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Sample records for subcutaneous injection site

  1. Subcutaneous Injections

    DEFF Research Database (Denmark)

    Thomsen, Maria

    This thesis is about visualization and characterization of the tissue-device interaction during subcutaneous injection. The tissue pressure build-up during subcutaneous injections was measured in humans. The insulin pen FlexTouchr (Novo Nordisk A/S) was used for the measurements and the pressure...... build-up was evaluated indirectly from the changes in the flow rate between subcutaneous injections and air injections. This method enabled the tissue counter pressure to be evaluated without a formal clinical study approval. The measurements were coupled to a model for the pressure evolution...... in subcutaneous tissue, based on mass conservation and flow in a porous medium. From the measurements the flow permeability and bulk modulus of the tissue were determined. In the adipose tissue the drug forms a bolus from where it is absorbed by the blood capillaries. The spatial distribution of the injected...

  2. Slow versus fast subcutaneous heparin injections for prevention of bruising and site pain intensity.

    Science.gov (United States)

    Mohammady, Mina; Janani, Leila; Akbari Sari, Ali

    2017-11-01

    Heparin is an anticoagulant medication that is usually injected subcutaneously. Subcutaneous administration of heparin may result in complications such as bruising, haematoma, and pain at the injection site. One of the factors that may affect pain, haematoma, and bruising is injection speed. For patients and healthcare providers, strategies that can reduce pain and bruising are considered important. Reducing patients' discomfort and concerns whenever and wherever possible is an important aim of nursing. Several studies have been carried out to see if speed of injection affects the amount of pain and bruising where the injection is given, but results of these studies have differed and study authors have not reached a clear final conclusion. This is the first update of the review first published in 2014. To assess the effects of duration (speed) of subcutaneous heparin injection on pain, haematoma, and bruising at the injection site in people admitted to hospitals or clinics who require treatment with unfractionated heparin (UFH) or low molecular weight heparin (LMWH). For this update, the Cochrane Vascular Information Specialist (CIS) searched the Specialised Register (last searched March 2017) and the Cochrane Central Register of Controlled Trials (CENTRAL; 2017, Issue 2). The CIS also searched trials registries for details of ongoing or unpublished studies. Review authors searched two Persian databases - Iranmedex and Scientific Information Database (SID) - as well as Google Scholar. We sought randomised controlled trials (RCTs) comparing the effects of different durations of subcutaneous injection of heparin on pain, bruising, and haematoma at the injection site. Two review authors (MM, LJ), working independently, extracted data onto a structured form and assessed study quality. We used the criteria recommended by Cochrane to assess the risk of bias of included studies. For the outcomes, we calculated the mean difference (MD) or the standardised MD (SMD) with

  3. Injectable agents affecting subcutaneous fats.

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    Chen, David Lk; Cohen, Joel L; Green, Jeremy B

    2015-09-01

    Mesotherapy is an intradermal or subcutaneous injection of therapeutic agents to induce local effects, and was pioneered in Europe during the 1950s. For the past 2 decades, there has been significant interest in the use of mesotherapy for minimally invasive local fat contouring. Based on the theorized lipolytic effects of the agent phosphatidylcholine, initial attempts involved its injection into subcutaneous tissue. With further studies, however, it became apparent that the activity attributed to phosphatidylcholine mesotherapy was due to the adipolytic effects of deoxycholate, a detergent used to solubilize phosphatidylcholine. Since then, clinical trials have surfaced that demonstrate the efficacy of a proprietary formulation of deoxycholate for local fat contouring. Current trials on mesotherapy with salmeterol, a b-adrenergic agonist and lipolysis stimulator, are underway-with promising preliminary results as well. ©2015 Frontline Medical Communications.

  4. Subcutaneous steroid injection as treatment for chalazion: prospective case series.

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    Ho, S Y; Lai, J S M

    2002-02-01

    To study the efficacy of subcutaneous steroid injection in the treatment of chalazion. Prospective consecutive case series. University teaching hospital, Hong Kong. Patients with chalazion presenting to the out-patient clinic of the Department of Ophthalmology at the Prince of Wales Hospital from January to June 1998. Size of the chalazion after steroid injection treatment. Forty-eight consecutive patients with chalazion were treated with injection of triamcinolone into the subcutaneous tissue around the lesion. In 43 (89.6%) patients, the lesion subsided completely. Twenty-six (54.2%) patients had lesions that subsided with one injection. The size and duration of the chalazion at presentation did not significantly affect the outcome of the treatment. Two patients developed depigmentation of the skin at the site of injection. No other major complications were encountered. Subcutaneous injection of the steroid triamcinolone acetonide appears to be a simple and effective treatment for chalazion. Further comparative clinical trials are indicated.

  5. Subcutaneous peginterferon β-1a injection-site reaction experience and mitigation: Delphi analysis of the ALLOW study.

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    Hendin, Barry; Huang, DeRen; Wray, Sibyl; Naismith, Robert T; Rosenblatt, Sheri; Zambrano, Javier; Werneburg, Brian

    2017-02-01

    The objective of this Delphi analysis was to obtain consensus on injection-site reaction (ISR) experience and mitigation strategies for patients with relapsing-remitting multiple sclerosis switching from nonpegylated interferons (IFNs) to peginterferon β-1a in the ALLOW Phase IIIb trial using a three-step approach. Study investigators and coordinators from investigative sites enrolling four or more patients in ALLOW participated in three rounds of questionnaires and interviews. Respondents (n = 37) agreed that the most common ISR, erythema, was not disruptive to daily activities. Patient education, as a conversation with a clinician about ISR potential, was recommended. The consensus of Delphi respondents on ISR experience and ISR management after switching from nonpegylated IFNs to peginterferon β-1a can help inform treatment decisions and manage patient expectations.

  6. Subcutaneous Injection Volume of Biopharmaceuticals-Pushing the Boundaries.

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    Mathaes, Roman; Koulov, Atanas; Joerg, Susanne; Mahler, Hanns-Christian

    2016-08-01

    Administration into the subcutaneous (SC) tissue is a typical route of delivery for therapeutic proteins, especially for frequent treatments, long-term regimens, or self-administration. It is currently believed that the maximum volume for SC injections is approximately 1.5 mL. Larger SC injection volumes are considered to be associated with injection pain and adverse events at the injection site. However, no controlled clinical studies and actual evidence exist to support this assumption. In this review, we discuss current and publically available data related to SC administration volumes. We conclude that injection volumes higher than 3.5 mL are worth exploring if required for the development of efficacious drug treatments. Studying tissue back pressure, injection site leakage, local tolerability, and injection-related adverse events, such as injection pain, should be considered for the development of higher SC injection volumes. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  7. An Innovative Needle-free Injection System: Comparison to 1 ml Standard Subcutaneous Injection.

    Science.gov (United States)

    Kojic, Nikola; Goyal, Pragun; Lou, Cheryl Hamer; Corwin, Michael J

    2017-11-01

    A needle-free delivery system may lead to improved satisfaction and compliance, as well as reduced anxiety among patients requiring frequent or ongoing injections. This report describes a first-in-man assessment comparing Portal Instruments' innovative needle-free injection system with subcutaneous injections using a 27G needle. Forty healthy volunteer participants each received a total of four injections of 1.0 mL sterile saline solution, two with a standard subcutaneous injection using a 27G needle, and two using the Portal injection system. Perception of pain was measured using a 100-mm visual analog scale (VAS). Injection site reactions were assessed at 2 min and at 20-30 min after each injection. Follow-up contact was made 24-48 h after the injections. Subject preference regarding injection type was also assessed. VAS pain scores at Portal injection sites met the criteria to be considered non-inferior to the pain reported at 27G needle injection sites (i.e., upper 95% confidence bound less than +5 mm). Based on a mixed effects model, at time 0, accounting for potential confounding variables, the adjusted difference in VAS scores indicated that Portal injections were 6.5 mm lower than the 27G needle injections (95% CI -10.5, -2.5). No clinically important adverse events were noted. Portal injections were preferred by 24 (60%) of the subjects (P = 0.0015). As an early step in the development of this new needle-free delivery system, the current study has shown that a 1.0-mL saline injection can be given with less pain reported than a standard subcutaneous injection using a 27G needle.

  8. Immunogenicity and safety of concomitant administration of a measles, mumps and rubella vaccine (M-M-RvaxPro® and a varicella vaccine (VARIVAX® by intramuscular or subcutaneous routes at separate injection sites: a randomised clinical trial

    Directory of Open Access Journals (Sweden)

    Thomas Stéphane

    2009-04-01

    Full Text Available Abstract Background When this trial was initiated, the combined measles, mumps and rubella (MMR vaccine was licensed for subcutaneous administration in all European countries and for intramuscular administration in some countries, whereas varicella vaccine was licensed only for subcutaneous administration. This study evaluated the intramuscular administration of an MMR vaccine (M-M-RvaxPro® and a varicella vaccine (VARIVAX® compared with the subcutaneous route. Methods An open-label randomised trial was performed in France and Germany. Healthy children, aged 12 to18 months, received single injections of M-M-RvaxPro and VARIVAX concomitantly at separate injection sites. Both vaccines were administered either intramuscularly (IM group, n = 374 or subcutaneously (SC group, n = 378. Immunogenicity was assessed before vaccination and 42 days after vaccination. Injection-site erythema, swelling and pain were recorded from days 0 to 4 after vaccination. Body temperature was monitored daily between 0 and 42 days after vaccination. Other adverse events were recorded up to 42 days after vaccination and serious adverse events until the second study visit. Results Antibody response rates at day 42 in the per-protocol set of children initially seronegative to measles, mumps, rubella or varicella were similar between the IM and SC groups for all four antigens. Response rates were 94 to 96% for measles, 98% for both mumps and rubella and 86 to 88% for varicella. For children initially seronegative to varicella, 99% achieved the seroconversion threshold (antibody concentrations of ≥ 1.25 gpELISA units/ml. Erythema and swelling were the most frequently reported injection-site reactions for both vaccines. Most injection-site reactions were of mild intensity or small size (≤ 2.5 cm. There was a trend for lower rates of injection-site erythema and swelling in the IM group. The incidence and nature of systemic adverse events were comparable for the two routes

  9. Ataxia and cranial neuropathies from subcutaneously injected elemental mercury.

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    Malkani, Roneil; Weinstein, Jill M; Kumar, Neeraj; Victor, Thomas A; Bernstein, Lawrence

    2011-04-01

    CONTEXT. Although neurological toxicity from elemental mercury vapor and organic mercury exposure has been commonly reported in the literature, it is rarely reported from soft tissue injection of elemental mercury. We present a case of neurological dysfunction from subcutaneous injection of elemental mercury. CASE DETAILS. A 35-year-old Latin American man subacutely developed gait ataxia, diplopia, and vomiting 1 year after subcutaneous injection of elemental mercury, a practice common in Afro-Caribbean and Latin-American cultures. Physical examination showed an indurated plaque on his right shoulder at the injection site, left third nerve and bilateral sixth nerve palsies, nystagmus, dysarthria, and gait and limb ataxia. The patient's serum and 24-h urine mercury levels were significantly elevated; he underwent excision of the mercury reservoir and chelation with dimercaptosuccinic acid but experienced only mild improvement after 1 year. DISCUSSION. Neurological sequelae from elemental mercury, specifically cognitive dysfunction, tremor, cortical myoclonus, and peripheral neuropathy, have been reported but cranial neuropathies, ataxia, cerebrospinal fluid pleocytosis, and the presence of anti-Purkinje cell type-Tr antibody have not. Treatment involves removal of any existing mercury reservoir and chelation; however, improvement in neurological dysfunction after treatment has rarely been reported in the literature.

  10. Allergic anaphylaxis due to subcutaneously injected heparin

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    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.

  11. Subcutaneous mercury injection by a child: A histopathology case report

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    Deepti Sukheeja

    2014-01-01

    Full Text Available Intentional subcutaneous injection of mercury by mentally healthy children is rare. Usually, it is seen as a part of suicidal attempt in severely depressed patients or by athletes to enhance their performance. We report a case of a 15-year-old child, inspired by a movie, who deliberately self-injected mercury subcutaneously into his forearm that led to the formation of a non-healing ulcer. Histopathology of the biopsy confirmed the diagnosis. A surgical procedure was thereby performed to treat the ulcer and reduce the blood and urinary levels of mercury. However, the patient did not develop clinical signs of chronic poisoning, proving that subcutaneous mercury injection has a low risk of systemic toxicity, and that histopathology plays an important role in diagnosis.

  12. Evaluation of the impact of viscosity, injection volume, and injection flow rate on subcutaneous injection tolerance

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    Berteau C

    2015-11-01

    Full Text Available Cecile Berteau,1 Orchidée Filipe-Santos,1 Tao Wang,2 Humberto E Rojas,2 Corinne Granger,1 Florence Schwarzenbach1 1Becton-Dickinson Medical Pharmaceutical Systems, Le Pont de Claix, France; 2Eli Lilly and Company, Indianapolis, IN, USA Aim: The primary objective of this study was to evaluate the impact of fluid injection viscosity in combination with different injection volumes and flow rates on subcutaneous (SC injection pain tolerance. Methods: The study was a single-center, comparative, randomized, crossover, Phase I study in 24 healthy adults. Each participant received six injections in the abdomen area of either a 2 or 3 mL placebo solution, with three different fluid viscosities (1, 8–10, and 15–20 cP combined with two different injection flow rates (0.02 and 0.3 mL/s. All injections were performed with 50 mL syringes and 27G, 6 mm needles. Perceived injection pain was assessed using a 100 mm visual analog scale (VAS (0 mm/no pain, 100 mm/extreme pain. The location and depth of the injected fluid was assessed through 2D ultrasound echography images. Results: Viscosity levels had significant impact on perceived injection pain (P=0.0003. Specifically, less pain was associated with high viscosity (VAS =12.6 mm than medium (VAS =16.6 mm or low (VAS =22.1 mm viscosities, with a significant difference between high and low viscosities (P=0.0002. Target injection volume of 2 or 3 mL was demonstrated to have no significant impact on perceived injection pain (P=0.89. Slow (0.02 mL/s or fast (0.30 mL/s injection rates also showed no significant impact on perceived pain during SC injection (P=0.79. In 92% of injections, the injected fluid was located exclusively in SC tissue whereas the remaining injected fluids were found located in SC and/or intradermal layers. Conclusion: The results of this study suggest that solutions of up to 3 mL and up to 15–20 cP injected into the abdomen within 10 seconds are well tolerated without pain. High

  13. Treatment of frozen shoulder with subcutaneous TNF-alpha blockade compared with local glucocorticoid injection

    DEFF Research Database (Denmark)

    Schydlowsky, Pierre; Szkudlarek, Marcin; Madsen, Ole Rintek

    2012-01-01

    We compared the effect of subcutaneous adalimumab injections with intraarticular glucocorticoid injections on frozen shoulder of 18 patients with unilateral joint involvement. Ten patients were randomised to subcutaneous injections with adalimumab and eight to intraarticular glucocorticoid inject...... injections administered every other week for a total of three administrations. The evaluation included validated scores. No effect of subcutaneous injections of adalimumab on frozen shoulder symptoms was demonstrated.......We compared the effect of subcutaneous adalimumab injections with intraarticular glucocorticoid injections on frozen shoulder of 18 patients with unilateral joint involvement. Ten patients were randomised to subcutaneous injections with adalimumab and eight to intraarticular glucocorticoid...

  14. Evaluation of the impact of viscosity, injection volume, and injection flow rate on subcutaneous injection tolerance

    Science.gov (United States)

    Berteau, Cecile; Filipe-Santos, Orchidée; Wang, Tao; Rojas, Humberto E; Granger, Corinne; Schwarzenbach, Florence

    2015-01-01

    Aim The primary objective of this study was to evaluate the impact of fluid injection viscosity in combination with different injection volumes and flow rates on subcutaneous (SC) injection pain tolerance. Methods The study was a single-center, comparative, randomized, crossover, Phase I study in 24 healthy adults. Each participant received six injections in the abdomen area of either a 2 or 3 mL placebo solution, with three different fluid viscosities (1, 8–10, and 15–20 cP) combined with two different injection flow rates (0.02 and 0.3 mL/s). All injections were performed with 50 mL syringes and 27G, 6 mm needles. Perceived injection pain was assessed using a 100 mm visual analog scale (VAS) (0 mm/no pain, 100 mm/extreme pain). The location and depth of the injected fluid was assessed through 2D ultrasound echography images. Results Viscosity levels had significant impact on perceived injection pain (P=0.0003). Specifically, less pain was associated with high viscosity (VAS =12.6 mm) than medium (VAS =16.6 mm) or low (VAS =22.1 mm) viscosities, with a significant difference between high and low viscosities (P=0.0002). Target injection volume of 2 or 3 mL was demonstrated to have no significant impact on perceived injection pain (P=0.89). Slow (0.02 mL/s) or fast (0.30 mL/s) injection rates also showed no significant impact on perceived pain during SC injection (P=0.79). In 92% of injections, the injected fluid was located exclusively in SC tissue whereas the remaining injected fluids were found located in SC and/or intradermal layers. Conclusion The results of this study suggest that solutions of up to 3 mL and up to 15–20 cP injected into the abdomen within 10 seconds are well tolerated without pain. High viscosity injections were shown to be the most tolerated, whereas injection volume and flow rates did not impact perceived pain. PMID:26635489

  15. Injection Technique and Pen Needle Design Affect Leakage From Skin After Subcutaneous Injections

    DEFF Research Database (Denmark)

    Præstmark, Kezia Ann; Stallknecht, Bente; Jensen, Morten Lind

    2016-01-01

    BACKGROUND: After a subcutaneous injection fluid might leak out of the skin, commonly referred to as leakage or backflow. The objective was to examine the influence of needle design and injection technique on leakage after injections in the subcutaneous tissue of humans and pigs. METHOD: Leakage...... data were obtained from a post hoc analysis of clinical trial data and from a pig study. Data from the clinical study were used to determine leakage as a function of injection volume, speed and region. Data from the pig study were used to determine leakage as a function of needle wall thickness, needle...... taper, injection angle, and wait time from end of injection to withdrawal of needle from skin. RESULTS: Leakage volume was positively related to injection volume. Injections in the abdomen caused less leakage than thigh injections. A 32G needle caused less leakage than a 31G and a 32G tip (tapered...

  16. The influence of Lidocaine temperature on pain during subcutaneous injection.

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    Lundbom, Janne S; Tangen, Lena F; Wågø, Kathrine J; Skarsvåg, Trine I; Ballo, Solveig; Hjelseng, Tonje; Foss, Olav A; Finsen, Vilhjalmur

    2017-04-01

    Injection of local anaesthetics is an uncomfortable procedure. The purpose of this study was to determine the influence of lidocaine temperature on pain during subcutaneous injection. A randomised, double blind trial with 36 healthy volunteers was performed. Each subject received three injections of 4.5 ml 1% lidocaine subcutaneously on the abdomen; refrigerated (8 °C), at room temperature (21 °C), and warmed to body temperature (37 °C). By giving every subject injections of all three temperatures they served as their own controls. The participants were asked to evaluate the pain felt during the injection by placing a pencil mark on a 100 mm Visual Analogue Scale without intermediate markings immediately after every injection. They were told that the scale ranged from no pain to worst imaginable pain (0 = best; 100 = worst). Retrospectively the participants did a verbal assessment of the most and least painful injection. The median VAS score for the heated lidocaine was 16 (range =11-28), lidocaine at room temperature 25 (13-40) and for the cold 24 (11-35). The VAS scores for the heated lidocaine was significantly lower than for lidocaine at room temperature (p = 0.004). Also, the verbal assessment of heated lidocaine being less painful than the injection at room temperature was statistically significant (p = 0.015). Injection with lidocaine heated to around body temperature was less painful than injection with lidocaine at room temperature. There was no statistically significant difference in verbal assessment or VAS scores between the cold lidocaine and that at room temperature.

  17. Pharmacokinetics and metabolic effects of growth hormone injected subcutaneously in growth hormone deficient patients: thich versus abdomen

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    Laursen, Torben; Jørgensen, Jens Otto Lunde; Christiansen, Jens Sandahl

    1994-01-01

    Abstract OBJECTIVE: The absorption of insulin following subcutaneous (s.c.) injection is faster in the abdomen than the thigh. We therefore studied the effect of changing the site of injection on the absorption and metabolic effects of human growth hormone. DESIGN AND MEASUREMENTS: In a cross...

  18. Clinical Trial of Subcutaneous Steroid Injection in Patients with Migraine Disorder

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    Karim Nikkhah

    2016-02-01

    Full Text Available Background: Neurologic literature on therapeutic effect of subcutaneous corticosteroids in patients with migrainous chronic daily headache is scarce. The aim of this research is to assess the therapeutic effects of this management in such patients. Methods: Consecutive patients with migrainous chronic daily headache enrolled a prospective before-after therapeutic study during 2010-2013. Methylprednisolone 40 mg was divided into four subcutaneous injection doses. Two injections were administered in the right and left suboccipital area (exactly at retromastoid cervicocranial junction and the other two injections in the lower medial frontal area (exactly at medial right and left eyebrows. A daily headache diary was filled out by the patients before and one month after the intervention. The severity of pain was classified based on a pain intensity instrument using numeric rating scale from 0-10 point scale. Paired t-test and Chi-square test were used for statistical analysis. Results: 504 patients (378 females, 126 males with migrainous chronic daily headache were enrolled in the study. Dramatic, significant, moderate, mild, or no improvements respectively constituted 28.6%, 33.3%, 23.8%, and 14.3% of the post treatment courses. Therapeutic effect of intervention on mean pain scores was significant; t=7.38, df=20, P=0.000. Two cases developed subcutaneous fat atrophy in frontal injection site and three cases experienced syncope during injection. Conclusion: Subcutaneous corticosteroids could be used as an adjunct therapy in patients with migrainous chronic daily headache.

  19. Subcutaneous extralesional triamcinolone acetonide injection versus conservative management in the treatment of chalazion.

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    Chung, C F; Lai, J S M; Li, P S H

    2006-08-01

    To compare the efficacy of subcutaneous extralesional triamcinolone acetonide injection versus conservative treatment for chalazion. Randomised controlled trial. Eye clinics of two regional hospitals in Hong Kong. Patients over 18 years old presenting with primary chalazion were randomised into two groups. In group 1, 12 patients were treated with lid hygiene, warm compresses, and chloramphenicol 1% ointment 4 times a day. In group 2, 16 patients were treated with 0.3 mL triamcinolone acetonide (10 mg/mL) injection to the subcutaneous tissue extralesionally via the percutaneous route. Exclusion criteria were: acutely infected chalazion with preseptal cellulitis, recurrent chalazion, small chalazion (chalazion. Size of chalazion, recurrence of chalazion, intra-ocular pressure, and complications from treatment, including skin pigmentary change or atrophy and pyogenic granuloma. There was a clinically and statistically significant difference between the success rates in group 1 (58.3%) and group 2 (93.8%). In group 1, the mean prior duration of chalazion before treatment was significantly shorter in success cases than in failed cases. One patient with multiple chalazia in group 2 developed hypopigmentary skin changes at one treatment site. Subcutaneous extralesional triamcinolone acetonide injection was more effective than conservative treatment for chalazion.

  20. Computed tomographic measurement of gluteal subcutaneous fat thickness in reference to failure of gluteal intramuscular injections

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    Burbridge, B.E. [Univ. of Saskatchewan, Royal Univ. Hospital, Academic Dept. of Medical Imaging, Saskatoon, Saskatchewan (Canada)]. E-mail: brent.burbridge@usask.ca

    2007-04-15

    Casual observation of gluteal region fat thickness on computed tomography (CT) of the pelvis leads to the hypothesis that, in some individuals intended intramuscular injections are not properly deposited in the gluteal muscle. We gathered and analyzed data to determine whether this hypothesis was true. CT scans of the pelvis were analyzed over an 18-day period in the tall of 2005. The thickness of gluteal region subcutaneous fat was measured in a standardized manner. Measurement of gluteal region subcutaneous fat thickness was performed for 298 pelvic CT scans. There were 150 male subjects and 148 female subjects. The average gluteal fat thickness for female subjects was 33.2 mm, whereas the average for male subjects was 23.1 mm. Analysis revealed a significant difference in gluteal region fat thickness between male and female subjects. A 37-mm needle, allowing for 6-mm penetration of the gluteal muscle, would not have entered the gluteal muscle fibres in 81 of 148 female subjects (54.7%), in 21 of 150 male subjects (14%), and in 102 of the 298 total sample (34.2%). Analysis revealed a significant difference between male and female subjects with regard to gluteal muscle needle penetration. An overall predicted failure rate of 34% was identified for intended gluteal intramuscular injections when the standard technique was used. This is important information for care providers who inject medications in the gluteal region. In a significant number of patients, the medications will be injected subcutaneously and not into the gluteal musculature, possibly altering the pharmacokinetics of the administered medication. An alternative injection site should probably be chosen to increase the success rate of intramuscular deposition of medications and vaccines in unselected adults. (author)

  1. Impact of injection speed and volume on perceived pain during subcutaneous injections into the abdomen and thigh: a single-centre, randomized controlled trial.

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    Heise, T; Nosek, L; Dellweg, S; Zijlstra, E; Præstmark, K A; Kildegaard, J; Nielsen, G; Sparre, T

    2014-10-01

    The aim of this study was to assess pain associated with subcutaneous injection into the abdomen and thigh of different combinations of injection speeds and volumes. The study was a single-centre, one-visit, double-blinded, randomized controlled trial in 82 adults with type 1 or type 2 diabetes receiving daily injections of insulin or glucagon-like peptide-1 (GLP-1) agonists. Participants received 17 subcutaneous injections (12 in abdomen, 5 in thigh) of saline at different injection speeds (150, 300 and 450 µl/s), with different volumes (400, 800, 1200 and 1600 µl), and two needle insertions without any injection. Pain was evaluated on a 100-mm visual analogue scale (VAS) (0 mm no pain, 100 mm worst pain) and on a yes/no scale for pain acceptability. Injection speed had no impact on injection pain (p = 0.833). Injection of larger volumes caused significantly more pain [VAS least square mean differences 1600 vs. 400 µl, 7 · 2 mm (95% confidence interval - CI; 4.6-9.7; p pain occurred in the thigh versus the abdomen [9.0 mm (6.7-11.3; p pain, whereas higher injection volumes caused more pain. The results of this study may be of value for guiding patients to use the appropriate injection site and technique to reduce their injection pain. Furthermore, these findings may have important implications for the development of new injection devices and drug formulations for clinical practice. © 2014 John Wiley & Sons Ltd.

