued normal vessel growth into the peripheral retina, without any signs of disease recurrence or progression during the follow up period. No ocular or systemic adverse effects were observed. Three years of follow up in a small series suggest that intravitreal ranibizumab injections for ROP result in apparently preserved ocular outcome. Further large scale studies are needed to address the long-term safety and efficacy.

  12. Impact of iodized oil injection during pregnancy on thyroid function tests of offspring

    International Nuclear Information System (INIS)

    Saadat, N.; Sheikholeslam, R.; Azizi, F.

    2002-01-01

    Previous studies have shown that injection of iodized oil in pregnant women can be used as a prophylactic strategy for iodine deficiency disorders and may improve the growth indices of their offspring. Since administration of pharmacological doses of iodine may lead occasionally to large goiter and rarely to hypothyroidism, in the present study the thyroid function tests of neonates and infants born to women who had received 480 mg iodized oil intramuscularly during pregnancy were assessed and compared to those of a control group. Off 277 cord blood samples obtained from Mazandaran and Khohkiluyeh-Boyerahmad provinces, 125 made up the case (injected) and 152 the control (non-injected) group. Of 1026 blood samples of the neonates and infants from Mazandaran province. 544 made up the case and 482 the control group. Serum T 4 , T 3 and TSH concentrations were measured with RIA kits. in the cord blood samples, mean serum T 4 in cases who had received iodized oil was lower than that of the control group:140± 32 vs. 149± 33 nmol/L, respectively; p 3 and TSH were not however different. In the neonates and infants, T 4 and T 3 concentrations were significantly higher in the case than control group:178± 40 vs. 168± and 3.5±0,02 nmol/L, respectively, both p 3 and decreased TSH were seen in infants of mothers who were injected in the second and third trimesters of pregnancy. Injection of iodized oil in pregnant women does not cause hypothyroidism in the offsprings, however it does cause a transient increase in serum thyroid hormones and a decrease in TSH concentrations

  13. Compressed air injection technique to standardize block injection pressures.

    Science.gov (United States)

    Tsui, Ban C H; Li, Lisa X Y; Pillay, Jennifer J

    2006-11-01

    Presently, no standardized technique exists to monitor injection pressures during peripheral nerve blocks. Our objective was to determine if a compressed air injection technique, using an in vitro model based on Boyle's law and typical regional anesthesia equipment, could consistently maintain injection pressures below a 1293 mmHg level associated with clinically significant nerve injury. Injection pressures for 20 and 30 mL syringes with various needle sizes (18G, 20G, 21G, 22G, and 24G) were measured in a closed system. A set volume of air was aspirated into a saline-filled syringe and then compressed and maintained at various percentages while pressure was measured. The needle was inserted into the injection port of a pressure sensor, which had attached extension tubing with an injection plug clamped "off". Using linear regression with all data points, the pressure value and 99% confidence interval (CI) at 50% air compression was estimated. The linearity of Boyle's law was demonstrated with a high correlation, r = 0.99, and a slope of 0.984 (99% CI: 0.967-1.001). The net pressure generated at 50% compression was estimated as 744.8 mmHg, with the 99% CI between 729.6 and 760.0 mmHg. The various syringe/needle combinations had similar results. By creating and maintaining syringe air compression at 50% or less, injection pressures will be substantially below the 1293 mmHg threshold considered to be an associated risk factor for clinically significant nerve injury. This technique may allow simple, real-time and objective monitoring during local anesthetic injections while inherently reducing injection speed.

  14. Repeat Customer Success in Extension

    Science.gov (United States)

    Bess, Melissa M.; Traub, Sarah M.

    2013-01-01

    Four multi-session research-based programs were offered by two Extension specialist in one rural Missouri county. Eleven participants who came to multiple Extension programs could be called "repeat customers." Based on the total number of participants for all four programs, 25% could be deemed as repeat customers. Repeat customers had…

  15. Film repeats in radiology department

    International Nuclear Information System (INIS)

    Suwan, A. Z.; Al-Shakharah, A. I

    1997-01-01

    During a one year period, 4910 radiographs of 55780 films were repeated. The objective of our study was to analyse and to classify the causes in order to minimize the repeats, cut the expenses and to provide optimal radiographs for accurate diagnosis. Analysis of the different factors revealed that, 43.6% of film repeats in our service were due to faults in exposure factors, centering comprises 15.9% of the repeats, while too much collimation was responsible for 7.6% of these repeats. All of which can be decreased by awareness and programmed training of technicians. Film blurring caused by patient motion was also responsible for 4.9% for radiographs reexamination, which can be minimized by detailed explanation to the patient and providing the necessary privacy. Fogging of X-Ray films by improper storage or inadequate handling or processing faults were responsible for 14.5% in repeats in our study. Methods and criteria for proper storage and handling of films were discussed. Recommendation for using modern day-light and laser processor has been high lighted. Artefacts are noticeably high in our cases, due to spinal dresses and frequent usage of precious metals for c osmotic purposes in this part of the world. The repeated films comprise 8.8% of all films We conclude that, the main factor responsible for repeats of up to 81.6% of cases was the technologists, thus emphasizing the importance of adequate training of the technologists. (authors). 15 refs., 9 figs., 1 table

  16. "Injection first": a unique group of injection drug users in Tijuana, Mexico.

    Science.gov (United States)

    Morris, Meghan D; Brouwer, Kimberly C; Lozada, Remedios M; Gallardo, Manuel; Vera, Alicia; Strathdee, Steffanie A

    2012-01-01

    Using baseline data from a study of injection drug users (IDUs) in Tijuana, Mexico (N = 1,052), we identified social and behavioral factors associated with injecting at the same age or earlier than other administration routes of illicit drug use (eg, "injection first") and examined whether this IDU subgroup had riskier drug using and sexual behaviors than other IDUs. Twelve-percent "injected first." Characteristics independently associated with a higher odds of "injection first" included being younger at first injection, injecting heroin as their first drug, being alone at the first injection episode, and having a sexual debut at the same age or earlier as when they initiated drug use; family members' illicit drug use was associated with lower odds of injecting first. When adjusting for age at first injection and number of years injecting, "injection first" IDUs had lower odds of ever overdosing, and ever trading sex. On the other hand, they were less likely to have ever been enrolled in drug treatment, and more commonly obtained their syringes from potentially unsafe sources. In conclusion, a sizable proportion of IDUs in Tijuana injected as their first drug using experience, although evidence that this was a riskier subgroup of IDUs was inconclusive.  Copyright © American Academy of Addiction Psychiatry.