  2. Intramuscular injection-site complications.

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    Greenblatt, D J; Allen, M D

    1978-08-11

    Among 26,294 hospitalized medical patients monitored by the Boston Collaborative Drug Surveillance Program, 46% received at least one intramuscular (IM) injection. Drugs for which IM injection was the route of administration in more than 80% of all exposures included penicillin G procaine, mercurial diuretics, cyanocobalamin, streptomycin sulfate, colistimethate sodium, meperidine hydrochloride, cephaloridine, scopolamine hydrobromide, kanamycin sulfate, and iron dextran injection. Local complications of IM injection were reported in a total of only 48 patients (0.4% of all IM recipients). Local complications were most commonly associated with IM injection of cephalothin sodium. Clinically important local complications are uncommonly associated with IM injections in general. However, certain drugs, eg, cephalothin, produce injection-site complications with relatively high frequency; the clinical role of IM injection of such drugs should be reevaluated.

  3. Generalized subcutaneous emphysema caused by injection of air into the penis for autoerotic purposes.

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    Ural, Y; Muthen, N; Engelmann, U; Wille, S

    2013-01-01

    The injection of air or water into the scrotum has been described only a few times so far in the literature. Injection of air into the penis and its consequences has not been described at all. Here, we present the case of a young man who, acting on his previously suppressed sexual fantasies, injected air into his penis and caused generalized subcutaneous emphysema.

  4. Generalized Subcutaneous Emphysema Caused by Injection of Air into the Penis for Autoerotic Purposes

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    Ural, Y.; Muthen, N.; Engelmann, U.; Wille, S.

    2013-01-01

    The injection of air or water into the scrotum has been described only a few times so far in the literature. Injection of air into the penis and its consequences has not been described at all. Here, we present the case of a young man who, acting on his previously suppressed sexual fantasies, injected air into his penis and caused generalized subcutaneous emphysema.

  5. A review of intermittent subcutaneous apomorphine injections for the rescue management of motor fluctuations associated with advanced Parkinson's disease.

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    Chen, Jack J; Obering, Crystal

    2005-11-01

    As Parkinson's disease (PD) progresses,despite optimized pharmacotherapy, patients experience more frequent fluctuations between symptomatic improvement ("on" times) and the return of motor features ("off" times). Apomorphine, the first injectable dopamine agonist available in the United States, is indicated for the acute treatment of "off" episodes (eg, end-of-dose wearing-off episodes, unpredictable "on/off" episodes) in patients with advanced PD who are receiving medically optimal antiparkinsonian therapy. This article reviews the pharmacology,clinical efficacy, and tolerability of intermittent subcutaneous apomorphine injections for the management of "off" episodes in patients with PD. MEDLINE (1966-July 2005), the Cochrane Database of Systematic Reviews, and International Pharmaceutical Abstracts (1970-July 2005) were searched for original research and review articles published in English. The search terms were apomorphine and Parkinson's disease. The reference lists of articles were also consulted, as was selected information provided by the manufacturer of apomorphine. All relevant identified studies on intermittent subcutaneous administration of apomorphine were included in the review; trials of continuous subcutaneous infusion and non-subcutaneous administration of apomorphine were excluded. Intermittent subcutaneous administration of apomorphine produced consistent rescue from "of" episodes in patients with advanced PD, with a symptomatic motor improvement between the predose "off" state and postdose "on" state similar to that achieved with levodopa. The onset of effect occurred within 20 minutes, and the duration of effect was approximately 100 minutes. The therapeutic rescue dose ranged from 2 to 6 mg. During the clinical development program for subcutaneously injected apomorphine, patients required a mean of approximately 3 rescue doses per day. Common adverse effects occurring in > or =20% of patients were injection-site reaction, yawning, dyskinesias

  6. Model study of the pressure build-up during subcutaneous injection.

    Directory of Open Access Journals (Sweden)

    Maria Thomsen

    Full Text Available In this study we estimate the subcutaneous tissue counter pressure during drug infusion from a series of injections of insulin in type 2 diabetic patients using a non-invasive method. We construct a model for the pressure evolution in subcutaneous tissue based on mass continuity and the flow laws of a porous medium. For equivalent injection forces we measure the change in the infusion rate between injections in air at atmospheric pressure and in tissue. From a best fit with our model, we then determine the flow permeability as well as the bulk modulus of the tissue, estimated to be of the order 10-11-10-10 m2 and 105 Pa, respectively. The permeability is in good agreement with reported values for adipose porcine tissue. We suggest our model as a general way to estimate the pressure build-up in tissue during subcutaneous injection.

  7. Model Study of the Pressure Build-Up during Subcutaneous Injection

    DEFF Research Database (Denmark)

    Thomsen, Maria; Hernandez Garcia, Anier; Mathiesen, Joachim

    2014-01-01

    In this study we estimate the subcutaneous tissue counter pressure during drug infusion from a series of injections of insulin in type 2 diabetic patients using a non-invasive method. We construct a model for the pressure evolution in subcutaneous tissue based on mass continuity and the flow laws...... of a porous medium. For equivalent injection forces we measure the change in the infusion rate between injections in air at atmospheric pressure and in tissue. From a best fit with our model, we then determine the flow permeability as well as the bulk modulus of the tissue, estimated to be of the order 10......-11-10-10 m2 and 105 Pa, respectively. The permeability is in good agreement with reported values for adipose porcine tissue. We suggest our model as a general way to estimate the pressure build-up in tissue during subcutaneous injection....

  8. Evaluation of performance, safety, subject acceptance, and compliance of a disposable autoinjector for subcutaneous injections in healthy volunteers.

    Science.gov (United States)

    Berteau, Cecile; Schwarzenbach, Florence; Donazzolo, Yves; Latreille, Mathilde; Berube, Julie; Abry, Herve; Cotten, Joël; Feger, Celine; Laurent, Philippe E

    2010-10-05

    A disposable autoinjector was developed for subcutaneous (SC) self-injection by patients with chronic diseases. To verify its performance and evaluate its acceptance, a clinical study was conducted in healthy volunteers, comparing SC injections performed by subjects using the autoinjector with SC injections performed by nurses using a syringe. This was a randomized, single-center, crossover study comparing SC self-injection using an autoinjector with SC nurse-administered injection using a syringe. Two volumes (0.2 mL and 1 mL) were injected into healthy volunteers. Study objectives included assessment of the accuracy and consistency of the volume injected by the injection systems, and skin reaction and pain associated with the injection. The fluid depot in the SC tissue layer was evaluated by ultrasound. Subject acceptance was evaluated using questionnaires on attitudes and emotions towards the injection technique, and challenged by seeking the subjects' preferred system for a final study injection or future treatment. A total of 960 injections (480 with autoinjector, 480 with syringe) were performed in 40 subjects. There were no significant differences in mean fluid leakage and injected volumes between the systems. Pain associated with the injection was significantly lower with the auto-injector than with the syringe. Local skin reaction at the injection site was overall satisfactory. Injections were appropriately performed by all subjects. At study end, all 40 subjects preferred the autoinjector for a final study injection and for future treatment. This study indicated that the autoinjector used by the subject was similar to a syringe used by a nurse in terms of performance and safety in administering the injections, and better in terms of pain, overall acceptance, and preference.

  9. Fate of Multimeric Oligomers, Submicron, and Micron Size Aggregates of Monoclonal Antibodies Upon Subcutaneous Injection in Mice.

    Science.gov (United States)

    Kijanka, Grzegorz; Bee, Jared S; Bishop, Steven M; Que, Ivo; Löwik, Clemens; Jiskoot, Wim

    2016-05-01

    The aim of this study was to examine the fate of differently sized protein aggregates upon subcutaneous injection in mice. A murine and a human monoclonal immunoglobulin G 1 (IgG1) antibody were labeled with a fluorescent dye and subjected to stress conditions to create aggregates. Aggregates fractionated by centrifugation or gel permeation chromatography were administered subcutaneously into SKH1 mice. The biodistribution was measured by in vivo fluorescence imaging for up to 1 week post injection. At several time points, mice were sacrificed and selected organs and tissues were collected for ex vivo analysis. Part of injected aggregated IgGs persisted much longer at the injection site than unstressed controls. Aggregate fractions containing submicron (0.1-1 μm) or micron (1-100 μm) particles were retained to a similar extent. Highly fluorescent "hot-spots" were detected 24 h post injection in spleens of mice injected with submicron aggregates of murine IgG. Submicron aggregates of human IgG showed higher accumulation in draining lymph nodes 1 h post injection than unstressed controls or micron size aggregates. For both tested proteins, aggregated fractions seemed to be eliminated from circulation more rapidly than monomeric fractions. The biodistribution of monomers isolated from solutions subjected to stress conditions was similar to that of unstressed control. Copyright © 2016 American Pharmacists Association®. Published by Elsevier Inc. All rights reserved.

  10. Ultrasonographic study of subcutaneous penile granuloma secondary to silicone injection

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    Lucio Dell'Atti

    2016-10-01

    Full Text Available Penile augmentation has been reported in the literature by injecting various materials. This study reports our experience in management of penile augmentation complications associated with selfpenile injection of silicone liquid. After a careful ultrasound study, the penile skin was excised through a circumferential sub-coronal incision and dissected with the silicon mass. Histology was well-compatible with silicone granulomas. The patient was discharged after 24 hours. Ultrasonography has permitted preoperatively to determine if the plane between the indurated inflammatory tissue and the Buck’s fascia was preserved for the complete surgical excision of affected tissue.

  11. Direct subcutaneous injection of polyethylene particles over the murine calvaria results in dramatic osteolysis.

    Science.gov (United States)

    Rao, Allison J; Zwingenberger, Stefan; Valladares, Roberto; Li, Chenguang; Lane Smith, Robert; Goodman, Stuart B; Nich, Christophe

    2013-07-01

    The murine calvarial model has been widely employed for the in vivo study of particle-induced osteolysis, the most frequent cause of aseptic loosening of total joint replacements. Classically, this model uses an open surgical technique in which polyethylene (PE) particles are directly spread over the calvarium for the induction of osteolysis. We evaluated a minimally invasive modification of the calvarial model by using a direct subcutaneous injection of PE particles. Polyethylene (PE) particles were injected subcutaneously over the calvaria of C57BL6J ten-week-old mice ("injection" group) or were implanted after surgical exposure of the calvaria ("open" group) (n = 5/group). For each group, five additional mice received no particles and served as controls. Particle-induced osteolysis was evaluated two weeks after the procedure using high-definition microCT imaging. Polyethylene particle injection over the calvaria resulted in a 40% ± 1.8% decrease in the bone volume fraction (BVF), compared to controls. Using the "open surgical technique", the BVF decreased by 16% ± 3.8% as compared to controls (p Polyethylene particle implantation by injection is less invasive and reliably induces osteolysis to a greater degree than the open technique. This subcutaneous injection method will prove useful for repetitive injections of particles, and the assessment of potential local or systemic therapies.

  12. 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

  13. 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

  14. Outbreak of nontuberculous mycobacterial subcutaneous infections related to multiple mesotherapy injections.

    Science.gov (United States)

    Carbonne, Anne; Brossier, Florence; Arnaud, Isabelle; Bougmiza, Iheb; Caumes, Eric; Meningaud, Jean-Paul; Dubrou, Sylvie; Jarlier, Vincent; Cambau, Emmanuelle; Astagneau, Pascal

    2009-06-01

    We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water.

  15. Ivermectin excreted in cattle dung after subcutaneous injection or pour-on treatment

    DEFF Research Database (Denmark)

    Sommer, C.; Steffansen, B.; Nielsen, B. Overgaard

    1992-01-01

    the first five days after dosing due to a more rapid distribution to intestinal contents. Later faecal concentrations after the pour-on treatment were lower than those found after subcutaneous injection. No degradation of ivermectin was detected in pats exposed in the field for up to 45 days. Ivermectin...

  16. Radionuclide venography of lower limbs by subcutaneous injection; Comparison with venography by intravenous injection

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Chung-Chieng; Jong, Shiang-Bin (Kaohsiung Medical College, Kaohsiung (Taiwan))

    1989-11-01

    We have proved that subcutaneous injection (SC) of a small dose of Tc-99m pertechnetate (1 to 2 mCi: 37 to 74 MBq) at acupuncture points (K-3 and B-60) may offer an alternative method of radionuclide venography (RNV) of the lower limbs. In this study, we compared intravenous (IV) RNV and SC-RNV in 22 consecutive cases with typical signs and symptoms suggesting venous abnormality of the lower limb(s) from March to May 1988. They are 11 male and 11 female, aged 47.7{plus minus}15.7 years. Among the 44 limbs of the 22 cases, 4 were normal, 12 (27.3%) were found to have varicose veins in the legs only, 18 (40.9%) had partial stenosis of the deep veins (14 poplito-tibial and 4 superficial femoral), and 13 (29.6%) had complete stenosis of the deep veins (4 poplito-tibial, 1 superficial femoral and 8 ilio-femoral). SC-RNV showed almost the same results as IV-RNV in 21 (47.7%), superior to IV-RNV in 22 (50%) (including 4.6% failure of IV-RNV), and inferior to IV-RNV in 1 (2.3%). We conclude that SC-RNV is definitely an alternative method of lower-limb venography. Since it is in most cases superior to IV-RNV, we suggest that it can take the place of IV-RNV in routine work. (author) 62 refs.

  17. Elemental mercury poisoning caused by subcutaneous and intravenous injection: An unusual self-injury

    Directory of Open Access Journals (Sweden)

    Wale Jaywant

    2010-01-01

    Full Text Available Elemental mercury poisoning most commonly occurs through vapor inhalation as mercury is well absorbed through the lungs. Administering subcutaneous and intravenous elemental mercury is very uncommon but with only a few isolated case reports in the literature. We present an unusual case of elemental mercury poisoning in a 20-year-old young male who presented with chest pain, fever, and hemoptysis. He had injected himself subcutaneously with elemental mercury obtained from a sphygmomanometer. The typical radiographic findings in the chest, forearm, and abdomen are discussed, with a review of the literature.

  18. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection.

    Science.gov (United States)

    Jin, Jing-Fen; Zhu, Ling-Ling; Chen, Meng; Xu, Hui-Min; Wang, Hua-Fen; Feng, Xiu-Qin; Zhu, Xiu-Ping; Zhou, Quan

    2015-01-01

    Intravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods. A literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies. "SC better than IV" involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. "IV better than SC" involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. "IM better than IV" involves epinephrine, hepatitis B immu-noglobulin, pegaspargase, and some antibiotics. "IV better than IM" involves ketamine, morphine, and antivenom. "IM better than SC" involves epinephrine. "SC better than IM" involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles governing the choice of injection route. Safety and efficacy must be the preferred principles to be considered (eg, epinephrine should be given intramuscularly during an episode of systemic anaphylaxis). If the safety and efficacy of two injection routes are equivalent, clinicians should consider more about patient preference and pharmacoeconomics because patient preference will

  19. Influence of hypodermic needle dimensions on subcutaneous injection delivery - a pig study of injection deposition evaluated by CT scanning, histology, and backflow

    DEFF Research Database (Denmark)

    Ann Praestmark Juul, Kezia; Bengtsson, Henrik; Eyving, Bente

    2012-01-01

    carried out on pigs, in neck tissue comparable to human skin at typical injection sites. Six pigs were included and a total of 72 randomized injections were given, i.e. 24 subcutaneous injections given with each needle type. Accordingly, 400 µL was injected including 70% NovoRapid(®) (Novo Nordisk A....../S, Bagsvµrd, Denmark) and 30% Xenetix(®) (Guerbet, Villepinte, France) contrast including 1 mg/mL Alcian blue. Surgical biopsies of injection sites were sampled and computer topographic (CT)-scanned in 3D to assess deposition and local distribution. Biopsies were prepared and stained to evaluate deposition......, in 5-6 mm depth for the 5 mm 32G needle, and in 9-10 mm depth for the 8 mm 30G needle. In general, injection depositions evaluated by histology and CT-scans compared well for the individual biopsies. The amount of backflow (n = 69) from the 3 mm 34G needle was smaller (P ...

  20. Dose comparison of ultrasonic transdermal insulin delivery to subcutaneous insulin injection

    Science.gov (United States)

    Park, Eun-Joo; Dodds, Jeff; Barrie Smith, Nadine

    2010-03-01

    Prior studies have demonstrated the effectiveness of noninvasive transdermal insulin delivery using a cymbal transducer array. In this study the physiologic response to ultrasound mediated transdermal insulin delivery is compared to that of subcutaneously administered insulin. Anesthetized rats (350-550 g) were divided into four groups of four animals; one group representing ultrasound mediated insulin delivery and three representing subcutaneously administered insulin (0.15, 0.20, and 0.25 U/kg). The cymbal array was operated for 60 minutes at 20 kHz with 100 mW/cm2 spatial-peak temporal-peak intensity and a 20% duty cycle. The blood glucose level was determined at the beginning of the experiment and, following insulin administration, every 15 minutes for 90 minutes for both the ultrasound and injection groups. The change in blood glucose from baseline was compared between groups. When administered by subcutaneous injection at insulin doses of 0.15 and 0.20 U/kg, there was little change in the blood glucose levels over the 90 minute experiment. Following subcutaneous administration of insulin at a dose of 0.25 U/kg, blood glucose decreased by 190±96 mg/dl (mean±SD) at 90 minutes. The change in blood glucose following ultrasound mediated insulin delivery was -262±40 mg/dl at 90 minutes. As expected, the magnitude of change in blood glucose between the three injection groups was dependant on the dose of insulin administered. The change in blood glucose in the ultrasound group was greater than that observed in the injection groups suggesting that a higher effective dose of insulin was delivered.

  1. Excretory Urography by Subcutaneous Injection of Iodixanol in Persian Squirrel (Sciurus Anomalous

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    A. Veshkini, M. Tavana*, I. Sohrabi Haghdost1, M. Nasroulahzadeh Masouleh and S Habib Savojbolaghi

    2011-01-01

    Full Text Available There are many indications for excretory urography in humans and animals. Intravenous urography (IVU is the most practical method about other urography techniques are used because of difficulties for finding veins in IVU, due to small size of the patients. This study was performed to evaluate the feasibility of subcutaneous injection of iodixanol in providing a safe and diagnostic urogram in Persian squirrel. Twelve clinically healthy adult Persian squirrels were prepared and kept for two weeks prior to study. Blood tests were performed 7 days prior to the study. After eighteen hour fasting, animals were sedated by using xylazine/diazepam cocktail (xylazine 5mg/kg, diazepam 30mg/kg. Lateral and ventrodorsal control radiographs were taken. Thirteen hundred and 1800 mg iodine per kilogram body weight of iodixanol was injected subcutaneously over shoulder area in Persian squirrels (each dose for six Persian squirrels. Lateral and ventrodorsal radiographs were taken every 5 minutes until the pyelogram was finished. Blood tests were performed 5 days after the study. Histopathologic samples were taken from skin, kidneys, ureters and urinary bladder. The kidneys of squirrels were bean-shaped and their size was approximately 1.7×0.8 cm in ventrodorsal view for both kidneys. Subcutaneous injection of iodixanol was successful to show pyelogram, uretrogram and cystogram but it was unsuccessful in showing nephrogram without pyelogram except in one case (8.33%. Good pictures of nephrograms, calices and the ureters were obtained approximately 70 min after injection. There were no abnormal clinical signs after one week of experiment. There were no abnormal blood chemistry and hematological changes. Urinary system and skin microscopic examinations were normal. It is concluded that subcutaneous urography is an effective and reliable method for urography studies in squirrel except for nephrogram. More investigations are needed to study reasons for the lack of

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

    Energy Technology Data Exchange (ETDEWEB)

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

    1988-04-01

    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 (/sup 35/S)IL-2 was detectable in a number of tissues 3 days after injection.

  3. Treatment of pretibial myxedema with dexamethazone injected subcutaneously by mesotherapy needles.

    Science.gov (United States)

    Vannucchi, Guia; Campi, Irene; Covelli, Danila; Forzenigo, Laura; Beck-Peccoz, Paolo; Salvi, Mario

    2013-05-01

    Pretibial myxedema (PTM) is a rare extrathyroidal manifestation of Graves' disease that requires treatment when the clinical picture is markedly evident. In addition to topical treatment with steroid ointments, there have been previous reports of subcutaneous injections of steroids. This procedure may cause nodular degeneration of the skin due to fat atrophy when standard needles are used. In the present study, we have tried a novel modality of treatment of PTM by injecting a solution of dexamethasone in the subcutaneous tissue using needles employed for mesotherapy. These needles are ≤4 mm long and deliver the medication within the dermis or the first layer of the subcutaneous fat. We have treated five patients, four with diffuse and one with elephanthiasic PTM. We utilized multiple injections of a solution of dexamethasone, lidocaine, and saline in the PTM plaque and in the pretibial area, both in the PTM plaque and in the area surrounding the lesions, once a week for three consecutive weeks. Two patients with a more severe form of PTM underwent another two cycles four to six weeks after initial treatment. Patients were studied before and after treatment by clinical assessment and ultrasound of the pretibial skin. The treatment was well-tolerated, with only moderate pain upon injection of the solution. One month after treatment, all patients showed improvement of PTM at clinical assessment and a reduction of the thickness of the lesions at ultrasound of ∼15%, involving mostly the dermis. Moreover, all patients reported amelioration of the leg appearance. The present study, although preliminary, shows that intralesion steroid injection with mesotherapy needles in PTM is effective and well tolerated, and does not cause undesired long-term modifications of the skin. More studies are warranted to standardize such treatment in larger groups of patients.

  4. Tumescent technique in digits: a subcutaneous single-injection digital block.

    Science.gov (United States)

    Tzeng, Yuan-Sheng; Chen, Shyi-Gen

    2012-05-01

    A modified subcutaneous single-injection approach to achieve digital block using a tumescent technique is described. A convenient sample of patients requiring digital anesthesia for minor surgical procedures on the fingers or thumb in the emergency and plastic departments were enrolled into the study. Digital nerve block was performed by injecting 1% lidocaine into the volar subcutaneous space at the proximal digit to create a firm, turgid feel to the tissue, the so-called tumescent state. The volume of anesthetic was based on the size of the digit. All nerve blocks were performed by 1 surgeon. Successful digital anesthesia was defined as complete loss of pinprick sensation on both the dorsal and volar aspects of the digit and the ability to complete the anticipated minor surgical procedure without pain. All patients were followed for 1 month to assess for adverse events. Between August 2009 and January 2011, 123 patients (123 digits) requiring digital anesthesia were enrolled into the study. Thirty-nine (32%) were volar lesions, and 84 (68%) were dorsal lesions. The tumescent technique single-injection digital block was successful in all digits. No adverse events were reported. The tumescent technique in digits to achieve a single-injection digital nerve block is an easy, safe and effective method for digital anesthesia. These data confirm the applicability of the tumescent technique in digits for patients with finger and thumb injuries or tumors that require minor surgical procedures. Copyright © 2012 Elsevier Inc. All rights reserved.

  5. Subcutaneous cod liver oil injection for penile augmentation: review of literature and report of eight cases.

    Science.gov (United States)

    Al-Ansari, Abdulla A; Shamsodini, Ahmed; Talib, Raidh A; Gul, Tawiz; Shokeir, Ahmed A

    2010-05-01

    To study the presentations and treatment outcome of 8 consecutive patients for whom cod liver oil was injected in the subcutaneous area of their penises by a lay person for purpose of augmentation. Various amounts of cod liver oil were injected in the subcutaneous area of the penis of 8 low socioeconomic class patients by a nonmedical person. They presented by various complications ranging from paraphimosis up to abscess formation and necrosis of penile skin. All the patients underwent emergency initial surgical intervention ranging from dorsal preputial slit to skin debridement. Definitive surgical treatment was carried out using local penile flap and V-Y plasty. The severity of complications was correlated to the amount of oil injected and the time interval between injections and presentation. All the 8 patients were cured after different staged surgical procedures. The postoperative course was uneventful in 6 patients, and 2 patients suffered from wound infection after the secondary treatment. All patients had acceptable cosmetic and functional outcome, and were satisfied regarding the length of the penis. None reported erectile dysfunction. Increased public awareness is indicated to avoid this problem. Early detection and prompt treatment give acceptable anatomic and functional results. Copyright 2010 Elsevier Inc. All rights reserved.

  6. Comparison of Intramuscular or Subcutaneous Injections vs. Castration in Pigs—Impacts on Behavior and Welfare

    Directory of Open Access Journals (Sweden)

    John McGlone

    2016-08-01

    Full Text Available Physical castration (PC is painful and stressful for nursing piglets. One alternative to PC is immunological castration (IC, but the pain and stress of handling associated with injections have not been assessed. The objectives of this study were to measure the pain and distress of subcutaneous (SQ and intramuscular (IM injections compared to PC in piglets, and to compare SQ or IM injections in finishing pigs. After farrowing, 3 to 5 d old male piglets were randomly assigned to (control no handling treatment (NO, sham-handling (SHAM, IM, SQ, or PC. Finishing pigs were assigned to NO, SHAM, IM, or SQ. Behavior was monitored for 1 h prior and 1 h post treatment in each age group. Social, feeding behaviors, and signs of pain were recorded. Finishing pigs treated with SQ injections had higher feeding behaviors pre-treatment than they did post-treatment. Overall, physical castrations caused measurable pain-like behaviors and general behavioral dysregulation at a much higher level than the other treatment groups. SQ and IM injections did not cause either significant behavioral or physiological alterations in piglets. SQ injections caused a decrease in finishing pig feed behaviors post treatment ( p = 0.02 and SHAM treated finishing pigs spent significantly more time lying than the other treatment groups. In general IM and SQ injections did not cause any other significant changes in behavior or physiology.

  7. Subcutaneous injection of sup 99m Tc pertechnetate at acupuncture points K-3 and B-60

    Energy Technology Data Exchange (ETDEWEB)

    Wu Chung-Chieng; Jong Shiang-Bin; Lin Chun-Ching; Chen Min-Fen; Chen Jong-Rern (Kaohsiung Medical Coll., Taiwan (China)); Chung Chieng

    1990-06-01

    The acupuncture points are known to be morphologically related to the nerves and vessels. Yet the physiological role of blood vessels in the formation of acupuncture points remains unknown. With subcutaneous injection of {sup 99m}Tc pertechnetate at the acupuncture points K-3 and B-60 and with intra-acupuncture point injection of {sup 99m}Tc pertechnetate at K-3 and B-60, a lower-limb venography like what was obtained by intravenous injection of {sup 99m}Tc macroaggregated albumin was demonstrated in the present study. It seems that some acupuncture points do play a role in drainage of tissue fluid from soft tissue into the veins. (author).