  17. Chronic copper poisoning. III. Effects of copper acetate injected into the bloodstream of sheep

    Energy Technology Data Exchange (ETDEWEB)

    Todd, J R; Thompson, R H

    1964-01-01

    A study was made of the clinical and biochemical effects of injections of copper (as acetate) into the bloodstream of sheep of 100 to 130 lb. liveweight. Copper in a dose of 160 mg. caused death in 3 sheep in a few hours, and 80 mg. caused death in 3 out of 4 sheep, 2 after 2 days and 1 after 11 days. Symptoms, biochemical lesions and post-mortem appearances did not resemble those of chronic copper poisoning, but rather those of gastro-enteritis. Blood glutathione concentrations were not markedly reduced, but haemoconcentration was a prominent feature. Post-mortem examination showed gross congestion of blood vessels and marked inflammatory reactions in the abomasum and small intestine. Single injections of smaller amounts (25 to 40 mg. copper) were tolerated without effect, but repeated injections, twice daily for 2 to 3 days, caused haemolytic episodes in 3 sheep similar to the crisis of chronic copper poisoning in that a marked reduction in blood glutathione concentration and accumulation of methaemoglobin occurred. No other clinical effects were produced, however, and all three animals recovered uneventfully.

  18. Repeat migration and disappointment.

    Science.gov (United States)

    Grant, E K; Vanderkamp, J

    1986-01-01

    This article investigates the determinants of repeat migration among the 44 regions of Canada, using information from a large micro-database which spans the period 1968 to 1971. The explanation of repeat migration probabilities is a difficult task, and this attempt is only partly successful. May of the explanatory variables are not significant, and the overall explanatory power of the equations is not high. In the area of personal characteristics, the variables related to age, sex, and marital status are generally significant and with expected signs. The distance variable has a strongly positive effect on onward move probabilities. Variables related to prior migration experience have an important impact that differs between return and onward probabilities. In particular, the occurrence of prior moves has a striking effect on the probability of onward migration. The variable representing disappointment, or relative success of the initial move, plays a significant role in explaining repeat migration probabilities. The disappointment variable represents the ratio of actural versus expected wage income in the year after the initial move, and its effect on both repeat migration probabilities is always negative and almost always highly significant. The repeat probabilities diminish after a year's stay in the destination region, but disappointment in the most recent year still has a bearing on the delayed repeat probabilities. While the quantitative impact of the disappointment variable is not large, it is difficult to draw comparisons since similar estimates are not available elsewhere.

  19. Intradiscal corticosteroid injections in spondylotic cervical radiculopathy

    International Nuclear Information System (INIS)

    Fayad, Fouad; Rannou, Francois; Rahmani, Lamia; Lefevre-Colau, Marie-Martine; Nys, Alain; Poiraudeau, Serge; Ledoux, Michel; Revel, Michel; Drape, Jean L.; Chevrot, Alain

    2007-01-01

    The purpose of this study was to evaluate treatment outcomes with intradiscal injection of corticosteroids (IDIC) in cervical spondylotic radiculopathy. Twenty consecutive patients were treated with intradiscal injection of 25 mg of acetate of prednisolone under fluoroscopic control. All patients had previously received a nonsurgical treatment for at least 3 months without success. Outcomes were assessed 1, 3 and 6 months after IDIC. Radicular pain reduction as scored on a visual analogue scale (VAS 100-mm length) was statistically significant at 1 month (19.0±28.0 mm; p=0.008), 3 months (25.2±27.5 mm; p=0.002), and 6 months (24.6±28.4 mm; p=0.001). In all, 40% of treated patients described at least 50% pain improvement 6 months after treatment. Four patients had complete relief of radicular pain. In conclusion, IDIC should be an alternative in the nonsurgical management of cervical spondylotic radiculopathy. (orig.)

  20. Value of computed tomography for evaluating the injection site in endosonography-guided celiac plexus neurolysis

    International Nuclear Information System (INIS)

    Sakamoto, Hiroki; Kitano, Masayuki; Nishio, Takeshi; Takeyama, Yoshifumi; Yasuda, Chikao; Kudo, Masatoshi

    2006-01-01

    Endosonography-guided celiac plexus neurolysis (EUS-CPN) safely and effectively relieves pain associated with intra-abdominal malignancies when the neurolytic is accurately injected. We applied contrast medium to evaluate the ethanol injection sites in patients who received EUS-CPN due to abdominal pain caused by malignancies. We injected, under the guidance of endoscopic ultrasonography (EUS), ethanol containing 10% contrast medium into the celiac plexus of patients with intra-abdominal pain due to malignancies. Immediately after the endoscopic therapy, patients underwent computed tomography (CT) to confirm the injection site. Images of distribution of injected solutions were classified into three groups. Injected solution dispersed in unilateral and bilateral anterocrural space was defined as ''unilateral injection'' or bilateral injection'', respectively. Injected solution located out of the anterocrural space was defined as ''inappropriate injection''. Pre- and postprocedure pain was assessed using a standard analog scale. Before and 2, 4, 8, 12, and 16 weeks after the procedure, pain scores were evaluated. From April 2003 to May 2005, 13 patients were enrolled in this study. Improvement of pain score in the ''bilateral injection'' and ''unilateral injection'' groups was significantly superior to the change in the ''inappropriate injection'' group. Although EUS-CPN was effective in eight of 13 patients (61.5%), additional EUS-CPN to the ''inappropriate injection group'' increased the response rate to 84.6%. Injection of ethanol to the anterocrural space by EUS-CPN produced adequate pain relief. Immediate examination by CT for confirmation of injection sites after EUS-CPN would increase the likelihood of induction of pain relief. (author)

  1. The Vestibular Effects of Repeated Low-Level Blasts.

    Science.gov (United States)

    Littlefield, Philip D; Pinto, Robin L; Burrows, Holly L; Brungart, Douglas S

    2016-01-01

    The objective of this study was to use a prospective cohort of United States Marine Corps (USMC) instructors to identify any acute or long-term vestibular dysfunction following repeated blast exposures during explosive breaching training. They were assessed in clinic and on location during training at the USMC Methods of Entry School, Quantico, VA. Subjects received comprehensive baseline vestibular assessments and these were repeated in order to identify longitudinal changes. They also received shorter assessments immediately following blast exposure in order to identify acute findings. The main outcome measures were the Neurobehavioral Symptom Inventory, vestibular Visual Analog Scale (VAS) of subjective vestibular function, videonystagmography (VNG), vestibular evoked myogenic potentials (VEMP), rotary chair (including the unilateral centrifugation test), computerized dynamic posturography, and computerized dynamic visual acuity. A total of 11 breachers and 4 engineers were followed for up to 17 months. No acute effects or longitudinal deteriorations were identified, but there were some interesting baseline group differences. Upbeat positional nystagmus was common, and correlated (p<0.005) with a history of mild traumatic brain injury (mTBI). Several instructors had abnormally short low-frequency phase leads on rotary chair testing. This study evaluated breaching instructors over a longer test period than any other study, and the results suggest that this population appears to be safe from a vestibular standpoint at the current exposure levels. Upbeat positional nystagmus correlated with a history of mTBI in this population, and this has not been described elsewhere. The data trends also suggest that this nystagmus could be an acute blast effect. However, the reasons for the abnormally short phase leads seen in rotary chair testing are unclear at this time. Further investigation seems warranted.

  2. Repeat participation in annual cross-sectional surveys of drug users and its implications for analysis.

    Science.gov (United States)

    Agius, P A; Aitken, C K; Breen, C; Dietze, P M

    2018-06-04

    We sought to establish the extent of repeat participation in a large annual cross-sectional survey of people who inject drugs and assess its implications for analysis. We used "porn star names" (the name of each participant's first pet followed by the name of the first street in which they lived) to identify repeat participation in three Australian Illicit Drug Reporting System surveys. Over 2013-2015, 2468 porn star names (96.2%) appeared only once, 88 (3.4%) twice, and nine (0.4%) in all 3 years. We measured design effects, based on the between-cluster variability for selected estimates, of 1.01-1.07 for seven key variables. These values indicate that the complex sample is (e.g.) 7% less efficient in estimating prevalence of heroin use (ever) than a simple random sample, and 1% less efficient in estimating number of heroin overdoses (ever). Porn star names are a useful means of tracking research participants longitudinally while maintaining their anonymity. Repeat participation in the Australian Illicit Drug Reporting System is low (less than 5% per annum), meaning point-prevalence and effect estimation without correction for the lack of independence in observations is unlikely to seriously affect population inference.

  3. Quantum repeated games revisited

    International Nuclear Information System (INIS)

    Frąckiewicz, Piotr

    2012-01-01

    We present a scheme for playing quantum repeated 2 × 2 games based on Marinatto and Weber’s approach to quantum games. As a potential application, we study the twice repeated Prisoner’s Dilemma game. We show that results not available in the classical game can be obtained when the game is played in the quantum way. Before we present our idea, we comment on the previous scheme of playing quantum repeated games proposed by Iqbal and Toor. We point out the drawbacks that make their results unacceptable. (paper)

  4. A 200kW central receiver CPV system

    Energy Technology Data Exchange (ETDEWEB)

    Lasich, John, E-mail: jbl@raygen.com; Thomas, Ian, E-mail: ithomas@raygen.com; Hertaeg, Wolfgang; Shirley, David; Faragher, Neil; Erenstrom, Neil; Carter, Sam; Cox, Brian; Zuo, Xinyi [Raygen Resources Pty. Ltd., 15 King Street, Blackburn, Victoria, 3130 (Australia)

    2015-09-28

    Raygen Resources has recently completed a Central Receiver CPV (CSPV) pilot plant in Central Victoria, Australia. The system is under final commissioning and initial operation is expected in late April 2015. The pilot demonstrates a full scale CSPV repeatable unit in a form that is representative of a commercial product and provides a test bed to prove out performance and reliability of the CSPV technology. Extensive testing of the system key components: dense array module, wireless solar powered heliostat and control system has been performed in the laboratory and on sun. Results from this key component testing are presented herein.

  5. Non-Operative Treatment Versus Steroid Injections in the Management of Unicameral Bone Cysts

    Directory of Open Access Journals (Sweden)

    WI Faisham

    2011-07-01

    Full Text Available The cases of nine patients with unicameral bone cysts were reviewed from two orthopaedic centres. In one hospital, five patients received serial steroid injections, and at the other hospital four patients were treated conservatively following fractures. In the steroid injection group, three cases were in the proximal femur and two in the proximal humerus. The five steroid injection patients showed radiological evidence of cyst healing within six months of treatment. Subsequently four of the patients showed a satisfactory radiological outcome after a year and complete resolution after 2 years. In the conservative group, all four cases were in the proximal humerus. Persistent cystic lesions were observed in all four patients and two was complicated by another fracture within six months.

  6. Dynamics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease

    Science.gov (United States)

    Malinova, Lidia I.; Simonenko, Georgy V.; Denisova, Tatyana P.; Tuchin, Valery V.

    2007-02-01

    Dynamics of glucose concentration in human organism is an important diagnostic characteristic for it's parameters correlate significantly with the severity of metabolic, vessel and perfusion disorders. 36 patients with stable angina pectoris of II and III functional classes were involved in this study. All of them were men in age range of 45-59 years old. 7 patients hospitalized with acute myocardial infarction (aged from 49 to 59 years old) form the group of compare. Control group (n = 5) was of practically healthy men in comparable age. To all patients intravenous glucose solution (40%) in standard loading dose was injected. Capillary and vein blood samples were withdrawn before, and 5, 60, 120, 180 and 240 minutes after glucose load. At these time points blood pressure and glucose concentration were measured. In prepared blood smears shape, deformability and sizes of erythrocytes, quantity and degree of shear stress resistant erythrocyte aggregates were studied. Received data were approximated by polynomial of high degree to receive concentration function of studied parameters, which first derivative elucidate velocity characteristics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease and practically healthy persons. Received data show principle differences in dynamics of morphofunctional erythrocyte properties during intravenous glucose injection in patients with coronary heart disease as a possible mechanism of coronary blood flow destabilization.

  7. A bio-ballistic micro-jet for drug injection into animal skin using a Nd:YAG laser

    Science.gov (United States)

    Yoh, J. J.; Jang, H.; Park, M.; Han, T.; Hah, J.