  8. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

    Directory of Open Access Journals (Sweden)

    Jin JF

    2015-07-01

    Full Text Available Jing-fen Jin,1 Ling-ling Zhu,2 Meng Chen,3 Hui-min Xu,3 Hua-fen Wang,1 Xiu-qin Feng,1 Xiu-ping Zhu,3 Quan Zhou31Division of Nursing, 2VIP Care Ward, Division of Nursing, 3Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaBackground: Intravenous (IV, intramuscular (IM, and subcutaneous (SC are the three most frequently used injection routes in medication administration. Comparative studies of SC versus IV, IM versus IV, or IM versus SC have been sporadically conducted, and some new findings are completely different from the dosage recommendation as described in prescribing information. However, clinicians may still be ignorant of such new evidence-based findings when choosing treatment methods.Methods: A literature search was performed using PubMed, MEDLINE, and Web of Sciences™ Core Collection to analyze the advantages and disadvantages of SC, IV, and IM administration in head-to-head comparative studies.Results: “SC better than IV” involves trastuzumab, rituximab, antitumor necrosis factor medications, bortezomib, amifostine, recombinant human granulocyte-macrophage colony-stimulating factor, granulocyte colony-stimulating factor, recombinant interleukin-2, immunoglobulin, epoetin alfa, heparin, and opioids. “IV better than SC” involves ketamine, vitamin K1, and abatacept. With respect to insulin and ketamine, whether IV has advantages over SC is determined by specific clinical circumstances. “IM better than IV” involves epinephrine, hepatitis B immunoglobulin, pegaspargase, and some antibiotics. “IV better than IM” involves ketamine, morphine, and antivenom. “IM better than SC” involves epinephrine. “SC better than IM” involves interferon-beta-1a, methotrexate, human chorionic gonadotropin, hepatitis B immunoglobulin, hydrocortisone, and morphine. Safety, efficacy, patient preference, and pharmacoeconomics are four principles

  9. Two injection digital block versus single subcutaneous palmar injection block for finger lacerations.

    Science.gov (United States)

    Okur, O M; Şener, A; Kavakli, H Ş; Çelik, G K; Doğan, N Ö; Içme, F; Günaydin, G P

    2017-12-01

    We aimed to compare two digital nerve block techniques in patients due to traumatic digital lacerations. This was a randomized-controlled study designed prospectively in the emergency department of a university-based training and research hospital. Randomization was achieved by sealed envelopes. Half of the patients were randomised to traditional (two-injection) digital nerve block technique while single-injection digital nerve block technique was applied to the other half. Score of pain due to anesthetic infiltration and suturing, onset time of total anesthesia, need for an additional rescue injection were the parameters evaluated with both groups. Epinephrin added lidocaine hydrochloride preparation was used for the anesthetic application. Visual analog scale was used for the evaluation of pain scores. Outcomes were compared by using Mann-Whitney U test and Student t-test. Fifty emergency department patients ≥18 years requiring digital nerve block were enrolled in the study. Mean age of the patients was 33 (min-max: 19-86) and 39 (78 %) were male. No statistically significant difference was found between the two groups in terms of our main parameters; anesthesia pain score, suturing pain score, onset time of total anesthesia and rescue injection need. Single injection volar digital nerve block technique is a suitable alternative for digital anesthesias in emergency departments.

  10. The optimal choice of medication administration route regarding intravenous, intramuscular, and subcutaneous injection

    OpenAIRE

    Jin JF; Zhu LL; Chen M; Xu HM; Wang HF; Feng XQ; Zhu XP; Zhou Q

    2015-01-01

    Jing-fen Jin,1 Ling-ling Zhu,2 Meng Chen,3 Hui-min Xu,3 Hua-fen Wang,1 Xiu-qin Feng,1 Xiu-ping Zhu,3 Quan Zhou31Division of Nursing, 2VIP Care Ward, Division of Nursing, 3Department of Pharmacy, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, People’s Republic of ChinaBackground: Intravenous (IV), intramuscular (IM), and subcutaneous (SC) are the three most frequently used injection routes in medication administration. Comparative studies of SC ver...

  11. Evaluation of performance, safety, subject acceptance, and compliance of a disposable autoinjector for subcutaneous injections in healthy volunteers

    OpenAIRE

    Berteau, Cecile; Schwarzenbach, Florence; Donazzolo, Yves; Latreille, Mathilde; Berube, Julie; Abry, Herve; Cotten, Jo?l; Feger, Celine; Laurent, Philippe E

    2010-01-01

    Objective: A disposable autoinjector was developed for subcutaneous (SC) self-injection by patients with chronic diseases. To verify its performance and evaluate its acceptance, a clinical study was conducted in healthy volunteers, comparing SC injections performed by subjects using the autoinjector with SC injections performed by nurses using a syringe. Methods: This was a randomized, single-center, crossover study comparing SC self-injection using an autoinjector with SC nurse-administered ...

  12. Subcutaneous injection is a simple and reproducible option to restore parathyroid function after total parathyroidectomy in patients with secondary hyperparathyroidism.

    Science.gov (United States)

    Ng, Jeremy C F; Wang, Weining; Chua, Min-Jia; Tan, Mui-Suan; Tan, Ngian Chye; Soo, Khee-Chee; Tan, Hiang Khoon; Iyer, N Gopalakrishna

    2014-04-01

    Secondary hyperparathyroidism is a common clinical problem seen in patients with end-stage renal disease (ESRD) undergoing hemodialysis. In patients with severe persistent hyperparathyroidism, parathyroidectomies are often required. We sought to evaluate the feasibility and efficacy of total parathyroidectomy followed by subcutaneous injection of parathyroid autograft compared with surgical implantation. We conducted a retrospective study of 132 patients with confirmed diagnoses of ESRD treated with hemodialysis or peritoneal dialysis, with secondary hyperparathyroidism who had undergone total parathyroidectomies. Clinical and biochemical characteristics, including preoperative and postoperative intact parathyroid hormone levels were recorded and compared between patients who had undergone subcutaneous injection or surgical implantation of autograft. From February 2005 to February 2012, 132 patients who had undergone total parathyroidectomies were included in our study. To compare the techniques of subcutaneous injection and surgical implantation, pre- and postoperative biochemistry was recorded and analyzed. Preoperative biochemistry was comparable in both groups. However, autograft recovery was significantly faster in the group with subcutaneous injection compared with surgical implantation (P = .03). Median time to parathyroid recovery was 2 months for injection compared with 9 months for implantation. There was no remarkable difference in the recurrence rates between the 2 groups. Subcutaneous injection of parathyroid tissue is a feasible and simple alternative to the more commonly used method of surgical implantation. Copyright © 2014 Mosby, Inc. All rights reserved.

  13. Acute urinary retention as a late complication of subcutaneous liquid silicone injection: a case report

    Directory of Open Access Journals (Sweden)

    Leandro Luongo de Matos

    2009-12-01

    Full Text Available Acute urinary retention is characterized by a sudden interruption of urinary output; urine is retained in the bladder due to either functional or obstructive anatomic factors, and cannot be voided. The main causes of acute urinary obstruction are benign prostatic hyperplasia, constipation, prostate adenocarcinoma, urethral stenosis, clot retention, neurological disorders, following surgery, calculi, drugs, or urinary tract infections. A transvestite patient, aged 55 years, described having had liquid silicone subcutaneously injected in various parts of the body, the last one four years ago. He complained of absent urinary output during the last 14 hours. The physical examination revealed skin deformation due to migration of implants; a hard nodule (characterized as a foreign body was present in the preputium and a diagnosis of acute urinary retention was made; an unsuccessful attempt to exteriorize the glans for urinary catheterization, was followed by therapeutic cystostomy. Acute urinary retention has not been mentioned in the medical literature as a complication of liquid silicone subcutaneous injection.

  14. Immune responses of BALB/c mice to subcutaneously injected multi-walled carbon nanotubes.

    Science.gov (United States)

    Meng, Jie; Yang, Man; Jia, Fumin; Xu, Zhen; Kong, Hua; Xu, Haiyan

    2011-12-01

    Carbon nanotubes have been shown to have the ability to transport therapeutic and detective reagents into cells. However, the rapid advances in new carbon nanotube-based materials and technologies have raised concerns about their safety. Such concerns require a fundamental understanding of the toxicological properties of carbon nanotubes. In particular, the use of carbon nanotubes as drug or probe delivery platforms may depend on the prevention of stimulatory side-effects to the immune system. In this study, we investigated the immunological properties of oxidized water dispersible multi-walled carbon nanotubes (MWCNTs) in healthy BALB/c mice. We injected the MWCNTs subcutaneously, and the immune responses of the mice were monitored over time. We show that the MWCNTs induce complement activation and the production of pro-inflammatory cytokines early after injection of the mice, and that the levels of complement and cytokines return to normal levels over time. With the exception of the lymph nodes, there was no obvious accumulation of MWCNTs observed in the liver, spleen, kidney, or heart. In addition, we did not observe injury in the organs or lymph nodes. Our results indicate that local, subcutaneous administration of MWCNTs induces obvious short-term immunological reactions, which can be eliminated over time.

  15. Therapeutic efficacy of monthly subcutaneous injection of daclizumab in relapsing multiple sclerosis

    Science.gov (United States)

    Cohan, Stanley

    2016-01-01

    Despite the availability of multiple disease-modifying therapies for relapsing multiple sclerosis (MS), there remains a need for highly efficacious targeted therapy with a favorable benefit–risk profile and attributes that encourage a high level of treatment adherence. Daclizumab is a humanized monoclonal antibody directed against CD25, the α subunit of the high-affinity interleukin 2 (IL-2) receptor, that reversibly modulates IL-2 signaling. Daclizumab treatment leads to antagonism of proinflammatory, activated T lymphocyte function and expansion of immunoregulatory CD56bright natural killer cells, and has the potential to, at least in part, rectify the imbalance between immune tolerance and autoimmunity in relapsing MS. The clinical pharmacology, efficacy, and safety of subcutaneous daclizumab have been evaluated extensively in a large clinical study program. In pivotal studies, daclizumab demonstrated superior efficacy in reducing clinical and radiologic measures of MS disease activity compared with placebo or intramuscular interferon beta-1a, a standard-of-care therapy for relapsing MS. The risk of hepatic disorders, cutaneous events, and infections was modestly increased. The monthly subcutaneous self-injection dosing regimen of daclizumab may be advantageous in maintaining patient adherence to treatment, which is important for optimal outcomes with MS disease-modifying therapy. Daclizumab has been approved in the US and in the European Union and represents an effective new treatment option for patients with relapsing forms of MS, and is currently under review by other regulatory agencies. PMID:27672308

  16. Lanreotide depot deep subcutaneous injection: a new method of delivery and its associated benefits

    Directory of Open Access Journals (Sweden)

    Carmichael JD

    2012-01-01

    Full Text Available John D CarmichaelDepartment of Medicine, Cedars-Sinai Medical Center, Los Angeles, CA, USAAbstract: Acromegaly is a rare disease characterized by excessive growth hormone secretion, usually from a pituitary tumor. Treatment options include surgery, medical therapy, and in some cases, radiation therapy. Current medical therapy consists of treatment with somatostatin analog medications or a growth hormone receptor antagonist. There are two somatostatin analogs currently in use, octreotide and lanreotide. Both are supplied in long-acting formulations and are of comparable biochemical efficacy. Lanreotide is supplied in a prefilled syringe and is injected into deep subcutaneous tissue. Studies have been conducted to assess the efficacy of self- or partner administration, and have demonstrated that injection of lanreotide can be accomplished reliably and safely outside a physician's office. For patients who have achieved biochemical control with lanreotide, the FDA has recently approved an extended dosing interval. Selected patients may be able to receive the medication less frequently with injections of 120 mg administered every 6 or 8 weeks. This review focuses on the use of lanreotide in the treatment of acromegaly, the safety and efficacy of the drug, and the benefits afforded to patients because of unique aspects of the delivery of lanreotide.Keywords: acromegaly, treatment, lanreotide, somatostatin analog, pituitary tumor

  17. Radionuclide venography of lower limbs by subcutaneous injection; A clinical evaluation

    Energy Technology Data Exchange (ETDEWEB)

    Wu, Chung-Chieng; Jong, Shiang-Bin (Kaohsiung Medical Coll., Taiwan (China))

    1993-02-01

    SC-RNV, radionuclide venography by subcutaneous injection of Tc-99m pertechnetate at acupuncture points K-3, a new alternative of lower limb venography, was recently developed in our clinical laboratory. In some of the previous studies, we have proved its superiority to radionuclide venography by intravenous injection. The current investigation was conducted to understand the reliability of SC-RNV in the diagnosis of deep vein thrombosis (DVT). Fifty-seven cases with lower leg edema, from November 1989 through October 1990, received both SC-RNV and duplex US for causative evaluation. As a result of duplex US, 26 were considered normal (non-DVT), 19 were classified as unilateral DVT, and 12 as bilateral DVT. In nineteen cases (61%, 19/31) with DVT also a XCT and/or a CV (contrast venography) was taken, that showed compatible results. All of the non-DVT had a normal pattern of SC-RNV, all of the unilateral DVT had unilateral impairment of deep vein drainage in SC-RNV, and all of the bilateral DVT had impaired deep venous drainage bilaterally in SC-RNV. It is therefore, concluded that SC-RNV is one of the best choices among available non-invasive lower-limb venographic methods. (author).

  18. Clinical Experience with U-500 Regular Insulin by Multiple Daily Injections and Continuous Subcutaneous Insulin Infusion.

    Science.gov (United States)

    Meade, Lisa T; Tart, Rebecca C; Nuzum, Donnie

    2017-04-01

    The effectiveness of U-500 regular insulin was assessed in patients with type 2 diabetes who were previously treated with U-100 insulin. A retrospective chart review was conducted on all patients who were prescribed U-500 insulin between January 2012 and December 2013. The primary outcome measure was change in glycosylated hemoglobin (A1C) 1 year after switching from U-100 insulin to U-500 regular insulin. Secondary outcomes included change in body weight, total daily insulin dose, number of daily injections, and episodes of hypoglycemia. Sixty-six patients met inclusion criteria: U-500 regular insulin via multiple daily injections (MDI; n = 36) or continuous subcutaneous insulin infusion (CSII; n = 30). The A1C in patients using MDI decreased by 1.8%, whereas patients using CSII experienced an A1C decrease of 0.63% after 1 year of U-500 regular insulin use. There was an increase of 3.1 + 0.73 kg in body weight in both the MDI and CSII groups, which was significant (P insulin in MDI and CSII patients can improve glycemic control, and it does not increase the frequency of hypoglycemia when compared with U-100 insulin hypoglycemic incidence reported in the literature.

  19. Comparison between subcutaneous injection of basic fibroblast growth factor-hydrogel and intracavernous injection of adipose-derived stem cells in a rat model of cavernous nerve injury.

    Science.gov (United States)

    Bae, Jang Ho; Shrestha, Kshitiz Raj; Park, Yong Hyun; Kim, In Gul; Piao, Shuyu; Jung, Ae Ryang; Jeon, Seung Hwan; Park, Ki Dong; Lee, Ji Youl

    2014-11-01

    To compare the effects of subcutaneous penile injection of basic fibroblast growth factor (bFGF)-hydrogel and intracavernous injection of human adipose-derived stem cells (h-ADSCs) on improving erectile function in a rat model of cavernous nerve injury. Adult male Sprague-Dawley rats were randomly divided into 5 groups (n = 10 per group): age-matched control (normal group), bilateral cavernous nerve injury (BCNI group), penile subcutaneous injection of hydrogel after BCNI (hydrogel group), penile subcutaneous injection of bFGF-hydrogel after BCNI (bFGF-hydrogel group) and intracavernous injection of h-ADSCs after BCNI (ADSC group). Four weeks after the treatment, all rats underwent an erectile function test. Then, penile tissue was harvested for immunohistological analysis of bFGF, phalloidin, and cluster of differentiation (CD) 31. The cyclic guanosine monophosphate (cGMP) level of the corpus cavernosum was quantified by cGMP assay. From the functional test and immunohistological result, we observed that bFGF-hydrogel and h-ADSCs injection significantly elevated intracavernous pressure. The evaluation of filamentous actin content, CD31 expression, and cGMP concentration in the corpus cavernosum were meaningfully increased in the bFGF-hydrogel and ADSC groups compared with BCNI group. The bFGF released from bFGF-hydrogel prevented smooth muscle atrophy. Moreover, bFGF expression was significantly increased in bFGF-hydrogel group. The subcutaneous injection of bFGF-hydrogel prevented smooth muscle atrophy, increased the intracavernous pressure, and improved erectile function like an intracavernous injection of h-ADSCs. Copyright © 2014. Published by Elsevier Inc.

  20. Widespread subcutaneous emphysema and barotrauma resulting from high pressure gas injection

    National Research Council Canada - National Science Library

    Smith, Barnaby; Brown, Troy

    2012-01-01

    Widespread subcutaneous emphysema is an unusual emergency presentation. We present a case of accidental high pressure insufflation, the pathophysiology and subsequent medical management in the acute setting...

  1. Medroxyprogesterone Injection

    Science.gov (United States)

    Medroxyprogesterone intramuscular (into a muscle) injection and medroxyprogesterone subcutaneous (under the skin) injection are used to prevent pregnancy. Medroxyprogesterone subcutaneous injection is also used to treat endometriosis ( ...

  2. Mycobacterium fortuitum skin infections after subcutaneous injections with Vietnamese traditional medicine: a case report

    NARCIS (Netherlands)

    Lan, Nguyen Phu Huong; Kolader, Marion-Eliëtte; van Dung, Nguyen; Campbell, James I.; Tham, Nguyen Thi; Chau, Nguyen Van Vinh; van Doorn, H. Rogier; Le, Dien Hoa

    2014-01-01

    Iatrogenic skin and soft tissue infections by rapidly growing mycobacteria are described with increasing frequency, especially among immunocompromised patients. Here, we present an immunocompetent patient with extensive Mycobacterium fortuitum skin and soft tissue infections after subcutaneous

  3. [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.

  4. Subcutaneous injection of thallium-201 chloride and gallium-67 citrate at acupuncture point K-3; An animal experiment and human-being study

    Energy Technology Data Exchange (ETDEWEB)

    Johg, Shiang-Bin; Wu, Chung-Chieng; Chen, Ming-Feng; Wu, Sheng-Nan (Kaohsiung Medical Coll., Taiwan (China))

    1992-09-01

    Subcutaneous (SC) injection of [sup 99m]Tc pertechnetate ([sup 99m]Tc) at acupuncture points K-3 is a new method of lower-limb radionuclide venography. To investigate the mechanism of absorption of [sup 99m]Tc from SC injected sites into vascular system, various radioisotopes such as [sup 201]Tl chloride ([sup 201]Tl) and [sup 67]Ga citrate ([sup 67]Ga) were SC injected at K-3 points in animal and human-beings experiments. It was found that [sup 99m]Tc and [sup 201]Tl were absorbed rapidly from K-3 points through venous system and into whole body soft tissue. However, [sup 67]Ga with a larger effective ionic radius than [sup 201]Tl was not absorbed throughout the observation of 5 minutes. Furthermore, intravenous administration of digitalis, a Na[sup +]-K[sup +] pump blocker, did not inhibit the absorption of [sup 99m]Tc and [sup 201]Tl after SC injection at K-3 points. These results suggest that absorption of radionuclides on SC injection at K-3 points is mainly through the passive pathway of diffusion rather than the active transport, and the effective ionic radius may be a major factor influencing the absorption rate of the radionuclides. (author).

  5. Subcutaneous injection of water-soluble multi-walled carbon nanotubes in tumor-bearing mice boosts the host immune activity

    Science.gov (United States)

    Meng, Jie; Yang, Man; Jia, Fumin; Kong, Hua; Zhang, Weiqi; Wang, Chaoying; Xing, Jianmin; Xie, Sishen; Xu, Haiyan

    2010-04-01

    The immunological responses induced by oxidized water-soluble multi-walled carbon nanotubes on a hepatocarcinoma tumor-bearing mice model via a local administration of subcutaneous injection were investigated. Experimental results show that the subcutaneously injected carbon nanotubes induced significant activation of the complement system, promoted inflammatory cytokines' production and stimulated macrophages' phagocytosis and activation. All of these responses increased the general activity of the host immune system and inhibited the progression of tumor growth.

  6. Subcutaneous injection of water-soluble multi-walled carbon nanotubes in tumor-bearing mice boosts the host immune activity

    Energy Technology Data Exchange (ETDEWEB)

    Meng Jie; Yang Man; Jia Fumin; Kong Hua; Zhang Weiqi; Xu Haiyan [Department of Biomedical Engineering, Institute of Basic Medical Sciences and School of Basic Medicine, Chinese Academy of Medical Sciences and Peking Union Medical College, 5 Dong Dan San Tiao, Beijing 100005 (China); Wang Chaoying; Xie Sishen [Beijing National Laboratory for Condensed Matter Physics, Institute of Physics, Chinese Academy of Sciences, 8 Nan San Jie, Zhongguancun, Beijing100080 (China); Xing Jianmin, E-mail: xuhy@pumc.edu.cn [Centre for Evidence-Based Chinese Medicine, Beijing University of Chinese Medicine, 11 Bei San Huan Dong Lu, Beijing 100029 (China)

    2010-04-09

    The immunological responses induced by oxidized water-soluble multi-walled carbon nanotubes on a hepatocarcinoma tumor-bearing mice model via a local administration of subcutaneous injection were investigated. Experimental results show that the subcutaneously injected carbon nanotubes induced significant activation of the complement system, promoted inflammatory cytokines' production and stimulated macrophages' phagocytosis and activation. All of these responses increased the general activity of the host immune system and inhibited the progression of tumor growth.

  7. Study of severe scorpion envenoming following subcutaneous venom injection into dogs: Hemodynamic and concentration/effect analysis.

    Science.gov (United States)

    Elatrous, Souheil; Ouanes-Besbes, Lamia; Ben Sik-Ali, Habiba; Hamouda, Zineb; BenAbdallah, Saoussen; Tilouche, Nejla; Jalloul, Faten; Fkih-Hassen, Mohamed; Dachraoui, Fahmi; Ouanes, Islem; Abroug, Fekri

    2015-09-15

    To evaluate the dose-effects of Androctonus australis hector (Aah) venom injected subcutaneously on hemodynamics and neurohormonal secretions, 10 anesthetized and ventilated mongrel dogs, were split in two groups (n = 5/group). Subcutaneous injection was done with either 0.2 mg/kg or 0.125 mg/kg of the purified G50 scorpion toxic fraction. Hemodynamic parameters using right heart catheter were recorded and plasma concentrations of catecholamine, troponin, and serum toxic fraction were measured sequentially from baseline to 120 min. We identified the dose of toxic fraction evoking characteristic hemodynamic perturbation of severe envenomation, the time-lapse to envenomation, and the associated plasma level. The injection of 0.125 mg/kg toxic fraction was not associated with significant variations in hemodynamic parameters, whereas the 0.2 mg/kg dose caused envenomation characterized by significant increase in plasma catecholamines, increased pulmonary artery occluded pressure, mean arterial pressure, and systemic vascular resistance (p < 0.05), in association with sustained decline in cardiac output (p < 0.001). Envenomation occurred by the 30th minute, and the corresponding concentration of toxic fraction was 1.14 ng/ml. The current experiment allowed the identification of the sub-lethal dose (0.2 mg/kg) of the toxic fraction of Aah administered by the subcutaneous route. Two parameters with potential clinical relevance were also uncovered: the time-lapse to envenomation and the corresponding concentration of toxic fraction. Copyright © 2015 Elsevier Ltd. All rights reserved.

  8. [Efficacy and safety study of subcutaneous injection of bortezomib in the treatment of de novo patients with multiple myeloma].

    Science.gov (United States)

    Liu, Hui; Fu, Cheng-cheng; Xue, Sheng-li; Li, Wei-yang; Wu, Qian; Gu, Bin; Jin, Song; Zhu, Xia-ming; Zhao, Su-fang; Xin, Xue; Ma, Ling; Sun, Ai-ning; Wu, De-pei

    2013-10-01

    To explore the efficacy and safety of subcutaneous injection of bortezomib in the treatment of de novo multiple myeloma (MM) patients. A total of 36 MM patients treated with bortezomib, adriamycin and dexamethasone (PAD) from January 2012 to April 2013 were analyzed. Among them, 18 received improved PAD (improved PAD group) with the subcutaneous injection of bortezomib, another 18 received conventional PAD (PAD group). The efficacy and safety of two groups were analyzed. Except 4 cases can not be assessed, 32 patients were evaluated. Of 32 cases, 19(59.4%) achieved complete remission (CR) or very good partial remission (VGPR) after induction therapy, which were 61.1% and 57.1% for PAD group and improved PAD group, respectively (P=1.000). No significant difference between the time to achieve maximum effectiveness in two groups was detected. In the PAD group, one patient (5.6%) died of serious lung infection and eight (44.4%) experienced grade 3 or higher adverse events, while only one (5.6%) discontinued treatment in improved PAD group due to similar toxicity. Compared to PAD group, grade 3 or worse adverse events was significantly reduced in improved PAD group, the most common symptoms were leucopenia (33.3% vs 61.1%, P=0.086), thrombocytopenia (50.0% vs 61.1%), anaemia (27.8% vs 16.7%), infection (16.7% vs 50.0%, P=0.075), diarrhea (5.6% vs 33.3%, P=0.088), peripheral neuropathy(0 vs 27.8%, P=0.045). The improved PAD regimen by changing bortezomib from intravenous administration to subcutaneous injection significantly reduced adverse events, improved the safety of clinical application of bortezomib without affecting curative effect, and had great progress.