    2016-01-01

    Imaging of the abdominal skin of a guinea pig after injecting a fluorescent probe and biotin via the laser-induced ballistic technique revealed the epidermal and dermal layers which were stained well below 60 \\upmu m underneath the outer layer of the skin. An extensive network of cells was evident in the deeper layer of the stained dermis as the distributed fluorescein isothiocyanate dose was administered by repeated injection using a laser-based micro-jet. We performed optically controlled release of the drug by breaching the guinea pig's skin tissue targeting the region 10-400 \\upmu m beneath the outermost layer. Tissue damage was minimized by reducing the injection volume to approximately 100 nl per pulse. This was done using a micro-jet diameter equal to half of that of a conventional 200 \\upmu m syringe needle. Thus, the optimally controlled delivery of liquid drugs using an irradiated laser pulse was shown to be possible.

  8. Female spouses of injection drug users in Pakistan: a bridge population of the HIV epidemic?

    Science.gov (United States)

    Ahmad, S; Mehmood, J; Awan, A B; Zafar, S T; Khoshnood, K; Khan, A A

    2011-04-01

    An estimated 21% of injection drug users (IDUs) in Pakistan are HIV-positive and data suggest that the spouses of IDUs may be a critical component of the HIV transmission chain. This study interviewed 101 spouses of male IDUs about their sexual practices and drug use. We found that 43% had been sexually active with their partners in the past month but only 4% reported selling sex. Almost a quarter (23%) used drugs and 19% injected drugs, usually a combination of diazepam and pheniramine. Although sex work was infrequent among spouses of IDUs, their risk of contracting HIV and transmitting it to others was high because they received injection drugs, sometimes along with their IDU husbands, from the same health centres that provided therapeutic injections to the rest of the community. IDU spouses may thus serve as a bridge group via therapeutic injections, rather than via sex work.

  9. Optical 16-QAM-52-OFDM transmission at 4 Gbit/s by directly modulating a coherently injection-locked colorless laser diode.

    Science.gov (United States)

    Chi, Yu-Chieh; Li, Yi-Cheng; Wang, Huai-Yung; Peng, Peng-Chun; Lu, Hai-Han; Lin, Gong-Ru

    2012-08-27

    Coherently injection-locked and directly modulated weak-resonant-cavity laser diode (WRC-FPLD) for back-to-back optical 16-quadrature-amplitude-modulation (QAM) and 52-subcarrier orthogonal frequency division multiplexing (OFDM) transmission with maximum bit rate up to 4 Gbit/s at carrier frequency of 2.5 GHz is demonstrated. The WRC-FPLD transmitter source is a specific design with very weak-resonant longitudinal modes to preserve its broadband gain spectral characteristics for serving as a colorless WDM-PON transmitter. Under coherent injection-locking, the relative-intensity noise (RIN) of the injection-locked WRC-FPLD can be suppressed to ?105 dBc/Hz and the error vector magnitude of the received optical OFDM data is greatly reduced with the amplitude error suppressed down 5.5%. Such a coherently injection-locked single-mode WRC-FPLD can perform both the back-to-back and the 25-km-SMF 16-QAM-52-OFDM transmissions with a symbol rate of 20-MSa/s in each OFDM subcarrier. After coherent injection locking, the BER of the back-to-back transmitted 16-QAM-52-OFDM data is reduced to 2.5 × 10(-5) at receiving power of ?10 dBm. After propagating along a 25-km-long SMF, a receiving power sensitivity of ?7.5 dBm is required to obtain a lowest BER of 2.5 × 10(-5), and a power penalty of 2.7 dB is observed when comparing with the back-to-back transmission.

  10. Time-lapse seismic - repeatability versus usefulness and 2D versus 3D

    Science.gov (United States)

    Landro, M.

    2017-12-01

    Time-lapse seismic has developed rapidly over the past decades, especially for monitoring of oil and gas reservoirs and subsurface storage of CO2. I will review and discuss some of the critical enabling factors for the commercial success of this technology. It was early realized that how well we are able to repeat our seismic experiment is crucial. However, it is always a question of detectability versus repeatability. For marine seismic, there are several factors limiting the repeatability: Weather conditions, positioning of sources and receivers and so on. I will discuss recent improvements in both acquisition and processing methods over the last decade. It is well known that repeated 3D seismic data is the most accurate tool for reservoir monitoring purposes. However, several examples show that 2D seismic data may be used for monitoring purposes despite lower repeatability. I will use examples from an underground blow out in the North Sea, and repeated 2D seismic lines acquired before and after the Tohoku earthquake in 2011 to illustrate this. A major challenge when using repeated 2D seismic for subsurface monitoring purposes is the lack of 3D calibration points and significantly less amount of data. For marine seismic acquisition, feathering issues and crossline dip effects become more critical compared to 3D seismic acquisition. Furthermore, the uncertainties arising from a non-ideal 2D seismic acquisition are hard to assess, since the 3D subsurface geometry has not been mapped. One way to shed more light on this challenge is to use 3D time lapse seismic modeling testing various crossline dips or geometries. Other ways are to use alternative data sources, such as bathymetry, time lapse gravity or electromagnetic data. The end result for all time-lapse monitoring projects is an interpretation associated with uncertainties, and for the 2D case these uncertainties are often large. The purpose of this talk is to discuss how to reduces and control these

  11. Safe injection procedures, injection practices, and needlestick ...

    African Journals Online (AJOL)

    Nermine Mohamed Tawfik Foda

    2017-01-10

    Jan 10, 2017 ... Background: Of the estimated 384,000 needle-stick injuries occurring in hospitals each year, 23% occur in surgical settings. This study was conducted to assess safe injection procedures, injection practices, and circumstances contributing to needlestick and sharps injures (NSSIs) in operating rooms.

  12. Injection frequency and anatomic outcomes 1 year following conversion to aflibercept in patients with neovascular age-related macular degeneration.

    Science.gov (United States)

    Messenger, Wyatt B; Campbell, J Peter; Faridi, Ambar; Shippey, Loton; Bailey, Steven T; Lauer, Andreas K; Flaxel, Christina J; Hwang, Thomas S

    2014-09-01

    To evaluate the clinical, anatomic and functional effects of conversion to aflibercept following ranibizumab and/or bevacizumab in patients with neovascular age-related macular degeneration (AMD). A retrospective review of patients with neovascular AMD treated with intravitreal ranibizumab and/or bevacizumab who were switched to aflibercept was performed. The primary outcome was change in injection frequency in the year following the change. Secondary outcomes included change in central macular thickness (CMT) at 6 months and 1 year, presence of intraretinal and subretinal fluid at 6 months and visual acuity at 1 year. A total of 109 eyes with neovascular AMD were switched to aflibercept and met inclusion criteria. Overall, aflibercept injection frequency was unchanged with patients receiving 7.4 antivascular endothelial growth factor (VEGF) injections the year prior to conversion compared with 7.2 aflibercept injections in the year following (p=0.47). However, the change to aflibercept was associated with improvement in CMT from 324 to 295 μm (p=0.0001) at 6 months and 299 μm (p=0.0047) at 1 year. There was no effect on visual acuity at 1 year. In a subgroup analysis, patients who had received ≥10 anti-VEGF injections in the year prior had fewer injections (11.1 to 8.4, p<0.0001) and clinic visits (13.9 to 9.6, p<0.0001) as well as a significant decrease in CMT (-35 μm, p=0.02). In our population, switching to aflibercept therapy was not associated with a change in injection frequency nor improved visual acuity, but was associated with improved CMT at 6 months and 1 year. In patients who received at least 10 anti-VEGF injections in the year prior, transitioning to aflibercept was associated with a reduced injection frequency and CMT, suggesting potential cost savings in this population. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://group.bmj.com/group/rights-licensing/permissions.

  13. Ultrasound-Guided 50% Ethyl Alcohol Injection for Patients With Malleolar and Olecranon Bursitis: A Prospective Pilot Study

    Science.gov (United States)

    Hong, Ji Seong; Lee, Jin Hyung

    2016-01-01

    Objective To evaluate the feasibility and effect of ultrasound-guided ethyl alcohol injection on malleolar and olecranon synovial proliferative bursitis. Methods Twenty-four patients received ultrasound-guided 50% diluted ethyl alcohol injection at the site of synovial proliferative bursitis after aspiration of the free fluid. Results Swelling and symptoms significantly decreased in 13 of the 24 patients without any complications. Eleven patients had partial improvement in swelling and symptoms. Conclusion Ultrasound-guided alcohol injection could be an alternative therapeutic option before surgery in patients with chronic intractable malleolar and olecranon synovial proliferative bursitis. PMID:27152282

  14. Schizophrenia symptoms and functioning in patients receiving long-term treatment with olanzapine long-acting injection formulation: a pooled analysis

    Directory of Open Access Journals (Sweden)

    Peuskens Joseph

    2012-08-01

    Full Text Available Abstract Background This analysis of pooled data evaluates treatment outcomes of patients with schizophrenia receiving maintenance treatment with olanzapine long-acting injection (OLAI by means of a categorical approach addressing the symptomatic and functional status of patients at different times. Methods Patients were grouped into 5 categories at baseline, 6 months, and 12 months. Shifts between categories were assessed for individual patients and factors associated with improvement were analyzed. 1182 patients from 3 clinical trials were included in the current analysis. Results At baseline, 434 (36.8% patients had minimal Positive and Negative Syndrome Scale (PANSS symptoms but seriously impaired Heinrich Carpenter’s Quality of Life Scale (QLS functioning; 303 (25.6% had moderate to severe symptoms and seriously impaired function; 208 (17.6% had mild to moderate symptoms but good functioning, and 162 (13.7% had minimal symptoms and good functioning. Baseline category was significantly associated with Clinical Global Impression – Severity (CGI-S, extrapyramidal symptoms, working status, age, and number of previous episodes. The majority of all patients starting OLAI treatment maintained or improved (62% at 6 months and 52% at 12 months their symptom and functioning levels on OLAI maintenance treatment. Less than 8% of the patients showed worsening of symptoms or functioning. An improvement in category was associated with high PANSS positive and low CGI-S scores at baseline. Conclusions We present evidence that a composite assessment of schizophrenic patients including symptom severity and functioning is helpful in the evaluation of maintenance treatment outcomes. This approach could also be useful for the assessment of treatment options in clinical practice. The trials from which data are reported here were registered on clinicaltrials.gov as NCT00088491, NCT00088465, and NCT00320489.

  15. Sequential MR images of uterus after Gd-DTPA injection

    International Nuclear Information System (INIS)

    Okada, Susumu; Kato, Tomoyasu; Yamada, Keiko; Sawano, Seishi; Yamashita, Takashi; Hirai, Yasuo; Hasumi, Katsuhiko

    1993-01-01

    To investigate the sequential changes in signal intensity (SI) of normal and abnormal uteri, T1-weighted images were taken repeatedly after the injection of Gd-diethylenetriaminepentaacetic acid (DTPA). Six volunteers and 19 patients with known uterine body malignancy (18 carcinomas, one carcinosarcoma) were examined. The results in volunteers were as follows. In the secretory phase, SI of the endometrium was stronger in the late images than in the early ones, whereas in the proliferative phase, SI was stronger in the early images. SI of the myometrium decreased rapidly and there were no differences in SI between menstrual phases. In 17 of 18 endometrial carcinomas, the tumors showed hypointensity relative to the myometrium, and the contrast between the tumor and the myometrium was better in the early images. In the remaining two cases, the tumor showed hyperintensity and the contrast was better in the late images. After the injection of Gd-DTPA, the endometrium appeared differently according to the menstrual cycle in normal volunteers, and the appearance of uterine structures and endometrial malignant tumors changed sequentially. These findings must be kept in mind when evaluating uterine diseases by Gd-DTPA enhanced MRI. (author)

  16. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique.

    Science.gov (United States)

    Kumar, Alok; Sharma, Dk; Sibi, Maj E; Datta, Barun; Gogoi, Biraj

    2014-01-01

    The established methods of nerve location were based on either proper motor response on nerve stimulation (NS) or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60), or ultrasound guidance (group US, n = 60) for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. The median (range) number of skin punctures were 2 (2-4) in group US and 3 (2-5) in group NS (P =0.27). Insufficient block was observed in three patient (5%) of group US and four patients (6.67%) of group NS (P > =0.35). Patient acceptance was similarly good in the two groups. Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

  17. Comparison of peripheral nerve stimulator versus ultrasonography guided axillary block using multiple injection technique

    Directory of Open Access Journals (Sweden)

    Alok Kumar

    2014-01-01

    Full Text Available Background: The established methods of nerve location were based on either proper motor response on nerve stimulation (NS or ultrasound guidance. In this prospective, randomised, observer-blinded study, we compared ultrasound guidance with NS for axillary brachial plexus block using 0.5% bupivacaine with the multiple injection techniques. Methods : A total of 120 patients receiving axillary brachial plexus block with 0.5% bupivacaine, using a multiple injection technique, were randomly allocated to receive either NS (group NS, n = 60, or ultrasound guidance (group US, n = 60 for nerve location. A blinded observer recorded the onset of sensory and motor blocks, skin punctures, needle redirections, procedure-related pain and patient satisfaction. Results: The median (range number of skin punctures were 2 (2-4 in group US and 3 (2-5 in group NS (P =0.27. Insufficient block was observed in three patient (5% of group US and four patients (6.67% of group NS (P > =0.35. Patient acceptance was similarly good in the two groups. Conclusion: Multiple injection axillary blocks with ultrasound guidance provided similar success rates and comparable incidence of complications as compared with NS guidance with 20 ml 0.5% bupivacaine.