  9. Best infection control practices for intradermal, subcutaneous, and intramuscular needle injections.

    OpenAIRE

    Hutin, Yvan; Hauri, Anja; Chiarello, Linda; Catlin, Mary; Stilwell, Barbara; Ghebrehiwet,Tesfamicael; Garner, Julia

    2003-01-01

    OBJECTIVE: To draw up evidence-based guidelines to make injections safer. METHODS: A development group summarized evidence-based best practices for preventing injection-associated infections in resource-limited settings. The development process included a breakdown of the WHO reference definition of a safe injection into a list of potentially critical steps, a review of the literature for each of these steps, the formulation of best practices, and the submission of the draft document to peer ...

  10. Injection-Site Sarcoma in a Dog: Clinical and Pathological Findings

    Directory of Open Access Journals (Sweden)

    Terry M. Jacobs

    2017-01-01

    Full Text Available This case report documents the clinical and pathological findings in a dog that rapidly developed a high-grade sarcoma at the site of multiple vaccinations and follows the response to surgery and adjunct treatment with toceranib. An 11-year-old female spayed Labrador Retriever presented with dorsocervical subcutaneous masses at the injection site three weeks after receiving DA2PP-Lepto, Rabies, and Bordetella vaccinations. A high-grade soft tissue sarcoma was diagnosed microscopically and immunohistochemistry revealed positive expression of VEGFr, PDGFr, SCF, and EGFR. Repeat surgical resections and targeted treatment with toceranib resulted in a stable remission for nearly two years.

  11. Intramuscular Injection of “Site Enhancement Oil”

    DEFF Research Database (Denmark)

    Petersen, Maria Louise; Colville-Ebeling, Bonnie; Jensen, Thomas Hartvig Lindkær

    2015-01-01

    The use of intramuscular injection of foreign substances for aesthetic purposes is well known. Complications are usually local to the site of injection but can be potentially lethal. Here, we present a case of "site enhancement oil" use in a 42-year-old man who died from asphyxia due to hanging....... Macroscopic and microscopic changes as well as computed tomographic changes in injected musculature are described and the potentially lethal adverse effects after site enhancement oil use are warranted....

  12. The effect of subcutaneous injection duration on bruising due to Clexane (enoxaparin injection in patients with ACS hospitalized in CCU and Post CCU wards in Vali-e Asrhospital of Fasain 2014

    Directory of Open Access Journals (Sweden)

    Bijani M.

    2016-11-01

    Full Text Available The aim of this study was to compare the duration of subcutaneous injection of Clexane on the bruising caused by the same. The sample included 80 patients with ACS under treatment with Clexanein CCU and Post CCU wards. For each patient, two 10-second subcutaneous injections (experimental group and a 30-second injection (control group of Clexane were performed in the abdominal area. The interval between injections was 12 hours and the bruising was measured using a flexible plastic ruler 48 and 60 hours after each injection. The size of bruising caused by 30-sec. injections was significantly less than that of 10-second injections. The average size of bruising for30-second injections in 48 and 60 hours after injection was 15.65 ±10.67 and 12.98 ± 8.12respectively. No bruising conditions observed 48 and 60 hours after 30-second injections were significantly lower than after 10- second injections. In most cases, bruising after 10- and 30-second injections was significantly higher in women than in men. There was no significant difference between bruising and age. It is suggested that the subcutaneous injection duration be increased to 30 seconds to enhance the quality of care and minimize the unpleasant and stressful experience for patients.

  13. Review of Subcutaneous Wound Drainage in Reducing Surgical Site Infections after Laparotomy

    Directory of Open Access Journals (Sweden)

    B. Manzoor

    2015-01-01

    Full Text Available Purpose. Surgical site infections (SSIs remain a significant problem after laparotomies. The aim of this review was to assess the evidence on the efficacy of subcutaneous wound drainage in reducing SSI. Methods. MEDLINE database was searched. Studies were identified and screened according to criteria to determine their eligibility for meta-analysis. Meta-analysis was performed using the Mantel-Haenszel method and a fixed effects model. Results. Eleven studies were included with two thousand eight hundred and sixty-four patients. One thousand four hundred and fifty patients were in the control group and one thousand four hundred and fourteen patients were in the drain group. Wound drainage in all patients shows no statistically significant benefit in reducing SSI incidence. Use of drainage in high risk patients, contaminated wound types, and obese patients appears beneficial. Conclusion. Using subcutaneous wound drainage after laparotomy in all patients is unnecessary as it does not reduce SSI risk. Similarly, there seems to be no benefit in using it in clean and clean contaminated wounds. However, there may be benefit in using drains in patients who are at high risk, including patients who are obese and/or have contaminated wound types. A well designed trial is needed which examines these factors.

  14. Magnitude and factors associated with injection site infections ...

    African Journals Online (AJOL)

    Injections are among the major procedures in health care facilities which need to be handled under sterile conditions. Unsafe injections have been found to cause deaths due to its associated complications. The burden of injection site infections is unknown in Tanzania. This study was designed to determine the burden of ...

  15. Prandial subcutaneous injections of glucagon-like peptide-1 cause weight loss in obese human subjects

    DEFF Research Database (Denmark)

    Näslund, Erik; King, N; Mansten, S

    2004-01-01

    Recombinant glucagon-like peptide-1 (7-36)amide (rGLP-1) was recently shown to cause significant weight loss in type 2 diabetics when administered for 6 weeks as a continuous subcutaneous infusion. The mechanisms responsible for the weight loss are not clarified. In the present study, rGLP-1......; BMI 39.0 (sem 1.2) kg/m(2)) in a prospective randomised, double-blind, placebo-controlled, cross-over study. Compared with the placebo, rGLP-1 administered as PSI and by CSI generated a 15 % reduction in mean food intake per meal (P=0.02) after 5 d treatment. A weight loss of 0.55 (sem 0.2) kg (P... as a probable mechanism of action of increased satiety, decreased hunger and, hence, reduced food intake with an ensuing weight loss....

  16. Effect of subcutaneous injection of estradiol on feeding and drinking behaviors and body weight in basolateral amygdaloid lesioned rats.

    Science.gov (United States)

    Rao, Bodepudi N; Pal, Gopal K; Pravati, Pal

    2013-10-01

    Estradiol is known to inhibit food intake (FI), water intake (WI) and body weight (BW) across the species including women and it is most evident in rats. Ovariectomy in rats and menopause in women produce hyperphagia and obesity. Estradiol substitution in ovariectomized (OVX) rats and hormone replacement in women reverses these changes suggesting that lack of estradiol causes eating related disorders. However, the neurobiological target/s for estradiol mediating effects remains largely unknown. While lesions of basolateral amygdala (BLA) also produce hyperphagia, polydipsia and obesity in female rats suggesting BLA normally inhibits these behaviors. Since ovariectomy is a useful model to study postmenopausal obesity in women, we have investigated the role of BLA in ovariectomy induced ingestive behaviors. Ovariectomy and stereotaxic lesions in experimental group (n = 6) whereas sham operations in control group (n = 6) were carried out in female rats. Estradiol was injected subcutaneously (s.c) before and after lesions in experimental group and vehicle was injected in control group. Data from the present study shows that there was an additional increase in FI, WI and BW in OVX animals following BLA lesions, but this additive effect was small compared to sham operated controls. Conversely, OVX rats with lesions have shown small but significant reductions in FI, WI, and lost less BW, following s.c injection of estradiol compared to rats with intact BLA. These findings suggest that ovariectomy and estradiol induced changes on ingestive behaviors and body weight are partly mediated via BLA.

  17. Subcutaneous injections of low doses of humanized anti-CD20 veltuzumab: a phase I study in chronic lymphocytic leukemia.

    Science.gov (United States)

    Kalaycio, Matt E; George Negrea, O; Allen, Steven L; Rai, Kanti R; Abbasi, Rashid M; Horne, Heather; Wegener, William A; Goldenberg, David M

    2016-01-01

    To evaluate the potential of subcutaneous (SC) injections with anti-CD20 antibody veltuzumab in chronic lymphocytic leukemia (CLL), 21 patients received 80, 160, or 320 mg injections every 2 weeks × 4 doses (n = 11) or 160 or 320 mg twice-weekly × 16 doses (n = 10). Treatment was well tolerated with only occasional, mild-moderate, transient injection reactions. Lymphocytosis decreased in all patients (maximum decrease, 5-91%), with 12 patients obtaining >50% decreases. Of 14 patients with lymphadenopathy on CT imaging, 5 (36%) achieved 14-61% reductions (sum of perpendicular diameters). By NCI-WG criteria, two patients achieved partial responses (10%). SC veltuzumab appeared active in all dose groups, with no obvious exposure-response relationship, despite cumulative doses ranging from 320-5120 mg. Overall median progression-free survival was 7.7 months; three patients remained progression-free >1 year (2 ongoing at 2-year study completion). These data suggest further studies of SC veltuzumab in CLL are warranted.

  18. Dose responsive effects of subcutaneous pentosan polysulfate injection in mucopolysaccharidosis type VI rats and comparison to oral treatment.

    Directory of Open Access Journals (Sweden)

    Michael Frohbergh

    Full Text Available BACKGROUND: We previously demonstrated the benefits of daily, oral pentosan polysulfate (PPS treatment in a rat model of mucopolysaccharidosis (MPS type VI. Herein we compare these effects to once weekly, subcutaneous (s.c. injection. The bioavailability of injected PPS is greater than oral, suggesting better delivery to difficult tissues such as bone and cartilage. Injected PPS also effectively treats osteoarthritis in animals, and has shown success in osteoarthritis patients. METHODOLOGY/PRINCIPAL FINDINGS: One-month-old MPS VI rats were given once weekly s.c. injections of PPS (1, 2 and 4 mg/kg, human equivalent dose (HED, or daily oral PPS (4 mg/kg HED for 6 months. Serum inflammatory markers and total glycosaminoglycans (GAGs were measured, as were several histological, morphological and functional endpoints. Overall, weekly s.c. PPS injections led to similar or greater therapeutic effects as daily oral administration. Common findings between the two treatment approaches included reduced serum inflammatory markers, improved dentition and skull lengths, reduced tracheal deformities, and improved mobility. Enhanced effects of s.c. treatment included GAG reduction in urine and tissues, greater endurance on a rotarod, and better improvements in articular cartilage and bone in some dose groups. Optimal therapeutic effects were observed at 2 mg/kg, s.c.. No drug-related increases in liver enzymes, coagulation factor abnormalities or other adverse effects were identified following 6 months of s.c. PPS administration. CONCLUSIONS: Once weekly s.c. administration of PPS in MPS VI rats led to equal or better therapeutic effects than daily oral administration, including a surprising reduction in urine and tissue GAGs. No adverse effects from s.c. PPS administration were observed over the 6-month study period.

  19. Math-free guides for glycerin and allergens at variable subcutaneous injection volumes: How's my dosing? Update.

    Science.gov (United States)

    Grier, Thomas J; Converse, Lorie M; Rekkerth, Donna J; Renahan, Kevin E

    2016-05-01

    Current summaries of effective maintenance dose ranges for subcutaneous immunotherapy (SCIT) are based on administration of 0.5-mL volumes. Extract formulations delivering equivalent dose ranges for practices using different injection volumes have not been reported, and calculation of the final glycerin concentrations in these solutions remains an inconvenient and repetitive process. To create math-free guides for allergen doses and glycerin concentrations that identify the extract concentrate volumes required to deliver doses within the ranges cited in the 2011 immunotherapy practice parameters for clinicians using 5.0-mL maintenance vials and injection volumes ranging from 0.2 to 1.0 mL. Algebraic calculations were performed to determine the specific combinations of extract concentrate strengths, volumes of these products in patient vaccines, and injection volumes needed for administration of target allergen doses spanning the current SCIT practice parameter recommendations. For each product or group (nonstandardized extracts), tables were constructed to define the allergen doses provided by various combinations of extract concentrate volumes and injection volumes. The values within the effective dose ranges for each product were highlighted to facilitate comparisons of specific conditions relevant to allergy specialists. Glycerin tables were also created to permit convenient assessments of the final concentrations of this stabilizer in patient prescriptions. SCIT dosing and glycerin tables are useful tools to assist allergists with practice decisions that involve variable patient formulas and injection volumes and can help identify suitable conditions for treatment of patients presenting with diverse allergen sensitivities and specificity profiles. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  20. Feasibility of subcutaneously implanted magnetic microarrays for site specific drug and gene targeting

    Directory of Open Access Journals (Sweden)

    M. Babincová

    2010-01-01

    Full Text Available The magnetic nanoparticles play a crucial role as a drug carriers in the human body. The wedge like magnetic arrays creatinga strongly non-homogeneous magnetic field are considered as a useful way to focus magnetic nanoparticles functionalizedwith various drugs or genes to desired sites. The goal of this study is to develop a numerical model of drug targetingusing subcutaneously implanted magnetic microarrays. The Finite Element Method is applied to solve partial differentialequations describing electromagnetic field (Maxwell equations and motion of these particles in a given magnetic field isobtained solving set of ordinary differential equations expressed by Newton law of motion. The results are encouragingshowing the potential to target drug to the tumour cell locally, without unwanted side effects.

  1. Cutaneous analgesia after subcutaneous injection of memantine and amantadine and their systemic toxicity in rats.

    Science.gov (United States)

    Chen, Yu-Wen; Shieh, Ja-Ping; Chen, Yu-Chung; Leung, Yuk-Man; Hung, Ching-Hsia; Wang, Jhi-Joung

    2012-10-15

    The purpose of the study is to find subcutaneous equianalgesic doses of memantine, amantadine and bupivacaine and use these doses to quantify the cardiovascular and central nervous system toxicity of these agents after intravenous administration. Memantine, amantadine and bupivacaine, a local anesthetic, in a dose-related fashion were determined for cutaneous analgesia by a block of the cutaneous trunci muscle reflex in rats, and equipotent doses were calculated. Following rapid intravenous infusion of equianalgesic bupivacaine, memantine, amantadine and saline (vehicle) in rats, we observed the onset time of seizure, apnea and impending death, and monitored mean arterial blood pressure and heart rate. Memantine and amantadine elicited dose-dependent cutaneous analgesia. At the 50% effective dose (ED(50)), the rank of potencies was bupivacaine [1.8 (1.7-2.0)]>memantine [19.1 (17.6-21.8)]>amantadine [36.1 (32.0-40.3)] (Pamantadine. At equianalgesic doses, the infusion time of memantine or amantadine required to induce seizure, impending death, and apnea was longer than that of bupivacaine during rapid intravenous infusion (Pamantadine when compared with bupivacaine at equivalent doses (Pamantadine (i) were equal to bupivacaine at producing durations of cutaneous analgesia but (ii) were less likely than bupivacaine to cause cardiovascular and central nervous system toxicity. Copyright © 2012 Elsevier B.V. All rights reserved.

  2. Minimal surgical management of penile paraffinoma after subcutaneous penile paraffin injection

    Directory of Open Access Journals (Sweden)

    Athanasios E. Dellis

    2017-12-01

    Full Text Available Objectives: To describe our reconstructive technique, without flap or graft use, after penile self-augmentation with injected substances, such as paraffin, which are still performed with unfortunate consequences. Patient and methods: Successful single-stage minimal surgical management of an already twice unsuccessfully managed ulcerative penile paraffinoma in a 38-year-old Greek man. Results: The patient was discharged with no postoperative complications, with a five-item version of the International Index of Erectile Function score of 23/25 (i.e. normal erectile function and flaccid penile length of 5 cm. Conclusions: Penile paraffinoma is a serious complication that can be successfully managed with a single-stage minimal surgical procedure, with normal aesthetic and functional results. Keywords: Paraffinoma, Penile augmentation, Penile injection, Penile reconstruction

  3. Pharmacokinetics of thymosin alpha1 after subcutaneous injection of three different formulations in healthy volunteers.

    Science.gov (United States)

    Rost, K L; Wierich, W; Masayuki, F; Tuthill, C W; Horwitz, D L; Herrmann, W M

    1999-01-01

    Thymosin alpha1, an immunomodulatory endogenous peptide, has been shown to be effective in the treatment of chronic hepatitis B and C. In this study, single- and 5-day multiple-dose pharmacokinetics were characterized in nine Caucasian volunteers after subcutaneous administration of 900 microg/m2 thymosin alpha1. Using a randomized, 3-way crossover design three available drug formulations were compared: Zadaxin (SciClone), Timosina (Sclavo), and Thymosin alpha1 (Tal-HLR; Hoffmann La Roche). AUC, Cmax, t(max), t(1/2), Cl/f, and the volume of distribution, V(Z)/f, were derived by model-independent methods. Endogenous serum concentrations were below the limit of quantification (0.10 microg/l) of the enzyme-linked immunosorbent assay method in most subjects. Thymosin alpha1 was well absorbed with a mean t(max) between 1-2 hours from all galenic formulations. Cmax concentrations of 30 to 80 microg/l and AUC(0-infinity) from 95 to 267 microg x h/l did not differ between single- and multiple-dose administration of all drugs. This apparent lack of accumulation was supported by the short elimination half-life of less than 3 hours. As indicated by a V(Z)/f in the range of 30-40 l, thymosin alpha1 appears to distribute within the extracellular volume. AUC and Cmax were similar for Zadaxin and T alpha1-HLR, but higher after administration of Timosina. Thymosin alpha1 kinetics from this study are comparable to those previously obtained in Japanese volunteers or cancer patients, but may be influenced by the drug formulation used.

  4. Concentrations of danofloxacin 18% solution in plasma, milk and tissues after subcutaneous injection in dairy cows

    Energy Technology Data Exchange (ETDEWEB)

    Mestorino, N. [Pharmacology Department, Faculty of Veterinary Science, Universidad Nacional de La Plata, CC 296, 1900 La Plata, Buenos Aires (Argentina)], E-mail: nmestorino@yahoo.com; Marchetti, M.L.; Turic, E.; Pesoa, J.; Errecalde, J. [Pharmacology Department, Faculty of Veterinary Science, Universidad Nacional de La Plata, CC 296, 1900 La Plata, Buenos Aires (Argentina)

    2009-04-01

    Danofloxacin is a fluoroquinolone developed for use in veterinary medicine. Its concentrations and pharmacokinetic profile in plasma, milk and tissues of lactating dairy cows were determined, and its milk withdrawal time (WT) calculated. Twenty-one dairy cows received a single subcutaneous administration of 18% mesylate danofloxacin salt (6 mg kg{sup -1}). Plasma and milk samples were obtained at different times until 48 h. Groups of three animals were sacrificed at different post-administration times and tissue samples (mammary gland, uterus, duodenum, jejunum, ileum, colon and mesenteric lymph nodes) obtained. Danofloxacin concentrations were determined by liquid chromatography with fluorescence detection. The milk WT was calculated by the Time to Safe Concentration method (Software WTM 1.4, EMEA). Danofloxacin was rapidly absorbed and its distribution from plasma to all sampled tissues and milk was extensive. Milk and tissues concentrations were several times above those found in plasma. Plasma area under the curve (AUCp) was 9.69 {mu}g h mL{sup -1} and its elimination half life (T{sub {beta}}{sup 1/2}) was 12.53 h. AUC values for the various tissues and milk greatly exceeded AUCp. T{sub {beta}}{sup 1/2} from milk and tissues ranged between 4.57 and 21.91 h and the milk withdrawal time was 73.48 h. The reported results support the potential use of danofloxacin in the treatment of mastitis and other infections in milk cows with 3 days of withdrawal.

  5. Differences in parental involvement in the care of children and adolescents with type 1 diabetes mellitus on multiple daily insulin injections versus continuous subcutaneous insulin infusion.

    Science.gov (United States)

    Cemeroglu, Ayse Pinar; Timmer, Scott; Turfe, Zaahir; Davis, Alan T; Koehler, Tracy J; Can, Argun; Kleis, Lora; Daniel, Maala S

    2016-03-01

    Assessing the degree of involvement of caregivers for children with type 1 diabetes mellitus (T1DM) in their diabetes care, differences in the degree of involvement based on the method of insulin administration (multiple daily injections: MDI/continuous subcutaneous insulin infusion: CSII), and its effect on glycemic control. This was a cross-sectional study with T1DM patients, ages 6-13 years using a six question survey derived from the Diabetes Family Responsibility Questionnaire (DFRQ). All caregivers (n=140) and participants between ages 11 and 13 (n=60) completed the survey. Significant differences between MDI and CSII caregiver responses were found for responsibility for giving insulin boluses, as well as for rotation of infusion/injection sites (pparental involvement on last 2-year average HbA1C was found for CSII or MDI groups (p>0.20). Caregiver reported diabetes care responsibility (mostly parent, mostly child, shared between parent and child) varies for certain aspects of diabetes related care for children ages 6-13, depending upon the mode of insulin administration. Based on the reported degree of parental collaboration, HbA1C did not differ significantly. However, long-term effects are yet to be determined in longitudinal studies.

  6. Pentosan Polysulfate: Oral Versus Subcutaneous Injection in Mucopolysaccharidosis Type I Dogs.

    Science.gov (United States)

    Simonaro, Calogera M; Tomatsu, Shunji; Sikora, Tracy; Kubaski, Francyne; Frohbergh, Michael; Guevara, Johana M; Wang, Raymond Y; Vera, Moin; Kang, Jennifer L; Smith, Lachlan J; Schuchman, Edward H; Haskins, Mark E

    2016-01-01

    We previously demonstrated the therapeutic benefits of pentosan polysulfate (PPS) in a rat model of mucopolysaccharidosis (MPS) type VI. Reduction of inflammation, reduction of glycosaminoglycan (GAG) storage, and improvement in the skeletal phenotype were shown. Herein, we evaluate the long-term safety and therapeutic effects of PPS in a large animal model of a different MPS type, MPS I dogs. We focused on the arterial phenotype since this is one of the most consistent and clinically significant features of the model. MPS I dogs were treated with daily oral or biweekly subcutaneous (subQ) PPS at a human equivalent dose of 1.6 mg/kg for 17 and 12 months, respectively. Safety parameters were assessed at 6 months and at the end of the study. Following treatment, cytokine and GAG levels were determined in fluids and tissues. Assessments of the aorta and carotid arteries also were performed. No drug-related increases in liver enzymes, coagulation factors, or other adverse effects were observed. Significantly reduced IL-8 and TNF-alpha were found in urine and cerebrospinal fluid (CSF). GAG reduction was observed in urine and tissues. Increases in the luminal openings and reduction of the intimal media thickening occurred in the carotids and aortas of PPS-treated animals, along with a reduction of storage vacuoles. These results were correlated with a reduction of GAG storage, reduction of clusterin 1 staining, and improved elastin integrity. No significant changes in the spines of the treated animals were observed. PPS treatment led to reductions of pro-inflammatory cytokines and GAG storage in urine and tissues of MPS I dogs, which were most evident after subQ administration. SubQ administration also led to significant cytokine reductions in the CSF. Both treatment groups exhibited markedly reduced carotid and aortic inflammation, increased vessel integrity, and improved histopathology. We conclude that PPS may be a safe and useful therapy for MPS I, either as an

  7. Pentosan Polysulfate: Oral Versus Subcutaneous Injection in Mucopolysaccharidosis Type I Dogs.

    Directory of Open Access Journals (Sweden)

    Calogera M Simonaro

    Full Text Available We previously demonstrated the therapeutic benefits of pentosan polysulfate (PPS in a rat model of mucopolysaccharidosis (MPS type VI. Reduction of inflammation, reduction of glycosaminoglycan (GAG storage, and improvement in the skeletal phenotype were shown. Herein, we evaluate the long-term safety and therapeutic effects of PPS in a large animal model of a different MPS type, MPS I dogs. We focused on the arterial phenotype since this is one of the most consistent and clinically significant features of the model.MPS I dogs were treated with daily oral or biweekly subcutaneous (subQ PPS at a human equivalent dose of 1.6 mg/kg for 17 and 12 months, respectively. Safety parameters were assessed at 6 months and at the end of the study. Following treatment, cytokine and GAG levels were determined in fluids and tissues. Assessments of the aorta and carotid arteries also were performed. No drug-related increases in liver enzymes, coagulation factors, or other adverse effects were observed. Significantly reduced IL-8 and TNF-alpha were found in urine and cerebrospinal fluid (CSF. GAG reduction was observed in urine and tissues. Increases in the luminal openings and reduction of the intimal media thickening occurred in the carotids and aortas of PPS-treated animals, along with a reduction of storage vacuoles. These results were correlated with a reduction of GAG storage, reduction of clusterin 1 staining, and improved elastin integrity. No significant changes in the spines of the treated animals were observed.PPS treatment led to reductions of pro-inflammatory cytokines and GAG storage in urine and tissues of MPS I dogs, which were most evident after subQ administration. SubQ administration also led to significant cytokine reductions in the CSF. Both treatment groups exhibited markedly reduced carotid and aortic inflammation, increased vessel integrity, and improved histopathology. We conclude that PPS may be a safe and useful therapy for MPS I

  8. Comparison between multiple daily insulin injection therapy (MDI) and continuous subcutaneous insulin infusion therapy (CSII), results of the five nations study

    NARCIS (Netherlands)

    Hoogma, Roel P. L. M.; Hoekstra, Joost B.; Michels, Bob P.; Levi, Marcel

    2006-01-01

    Continuous subcutaneous insulin infusion (CSII) is an alternative to multiple daily insulin injections (MDII) as intensive insulin therapy for optimising glycaemic control in type 1 diabetes. The Diabetes Control and Complications Trial (DCCT) showed the benefits of intensive insulin therapy in

  9. The effect of subcutaneous Insulin-like Growth Factor-1 (IGF-1 injection on rabbit auricular cartilage autograft viability

    Directory of Open Access Journals (Sweden)

    Guclu Kaan Beriat

    2012-11-01

    Full Text Available Insulin-like Growth Factor-1 (IGF-1 is one of the significant substances affecting the growth and development of cartilage tissue in the body. The aim of this study is to evaluate the possible histopathological effects of local IGF-1 injection on the viability of rabbit auricular cartilage autografts.To this end, the single-piece and sliced cartilage tissues obtained from 20 albino rabbits’ auricula were implanted in the subcutaneous pockets created on the back skins of the experimental animals. Every two weeks IGF-1 (10 mg/ml injections were performed on the autograft implants of one group and normal saline (0.9% injections were performed on the other group. Experimental animals were sacrificed at the end of the third month. A total of 34 tissue samples obtained after dissection were evaluated and scored histopathologically according to their cartilage viability, environmental reaction, and regenerative activities.The intergroup evaluation carried out for the single-piece and sliced cartilage grafts revealed that there was statistically more cartilage viability and less foreign-body reaction in the IGF-1 group than the normal saline group (p<0.05.While there was a statistically significant difference between the groups for single-piece grafts regarding regenerative activity (p<0.05, there was no significant difference for sliced grafts. The IGF-1 group, however, showed more activity.The results we obtained point out to the fact that IGF-1 increases the tissue viability of the implanted auricular autograft and it suppresses immune modulation effect.