  18. Anaesthetic efficacy of intraligamentary injection techniques on mandibular molars diagnosed with asymptomatic irreversible pulpitis: A retrospective study.

    Science.gov (United States)

    Lin, Shaul; Wigler, Ronald; Huber, Ronen; Kaufman, Arieh Y

    2017-04-01

    The objective of this study was to evaluate the success rate of intraligamentary injections (ILI) using a two- or four-site injection technique. One hundred and fifty-one mandibular molars diagnosed with asymptomatic irreversible pulpitis received ILI at the mesiobuccal and distobuccal aspects of the roots. Patients who experienced pain when the access cavity was performed received additional supplemental ILI in the mesiolingual and distolingual aspects. Pulpal anaesthesia was considered successful when complete analgesia was achieved. The data were analysed by means of the Fisher's exact and Pearson's chi-square tests. IL anaesthesia was successful for 92.1% of the teeth. Forty-eight teeth (31.8%) were sufficiently anaesthetised using the two-site ILI and 91 teeth (60.3%) following supplemental IL anaesthesia in two more sites. The results of this study indicate that the use of four-site IL injections as a primary anaesthetic technique may be considered a favourable alternative to the common IANB. © 2016 Australian Society of Endodontology Inc.

  19. Short-term intraocular pressure changes after intravitreal injection of bevacizumab in diabetic retinopathy patients

    Directory of Open Access Journals (Sweden)

    Farhood QK

    2014-03-01

    Full Text Available Qasim Kadhim Farhood,1 Sinan Mohammad Twfeeq21College of Medicine, Babylon University, Babylon; 2Al-Jumhori teaching hospital, Mosul, IraqBackground: This study examined the changes in short-term intraocular pressure (IOP in a prospective series of patients undergoing intravitreal bevacizumab injection. The aim was to evaluate the frequency and predictive factors related to intraocular pressure (IOP elevation in patients receiving intravitreal bevacizumab.Patients and methods: This study included 52 patients with diabetic retinopathy between 28 to 75 years of age with a mean age of 51 years; 30 (58% were females, and 22 (42% were males. All patients received bevacizumab (1.25 mg/0.05 mL injected intravitreally in a standard fashion between May 2012 to February 2013 in the AL-Jumhoury teaching hospital. IOP was measured at baseline, 5, 10, and 30 minutes after injection using Goldman applanation tonometry.Statistics: Data were analyzed using the SPSS v.12.0 for windows. Basic, demographic, and clinical data were analyzed using means, proportions, and appropriate 95% confidence intervals (CIs.Results: Most patients (85% were diagnosed with proliferative diabetic retinopathy, while 15% presented with diabetic macular edema. The mean IOP values at baseline, 5, 10, and 30 minutes after injection were 14.0 mmHg (95% CI 13.4–14.7, 36.1 mmHg (95% CI 33.5–38.6, 25.7 mmHg (95% CI 23.8–27.5, and 15.5 mmHg (95% CI 12.4–16.51, respectively. Regression analysis showed a trend toward phakic patients having higher IOP at 30 minutes.Conclusion: Intravitreal injection of bevacizumab is safe with respect to short-term IOP changes, as almost all IOP returned to a safe range (<25 mmHg within 30 minutes. Elevated IOP 30 minutes after injection only occurs rarely, so routine prophylactic use of anti-glaucoma medication is not indicated.Keywords: intravitreal injection, bevacizumab, intraocular pressure, Goldmann applanation tonometry

  20. Comparative efficacy and safety of local and systemic methotrexate injection in cesarean scar pregnancy

    Directory of Open Access Journals (Sweden)

    Peng P

    2015-01-01

    Full Text Available Ping Peng,1 Ting Gui,1 Xinyan Liu,1 Weilin Chen,1 Zhenzhen Liu2 1Department of Obstetrics and Gynecology, 2Department of Ultrasonography, Peking Union Medical College Hospital, Peking Union Medical College, Chinese Academy of Medical Sciences, Beijing, People’s Republic of China Objective: To investigate the efficacy of methotrexate (MTX injection in treatment of cesarean scar pregnancy (CSP. Method: A randomized controlled study was performed in 104 CSP patients receiving either local or systemic MTX injection at the Peking Union Medical College Hospital from the year 2008 to 2013. Results: Complete cure was defined as regression of ultrasonographic findings and normalization of serum β-hCG within 60 days. It was regarded as delayed cure if additional dilation and curettage (D&C was needed. The overall cure rate (complete cure plus delayed cure was 69.2% versus 67.3% for local injection versus systemic administration (P>0.05. The median time for serum β-hCG remission and uterine mass disappearance after systemic administration (42 [21–69] days and 40 [20–67] days were significantly lower than those receiving local injection (56 [24–92] days and 53 [23–88] days, with P=0.029 and 0.046, respectively. The mean pretreatment serum β-hCG (human chorionic gonadotropin level and lesion size in cured group (21,941±18,351 mIU/mL and 2.9±1.3 cm, respectively were significantly lower than those in the failed group (37,047±30,864 mIU/mL and 3.6±1.3 with P=0.038 and 0.044, respectively. Conclusion: MTX injection is effective in CSP treatment. Systemic administration shows similar overall cure rate compared to local injection, but requires shorter time for serum β-hCG remission and uterine mass disappearance. Keywords: cesarean scar pregnancy, methotrexate injection, local, systemic

  1. Efficiency and safety of subconjunctival injection of anti-VEGF agent - bevacizumab - in treating dry eye.

    Science.gov (United States)

    Jiang, Xiaodan; Lv, Huibin; Qiu, Weiqiang; Liu, Ziyuan; Li, Xuemin; Wang, Wei

    2015-01-01

    Dry eye is a chronic inflammatory ocular surface disease with high prevalence. The current therapies for dry eye remain to be unspecific and notcomprehensive. This study aims to explore safety and efficacy of a novel treatment - subconjunctival injection of bevacizumab - in dry eye patients. Sixty-four eyes of 32 dry eye patients received subconjunctival injection of 100 μL 25 mg/mL bevacizumab. Dry eye symptoms, signs (corrected visual acuity, intraocular pressure, conjunctival vascularity, corneal staining, tear break-up time, Marx line score, and blood pressure), and conjunctival impression cytology were evaluated 3 days before and 1 week, 1 month, and 3 months after injection. Significant improvements were observed in dry eye symptoms, tear break-up time, and conjunctival vascularization area at all the visits after injection compared to the baseline (Pdry eye disease.

  2. Flow injection analysis using carbon film resistor electrodes for amperometric determination of ambroxol.

    Science.gov (United States)

    Felix, Fabiana S; Brett, Christopher M A; Angnes, Lúcio

    2008-06-30

    Flow injection analysis (FIA) using a carbon film sensor for amperometric detection was explored for ambroxol analysis in pharmaceutical formulations. The specially designed flow cell designed in the lab generated sharp and reproducible current peaks, with a wide linear dynamic range from 5x10(-7) to 3.5x10(-4) mol L(-1), in 0.1 mol L(-1) sulfuric acid electrolyte, as well as high sensitivity, 0.110 Amol(-1) L cm(-2) at the optimized flow rate. A detection limit of 7.6x10(-8) mol L(-1) and a sampling frequency of 50 determinations per hour were achieved, employing injected volumes of 100 microL and a flow rate of 2.0 mL min(-1). The repeatability, expressed as R.S.D. for successive and alternated injections of 6.0x10(-6) and 6.0x10(-5) mol L(-1) ambroxol solutions, was 3.0 and 1.5%, respectively, without any noticeable memory effect between injections. The proposed method was applied to the analysis of ambroxol in pharmaceutical samples and the results obtained were compared with UV spectrophotometric and acid-base titrimetric methods. Good agreement between the results utilizing the three methods and the labeled values was achieved, corroborating the good performance of the proposed electrochemical methodology for ambroxol analysis.

  3. CRISPR-Cas systems exploit viral DNA injection to establish and maintain adaptive immunity.

    Science.gov (United States)

    Modell, Joshua W; Jiang, Wenyan; Marraffini, Luciano A

    2017-04-06

    Clustered regularly interspaced short palindromic repeats (CRISPR)-Cas systems provide protection against viral and plasmid infection by capturing short DNA sequences from these invaders and integrating them into the CRISPR locus of the prokaryotic host. These sequences, known as spacers, are transcribed into short CRISPR RNA guides that specify the cleavage site of Cas nucleases in the genome of the invader. It is not known when spacer sequences are acquired during viral infection. Here, to investigate this, we tracked spacer acquisition in Staphylococcus aureus cells harbouring a type II CRISPR-Cas9 system after infection with the staphylococcal bacteriophage ϕ12. We found that new spacers were acquired immediately after infection preferentially from the cos site, the viral free DNA end that is first injected into the cell. Analysis of spacer acquisition after infection with mutant phages demonstrated that most spacers are acquired during DNA injection, but not during other stages of the viral cycle that produce free DNA ends, such as DNA replication or packaging. Finally, we showed that spacers acquired from early-injected genomic regions, which direct Cas9 cleavage of the viral DNA immediately after infection, provide better immunity than spacers acquired from late-injected regions. Our results reveal that CRISPR-Cas systems exploit the phage life cycle to generate a pattern of spacer acquisition that ensures a successful CRISPR immune response.

  4. Secondary and tertiary gas injection in fractured carbonate rock: Experimental study

    Energy Technology Data Exchange (ETDEWEB)

    Karimaie, H.; Torsaeter, O. [SPE, NTNU (Norway); Darvish, G.R. [SPE, STATOIL (Norway); Lindeberg, E. [SPE, SINTEF (Norway)

    2008-09-15

    The use of CO{sub 2} has received considerable interest as a method of EOR but a major drawback is its availability and increasing cost. Therefore, as the number of CO{sub 2} injection projects increase, an alternative must be considered to meet the economic considerations. For this reason attention has been directed to nitrogen injection which may be a good substitute for CO{sub 2}. The purpose of the experiments described in this paper was to investigate the efficiency of oil recovery by CO{sub 2} and N{sub 2} in fractured carbonate rock. The combined effects of gravity drainage and component exchange between gas in fracture and oil in matrix on oil recovery in fractured reservoirs subjected to CO{sub 2} or nitrogen gas injection are experimentally studied. Laboratory experiments have been carried out on a low permeable outcrop chalk, as an analogue to a North Sea reservoir rock. This was surrounded by a fracture, established with a novel experimental set-up. The experiments aimed to investigate the potential of oil recovery by secondary and tertiary CO{sub 2} and nitrogen gas injection at high pressure high temperature condition. The matrix block was saturated using recombined binary mixture live oil (C{sub 1}-C{sub 7}), while the fracture was filled with a sealing material to obtain a homogeneous saturation. The sealing material was then removed by increasing the temperature which in turn creates the fracture surrounding the core. Gas was injected into the fracture at pressures above the bubble point of the oil. Oil recovery as a function of time was monitored during the experiments. Results from secondary gas injection experiments indicate that CO{sub 2} injection at elevated pressure and temperature is more efficient than N{sub 2} injection. Results from tertiary gas injection experiments also show that injection of CO{sub 2} could significantly recover the oil, even after waterflooding, compared to N{sub 2} injection. (author)

  5. The last half-repeat of transcription activator-like effector (TALE) is dispensable and thereby TALE-based technology can be simplified.

    Science.gov (United States)

    Zheng, Chong-Ke; Wang, Chun-Lian; Zhang, Xiao-Ping; Wang, Fu-Jun; Qin, Teng-Fei; Zhao, Kai-Jun

    2014-09-01

    To activate the expression of host genes that contribute to pathogen growth, pathogenic Xanthomonas bacteria inject their transcription activator-like effectors (TALEs) into plant cells and the TALEs bind to target gene promoters by the central repeat region consisting of near-perfect 34-amino-acid repeats (34-aa repeats). Based on the recognition codes between the 34-aa repeats and the targeted nucleotides, TALE-based technologies, such as designer TALEs (dTALEs) and TALE nucleases (TALENs), have been developed. Amazingly, every natural TALE invariantly has a truncated last half-repeat (LHR) at the end of the 34-aa repeats. Consequently, all the reported dTALEs and TALENs also harbour their LHRs. Here, we show that the LHRs in dTALEs are dispensable for the function of gene activation by both transient expression assays in Nicotiana benthamiana and gene-specific targeting in the rice genome, indicating that TALEs might originate from a single progenitor. In the light of this finding, we demonstrate that dTALEs can be constructed through two simple steps. Moreover, the activation strengths of dTALEs lacking the LHR are comparable with those of dTALEs harbouring the LHR. Our results provide new insights into the origin of natural TALEs, and will facilitate the simplification of the design and assembly of TALE-based tools, such as dTALEs and TALENs, in the near future. © 2014 BSPP AND JOHN WILEY & SONS LTD.