  10. Apomorphine Subcutaneous Injection for the Management of Morning Akinesia in Parkinson's Disease.

    Science.gov (United States)

    Isaacson, Stuart; Lew, Mark; Ondo, William; Hubble, Jean; Clinch, Thomas; Pagan, Fernando

    2017-01-01

    In patients with motor fluctuations complicating Parkinson's disease (PD), delays in time-to-ON with levodopa are common. This open-label study aimed to assess the effect of apomorphine on time-to-ON in PD patients with morning akinesia. The safety population included 127 enrolled patients, and the full analysis set (FAS) included 88 patients. Patients completed a 7-day levodopa baseline period recording their time-to-ON following each morning dose of levodopa. Patients were titrated to an optimal dose of apomorphine (2-6 mg) while taking trimethobenzamide antiemetic therapy. Apomorphine was injected each morning for a 7-day treatment period and time-to-ON was self-recorded in 5-minute blocks. The primary efficacy variable was time-to-ON in the apomorphine treatment period versus the baseline levodopa period. Secondary assessments included and global impression scales. Safety and tolerability were assessed through adverse events (AEs). Patients receiving apomorphine achieved mean ± standard deviation (SD) time-to-ON 23.72 ± 14.55 minutes, reduced from 60.86 ± 18.11 minutes with levodopa (P 60 minutes) were more commonly reported with levodopa versus apomorphine (46% vs. 7% of diary entries, respectively). Secondary endpoints supported the primary efficacy findings, with significant improvements from levodopa baseline to apomorphine treatment period (all P < 0.0001). The most common AEs were nausea and dizziness. Most patients who discontinued because of AEs did so in the titration phase. Apomorphine injections significantly reduced time-to-ON in PD patients experiencing delayed onset of their morning levodopa dose, and was well tolerated in most patients. After apomorphine treatment, fluctuating patients with morning akinesia experienced rapid and reliable improvement of time-to-ON.

  11. Transient severe hypotension with once-weekly subcutaneous injection of teriparatide in osteoporotic patient: a case report and insight for the drug interaction between hypotensive agents and teriparatide.

    Science.gov (United States)

    Enishi, Tetsuya; Uemura, Hirokazu; Katoh, Shinsuke; Inatsugi, Masanori; Minato, Sho; Inatsugi, Kei; Inatsugi, Mikiko; Sato, Nori; Siryo, Koichi

    2015-01-01

    Teriparatide, a recombinant form of parathyroid hormone, were well recognized as a useful option for the treatment of the osteoporosis. Although some side effects of teriparatide include headache, nausea, dizziness, and limb pain were reported. Here we present a 80-year-old woman of transient asymptomatic hypotension with once-weekly subcutaneous injection of teriparatide for the treatment of osteoporosis with hypertension disease as acute-phase reactions. Systolic blood pressure decreased in both 30 min and 60 min after injection compared with before injection. Heart rate increased with passage of time. Statistically significant were observed among before, 30 min, 60 min after injection of teriparatide. Slight nausea was seen as subjective symptoms with the first and second injection after 30 min. This case indicates careful attention, at least 1 hr, was recommended with weekly subcutaneous injections of teriparatide in the treatment for osoteoproteic patient with hypertension decreases. This is a first report, to the best of our knowledge, to demonstrate the transient asymptomatic hypotension after once-weekly injection of teriparatide with hypertension disease. Transient hypotension occurred after injection of teriparatide during the treatment period and was asymptomatic except for the first 2 injections.

  12. Does measurement site for visceral and abdominal subcutaneous adipose tissue alter associations with the metabolic syndrome?

    Science.gov (United States)

    Kuk, Jennifer L; Church, Timothy S; Blair, Steven N; Ross, Robert

    2006-03-01

    To determine whether the associations between visceral adipose tissue (VAT), abdominal subcutaneous adipose tissue (ASAT), and the metabolic syndrome are altered depending on measurement site for VAT and ASAT and the definition used to identify the metabolic syndrome. Total VAT and ASAT volume was derived using approximately 37 contiguous computed tomography (CT) images from T10-T11 to L5-S1 in 85 men. CT images obtained at eight intervertebral locations (e.g., L4-L5, L3-L4, etc.) were used to determine the associations between partial volumes (single images) and metabolic syndrome. Metabolic syndrome was defined using the National Cholesterol Education Program (NCEP) and International Diabetes Federation (IDF) criteria. Logistic regression was used to calculate the odds ratio (OR) per SD increase in adipose tissue. For total and all partial volumes, VAT was more strongly associated with metabolic syndrome than ASAT independent of metabolic syndrome criteria. The OR (per SD) for NCEP metabolic syndrome was higher for total VAT volume (OR = 7.26) and for the partial volumes at T12-L1 (7.46) and L1-L2 (8.77) than those at the L4-L5 level (3.94). The OR for metabolic syndrome ( approximately 2.6) was not substantially different among the ASAT measures. A similar pattern of association was observed using the IDF metabolic syndrome criteria. The measurement site for VAT, but not for ASAT, has a substantial influence on the magnitude of the association with both metabolic syndrome definitions. However, because VAT remained significantly associated with metabolic syndrome regardless of measurement site, the clinical interpretation was unaltered by measurement protocol or metabolic syndrome definition.

  13. Transplantation of Human Pancreatic Endoderm Cells Reverses Diabetes Post Transplantation in a Prevascularized Subcutaneous Site.

    Science.gov (United States)

    Pepper, Andrew R; Pawlick, Rena; Bruni, Antonio; Wink, John; Rafiei, Yasmin; O'Gorman, Doug; Yan-Do, Richard; Gala-Lopez, Boris; Kin, Tatsuya; MacDonald, Patrick E; Shapiro, A M James

    2017-06-06

    Beta-cell replacement therapy is an effective means to restore glucose homeostasis in select humans with autoimmune diabetes. The scarcity of "healthy" human donor pancreata restricts the broader application of this effective curative therapy. "β-Like" cells derived from human embryonic stem cells (hESC), with the capacity to secrete insulin in a glucose-regulated manner, have been developed in vitro, with limitless capacity for expansion. Here we report long-term diabetes correction in mice transplanted with hESC-derived pancreatic endoderm cells (PECs) in a prevascularized subcutaneous site. This advancement mitigates chronic foreign-body response, utilizes a device- and growth factor-free approach, facilitates in vivo differentiation of PECs into glucose-responsive insulin-producing cells, and reliably restores glycemic control. Basal and stimulated human C-peptide secretion was detected throughout the study, which was abolished upon graft removal. Recipient mice demonstrated physiological clearance of glucose in response to metabolic challenge and safely retrieved grafts contained viable glucose regulatory cells. Copyright © 2017 The Authors. Published by Elsevier Inc. All rights reserved.

  14. Transplantation of Human Pancreatic Endoderm Cells Reverses Diabetes Post Transplantation in a Prevascularized Subcutaneous Site

    Directory of Open Access Journals (Sweden)

    Andrew R. Pepper

    2017-06-01

    Full Text Available Beta-cell replacement therapy is an effective means to restore glucose homeostasis in select humans with autoimmune diabetes. The scarcity of “healthy” human donor pancreata restricts the broader application of this effective curative therapy. “β-Like” cells derived from human embryonic stem cells (hESC, with the capacity to secrete insulin in a glucose-regulated manner, have been developed in vitro, with limitless capacity for expansion. Here we report long-term diabetes correction in mice transplanted with hESC-derived pancreatic endoderm cells (PECs in a prevascularized subcutaneous site. This advancement mitigates chronic foreign-body response, utilizes a device- and growth factor-free approach, facilitates in vivo differentiation of PECs into glucose-responsive insulin-producing cells, and reliably restores glycemic control. Basal and stimulated human C-peptide secretion was detected throughout the study, which was abolished upon graft removal. Recipient mice demonstrated physiological clearance of glucose in response to metabolic challenge and safely retrieved grafts contained viable glucose regulatory cells.

  15. Energy dispersive X-ray analysis of titanium dioxide nanoparticle distribution after intravenous and subcutaneous injection in mice.

    Science.gov (United States)

    Patri, Anil; Umbreit, Thomas; Zheng, J; Nagashima, K; Goering, Peter; Francke-Carroll, Sabine; Gordon, Edward; Weaver, James; Miller, Terry; Sadrieh, Nakissa; McNeil, Scott; Stratmeyer, Mel

    2009-11-01

    In an effort to understand the disposition and toxicokinetics of nanoscale materials, we used EDS (energy dispersive X-ray spectroscopy) to detect and map the distribution of titanium dioxide (TiO2) in tissue sections from mice following either subcutaneous (s.c.) or intravenous (i.v.) injection. TiO2 nanoparticles were administered at a dose of 560 mg/kg (i.v.) or 5600 mg/kg (s.c.) to Balb/c female mice on two consecutive days. Tissues (liver, kidney, lung, heart, spleen, and brain) were examined by light microscopy, TEM (transmission electron microscopy), SEM (scanning electron microscopy), and EDS following necropsy one day after treatment. Particle agglomerates were detected by light microscopy in all tissues examined, EDS microanalysis was used to confirm that these tissues contained elemental titanium and oxygen. The TEM micrographs and EDS spectra of the aggregates were compared with in vitro measurements of TiO2 nanoparticle injection solution (i.e., in water). The nanoparticles were also characterized using dynamic light scattering in water, 10 mM NaCl, and phosphate buffered saline (PBS). In low ionic strength solvents (water and 10 mM NaCl), the TiO2 particles had average hydrodynamic diameters ranging from 114-122 nm. In PBS, however, the average diameter increases to 1-2 microm, likely due to aggregation analogous to that observed in tissue by TEM and EDS. This investigation demonstrates the suitability of energy dispersive X-ray spectroscopy (EDS) for detection of nanoparticle aggregates in tissues and shows that disposition of TiO2 nanoparticles depends on the route of administration (i.v. or s.c.).

  16. Islet Transplantation Provides Superior Glycemic Control With Less Hypoglycemia Compared With Continuous Subcutaneous Insulin Infusion or Multiple Daily Insulin Injections.

    Science.gov (United States)

    Holmes-Walker, Deborah Jane; Gunton, Jenny E; Hawthorne, Wayne; Payk, Marlene; Anderson, Patricia; Donath, Susan; Loudovaris, Tom; Ward, Glenn M; Kay, Thomas Wh; OʼConnell, Philip J

    2017-06-01

    The aim was to compare efficacy of multiple daily injections (MDI), continuous subcutaneous insulin infusion (CSII) and islet transplantation to reduce hypoglycemia and glycemic variability in type 1 diabetes subjects with severe hypoglycemia. This was a within-subject, paired comparison of MDI and CSII and CSII with 12 months postislet transplantation in 10 type 1 diabetes subjects referred with severe hypoglycemia, suitable for islet transplantation. Individuals were assessed with HbA1c, Edmonton Hypoglycemia Score (HYPOscore), continuous glucose monitoring (CGM) and in 8 subjects measurements of glucose variability using standard deviation of glucose (SD glucose) from CGM and continuous overlapping net glycemic action using a 4 hour interval (CONGA4). After changing from MDI to CSII before transplantation, 10 subjects reduced median HYPOscore from 2028 to 1085 (P transplantation, there were significant reductions in all baseline parameters versus CSII, respectively, HbA1c (6.4% cf 8.2%), median HYPOscore (0 cf 1085), mean glucose (7.1 cf 8.6 mmol L), SD glucose (1.7 cf 3.2 mmol/L), and CONGA4 (1.6 cf 3.0). In subjects with severe hypoglycemia suitable for islet transplantation, CSII decreased hypoglycemia frequency and glycemic variability compared with MDI whereas islet transplantation resolved hypoglycemia and further improved glycemic variability regardless of insulin independence.

  17. Subcutaneous Construction of Engineered Adipose Tissue with Fat Lobule-Like Structure Using Injectable Poly-Benzyl-L-Glutamate Microspheres Loaded with Adipose-Derived Stem Cells.

    Directory of Open Access Journals (Sweden)

    Wentao Sun

    Full Text Available Porous microcarriers were fabricated from synthesized poly(γ-benzyl-L-glutamate (PBLG polymer to engineer adipose tissue with lobule-like structure via the injectable approach. The adipogenic differentiation of human adipose-derived stem cells (hASCs seeded on porous PBLG microcarriers was determined by adipogenic gene expression and glycerol-3-phosphate dehydrogenase enzyme activity. In vitro adipogenic cultivation was performed for 7 days, and induced hASC/PBLG complex (Adi-ASC/PBLG group was subcutaneously injected into nude mice. Injections of PBLG microcarriers alone (PBLG group and non-induced hASC/PBLG complex (ASC/PBLG group served as controls. Newly formed tissues were harvested after 4 and 8 weeks. Generation of subcutaneous adipose tissue with typical lobule-like structure separated by fibrous septa was observed upon injection of adipogenic-induced hASC/microsphere complex. Adipogenesis significantly increased in the Adi-ASC/PBLG group compared with the control groups. The angiogenesis in the engineered adipose tissue was comparable to that in normal tissue as determined by capillary density and luminal diameter. Cell tracking assay demonstrated that labeled hASCs remained detectable in the neo-generated tissues 8 weeks post-injection using green fluorescence protein-labeled hASCs. These results indicate that adipose tissue with typical lobule-like structure could be engineered using injectable porous PBLG microspheres loaded with adipogenic-induced hASCs.

  18. An observational, retrospective, UK and Ireland audit of patient adherence to subcutaneous interferon beta-1a injections using the RebiSmart® injection device

    Directory of Open Access Journals (Sweden)

    Willis H

    2014-06-01

    Full Text Available Helen Willis,1 Julie Webster,1 Anne Marie Larkin,2 Laura Parkes,31Broomfield Hospital, Chelmsford, Essex, United Kingdom; 2MySupport Nurse, Quintiles Ireland Ltd, Dublin, Ireland; 3Medical Affairs, Merck Serono Ltd, Feltham, United KingdomBackground: Poor adherence to disease-modifying drugs is associated with an increased risk of relapse in patients with multiple sclerosis. However, adherence is difficult to assess objectively. RebiSmart® (Merck Serono SA, Geneva, Switzerland, a device for subcutaneous (sc injection of interferon (IFN β-1a, features an electronic injection log that can assist in objective monitoring of adherence.Objective: To assess adherence to sc IFN β-1a injections using data from RebiSmart®.Methods: This was a single-group, observational, retrospective audit. Adherence data were collected from patients with relapsing multiple sclerosis in the United Kingdom and Ireland who had been prescribed sc IFN β-1a and had been using RebiSmart® for a minimum of 24 months.Results: In total, 225 patients were included in the full analysis set; 72% were in the United Kingdom, and 28% were in Ireland. Overall, the mean age was 44.1 years, and 73% were women. Patients received sc IFN β-1a 44 µg (68% or 22 µg (32% three times per week. Mean adherence over the course of 24 months was 95.0% (median, 99.4%, and similar values were observed across all periods. The proportion of patients with 80% or higher adherence was 92.0% at 12 months and 91.1% at 24 months.Conclusion: High adherence to sc IFN β-1a was observed across all patient groups using RebiSmart®, according to 2-year treatment adherence data. This may be partly attributed to the expert support patients received, supplemented by routine and regular contact from the MySupport patient-support program, as well as the self-motivation of patients who persisted with treatment for 2 or more years.Keywords: multiple sclerosis, support program, persistence, objective

  19. Penile paraffinoma after subcutaneous injection of paraffin. Treatment with a two step cutaneous plasty of the penile shaft with scrotal skin.

    Science.gov (United States)

    Oñate Celdrán, Julián; Sanchez Rodríguez, Carlos; Tomás Ros, Mariano; González Valverde, Francisco Miguel; Morga Egea, Juan Pedro; Ruiz Marín, Miguel; Valdelvira Nadal, Pedro; Jiménez López, José Miguel; Fontana Compiano, Luis Oscar

    2012-06-01

    To report a rare case of penile paraffinoma caused by the subcutaneous or intra-urethral injection of foreign substances containing long-chain saturated hydrocarbons. These were injected in order to increase the penis size which generated a chronic granulomatous inflammatory reaction. This is a rare practice in the western world. We present the case of a 32-year-old Bulgarian male who presented with a two-year history of elastic, slightly painful penis swelling after subcutaneous liquid paraffin injection. The proposed treatment was excision of the affected tissue and penile reconstruction in a two-stage procedure. The operative procedure was successful and the patient had good aesthetic and functional results. Paraffin and other materials injected into the penis can produce many complications. Foreign body granuloma, skin necrosis, penile deformity, chronic and unhealed ulcer, painful erection, and the inability to achieve a satisfactory sexual relationship are some of the resulting complications. Intralesional or systemic steroids have been used in primary sclerosing lipogranuloma resulting in the disappearance of the granuloma, but in our opinion the treatment of choice should be radical excision, and, if necessary, secondary reconstruction of the penis. The injection of foreign substances to enhance penis size is currently an unjustifiable practice. However, it is still carried out, especially in Eastern Europe and Asia. In most cases surgical treatment is needed to treat the complications and the best modality seems to be radical excision together with follow-up.

  20. The Difference of Treatment Results between Botulinum Toxin A Split Injection Sites and Botulinum Toxin A Non-Split Injection Sites for Hemifacial Spasm.

    Science.gov (United States)

    Prutthipongsit, Anuwat; Aui-aree, Nipat

    2015-11-01

    To compare hemifacial spasm treatment results between Botulinum toxin A split injection sites and Botulinum toxin A non-split injection sites. Thirty-one hemifacial spasm patients were randomly assigned into the non-split injection sites group (injecting Botulinum toxin A to the zygomaticus major and risorius each) or split injection sites group with the same amount of Botulinum toxin A as the first method (injection Botulinum toxin A to the zygomaticus major and minor and risorius two injections each) The main outcomes are onset of improvement and effective duration of treatment. Fifteen patients were assigned to non-split injection sites group and 16 patients were assigned to split injection sites group. The median onset of improvement in non-split injection sites group and split injection sites group was 4.0 and 4.5 days, respectively (p = 0.984). The effective duration of treatment in the non-split injection sites group was 60.0 days and in the split injection sites group was 54.5 days (p = 0.582). The splitting of injection sites did not signicantly improve the efficacy of Botulinum toxin A in the treatment of hemifacial spasm.

  1. ExtaviJect® 30G device for subcutaneous self-injection of interferon beta-1b for multiple sclerosis: a prospective European study

    Directory of Open Access Journals (Sweden)

    Boeru G

    2013-11-01

    Full Text Available Gabriel Boeru,1 Ivan Milanov,2 Francesca De Robertis,3 Wojciech Kozubski,4 Michael Lang,5 Sònia Rojas-Farreras,6 Mark Tomlinson7 1Military Hospital, Bucharest, Romania; 2University Hospital Saint Naum, Sofia, Bulgaria; 3Department of Neurology, Vito Fazzi Hospital of Lecce, Lecce, Italy; 4Department of Neurology, Poznan University of Medical Sciences, Poznan, Poland; 5NeuroPoint Patient Academy and Neurological Practice, Ulm, Germany; 6IMS Health, Barcelona, Spain; 7Novartis Pharma AG, Basel, Switzerland Background: The ExtaviJect® 30G autoinjector was developed to facilitate parenteral self-administration of interferon beta-1b (Extavia®, a first-line disease-modifying therapy in patients with multiple sclerosis. Our aim was to assess patient compliance with treatment when using the autoinjector, patients' and nurses' experiences of using the device, its tolerability, and patient satisfaction. Methods: This was a 12-week, real-world, prospective, observational, noninterventional study conducted in nine European countries. Questionnaires were used to measure patient compliance and to assess patients' and nurses' experiences. All adverse events were recorded by severity, including injection site reactions or pain. Patient satisfaction and health-related quality of life were assessed using the Treatment Satisfaction Questionnaire for Medication-9 (TSQM-9 and EuroQol-5 Dimension (EQ-5D instruments, respectively. Results: Of 582 patients enrolled, 568 (98% received at least one injection and attended the first follow-up visit at 6 weeks, and 542 (93% attended the second follow-up visit at 12 weeks. For the whole study, 548 of 568 (97% patients were compliant with treatment. Among the various questions assessing whether the device was easy and quick to use accurately, without fear of the needle, 56%–98% of patients and 59%–98% of nurses were in agreement. There were nine serious adverse events (four disease-related reported among the 227 (39

  2. Time Savings with Rituximab Subcutaneous Injection versus Rituximab Intravenous Infusion: A Time and Motion Study in Eight Countries.

    Directory of Open Access Journals (Sweden)

    Erwin De Cock

    Full Text Available Rituximab is a standard treatment for non-Hodgkin lymphoma. The SABRINA trial (NCT01200758 showed that a subcutaneous (SC rituximab formulation did not compromise efficacy or safety compared with intravenous (IV infusion. We aimed to quantify active healthcare professional (HCP time and patient chair time for rituximab SC and IV, including potential time savings.This non-interventional time and motion study was run in eight countries and 30 day oncology units. Rituximab SC data were collected alongside the MabCute trial (NCT01461928; IV data were collected per routine real-world practice. Trained observers recorded active HCP time for pre-specified tasks (stopwatch and chair time (time of day. A random intercept model was used to analyze active HCP time (by task and for all tasks combined in the treatment room and drug preparation area, drug administration duration, chair time and patient treatment room time by country and/or across countries. Active HCP and chair time were extrapolated to a patient's first year of treatment (11 rituximab sessions.Mean active HCP time was 35.0 and 23.7 minutes for IV and SC process, respectively (-32%, p <0.0001. By country, relative reduction in time was 27-58%. Absolute reduction in extrapolated active HCP time (first year of treatment was 1.1-5.2 hours. Mean chair time was 262.1 minutes for IV, including 180.9 minutes infusion duration, vs. 67.3 minutes for SC, including 8.3 minutes SC injection administration (-74%, p <0.0001. By country, relative reduction was 53-91%. Absolute reduction in extrapolated chair time for the first year of treatment was 3.1-5.5 eight-hour days.Compared with rituximab IV, rituximab SC was associated with reduced chair time and active HCP time. The latter could be invested in other activities, whereas the former may lead to more available appointments, reducing waiting lists and increasing the efficiency of day oncology units.ClinicalTrials.gov NCT01200758.

  3. Pharmaceutical amyloidosis associated with subcutaneous insulin and enfuvirtide administration

    OpenAIRE

    D’Souza, Anita; Theis, Jason D.; Vrana, Julie A; Dogan, Ahmet

    2014-01-01

    Protein and peptide drugs administered subcutaneously, such as insulin can be amyloidogenic and result in localized amyloid deposits at the sites of medication injections. These iatrogenic amyloidoses typically present as a localized subcutaneous nodule or skin reaction at the site of administration, and often pose diagnostic challenges. We have analyzed the amyloid proteome in 52 cases of insulin and enfuvirtide associated amyloidosis using laser microdissection/tandem mass spectrometry. We ...

  4. Povidone-Iodine Irrigation of Subcutaneous Tissues May Decrease Surgical Site Infections in Elective Colorectal Operations: A Systematic Review.

    Science.gov (United States)

    Gill, Richdeep S; Al-Adra, David P; Campbell, Sandy; Olson, David W; Rowe, Brian H

    2011-06-01

    Postoperative wound infection is the most common complication following abdominal surgery and leads to delayed wound healing, prolonged hospital length of stay (LOS), and causes morbidity. Povidone-Iodine (PVI) is a broad-spectrum anti-septic and disinfectant solution, and can be used intra-operatively to irrigate subcutaneous tissues prior to abdominal skin closure. We systematically reviewed the literature regarding the efficacy of intra-operative PVI irrigation of subcutaneous tissues following elective colorectal surgery. A comprehensive search of electronic databases and various grey literature sources was completed. Unpublished and non-English-language results were included. All clinical controlled trials involving PVI solution in adult colorectal surgery were included. Two independent reviewers assessed the studies for relevance, inclusion, methodological quality and extracted data from the full versions of the manuscripts. Disagreements were resolved by re-extraction or third party adjudication. Data for dichotomous outcomes are reported as relative risks (RR) with 95% confidence intervals (CI). For continuous data, mean differences (MD) are reported with 95% CIs. Five randomized controlled trials (RCTs) involving 205 patients comparing PVI solution or spray to a control group following abdominal fascial closure in elective colorectal or clean-contaminated operations were identified. Pooled results demonstrated a reduction in surgical site infection for patients treated with PVI (RR = 1.97; 95% CI: 1.22 to 3.17) compared to controls. Irrigation of subcutaneous tissues with PVI following abdominal fascial closure is associated with a reduced incidence of surgical site infection. Due to the small number of included trials and patients, additional robust randomized trials are needed.

  5. Bortezomib-associated peripheral neuropathy requiring medical treatment is decreased by administering the medication by subcutaneous injection in Korean multiple myeloma patients.

    Science.gov (United States)

    Koh, Youngil; Lee, So Young; Kim, Inho; Kwon, Ji-Hyun; Yoon, Sung-Soo; Park, Seonyang; Chung, Mi Hye; Suh, Sung Yun; Kim, Kwi Suk; Kim, Hyang Sook

    2014-09-01

    Bortezomib-induced peripheral neuropathy (BIPN) is a significant neurotoxicity, requiring dose reduction or the delay of treatment. In a multicentre trial including 97 % Caucasians and 3 % Asians, BIPN was shown to occur less frequently in cases in which bortezomib was administered subcutaneously. Considering the different pharmacokinetics between Caucasians and Asians, we analysed BIPN according to the administration route, specifically in Korean myeloma patients. We surveyed the prescribed anticonvulsants for the treatment of BIPN and analysed the data after stratifying the results by the cumulative dose of bortezomib. Exclusion criteria were as follows: treated with administration route during the treatment, or receiving anticonvulsants for other reasons prior to bortezomib administration. A total of 101 patients were enrolled; 60 were treated with bortezomib and dexamethasone, and 37 were treated with bortezomib, melphalan, and prednisolone. The median number of treatment courses was four for each regimens. The median exposure to bortezomib for all patients was 19 mg/m(2). Progression-free survival (PFS) and overall survival rates were not statistically different between the groups. There was no difference in the proportion of patients requiring medical treatment (p = 0.388). After stratifying the results, BIPN developed less frequently when bortezomib was administered subcutaneously rather than intravenously in patients receiving more than 23.4 mg/m(2) of bortezomib (p administration route, the subcutaneous injection of bortezomib should be considered in Asian myeloma patients who are expected to achieve a longer PFS with bortezomib.

  6. Subcutaneous administration of carrier erythrocytes: slow release of entrapped agent

    Energy Technology Data Exchange (ETDEWEB)

    DeLoach, J.R.; Corrier, D.E.

    1988-08-01

    Carrier erythrocytes administered subcutaneously in mice release encapsulated molecules at the injection site and through cells that escape the injection site. One day postinjection, the efflux of encapsulated (/sup 14/C)sucrose, (/sup 3/H)inulin, and /sup 51/Cr-hemoglobin from the injection site was 45, 55, and 65%, respectively. Intact carrier erythrocytes escaped the injection site and entered the blood circulation carrying with them the encapsulated molecules. Most of the encapsulated (/sup 3/H)inulin that reached whole blood circulated within erythrocytes. Small but measurable numbers of encapsulated molecules were trapped within lymph nodes. Subcutaneous injection of carrier erythrocytes may allow for limited extravascular tissue targeting of drugs.

  7. A randomized controlled trial of subcutaneous closed-suction Blake drains for the prevention of incisional surgical site infection after colorectal surgery.

    Science.gov (United States)

    Watanabe, Jun; Ota, Mitsuyoshi; Kawamoto, Makoto; Akikazu, Yago; Suwa, Yusuke; Suwa, Hirokazu; Momiyama, Masashi; Ishibe, Atsushi; Watanabe, Kazuteru; Masui, Hidenobu; Nagahori, Kaoru

    2017-03-01

    The effects of subcutaneous closed-suction Blake drain for preventing incisional surgical site infections (SSIs) after colorectal surgery have never been evaluated in a randomized controlled trial (RCT). Thus, we performed a RCT to evaluate the clinical benefits of using a subcutaneous closed-suction Blake drain in patients undergoing colorectal surgery. Consecutive patients who underwent colorectal surgery were enrolled in this study. Patients were randomly assigned to the subcutaneous closed-suction drainage arm or the control (no subcutaneous drainage) arm. The primary endpoint was incidence rate of incisional SSIs. And, we performed logistic regression analysis to detect predictive factors for incisional SSIs after colorectal surgery. From November 2012 to September 2014, a total of 240 patients were enrolled in this study. One-hundred-seventeen patients who were treated by the control arm and 112 patients by the subcutaneous drainage arm were judged to be eligible for analysis. The incidence of incisional SSIs rate was 8.7 % in the overall patients. The incidence of incisional SSIs rate was 12.8 % in the control arm and 4.5 % in the subcutaneous drainage arm. There was significantly reduction of the incidence in the subcutaneous drainage arm than in the control arm (p = 0.025). Logistic regression analysis demonstrated that thickness of subcutaneous fat >3.0 cm, forced expiratory volume in 1 s as percent of forced vital capacity (FEV1.0 %) >70 %, and subcutaneous drain were independent predictors of postoperative incisional SSIs (p = 0.008, p = 0.004, and p = 0.017, respectively). The results of our RCT suggest that a subcutaneous Blake drain is beneficial for preventing incisional SSIs in patients undergoing colorectal surgery.

  8. Quality of life in Danish children and adolescents with type 1 diabetes treated with continuous subcutaneous insulin infusion or multiple daily injections

    DEFF Research Database (Denmark)

    Birkebæk, Niels; Kristensen, Lene Juel; Mose, Anne

    2014-01-01

    AIMS: The aims of the study were to compare health-related quality of life (HRQoL) in a National Danish population of children and adolescents with type 1 diabetes (T1D) treated with either continuous subcutaneous insulin injection (CSII) or multiple daily insulin injections (MDI...... for more than one year) and 405 with MDI (238 for more than one year). Participants and their parents completed the Pediatric Quality of Life Inventory Diabetes and Generic Module. HbA1c was analyzed centrally. RESULTS: Parents reported children and adolescents on CSII for more than one year to have less......), and to investigate whether HRQoL assessments were influenced by treatment duration. METHODS: Participants were recruited through the Danish Registry for Diabetes in Childhood and Adolescence. A total of 700 children and adolescents (360 girls), 8-17 years, were included. Of these, 295 were treated with CSII (160...

  9. Comparison of two dosing schedules for subcutaneous injections of low-dose anti-CD20 veltuzumab in relapsed immune thrombocytopenia.

    Science.gov (United States)

    Liebman, Howard A; Saleh, Mansoor N; Bussel, James B; Negrea, O George; Horne, Heather; Wegener, William A; Goldenberg, David M

    2016-11-01

    We compared two dosing schedules for subcutaneous injections of a low-dose humanized anti-CD20 antibody, veltuzumab, in immune thrombocytopenia. Fifty adults with primary immune thrombocytopenia, in whom one or more lines of standard therapy had failed and who had a platelet count <30×10(9)/L but no major bleeding, initially received escalating 80, 160, or 320 mg doses of subcutaneous veltuzumab administered twice, 2 weeks apart; the last group received once-weekly doses of 320 mg for 4 weeks. In all dose groups, injection reactions were transient and mild to moderate; there were no other safety issues. Forty-seven response-evaluable patients had 23 (49%) objective responses (platelet counts ≥30×10(9)/L and ≥2 × baseline) including 15 (32%) complete responses (platelets ≥100×10(9)/L). Responses (including complete responses) and bleeding reduction occurred in all dose groups and were not dose-dependent. In contrast, response duration increased progressively with total dose, reaching a median of 2.7 years with the four once-weekly 320-mg doses. Among nine responders retreated at relapse, three at higher dose levels responded again, including one patient who was retreated four times. In all dose groups, B-cell depletion occurred after the first dose until recovery starting 12 to 16 weeks after treatment. Veltuzumab serum levels increased with dose group according to total dose administered, but terminal half-life and clearance were comparable. Human anti-veltuzumab antibody titers developed without apparent dose dependence in nine patients, of whom six responded including five who had complete responses. Subcutaneous veltuzumab was convenient, well-tolerated, and active, without causing significant safety concerns. Platelet responses and bleeding reduction occurred in all dose groups, and response durability appeared to improve with higher doses. Clinicaltrials.gov identifier: NCT00547066. Copyright© Ferrata Storti Foundation.

  10. Epidural catheterization with a subcutaneous injection port for the long-term administration of opioids and local anesthetics to treat zoster-associated pain -a report of two cases-

    OpenAIRE

    Min, Bo Mi; Kim, Jong Hae

    2013-01-01

    Continuous epidural analgesia has been used for decades to treat acute herpes zoster pain and to prevent postherpetic neuralgia. However, many technical problems can arise during chronic treatment with epidural medications. These complications include catheter dislodgement, infection, injection pain, leakage, and occlusion. Epidural catheter placement utilizing subcutaneous injection port implantation has gained widespread acceptance as a method to overcome such complications. The technique r...

  11. Patient assessment of an electronic device for subcutaneous self-injection of interferon ß-1a for multiple sclerosis: an observational study in the UK and Ireland

    Directory of Open Access Journals (Sweden)

    D'Arcy C

    2012-01-01

    Full Text Available Caroline D’Arcy1, Del Thomas2, Dee Stoneman3, Laura Parkes31West London Neuroscience Centre, Charing Cross Hospital, London, UK; 2Wye Valley NHS Trust, Hereford, UK; 3Merck Serono Ltd, Feltham, Middlesex, UKBackground: Injectable disease-modifying drugs (DMDs reduce the number of relapses and delay disability progression in patients with relapsing–remitting multiple sclerosis (RRMS. Regular self-injection can be stressful and impeded by MS symptoms. Auto-injection devices can simplify self-injection, overcome injection-related issues, and increase treatment satisfaction. This study investigated patient responses to an electronic auto-injection device.Methods: Patients with RRMS (n = 63, aged 18–65 years, naïve to subcutaneous (sc interferon (IFN ß-1a therapy, were recruited to a Phase IV, observational, open-label, multicenter study (NCT01195870. Patients self-injected sc IFN ß-1a using the RebiSmart™ (Merck Serono S.A. – Geneva, Switzerland electronic auto-injector for 12 weeks, including an initial titration period if recommended by the prescribing physician. In week 12, patients completed a questionnaire comprising of a visual analog scale (VAS to rate how much they liked using the device, a four-point response question on ease of use (‘very difficult’, ‘difficult’, ‘easy’, or ‘very easy’, and a list of ten device functions to rank, based upon their experiences.Results: Six patients (9.5% discontinued the study: one switched to manual injection; two discontinued all treatment; three changed therapy. In total, 59 out of 63 patients (93.7% completed the VAS; 54 out of 59 (91.5%; 95% confidence interval: 81.3%–97.2% ‘liked’ using the electronic auto-injector (score ≥6, whereas 57 out of 59 (96.6% rated the device overall as ‘easy’ or ‘very easy’ to use. Device features rated as most useful were the hidden needle (mean [standard deviation] score: 3.3 [3.01]; n = 56, confirmation sound (3.9 [2.45], and

  12. The formalin test: effects of different injection sites on the pattern of ...

    African Journals Online (AJOL)

    This study evaluated the effects of different injection sites on the pattern of nociceptive responses. The responses to forepaw injection was found to be significantly higher than that of hind paw injection in the first phase while the response to plantar injection was found to be significantly higher than that of dorsal injection.

  13. Hair loss at injection sites of mesotherapy for alopecia.

    Science.gov (United States)

    El-Komy, Mohamed; Hassan, Akmal; Tawdy, Amira; Solimon, Mohamed; Hady, Mohamed Abdel

    2017-02-03

    The side effects of mesotherapy for treatment of various forms of alopecia are often underreported, while scientific data for its efficacy are severely lacking. To demonstrate the late onset side effects of mesotherapy for alopecia. Three patients with androgenetic alopecia showed hair loss after previously uneventful mesotherapy sessions up to 1 year. Clinical, dermoscopic, and histopathological findings suggested an inflammatory scaring process at sites of mesotherapy injections. Mesotherapy for androgenetic alopecia may paradoxically induce hair loss and scarring. Proper regulation and monitoring of the use of mesotherapy products for treating hair loss in women, needs to be addressed. © 2017 Wiley Periodicals, Inc.

  14. Subcutaneous granuloma annulare

    Directory of Open Access Journals (Sweden)

    Dhar Sandipan

    1993-01-01

    Full Text Available Two cases of subcutaneous granuloma annulare are reported. Clinical presentation was in the form of hard subcutaneous nodules, histopathology confirmed the clinical diagnosis. The cases were unique because of onset in adult age, occurrence over unusual sites and absence of classical lesions of granuloma annulare elsewhere.

  15. Standardized modulation of the injection site allows for insulin dose reduction without deterioration of metabolic control.

    Science.gov (United States)

    Pfützner, A; Dissel, S; Forkel, C; Grenningloh, M; Bitton, G; Nagar, R; Forst, T

    2014-10-01

    Use of an injection site modulation device (InsuPad) in intensive insulin treatment reduces frequency of hypoglycemia and prandial insulin requirements by enhancing subcutaneous microcirculation. This meal tolerance test (MTT) investigation was performed as a sub-study during the real-world BARMER study to demonstrate non-inferiority of the reduced insulin doses observed in this study with respect to metabolic control. The MTT was performed at baseline and after 3 months in insulin treated diabetes patients using the modulation device vs. a control group without device. The dose used for the MTT was individually calculated based on the prandial insulin records from the patient diaries before the test. Blood was drawn for determination of glucose, insulin, C-peptide, proinsulin, triglycerides, free fatty acids, nitrotyrosine, and asymmetric dimethyl-arginine (ADMA) at multiple time-points from 0 to 300 min. A total of 32 patients from one site were included into this MTT study (8 female, 7 type 1 diabetes, age: 49.9 ± 12.5 yrs, HbA1c: 7.2 ± 0.5%). During the BARMER study, mean HbA1c was treated to target (control group (-0.1%, p metabolism.

  16. Phase I/II clinical trial to assess safety and efficacy of intratumoral and subcutaneous injection of HVJ-E in castration-resistant prostate cancer patients.

    Science.gov (United States)

    Fujita, K; Nakai, Y; Kawashima, A; Ujike, T; Nagahara, A; Nakajima, T; Inoue, T; Lee, C M; Uemura, M; Miyagawa, Y; Kaneda, Y; Nonomura, N

    2017-07-01

    Inactivated Sendai virus particles (hemagglutinating virus of Japan envelope (HVJ-E)) have a novel antitumor effect: HVJ-E fused to prostate cancer cells via cell surface receptor causes apoptosis of prostate cancer cells in vitro and in vivo. HVJ-E also induces antitumor immunity by activating natural killer (NK) cells and cytotoxic T cells and suppressing regulatory T cells in vivo. We conducted an open-label, single-arm, phase I/II clinical trial in patients with castration-resistant prostate cancer (CRPC) to determine the safety and efficacy of intratumoral and subcutaneous injection of HVJ-E. Patients with CRPC who were docetaxel-resistant or could not receive docetaxel treatment were eligible. HVJ-E was injected directly into the prostate on day 1 and subcutaneously on days 5, 8 and 12 in two 28-day treatment cycles using a 3+3 dose-escalation design. The primary end points were to evaluate safety and tolerability of HVJ-E. The secondary end points were to analyze tumor immunity and antitumor effect. The study is registered at UMIN Clinical Trials Registry, number UMIN000006142. Seven patients were enrolled, and six patients received HVJ-E. Grade 2 or 3 adverse events (Common Terminology Criteria for Adverse Events Ver. 4.0) were urinary retention and lymphopenia from which the patients recovered spontaneously. No Grade 4 adverse events were observed. Radiographically, three patients had stable disease in the low-dose group, and one patient had stable disease and two had progressive disease in the high-dose group. The prostate-specific antigen (PSA) declined from 14 to 1.9 ng ml(-1) in one patient in the low-dose group after two cycles of HVJ-E treatment, and the PSA response rate was 16.6%. NK cell activity was elevated from day 12 to day 28 after HVJ-E administration, whereas serum interleukin-6, interferon (IFN)-α, IFN-β and IFN-γ levels were not affected by HVJ-E treatment. Intratumoral and subcutaneous injections of HVJ-E are feasible and PSA

  17. UK owner preferences for treatment of feline injection site sarcomas.

    Science.gov (United States)

    Carwardine, D; Friend, E; Toscano, M; Bowlt, K

    2014-02-01

    Feline injection site sarcomas are therapeutically challenging because of their locally invasive nature. Several protocols recommend that the two perceived high-risk adjuvanted vaccines should be administered into distinct anatomical sites ("left hind leg leukaemia, right hind leg rabies"), which should aid surgical resection. This has resulted in a change in tumour distribution with an increased proportion situated caudal to the diaphragm when such a policy is adopted. The aim of this study was to determine UK cat owners' attitudes towards surgical treatments of different anatomical regions. A cross-sectional study of an anonymous convenience sample of UK cat owners was conducted from September to December, 2012 using an internet-based survey. There were a total of 208 respondents: 39% would pursue surgery regardless of tumour site. One percent would not pursue surgery. Of the remainder, respondents would not allow amputation of the forelimb (20%), hindlimb (15%) or tail (15%). Twenty-six, 32 and 27% would not have surgical treatment of the inter-scapular region, chest or abdomen, respectively. The majority of respondents were willing to travel up to 100 miles for radiotherapy or chemotherapy (66 and 69%, respectively). The current feline vaccine site recommendations may not be appropriate for UK cat owners. © 2013 British Small Animal Veterinary Association.

  18. Dynamics of APC recruitment at the site of injection following injection of vaccine adjuvants.

    Science.gov (United States)

    van Aalst, Susan; Ludwig, Irene Stephanie; van Kooten, Peter Johannes Sylvester; van der Zee, Ruurd; van Eden, Willem; Broere, Femke

    2017-03-14

    Vaccines often contain adjuvants to strengthen the response to the vaccine antigen. However, their modes of action at the site of injection (SOI) are poorly understood. Therefore, we assessed the local effects of adjuvant on the innate immune system in mice. We investigated the safe, widely used adjuvants MF59 and aluminum hydroxide (alum), as well as trehalose-6,6'-dibehenate (TDB), Complete Freund's Adjuvant (CFA) and the Toll-Like-Receptor-ligands lipopolysaccharide (LPS) and Pam3CysSerLys4 (Pam3CSK4). We assessed muscle immune cell infiltration after adjuvant injection and observed 16h post immunization (hpi) an increased influx with CFA, MF59 and TDB, but not with alum, LPS or Pam3CSK4. An elevated influx with the latter three became visible only 72hpi. Contribution of granulocytes, macrophages and dendritic cells to the influx differed per adjuvant and in time. Adjuvants generally induced a local pro-inflammatory micro-milieu that was transient except for CFA and TDB. The gene expression of CXCL-1, CCL-2 and CCL-5, involved in recruitment of immune cells, varied per adjuvant and corresponded grossly with the observed influx of granulocytes and monocytes/macrophages. Muscles injected with CFA or MF59 (when co-injected with peptide) resulted in APC ex vivo capable to induce proliferation of peptide-specific T-cells. By adding in vitro an excess of peptide to the APC/T cell co-cultures, we observed an adjuvant-enhanced co-stimulation or antigen presentation by APC after CFA- but not MF59-injection. After TDB-injection this effect was observed only at 72hpi, but not 24hpi. Thus the cellular influx profile and the local cytokine and chemokine micro-milieu in the muscle were strongly influenced by the type of adjuvant. Additionally, the capacity of muscle APC to load and present antigen was affected by the adjuvant. These findings may assist the development of novel adjuvanted vaccines in a more rational manner. Copyright © 2017 Elsevier Ltd. All rights reserved.

  19. Golimumab, a human antibody to tumour necrosis factor {alpha} given by monthly subcutaneous injections, in active rheumatoid arthritis despite methotrexate therapy: the GO-FORWARD Study.

    Science.gov (United States)

    Keystone, E C; Genovese, M C; Klareskog, L; Hsia, E C; Hall, S T; Miranda, P C; Pazdur, J; Bae, S-C; Palmer, W; Zrubek, J; Wiekowski, M; Visvanathan, S; Wu, Z; Rahman, M U

    2009-06-01

    The phase III GO-FORWARD study examined the efficacy and safety of golimumab in patients with active rheumatoid arthritis (RA) despite methotrexate therapy. Patients were randomly assigned in a 3 : 3 : 2 : 2 ratio to receive placebo injections plus methotrexate capsules (group 1, n = 133), golimumab 100 mg injections plus placebo capsules (group 2, n = 133), golimumab 50 mg injections plus methotrexate capsules (group 3, n = 89), or golimumab 100 mg injections plus methotrexate capsules (group 4, n = 89). Injections were administered subcutaneously every 4 weeks. The co-primary endpoints were the proportion of patients with 20% or greater improvement in the American College of Rheumatology criteria (ACR20) at week 14 and the change from baseline in the health assessment questionnaire-disability index (HAQ-DI) score at week 24. The proportion of patients who achieved an ACR20 response at week 14 was 33.1% in the placebo plus methotrexate group, 44.4% (p = 0.059) in the golimumab 100 mg plus placebo group, 55.1% (p = 0.001) in the golimumab 50 mg plus methotrexate group and 56.2% (p<0.001) in the golimumab 100 mg plus methotrexate group. At week 24, median improvements from baseline in HAQ-DI scores were 0.13, 0.13 (p = 0.240), 0.38 (p<0.001) and 0.50 (p<0.001), respectively. During the placebo-controlled portion of the study (to week 16), serious adverse events occurred in 2.3%, 3.8%, 5.6% and 9.0% of patients and serious infections occurred in 0.8%, 0.8%, 2.2% and 5.6%, respectively. The addition of golimumab to methotrexate in patients with active RA despite methotrexate therapy significantly reduced the signs and symptoms of RA and improved physical function.

  20. Liver injury in rhesus monkeys subcutaneously injected with 2.3.7.8-tetrachlorodibenzo-p-dioxin

    Energy Technology Data Exchange (ETDEWEB)

    Tatsumi, Korenaga; Fukusato, Toshio [Teikyo Univ., Tokyo (Japan). School of Medicine; Kubota, Shunichiro; Ohta, Mari [Tokyo Univ. (Japan); Asaoka, Kazuo [Kyoto Univ., Aichi (Japan); Murata, Nobuo [Teikyo Univ., Kawasaki (Japan). Mizonokuchi Hospital, School of Medicine; Nomizu, Motoyoshi [Hokkaido Univ., Sapporo (Japan); Arima, Akihiro [Shin Nippon Biomedical Laboratories, Ltd., Kagoshima (Japan)

    2004-09-15

    2.3.7.8-tetrachlorodibenzo-p-dioxin (TCDD) is the most toxic member of dioxins which are environmentally and biologically stable. Exposure to these compounds results in wide variety of effects including immunological dysfunction, tetragenecity and carcinogenesis. The liver is one of the central organs in which TCDD metabolized after absorption into the human and animal bodies. In experiments using rodents, TCDD accumulates and remains stable in the fatty tissues and liver for a long time. Kinetic profile of TCDD in our experiments using rhesus monkeys demonstrated the higher concentrations of TCDD in the fat, liver, and mammary gland. TCDD-induced liver injury in humans has been reported in Japan (PCB), Taiwan (PCB or PCDF), Italy (Sebeso, TCDD), and Vietnam (TCDD). Considerating the pronounced difference between species observed in some studies on non-human primates to assess effects of relatively low dose of TCDD, in the present study, liver injury in rhesus monkeys after a single subcutaneous administration of low dose of TCDD during pregnancy was investigated.

  1. Site Characterization Plan: Uranium Stabilization through Polyphosphate Injection

    Energy Technology Data Exchange (ETDEWEB)

    Vermeul, Vince R.; Fruchter, Jonathan S.; Wellman, Dawn M.; Williams, Bruce A.; Williams, Mark D.

    2006-12-01

    An initial feasibility study of options to treat the uranium plume at the 300-FF-5 Operable Unit considered hydraulic containment, slurry wall containment, and groundwater extraction as potential remedial action technologies. None were selected for interim action, and reduction of contamination levels by natural processes was considered a viable alternative while source removal actions continued. Subsequent planning for a Phase III feasibility study focused on methods that would reduce the concentration of uranium in the aquifer, including multiple methods to immobilize uranium using chemical-based technologies. Based on an initial technology screening, the polyphosphate technology was identified as the best candidate to treat the for further evaluation and selected for treatability testing. The overall objective of the polyphosphate treatability test is to evaluate the efficacy of using polyphosphate injections to treat uranium contaminated groundwater in situ. The objective of the work elements included in this site characterization plan is to collect site-specific characterization data that will be needed to design and implement a field-scale demonstration of the technology.

  2. Therapy of an incomplete spinal cord injury by intrathecal injection of EPO and subcutaneous injection of EPO, vitamin C and G-CSF

    Directory of Open Access Journals (Sweden)

    Bader A

    2017-11-01

    Full Text Available Augustinus Bader,1 Martin Reinhardt,1 Achim Beuthe,2 Klaus Röhl,2 Shibashish Giri1,31Department of Cell Techniques and Applied Stem Cell Biology, Centre for Biotechnology and Biomedicine, Medical faculty of University of Leipzig, Leipzig, 2Department of Orthopedic Surgery, BG clinics Bergmannstrost Halle, 3Department of Plastic and Hand Surgery, University Hospital Rechts der Isar, Munich Technical University, Munich, GermanyAbstract: Spinal cord injury is a rare disease with an incidence about 40 cases per million population in the USA. The most common reasons are traffic accidents, falls, violence and sports. A 53-year-old male patient presented with an incomplete tetraparesis as a result of a spinal cord injury after a boat accident. It was not possible to treat him with steroids because he was out of the therapeutic time period of 8 hours when he presented to the hospital. The main problem of spinal cord injuries is the secondary injury caused by inflammation and swelling of the spinal cord. To avoid this, the patient was experimentally treated with erythropoietin (EPO intrathecal and EPO, granulocyte-colony-stimulating factor and vitamin C subcutaneous after his initial spinal cord relief surgery. These drugs might be able to relieve this secondary reaction but were never applied for this indication in human before. This study shows that it could be a promising treatment for spinal cord injuries with potential therapeutic benefits.Keywords: EPO, G-CSF, spinal cord injury, vitamin C

  3. Changes in glycemic control and quality of life in pediatric type 1 diabetics with continuous subcutaneous insulin infusion of insulin aspart following multiple daily injection therapy.

    Science.gov (United States)

    Kawamura, Tomoyuki; Urakami, Tatsuhiko; Sugihara, Shigetaka; Kim, Hey Sook; Mochizuki, Mie; Amamiya, Shin

    2008-01-01

    The efficacy of continuous subcutaneous insulin infusion (CSII) of the rapid-acting insulin analogue, insulin aspart, was evaluated in 26 patients with childhood-onset type 1 diabetes aged between 6 and 18 yr who had been on basal-bolus therapy (multiple daily injection (MDI) of regular human insulin or rapid-acting insulin and intermediate/long-acting insulin). The glycemic control in the patients was evaluated based on changes in the clinical parameters and the patient quality of life (QOL) was evaluated by using the insulin therapy-related QOL questionnaire. Twenty two patients continued CSII during the 6-mo study period. The mean HbA1c was 7.8 ± 1.8% at baseline and it decreased to 7.4 ± 0.8% at 6 mo after the start of the CSII. Overall, no decrease of the QOL post-CSII initiation was noted. The possible superiority of CSII as compared to MDI was suggested for patients who "eat out" or "have to look for an appropriate place for insulin injection." Aside from an inadequate indwelling needle placement detected after the initiation of CSII in several patients, no adverse event associated with NovoRapid(®) was seen. In conclusion, CSII of rapid-acting insulin appears to be a useful therapy for patients with childhood-onset type 1 diabetes.