  6. Safety and efficacy of multiuse botulinum toxin vials for intralaryngeal injection.

    Science.gov (United States)

    Barrow, Emily M; Rosen, Clark A; Hapner, Edie R; Smith, Sarah; Hatcher, Jeanne L; Simpson, Blake; Johns, Michael M

    2015-05-01

    Centers for Disease Control and Prevention guidelines maintain that single-use vials cannot be used for multiple patients. Botox product labeling states that the reconstituted toxin should be used within 4 hours on a single patient based on concerns of reduced potency, contamination, and consequent infections. The purpose of this study was to determine the safety and efficacy of using single-use vials in a multidose fashion. Prospective study and cohort chart review. A multi-institutional three-part study was performed between May 2013 and October 2013: 1) a summation of subjects' recall of their past experiences (symptoms/response) with previous multidose Botox injections, 2) a prospective study of intralaryngeal injections, and 3) a chart review of injection responses in a subset of the cohort. Seven hundred forty-three subjects receiving 6,216 injections demonstrated zero infection-related complications on retrospective chart review. One hundred seventy-nine subjects recalled 24.0% overall adverse events, 10.6% redness, 7.3% pain and swelling at the injection site, and 0% fever. One hundred seventy-four subjects prospectively reported 12.6% overall adverse events. The self-reported efficacy rate of Botox injection was 96.6%. The low rates of adverse events following the use of Botox in a multipatient fashion are consistent with other percutaneous injections. No evidence of infection was found with multidose Botox use. Given the low incidence of side effects and high success rate, Botox can be used both safely and effectively in a multipatient fashion. 4 © 2014 The American Laryngological, Rhinological and Otological Society, Inc.

  7. Rapid isolation of biomarkers for compound specific radiocarbon dating using high-performance liquid chromatography and flow injection analysis-atmospheric pressure chemical ionisation mass spectrometry

    NARCIS (Netherlands)

    Sinninghe Damsté, J.S.; Smittenberg, R.H.; Hopmans, E.C.; Schouten, S.

    2002-01-01

    Repeated semi-preparative normal-phase HPLC was performed to isolate selected biomarkers from sediment extracts for radiocarbon analysis. Flow injection analysis mass spectrometry was used for rapid analysis of collected fractions to evaluate the separation procedure, taking only 1 min per fraction.

  8. Sex differences in behavioral and PKA cascade responses to repeated cocaine administration.

    Science.gov (United States)

    Zhou, Luyi; Sun, Wei-Lun; Weierstall, Karen; Minerly, Ana Christina; Weiner, Jan; Jenab, Shirzad; Quinones-Jenab, Vanya

    2016-10-01

    Previous studies have shown sex different patterns in behavioral responses to cocaine. Here, we used between-subject experiment design to study whether sex differences exist in the development of behavioral sensitization and tolerance to repeated cocaine, as well as the role of protein kinase A (PKA) signaling cascade in this process. Ambulatory and rearing responses were recorded in male and female rats after 1 to 14 days of administration of saline or cocaine (15 mg/kg; ip). Correspondent PKA-associated signaling in the nucleus accumbens (NAc) and caudate-putamen (CPu) was measured at each time point. Our results showed that females exhibited higher cocaine-induced behavioral responses and developed behavioral sensitization and tolerance faster than males. Whereas females developed behavioral sensitization to cocaine after 2 days and tolerance after 14 days, male rats developed sensitization after 5 days. In addition, cocaine induced a sexual dimorphic pattern in the progression of neuronal adaptations on the PKA cascade signaling in region (NAc vs. CPu) and time (days of cocaine administration)-dependent manners. In general, more PKA signaling cascade changes were found in the NAc of males on day 5 and in the CPu of females with repeated cocaine injection. In addition, in females, behavioral activities positively correlated with FosB levels in the NAc and CPu and negatively correlated with Cdk5 and p35 in the CPu, while no correlation was observed in males. Our studies suggest that repeated cocaine administration induced different patterns of behavioral and molecular responses in the PKA cascade in male and female rats.

  9. Effects of injection-site splinting on the incidence of phlebitis in patients taking peripherally infused amiodarone: A randomized clinical trial.

    Science.gov (United States)

    Ayat-Isfahani, Farah; Pashang, Mina; Davoudi, Bita; Sadeghian, Saeed; Jalali, Arash

    2017-03-01

    Intravenous amiodarone is considered an effective treatment option for cardiac ventricular and atrial arrhythmias. Peripheral infusion of amiodarone may cause blood vessels irritation and phlebitis that is the most common complication of this drug by this route even when it is administered within recommended dosing limits. The effect of injection-site splinting on the occurrence of phlebitis among a group of cardiac arrhythmia patients receiving peripherally infused amiodarone. This research is a clinical trial on patients of Tehran Heart Center who were hospitalized due to cardiac arrhythmias. A sample of 60 patients with mean age 65 ± 14 years were randomly divided into control and test groups. In the experimental group with close splint and restrict the movement of the injection site until the end of the infusion and control groups without closing brace, at the same time received amiodarone. Injection protocol was similar for both groups. The results were analyzed with Spss18. The results of this research still significantly reduced the incidence of amiodarone injection-site phlebitis in the injection time (P = .005). Copyright © 2016 Society for Vascular Nursing, Inc. Published by Elsevier Inc. All rights reserved.

  10. Single injection of basic fibroblast growth factor to treat severe vocal fold lesions and vocal fold paralysis.

    Science.gov (United States)

    Kanazawa, Takeharu; Komazawa, Daigo; Indo, Kanako; Akagi, Yusuke; Lee, Yogaku; Nakamura, Kazuhiro; Matsushima, Koji; Kunieda, Chikako; Misawa, Kiyoshi; Nishino, Hiroshi; Watanabe, Yusuke

    2015-10-01