  4. Side-to-side symmetry of radioprotein transfer from tissue space to systemic vasculature following subcutaneous injection in normal subjects and patients with breast cancer

    Energy Technology Data Exchange (ETDEWEB)

    Pain, Simon J.; O' Mahony, Susan; Purushotham, Arnie [Cambridge Breast Unit, Addenbrooke' s Hospital, Cambridge (United Kingdom); Barber, Robert W.; Ballinger, James R.; Solanki, Chandra K.; Peters, A.Michael [Department of Nuclear Medicine, Addenbrooke' s Hospital, Hills Road, Box 170, CB2 2QQ, Cambridge (United Kingdom); Mortimer, Peter S. [Department of Physiological Medicine, St George' s Hospital Medical School, London (United Kingdom)

    2003-05-01

    Quantitative lymphoscintigraphy can be used for investigation of unilateral lymphatic disease of the limbs, such as breast cancer-related lymphoedema (BCRL). Previous studies have compared lymphatic function in the affected limb with that in the unaffected contralateral limb. This study aims to confirm that the assumption of pre-morbid symmetry, never previously demonstrated, is valid. A dual-isotope technique, with bilateral subcutaneous hand injection of polyclonal human immunoglobulin G (HIgG) labelled with either technetium-99m or indium-111, was performed on a total of 37 subjects. The use of two different labels, one for each limb, enabled comparison not only of the rate of clearance from the injection depot, but also of the rate of appearance in venous blood. Results demonstrate clear symmetry between the two arms with respect to both depot clearance and blood appearance rates, as well as the coupling between these two variables. In unilateral lymphatic disease, results of quantitative lymphoscintigraphy should be expressed in relation to the normal arm rather than to an independent control population. (orig.)

  5. Patient adherence to subcutaneous IFN beta-1a injections using the RebiSmart® injection device: a retrospective real-world study among Dutch and German patients with multiple sclerosis

    Directory of Open Access Journals (Sweden)

    Krol M

    2017-07-01

    Full Text Available Marieke Krol,1 Gert de Voer,2 Ulrike Osowski3 1QuintilesIMS, Capelle aan den Ijssel, the Netherlands; 2Merck B.V., Schiphol-Rijk, the Netherlands; 3Merck KGaA, Darmstadt, Germany Purpose: Long-term treatment adherence among patients with multiple sclerosis (MS is a general concern, with an established correlation with clinical efficacy. Closely monitoring patients’ treatment behavior may have a beneficial effect on adherence. This study assessed adherence, in daily life, to subcutaneous (sc IFN beta-1a, self-administered using the RebiSmart® electronic injection device (the IFN beta-Ia autoinjector device, in patients with MS. Patients and methods: This was a retrospective observational study analyzing treatment adherence based on injection data, eg, injection date and dose, extracted from the IFN beta-Ia autoinjector devices collected from patients in Germany and the Netherlands. Results: Data recorded in the period from 2007 to 2012 by the IFN beta-Ia autoinjector devices from 1,682 (79.7% from Germany, 20.3% from the Netherlands patients were analyzed. A mean of 94.8% of the multi-dose cartridges (containing sc IFN beta-1a for three injections were used completely, indicating a low incidence of application errors and drug wastage. The mean adherence rate was 90.7% and 82.9% over the entire observation period (mean treatment duration: 150.1 weeks. Median adherence rates were similar between German and Dutch patients (97.9% vs 99.0%. Conclusion: In daily clinical practice, patients using the IFN beta-Ia autoinjector device were highly adherent to sc IFN beta-1a. The injection data stored electronically in the device may help patients to adhere to treatment regimens and, if viewed by physicians, promote discussion of adherence issues with patients. Keywords: multiple sclerosis, injection device, IFN beta-1a, observational study 

  6. Full Life Cycle Research at the Ketzin Pilot Site, Germany - From Safe and Successful CO2 Injection Operation to Post-Injection Monitoring and Site Closure

    Science.gov (United States)

    Liebscher, A. H.

    2016-12-01

    The Ketzin pilot site near Berlin, Germany, was initiated in 2004 as the first European onshore storage project for research and development on geological CO2 storage. The operational CO2 injection period started in June 2008 and ended in August 2013 when the site entered the post-injection closure period. During these five years, a total amount of 67 kt of CO2 was safely injected into a saline aquifer (Upper Triassic sandstone) at a depth of 630 m - 650 m. In fall 2013, the first observation well was partially plugged in the reservoir section; full abandonment of this well finished in 2015 after roughly 2 years of well closure monitoring. Abandonment of the remaining 4 wells will be finished by 2017 and hand-over of liability to the competent authority is planned for end of 2017. The CO2 injected was mainly of food grade quality (purity > 99.9%). In addition, 1.5 kt of CO2 from the pilot capture facility "Schwarze Pumpe" (oxyfuel power plant CO2 with purity > 99.7%) was injected in 2011. The injection period terminated with a CO2-N2 co-injection experiment of 650 t of a 95% CO2/5% N2 mixture in summer 2013 to study the effects of impurities in the CO2 stream on the injection operation. During regular operation, the CO2 was pre-heated on-site to 40 - 45°C prior to injection to ensure a single-phase injection process and avoid any phase transition or transient states within the injection facility or the reservoir. Between March and July 2013, just prior to the CO2-N2 co-injection experiment, the injection temperature was stepwise decreased down to 10°C within a "cold-injection" experiment to study the effects of two-phase injection conditions. During injection operation, the combination of different geochemical and geophysical monitoring methods enabled detection and mapping of the spatial and temporal in-reservoir behaviour of the injected CO2 even for small quantities. After the cessation of CO2 injection, post-injection monitoring continued and two additional

  7. Continuous subcutaneous insulin infusion is more effective than multiple daily insulin injections in preventing albumin excretion rate increase in Type 1 diabetic patients.

    Science.gov (United States)

    Lepore, G; Bruttomesso, D; Bonomo, M; Dodesini, A R; Costa, S; Meneghini, E; Corsi, A; Nosari, I; Trevisan, R

    2009-06-01

    To compare the effect of continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) on albumin excretion rate (AER) in Type 1 diabetic patients. In a 3-year multicentre retrospective observational study, 110 Type 1 diabetic patients treated with CSII were compared with 110 patients treated with MDI matched at baseline for age, sex, diabetes duration and HbA(1c). At entry, 90 patients in each group had normal AER and 20 persistent microalbuminuria. AER, estimated glomerular filtration rate (eGFR), HbA(1c,) lipids and blood pressure were assessed. HbA(1c) was lower in the CSII than in the MDI group (8.1 +/- 0.9 vs. 8.4 +/- 1.3%; P AER [median (95% confidence interval)], similar at baseline [6.0 microg/min (9, 21) in the CSII group vs. 4.4 (8, 16) in the MDI group, NS] was significantly lower in the patients treated with CSII both at year 2 and at year 3 of follow-up [4.7 microg/min (6, 12) vs. 6.4 (13, 29), P therapy may be useful in decreasing the progressive increase in AER in Type 1 diabetic patients.

  8. Injection site abscess due to mycobacterium fortuitum: A case report

    Directory of Open Access Journals (Sweden)

    Devi DR

    2003-01-01

    Full Text Available Injection abscess is an iatrogenic infection occurring as an isolated case or as cluster outbreak. These infections occur due to contaminated injectables or lapse in sterilisation protocol. While pathogens such as Pseudomonas, Klebsiella, E. coli, and S. aureus are the usual causative agents, unusual organisms such as mycobacteria, particularly the rapidly growing non-tuberculous mycobacteria (NTM may cause the abscess. The chances of overlooking these organisms is high unless an acid fast bacilli (AFB smear and culture is done on all aspirated pus specimens. We report a case of a three year old child who presented with a gluteal abscess following an intramuscular infection with an unknown preparation.

  9. A Comparison of Continuous Subcutaneous Insulin Infusion vs. Multiple Daily Insulin Injection in Children with Type I Diabetes in Kuwait: Glycemic Control, Insulin Requirement, and BMI

    Directory of Open Access Journals (Sweden)

    Majedah M. AbdulRasoul

    2015-09-01

    Full Text Available Objective: Continuous subcutaneous insulin infusion (CSII and multiple daily insulin injections (MDI are two methods currently used to manage type I diabetes mellitus (T1DM. Here we compare our experiences with CSII and MDI in a large cohort of pediatric patients in Kuwait. Methods: Data on 326 patients with T1DM who were started on CSII between 2007 and 2012 were retrospectively compared with those of 326 patients on MDI. They were matched for sex, age at diagnosis, T1DM duration, glycemic control, insulin requirement, and body mass index (BMI. Data were collected at baseline and every three months and included glycated hemoglobin (HbA1c, insulin dose, and adverse events (severe hypoglycemia, diabetic ketoacidosis, and skin problems. Results: The main reason for switching to CSII was to achieve better glycemic control (37%, followed by reducing hypoglycemia, and improving the quality of life (13.3% each. Although HbA1c decrease was most significant in the first year, it continued to be significantly lower in the CSII group compared to the MDI throughout the study period. Total daily insulin requirements were significantly lower in the CSII group. BMI increased in both groups, but the difference was significant only at the end of the fifth year. There was no significant change in the rate of diabetic ketoacidosis in either group. The CSII patients had more severe hypoglycemic episodes at baseline; however, it significantly decreased throughout the study period. Only five patients discontinued CSII therapy and two of these restarted within three months. Conclusion: CSII is a safe intensive insulin therapy in youngsters with T1DM and achieved markedly fewer severe hypoglycemic episodes and lower daily insulin requirements

  10. Use and Effectiveness of Continuous Subcutaneous Insulin Infusion (CSII) and Multiple Daily Insulin Injection Therapy (MIT) in Children, Adolescents and Young Adults with Type 1 Diabetes Mellitus.

    Science.gov (United States)

    Schiel, R; Burgard, D; Perenthaler, T; Stein, G; Kramer, G; Steveling, A

    2016-02-01

    Today continuous subcutaneous insulin infusion (CSII) is frequently used in children and adolescents with type 1 diabetes mellitus. The present cross-sectional trial aimed to document current practice, quality of diabetes control and incidence of acute complications in different age-groups under CSII vs. multiple daily insulin injection therapy (MIT). Moreover the survey analyzed socio-demographic backgrounds of the patients. A total of 901 patients (age 11.5±4.0, diabetes duration 4.0±3.6 years) was entered in the database. Clinical data, laboratory parameters and, using a standardized questionnaire, socio-demographic data were assessed. For age-related analyses patients were allocated to 4 groups: pre-school children (diabetes duration, they used more frequently insulin analogues, performed more frequently blood-glucose self-tests and had a lower insulin dosage per kilogram body weight. In respect of HbA1c, the mean amplitude of blood-glucose excursions, but also of lipids, creatinine, microalbuminuria and blood pressure, there were no differences in neither age-group between patients with CSII and MIT. In patients with CSII and MIT, there was a tendency (plevel. Pre-adolescents, adolescents and young adults with CSII have also better diabetes-related knowledge. Moreover, in all age-groups, the parents of patients with CSII had mostly a lower unemployment rate and higher educational levels. The present analyses demonstrate that in all age-groups CSII provides convenient and flexible insulin delivery during routine treatment of type 1 diabetes. There is reasonable quality of diabetes control accompanied by a low incidence of hypoglycaemia and ketoacidosis. However, under CSII and MIT there is an increase of HbA1c towards adolescence. It must also highlighted that CSII seems to be expansive and that CSII is more frequently used in patients with better educational levels and deriving from higher social classes. © Georg Thieme Verlag KG Stuttgart · New York.

  11. A dose-equivalent comparison of the effects of continuous subcutaneous glucagon-like peptide 2 (GLP-2) infusions versus meal related GLP-2 injections in the treatment of short bowel syndrome (SBS) patients

    DEFF Research Database (Denmark)

    Naimi, R M; Madsen, K B; Askov-Hansen, C

    2013-01-01

    Glucagon-like peptide 2 (GLP-2), secreted endogenously from L-cells in the distal bowel in relation to meals, modulates intestinal absorption by adjusting gastric emptying and secretion and intestinal growth. Short bowel syndrome (SBS) patients with distal intestinal resections have attenuated en...... effects of continuous, subcutaneous (s.c.), exogenous GLP-2 infusion (CONT-GLP-2) versus three daily s.c. GLP-2 injections (TID-GLP-2) on intestinal absorption in SBS patients....

  12. Opiate Injection Site Infections--19 years in the UK

    Centers for Disease Control (CDC) Podcasts

    2017-09-06

    Dan Lewer, a public health registrar in England, discusses an increase in infections related to opiate injections in the U.K.  Created: 9/6/2017 by National Center for Emerging and Zoonotic Infectious Diseases (NCEZID).   Date Released: 9/6/2017.

  13. Subcutaneous granuloma annulare

    Directory of Open Access Journals (Sweden)

    Dhar Sandipan

    1994-01-01

    Full Text Available Two cases of subcutaneos granuloma annulare are reported. Clinical presentation was in the form of hard subcutaneous nodules; histopathology confirmed the clinical diagnosis. The cases were unique because of onset in adult hood, occurrence over unusual sites and absence of classical lesions of granuloma annulare elsewhere.

  14. 21 CFR 522.784 - Doxylamine succinate injection.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Doxylamine succinate injection. 522.784 Section... § 522.784 Doxylamine succinate injection. (a) Specifications. Each milliliter of the drug contains 11.36... subcutaneous administration should be by divided injection sites. 1 (3) Not for use in horses intended for food...

  15. [Biometric ranging of the corpses destroyed at the site of a catastrophe in terms of gender, longitudinal and circumferencial dimensions, and the degree of subcutaneous fat distribution].

    Science.gov (United States)

    Zviagin, V N; Galitskaia, O I; Negasheva, M A

    2012-01-01

    The quantitative criteria for biometric ranging of destroyed corpses in terms of anatomical localization, gender, longitudinal length, trunk circumference, and the folds of subcutaneous fat are proposed. The wealth of anthropometric materials obtained in the studies of various Caucasoid populations was used to calculate the normative tables for biometric ranging of the decomposed corpses. The proposed technology excludes the subjective assessments for the purpose of such classification at the sites of catastrophes. Moreover, it promotes the accumulation of the variety of valuable information, such as the size of the collar, headwear, and footwear, clothing size and height, and portrait features, that can be used for victim identification.

  16. The Efficacy of a Prevascularized, Retrievable Poly(D,L,-lactide-co-ε-caprolactone) Subcutaneous Scaffold as Transplantation Site for Pancreatic Islets.

    Science.gov (United States)

    Smink, Alexandra M; Li, Shiri; Hertsig, Don T; de Haan, Bart J; Schwab, Leendert; van Apeldoorn, Aart A; de Koning, Eelco; Faas, Marijke M; Lakey, Jonathan R T; de Vos, Paul

    2017-04-01

    The liver as transplantation site for human pancreatic islets is a harsh microenvironment for islets and it lacks the ability to retrieve the graft. A retrievable, extrahepatic transplantation site that mimics the pancreatic environment is desired. Ideally, this transplantation site should be located subdermal for easy surgical-access but this never resulted in normoglycemia. Here, we describe the design and efficacy of a novel prevascularized, subcutaneously implanted, retrievable poly (D,L-lactide-co-ε-caprolactone) scaffold. Three dosages of rat islets, that is, 400, 800, and 1200, were implanted in immune compromised mice to test the efficacy (n = 5). Islet transplantation under the kidney capsule served as control (n = 5). The efficacy was determined by nonfasting blood glucose measurements and glucose tolerance tests. Transplantation of 800 (n = 5) and 1200 islets (n = 5) into the scaffold reversed diabetes in respectively 80 and 100% of the mice within 6.8 to 18.5 days posttransplant. The marginal dose of 400 islets (n = 5) induced normoglycemia in 20%. The glucose tolerance test showed major improvement of the glucose clearance in the scaffold groups compared to diabetic controls. However, the kidney capsule was slightly more efficacious because all 800 (n = 5) and 1200 islets (n = 5) recipients and 40% of the 400 islets (n = 5) recipients became normoglycemic within 8 days. Removal of the scaffolds or kidney grafts resulted in immediate return to hyperglycemia. Normoglycemia was not achieved with 1200 islets in the unmodified skin group. Our findings demonstrate that the prevascularized poly (D,L-lactide-co-ε-caprolactone) scaffold maintains viability and function of islets in the subcutaneous site.

  17. Effect of 4 years subcutaneous insulin infusion treatment on albuminuria, kidney function and HbA1c compared with multiple daily injections

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Hansen, Tine Willum; Andersen, Steen

    2015-01-01

    AIM: The effect of insulin pump [continuous subcutaneous insulin infusion (CSII)] treatment on diabetes complications in a modern clinical setting is largely unknown. We investigated the effect of 4 years CSII treatment on HbA1c, albuminuria and kidney function compared with multiple daily...

  18. Optimum site for in ovo amino acid injection in broiler breeder eggs.

    Science.gov (United States)

    Ohta, Y; Kidd, M T

    2001-10-01

    Three experiments were conducted to evaluate the effect of differences in in ovo amino acid (AA) injection sites in broiler breeder eggs on subsequent hatchability and BW of chicks. In Experiment 1, an AA solution was injected into eggs with 13-mm or 19-mm, 27-ga needles. Uninjected eggs served as controls. Hatchability was decreased (P coelom in eggs treated by both needles. However, the occurrence of India ink in the extra embryonic coelom was higher (P coelom, or amniotic cavity at Day 7 of incubation. Hatchability was reduced, but chicks hatched when eggs were windowed and when AA were injected into the yolk sac or extra-embryonic coelom. However, chicks did not hatch when AA were administered to the chorioallantoic membrane or into the amniotic cavity. These results suggest that the best AA injection sites in ovo may be the yolk and extra-embryonic coelom.

  19. From Site Characterization through Safe and Successful CO2 Injection Operation to Post-injection Monitoring and Site Closure - Closing the Full Life Cycle Research at the Ketzin Pilot Site, Germany

    Science.gov (United States)

    Liebscher, Axel

    2017-04-01

    Initiated in 2004, the Ketzin pilot site near Berlin, Germany, was the first European onshore storage project for research and development on geological CO2 storage. After comprehensive site characterization the site infrastructure was build comprising three deep wells and the injection facility including pumps and storage tanks. The operational CO2 injection period started in June 2008 and ended in August 2013 when the site entered the post-injection closure period. During these five years, a total amount of 67 kt of CO2 was safely injected into an Upper Triassic saline sandstone aquifer at a depth of 630 m - 650 m. In fall 2013, the first observation well was partially plugged in the reservoir section with CO2 resistant cement; full abandonment of this well finished in 2015 after roughly 2 years of cement plug monitoring. Abandonment of the remaining wells will be finished by summer 2017 and hand-over of liability to the competent authority is scheduled for end of 2017. The CO2 injected was mainly of food grade quality (purity > 99.9%). In addition, 1.5 kt of CO2 from the oxyfuel pilot capture facility "Schwarze Pumpe" (purity > 99.7%) was injected in 2011. The injection period terminated with a CO2-N2 co-injection experiment of 650 t of a 95% CO2/5% N2 mixture in summer 2013 to study the effects of impurities in the CO2 stream on the injection operation. During regular operation, the CO2 was pre-heated on-site to 40°C prior to injection to ensure a single-phase injection process and avoid any phase transition or transient states within the injection facility or the reservoir. Between March and July 2013, just prior to the CO2-N2 co-injection experiment, the injection temperature was stepwise decreased down to 10°C within a "cold-injection" experiment to study the effects of two-phase injection conditions. During injection operation, the combination of different geochemical and geophysical monitoring methods enabled detection and mapping of the spatial and

  20. Fibrosarcomas at presumed sites of injection in dogs: characteristics and comparison with non-vaccination site fibrosarcomas and feline post-vaccinal fibrosarcomas.

    Science.gov (United States)

    Vascellari, M; Melchiotti, E; Bozza, M A; Mutinelli, F

    2003-08-01

    Fifteen fibrosarcomas, surgically excised from presumed sites of injection in dogs, and 10 canine fibrosarcomas excised from sites not used for injection were histologically and immunohistochemically compared with 20 feline post-vaccinal fibrosarcomas. Canine fibrosarcomas from presumed injection sites were of grade I (3), of grade II (4) and grade III (8). Two fibrosarcomas from non-injection sites were of grade I, four of grade II and four of grade III. Feline samples were classified as grade I (2), grade II (4) and grade III (14). All fibrosarcomas from presumed injection sites of both species showed lymphocytic inflammatory infiltration located at the tumour periphery, while two canine fibrosarcomas from non-injection sites showed perivascular inflammatory infiltration within the neoplasm. All samples were immunohistochemically examined for vimentin, smooth muscle actin, muscle specific actin and desmin expression. All tumours were positive for vimentin. Ten canine fibrosarcomas from presumed injection sites and all feline samples contained cells consistent with a myofibroblastic immunophenotype. Aluminium deposits were detected in eight canine fibrosarcomas from presumed injection sites and 11 feline post-vaccinal fibrosarcomas by the aurintricarboxylic acid method. The present study identifies distinct similarities between canine fibrosarcomas from presumed injection sites and feline post-vaccinal fibrosarcomas, suggesting the possibility of the development of post-injection sarcomas not only in cats, but also in dogs.

  1. Patient-rated suitability of a novel electronic device for self-injection of subcutaneous interferon beta-1a in relapsing multiple sclerosis: an international, single-arm, multicentre, Phase IIIb study

    Directory of Open Access Journals (Sweden)

    Verdun di Cantogno Elisabetta

    2010-04-01

    Full Text Available Abstract Background Multiple sclerosis (MS currently requires long-term treatment with disease-modifying drugs, administered parenterally up to once daily. The need for regular self-injection can be a barrier to treatment for many patients. Autoinjectors can help patients overcome problems or concerns with self-injection and could, therefore, improve treatment adherence. This study was performed to assess the suitability of a new electronic device for the subcutaneous (sc administration of interferon (IFN beta-1a, 44 mcg three times weekly, for relapsing MS. Methods In this Phase IIIb, multicentre, single-arm study, patients with relapsing MS who had been consistently self-injecting sc IFN beta-1a using an autoinjector for at least 6 weeks were taught to use the new device and self-administered treatment for 12 weeks thereafter. Patient-rated suitability of the device was assessed at the end of Week 12 using the Patient User Trial Questionnaire. Patient satisfaction with, and evaluation of, the injection process was assessed using the MS Treatment Concern Questionnaire. Trainers evaluated the device using the Trainer User Trial Questionnaire. Results At Week 12, 71.6% (73/102 of patients considered the device 'very suitable' or 'suitable' for self-injection; 92.2% (94/102 reported some degree of suitability and only 7.8% (8/102 found the device 'not at all suitable'. At Weeks 4, 8 and 12, most patients reported that injection preparation and clean-up, performing injections and ease of device use in the previous 4 weeks compared favourably with, or was equivalent to, their previous experience of self-injection. Injection-related pain, injection reactions and 'flu-like' symptoms remained stable over the 12 weeks. Each device feature was rated 'very useful' or 'useful' by at least 80% of patients. All trainers and 95.2% (99/104 of patients found device functions 'very easy' or 'easy' to use. Overall convenience was considered the most important

  2. Patient assessment of an electronic device for subcutaneous self-injection of interferon ß-1a for multiple sclerosis: an observational study in the UK and Ireland

    OpenAIRE

    D'Arcy C; Thomas D; Stoneman D; Parkes L

    2012-01-01

    Caroline D’Arcy1, Del Thomas2, Dee Stoneman3, Laura Parkes31West London Neuroscience Centre, Charing Cross Hospital, London, UK; 2Wye Valley NHS Trust, Hereford, UK; 3Merck Serono Ltd, Feltham, Middlesex, UKBackground: Injectable disease-modifying drugs (DMDs) reduce the number of relapses and delay disability progression in patients with relapsing–remitting multiple sclerosis (RRMS). Regular self-injection can be stressful and impeded by MS symptoms. Auto-injection device...

  3. Harm-reduction activism: a case study of an unsanctioned user-run safe injection site.

    Science.gov (United States)

    Kerr, Thomas; Oleson, Megan; Wood, Evan

    2004-08-01

    Due to the ongoing health crisis among injection drug users in Vancouver, Canada, there have been repeated calls for the establishment of safe injection sites (SISs) since the early 1990s. In April 2003, in response to a large-scale police crackdown and government inaction, a group of activists opened an unsanctioned SIS in Vancouver's Downtown Eastside (DTES). The 327 Carrall Street SIS operated for 181 days despite considerable police harassment and limited financial support. During the operation of the SIS, volunteers supervised over 3000 injections and demonstrated the feasibility of a user-run low-threshold SIS. The experience of the SIS provides valuable lessons for those seeking to advance the interests of injection drug users through community mobilization and direct action approaches. In this article, Thomas Kerr, Megan Oleson, and Evan Wood describe the events surrounding the establishment, operation, and closing of the unsanctioned SIS, and outline the lessons learned.

  4. Long-term effects of continuous subcutaneous infusion versus daily subcutaneous injections of growth hormone (GH) on the insulin-like growth factor system, insulin sensitivity, body composition, and bone and lipoprotein metabolism in GH-deficient adults

    DEFF Research Database (Denmark)

    Laursen, Torben; Gravholt, Claus Højbjerg; Heickendorff, Lene

    2001-01-01

    injections (inj) in the evening as usual, and 7 received a continuous infusion (inf) of GH by means of a portable pump. The GH dose was kept unchanged before and during the study. Serum levels of insulin-like growth factor I (IGF-I) tended to increase in the patients switched to constant infusion (from 175...... not influence insulin sensitivity (P = 0.71) or glucose effectiveness (P = 0.15) derived from Bergman's minimal model. Similarly, the two treatment regimens had no differential impact on lipoprotein levels, bone metabolism, or body composition. In conclusion, continuous and intermittent administrations of GH...... for 6 months are comparable with respect to the IGF-IGFBP axis, whereas intermittent exposure may be of importance for the lipolytic effect of GH. The data on insulin sensitivity and lipoproteins suggest that constant GH exposure is as safe as intermittent GH administration....

  5. Reversible Crystallization of Argatroban after Subcutaneous Application in Pigs

    Directory of Open Access Journals (Sweden)

    Mercedes Lopez

    2012-01-01

    Full Text Available Argatroban is a thrombin inhibitor used as anticoagulant in patients with heparin-induced thrombocytopenia. It is usually administered as an intravenous bolus followed by infusion. Nevertheless, its pharmacokinetics after subcutaneous administration is unknown. The aim of this study was to assess the pharmacokinetics of two different formulations of argatroban in pigs after subcutaneous administration. Antithrombotic activity in plasma was determined by ecarin chromogenic assay. To visualize the formation of crystals, argatroban was administered to rats into the subcutaneous tissue exposed after removing the skin, and the injection site was photographed at different times. After subcutaneous administration of a sorbitol/ethanol formulation of argatroban in pigs was observed a slow absorption phase was followed by long-lasting levels of this inhibitor. Cmax and AUC(0-24 showed dose-dependent increases, while elimination half-life and tmax value did not change significantly with dose. In contrast, saline-dissolved argatroban showed a faster absorption phase followed by a shorter elimination half-life. Argatroban dissolved in sorbitol/ethanol leads to long-lasting plasma levels due to the formation and permanent dissolution of a crystalline depot at the injection place. This represents a simple way to deliver argatroban continuously over an extended period which can be beneficial for prophylaxis or treatment of chronic coagulations disorders.

  6. The effects of differential injection sites of cold saline on transpulmonary thermodilution parameter values

    Directory of Open Access Journals (Sweden)

    Yang W

    2015-04-01

    Full Text Available Wanjie Yang,1 Qingguo Feng,1 Youzhong An,2 Xuefeng Zhao,1 Kai Wei,1 Chang Li,1 Wei Wang,1 Hongyun Teng1 1Department of Critical Care, The Fifth Central Hospital of Tianjin, Tianjin, People’s Republic of China; 2Department of Critical Care, The People’s Hospital, Peking University, Beijing, People’s Republic of China Aim: To investigate the effects of differential sites for cold saline injection on transpulmonary thermodilution parameter values.Methods: This was a prospective study. Twelve patients were recruited for the following examinations: control condition (injection site at proximal injection end of the Swan-Ganz catheter, proximal end condition (injection site at sheath of the Swan-Ganz catheter, and distal end condition (injection site at PA end of the Swan-Ganz catheter. Sixty measurements were performed for each condition. The cardiac index, global end diastolic volume index (GEDI, and extravascular lung water index for the three different injection sites were recorded from each patient. In addition, the mean transmission time (MTt, downslope time, and area under the curve obtained from PiCCO-VoLEF-Win software were compared among different groups.Results: There were no differences in cardiac index and extravascular lung water index values among the three conditions (P>0.05. There were no differences in GEDI between the proximal end condition and control condition (P>0.05, while the GEDI was significantly lower for the distal end condition (493.33±254.65 mL/m2 than for the control condition (645.53±234.46 mL/m2 (P<0.05 and proximal end condition (717.96±321.63 mL/m2 (P<0.01. There were no differences in downslope time and area under the curve among the three conditions (P>0.05. There were no differences in MTt between the proximal end condition and control condition (P>0.05, while the MTt was significantly lower for distal end condition (40.22±16.37 seconds than for the control condition (42.91±17.93 seconds (P<0.05 and

  7. Subcutaneous granuloma annulare following influenza vaccination in a patient with diabetes mellitus

    Directory of Open Access Journals (Sweden)

    Takahiro Suzuki

    2014-03-01

    Full Text Available An influenza vaccination often causes local reactions, such as induration and erythema at the injection site, and occasionally systemic reactions. The association between these reactions and influenza vaccinations has not been fully recognized. By contrast, granuloma annulare (GA is an idiopathic, palisaded, granulomatous condition, and has some clinical variants, including localized, generalized, perforating, and subcutaneous types. We report a 76-year-old woman, who was suffering from a tender subcutaneous nodule on her left upper arm. One month before, she had just received influenza vaccination on the same area. Histological analysis demonstrated that subcutaneous tissue contained numerous large areas of necrosis, surrounded by palisaded epithelioid histiocytes. We diagnosed our case as a subcutaneous type of GA following influenza vaccination. To our knowledge, this is the first report of GA associated with influenza vaccination.

  8. The relationship between the frequency of self-monitoring of blood glucose and glycemic control in patients with type 1 diabetes mellitus on continuous subcutaneous insulin infusion or on multiple daily injections.

    Science.gov (United States)

    Murata, Takashi; Tsuzaki, Kokoro; Yoshioka, Fumi; Okada, Hiroshi; Kishi, Junichiro; Yamada, Kazunori; Sakane, Naoki

    2015-11-01

    We investigated the relationship between the frequency of self-monitoring of blood glucose (SMBG) and glycemic control in type 1 diabetes mellitus patients on continuous subcutaneous insulin infusion (CSII) or on multiple daily injections (MDI) using data management software. We recruited 148 adult type 1 diabetes mellitus patients (CSII n = 42, MDI n = 106) and downloaded their SMBG records to the MEQNET™ SMBG Viewer software (Arkray Inc., Kyoto, Japan). The association between the SMBG frequency and the patients' hemoglobin A1c (HbA1c) levels was analyzed using the χ(2)-test and linear regression analysis was carried out to clarify their relationship. The odds ratio of achieving a target HbA1c level of diabetes mellitus patients on CSII.

  9. Effects of subcutaneously injected Ca Cu EDTA on concentrations of Cu in liver, milk production and reproductive performance in New Zealand dairy cows.

    Science.gov (United States)

    Hawkins, D

    2014-09-01

    To determine the effect of dose and frequency of injection of Cu as Ca Cu EDTA on concentrations of Cu in liver, and the effect of a single 200 mg treatment on milk production and reproductive performance in New Zealand dairy cows. Four groups of dairy cows (n=18 per group) on three farms were injected with 100 or 200 mg Cu S/C once, or three times at 6-weekly intervals, commencing 6-8 weeks into lactation. Concentrations of Cu in liver were determined to 119 days after treatment. Cows at peak lactation on one farm were treated with 200 mg of Cu S/C, or received no treatment (n=92 per group). Milk production was determined 11 days before and 24 hours following treatment. In seven dairy herds from throughout New Zealand cows were injected S/C with 200 mg Cu 10 days prior to mating start date (MSD) or received no treatment. Oestrus detection and artificial inseminations were carried out for ≥ 2 - 4 days from MSD. Pregnancy diagnosis was performed at 12 weeks following MSD. The percentage of cows inseminated in the 21 days after MSD (21-day submission rate; n=2,022) and cows pregnant after 21 or 28 days (21- and 28-day pregnancy rates; n=2520) was determined. Injecting with 200 mg Cu once or 6-weekly increased concentrations of Cu in liver compared with 100 mg (pmilk yield (p=0.006) and protein production (pcows, 200 mg Cu 10 days before MSD reduced 21-day submission (78 vs. 75%; p=0.04) and 21-day pregnancy rates (47 vs. 43%; p=0.03). For 28-day pregnancy rates there was a farm by treatment interaction (p=0.02), with a negative effect observed on some, but not other, farms. Injection of 200 mg Cu raised concentrations of Cu in liver for >42 days. A negative impact on milk yield and composition occurred immediately following injection. Injection 10 days prior to mating had a negative effect on submission and pregnancy rates. Further study is required to determine a safe treatment to mating interval and the mechanism by which adverse impacts occur. Although

  10. A survey of injection site lesions in fed cattle in Canada.

    OpenAIRE

    Van Donkersgoed, J; Dixon, S; Brand, G; VanderKop, M

    1997-01-01

    During November 1996 to January 1997, a survey was conducted at 5 Canadian purveyors to measure the prevalence of injection site lesions in the top butt, boneless blade, outside round, inside round, and eye of the round. As trimmers were cutting these subprimals into steaks, technicians monitored each steak for grossly obvious scars. These scars were trimmed, weighed, and scored as either a "clear scar," "woody callus," or "cyst." All scars were subsequently examined histologically and classi...

  11. Medical approach to the treatment of feline injection site sarcoma with masitinib: a case report

    Directory of Open Access Journals (Sweden)

    Ledoux JM

    2014-09-01

    Full Text Available Jean-Marie Ledoux,1 Pascal Brun,2 Tom Chapuis,2 Paul Dumas,3 Jean Guillotin41Veterinary Surgery, Lys-Lez-Lannoy, 2AB Science, Paris, 3Laboratoire de Pathologie Vétérinaire du Nord, Annœullin, 4Laboratoire Départemental Public, Villeneuve d'Ascq, FranceAbstract: Feline injection site sarcoma is a common tumor among cats, for which existing medical treatments do not prove to be entirely satisfactory. In this tumor, the platelet-derived growth factor receptor, a tyrosine kinase receptor, is frequently hyperactivated. In the past, clinical case reports with imatinib, a tyrosine kinase inhibitor (TKI, have demonstrated tumoral stabilization. Here we describe the use of another TKI, masitinib, which specifically inhibits c-Kit, platelet-derived growth factor receptor, and Lyn, and is currently licensed for veterinary use in canine mast cell tumors. The therapeutic results were initially satisfactory, with regression of the tumor followed by tumoral recurrence which was stabilized and moderately reduced. Further studies are suggested, in order to evaluate the relevance of TKIs in the treatment and prevention of recurrences of feline injection site sarcoma. Tumoral stabilization by means of an inexpensive and reasonably well tolerated treatment would prove to be of true therapeutic relevance, in particular for inoperable feline injection site sarcomas. Another indication for such TKIs could be in preoperative treatment as a means of facilitating surgical excision by reduction of adhesions.Keywords: fibrosarcoma, imatinib, platelet-derived growth factor receptor, tyrosine kinase receptor

  12. Pharmacokinetics of enrofloxacin and ceftiofur in plasma, interstitial fluid, and gastrointestinal tract of calves after subcutaneous injection, and bactericidal impacts on representative enteric bacteria.

    Science.gov (United States)

    Foster, D M; Jacob, M E; Warren, C D; Papich, M G

    2016-02-01

    This study's objectives were to determine intestinal antimicrobial concentrations in calves administered enrofloxacin or ceftiofur sodium subcutaneously, and their impact on representative enteric bacteria. Ultrafiltration devices were implanted in the ileum and colon of 12 steers, which received either enrofloxacin or ceftiofur sodium. Samples were collected over 48 h after drug administration for pharmacokinetic/pharmacodynamic analysis. Enterococcus faecalis or Salmonella enterica (5 × 10(5) CFU/mL of each) were exposed in vitro to peak and tail (48 h postadministration) concentrations of both drugs at each location for 24 h to determine inhibition of growth and change in MIC. Enrofloxacin had tissue penetration factors of 1.6 and 2.5 in the ileum and colon, while ciprofloxacin, an active metabolite of enrofloxacin, was less able to cross into the intestine (tissue penetration factors of 0.7 and 1.7). Ceftiofur was rapidly eliminated leading to tissue penetration factors of 0.39 and 0.25. All concentrations of enrofloxacin were bactericidal for S. enterica and significantly reduced E. faecalis. Peak ceftiofur concentration was bactericidal for S. enterica, and tail concentrations significantly reduced growth. E. faecalis experienced growth at all ceftiofur concentrations. The MICs for both organisms exposed to peak and tail concentrations of antimicrobials were unchanged at the end of the study. Enrofloxacin and ceftiofur achieved intestinal concentrations capable of reducing intestinal bacteria, yet the short exposure of ceftiofur in the intestine may select for resistant organisms. © 2015 John Wiley & Sons Ltd.

  13. Subcutaneous delivery of sumatriptan in the treatment of migraine and primary headache

    Directory of Open Access Journals (Sweden)

    Moore JC

    2012-01-01

    Full Text Available Johanna C Moore, James R MinerDepartment of Emergency Medicine, Hennepin County Medical Center, Minneapolis, MN, USAAbstract: Subcutaneous sumatriptan is an effective treatment for pain from acute migraine headache, and can be used in patients with known migraine syndrome and in patients with primary headaches when secondary causes have been excluded. In limited comparative trials, subcutaneous sumatriptan performed in a manner comparable with oral eletriptan and intravenous metoclopramide, was superior to intravenous aspirin and intramuscular trimethobenzamide-diphenhydramine, and was inferior to intravenous prochlorperazine for pain relief. The most common side effects seen with subcutaneous sumatriptan are injection site reactions and triptan sensations. As with all triptans, there is a risk of rare cardiovascular events with subcutaneous sumatriptan and its use should be limited to those without known cerebrovascular disease and limited in those with known cardiovascular risk factors and unknown disease status. In studies of patient preference and tolerability, the subcutaneous formulation has a faster time of onset and high rate of efficacy when compared with the oral formulation, but the oral formulation appears to be better tolerated. It is important to consider the needs of the patient, their past medical history, and what aspects of migraine treatment are most important to the patient when considering treatment of acute migraine or primary headache. Subcutaneous sumatriptan is a good first-line agent for the treatment of pain from acute migraine headaches and primary headaches.Keywords: sumatriptan, subcutaneous, migraine headache, primary headache

  14. Pharmacokinetics and Bioavailability of the GnRH Analogs in the Form of Solution and Zn2+-Suspension After Single Subcutaneous Injection in Female Rats.

    Science.gov (United States)

    Suszka-Świtek, Aleksandra; Ryszka, Florian; Dolińska, Barbara; Dec, Renata; Danch, Alojzy; Filipczyk, Łukasz; Wiaderkiewicz, Ryszard

    2017-04-01

    Although many synthetic gonadoliberin analogs have been developed, only a few of them, including buserelin, were introduced into clinical practice. Dalarelin, which differs from buserelin by just one aminoacid in the position 6 (D-Ala), is not widely used so far. Gonadotropin-releasing hormone (GnRH) analogs are used to treat many different illnesses and are available in different forms like solution for injection, nasal spray, microspheres, etc. Unfortunately, none of the above drug formulations can release the hormones for 24 h. We assumed that classical suspension could solve this problem. Two sets of experiments were performed. In the first one, buserelin and dalarelin were injected into mature female rats in two forms: suspension, in which the analogs are bounded by Zn2+ ions and solution. The pharmacokinetic parameters and bioavailability of the analogs were calculated, based on their concentration in the plasma measured by high-performance liquid chromatography method (HPLC). In the second experiment, the hormones in two different forms were injected into superovulated immature female rats and then the concentration of Luteinizing hormone (LH), Follicle-stimulating hormone (FSH) and 17β-estradiol in the serum was measured by radioimmunological method. The Extent of Biological Availability (EBA), calculated on the base of AUC0-∞, showed that in the form of solution buserelin and dalarelin display, respectively, only 13 and 8 % of biological availability of their suspension counterparts. Comparing both analogs, the EBA of dalarelin was half (53 %) that of buserelin delivered in the form of solution and 83 % when they were delivered in the form of suspension. The injection of buserelin or dalarelin, in the form of solution or suspension, into superovulated female rats increased LH, FSH and estradiol concentration in the serum. However, after injection of the analogs in the form of suspension, the high concentration of LH and FSH in the serum persisted

  15. Comparison of treatment with continuous subcutaneous insulin infusion versus multiple daily insulin injections with bolus calculator in patients with type 1 diabetes.

    Science.gov (United States)

    Pérez-García, L; Goñi-Iriarte, M J; García-Mouriz, M

    2015-01-01

    A study of the glycemic control, quality of life, and fear and perception of hypoglycemia by comparing continuous subcutaneous insulin infusion (CSII) group with multiple daily inyections (MDI) with bolus calculator group. This is a retrospective cohort study with following up during the first 12 months that CSII group (n=30) begins the use of "bolus wizard" and the MDI-calculator (n=30) group begins the use of the bolus calculator (Accu-Chek(®) Aviva Expert). HbA1c (3, 6 and 12 months). Questionnaires used: EsDQOL (quality of life), FH-15 (fear of hypoglycemia), and Clarke (perception of hypoglycemia). T Student and nonparametric tests. The average reduction in HbA1c during the study was significantly higher in CSII group (-0.56±0.84%) compared with the MDI group (0.097±0.94%), P=.028. The average basal insulin dose was significantly higher in the MDI group (at baseline, 6 and 12 months). No significant differences were found between the 2 treatment groups after analyzing the EsDQOL, FH-15 and Clarke questionnaires. In the CSII group, perceived quality of life assessed by the EsDQOL questionnaire was found to be better at the end of the study than at the beginning of using the insulin pump. The average reduction in HbA1c was significantly higher in the CSII group. In the CSII group, perceived quality of life was better at the end of the study than at the beginning. Copyright © 2014 SEEN. Published by Elsevier España, S.L.U. All rights reserved.

  16. In Situ Oxalic Acid Injection to Accelerate Arsenic Remediation at a Superfund Site in New Jersey.

    Science.gov (United States)

    Wovkulich, Karen; Stute, Martin; Mailloux, Brian J; Keimowitz, Alison R; Ross, James; Bostick, Benjamin; Sun, Jing; Chillrud, Steven N

    2014-09-25

    Arsenic is a prevalent contaminant at a large number of US Superfund sites; establishing techniques that accelerate As remediation could benefit many sites. Hundreds of tons of As were released into the environment by the Vineland Chemical Co. in southern New Jersey during its manufacturing lifetime (1949-1994), resulting in extensive contamination of surface and subsurface soils and sediments, groundwater, and the downstream watershed. Despite substantial intervention at this Superfund site, sufficient aquifer cleanup could require many decades if based on traditional pump and treat technologies only. Laboratory column experiments have suggested that oxalic acid addition to contaminated aquifer solids could promote significant As release from the solid phase. To evaluate the potential of chemical additions to increase As release in situ and boost treatment efficiency, a forced gradient pilot scale study was conducted on the Vineland site. During spring/summer 2009, oxalic acid and bromide tracer were injected into a small portion (~50 m2) of the site for 3 months. Groundwater samples indicate that introduction of oxalic acid led to increased As release. Between 2.9 and 3.6 kg of As were removed from the sampled wells as a result of the oxalic acid treatment during the 3-month injection. A comparison of As concentrations on sediment cores collected before and after treatment and analyzed using X-ray fluorescence spectroscopy suggested reduction in As concentrations of ~36% (median difference) to 48% (mean difference). While further study is necessary, the addition of oxalic acid shows potential for accelerating treatment of a highly contaminated site and decreasing the As remediation time-scale.

  17. Nicolau Syndrome after Intramuscular Injection: 3 Cases

    Directory of Open Access Journals (Sweden)

    Seok-Kwun Kim

    2012-05-01

    Full Text Available Nicolau syndrome is a rare complication of intramuscular injection consisting of ischemic necrosis of skin, soft tissue, and muscular tissue that arises locoregionally. The characteristic pattern is pain around the injection site, developing into erythema, a livedoid dermatitis patch, and necrosis of the skin, subcutaneous fat, and muscle tissue. Three patients were injected with drugs (diclofenac sodium, ketoprofen, meperidine for pain relief. Three patients complained of pain, and a skin lesion was observed, after which necrosis developed on their buttocks. Each patient underwent debridement and coverage. The wound healed uneventfully. We report three cases of Nicolau syndrome in the buttocks following diclofenac intramuscular injection.

  18. Effect of pre-cooling injection site on pain perception in pediatric dentistry: "A randomized clinical trial"

    OpenAIRE

    Faezeh Ghaderi; Shahin Banakar; Shima Rostami

    2013-01-01

    Background: Injection of local anesthesia is one of the most important reasons for development of avoidance behavior in children. Efforts have been performed to decrease pain perception of injection. The present research evaluated the effect of cooling the injection site on pain perception before infiltration of local anesthetics. Materials and Methods: A prospective single-blind crossover clinical trial was used to investigate pain perception in 50 healthy pediatric patients who needed b...

  19. Aluminium overload after 5 years in skin biopsy following post-vaccination with subcutaneous pseudolymphoma.

    Science.gov (United States)

    Guillard, Olivier; Fauconneau, Bernard; Pineau, Alain; Marrauld, Annie; Bellocq, Jean-Pierre; Chenard, Marie-Pierre

    2012-10-01

    Aluminium hydroxide is used as an effective adjuvant in a wide range of vaccines for enhancing immune response to the antigen. The pathogenic role of aluminium hydroxide is now recognized by the presence of chronic fatigue syndrome, macrophagic myofasciitis and subcutaneous pseudolymphoma, linked to intramuscular injection of aluminium hydroxide-containing vaccines. The aim of this study is to verify if the subcutaneous pseudolymphoma observed in this patient in the site of vaccine injection is linked to an aluminium overload. Many years after vaccination, a subcutaneous nodule was discovered in a 45-year-old woman with subcutaneous pseudolymphoma. In skin biopsy at the injection site for vaccines, aluminium (Al) deposits are assessed by Morin stain and quantification of Al is performed by Zeeman Electrothermal Atomic Absorption Spectrophotometry. Morin stain shows Al deposits in the macrophages, and Al assays (in μg/g, dry weight) were 768.10±18 for the patient compared with the two control patients, 5.61±0.59 and 9.13±0.057. Given the pathology of this patient and the high Al concentration in skin biopsy, the authors wish to draw attention when using the Al salts known to be particularly effective as adjuvants in single or repeated vaccinations. The possible release of Al may induce other pathologies ascribed to the well-known toxicity of this metal. Copyright © 2012 Elsevier GmbH. All rights reserved.

  20. 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

  1. Temporal changes in characteristics of injection-site sarcomas in cats: 392 cases (1990-2006).

    Science.gov (United States)

    Shaw, Stephen C; Kent, Michael S; Gordon, Ira K; Collins, Cameron J; Greasby, Tamara A; Beckett, Laurel A; Hammond, Genevieve M; Skorupski, Katherine A

    2009-02-01

    To evaluate changes in characteristics of feline injection-site sarcomas (ISSs) from 1990 through 2006. Retrospective case series. 392 cats with a histologic diagnosis of soft tissue sarcoma, osteosarcoma, or chondrosarcoma at potential injection sites. Classification and anatomic location of tumors and signalment of affected cats were compared between ISSs diagnosed before and after publication of the Vaccine Associated Feline Sarcoma Task Force vaccination recommendations in 1996. From before to after publication of the vaccination recommendations, proportions of ISSs significantly decreased in the interscapular (53.4% to 39.5%) and right and left thoracic (10.2% to 3.6% and 9.1% to 1.3%, respectively) regions. On the other hand, proportions of ISSs significantly increased in the right thoracic limb (1.1% to 9.5%) and the combined regions of the right pelvic limb with right lateral aspect of the abdomen (12.5% to 25.0%) and the left pelvic limb with left lateral aspect of the abdomen (11.4% to 13.8%). Patterns of tumor classification and signalment did not change. Despite publication of the vaccination recommendations, a high proportion of tumors still developed in the interscapular region. There was also an increase in lateral abdominal ISSs, which are more difficult to treat and are likely attributable to aberrant placement of injections intended for the pelvic limbs. Veterinarians are complying with vaccination recommendations to some extent, but they need to focus on administering vaccines as distally as possible on a limb to allow for complete surgical margins if amputation of a limb is required.

  2. A survey of injection site lesions in fed cattle in Canada.

    Science.gov (United States)

    Van Donkersgoed, J; Dixon, S; Brand, G; VanderKop, M

    1997-12-01

    During November 1996 to January 1997, a survey was conducted at 5 Canadian purveyors to measure the prevalence of injection site lesions in the top butt, boneless blade, outside round, inside round, and eye of the round. As trimmers were cutting these subprimals into steaks, technicians monitored each steak for grossly obvious scars. These scars were trimmed, weighed, and scored as either a "clear scar," "woody callus," or "cyst." All scars were subsequently examined histologically and classified as a "clear scar," "woody callus," "scar with nodules," "mineralized scar," or "cyst." Pieces were observed for broken needles while being processed and none were found. The estimated prevalence of injection site lesions was 18.8% (95% CI, 16.4% to 21.2%) in top butts, 22.2% (95% CI, 18.8% to 25.7%) in boneless blades, 4.9% (95% CI, 3.6% to 6.3%) in the eye of round, 1.8% (95% CI, 1.1% to 2.9%) in the inside round, and 7.6% (95% CI, 5.6% to 9.8%) in the outside round. Some top butts originated from American fed cattle; the estimated prevalence of lesions was 9.0% (95% CI, 5.9% to 12.9%) in American top butts and 22.3% (95% CI, 19.4% to 25.3%) in Canadian top butts. The median weight of the lesions varied among subprimals and ranged from 64 g to 117 g. Histologically, 13% of the scars were clear scars, 47% were woody calluses, 5% were mineralized scars, 34% were scars with nodules, 0.2% were cysts, and 0.9% were normal fat infiltrations. An economic analysis estimated an average loss of $8.95 per fed animal processed or $19 million dollars annually to the Canadian beef industry from injection scars.

  3. Intramuscular injections into the buttocks: Are they truly intramuscular?

    Energy Technology Data Exchange (ETDEWEB)

    Chan, V.O. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Colville, J. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Persaud, T. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Buckley, O. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Hamilton, S. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland); Torreggiani, W.C. [Department of Radiology, Adelaide and Meath Hospital, Tallaght, Dublin 24 (Ireland)]. E-mail: William.Torreggiani@amnch.ie

    2006-06-15

    Aim: To radiologically determine if intramuscular (IM) injections into the buttocks are truly intramuscular. Materials and methods: This was a prospective study conducted during a 6 month period beginning in October 2004. Fifty inpatients were recruited from a single tertiary referral hospital. Approval was obtained from the hospital research ethics committee and informed written consent was acquired from all participants. Prior to computerised tomography (CT), each patient received an IM injection of their prescribed medication along with 1 mL of air into the upper outer quadrant of the buttocks. CT images were subsequently analyzed by two radiologists to determine the position of the injected air bubble and to assess whether it was intramuscular or subcutaneous in position. Body mass index (BMI), distance to injection site, subcutaneous fat and muscle thickness were also measured. Results: Overall, only 32% (n = 16/50) of patients had intramuscular injections, with the majority of injections (68%, n = 34/50) being subcutaneous. When analysed by gender, 56% (n = 14/25) of males had intramuscular injections while in females, the efficacy rate was significantly lower at 8% (n = 2/25). Conclusion: The majority of assumed intramuscular injections are actually subcutaneous.

  4. Principles of subcutaneous port placement.

    Science.gov (United States)

    Gonda, Shaun J; Li, Ruizong

    2011-12-01

    The introduction of totally implantable subcutaneous devices in the early 1980s provided patients with secure, reliable venous access and also gave them the ability to move more freely and have a more normal lifestyle with these devices in place. The most common totally implantable device used today is the subcutaneous port. These ports consist of an injection port connected to a catheter. Ports provide a number of advantages compared with other venous catheters; the most important is the reduced risk of infection. These devices have significantly lower rates of infection than nontunneled and tunneled catheters. Additional advantages include less frequent irrigation and minimal home care, and they are less prone to environmental or cutaneous contamination when not being accessed. This article will focus on the placement of these ports. Copyright © 2011 Elsevier Inc. All rights reserved.

  5. CO2 Field Laboratory at Svelvik Ridge: Site characterization after the first injection experiment

    Science.gov (United States)

    Buddensiek, M. L.; Lindeberg, E.; Mørk, A.; Jones, D.; Girard, J. F.; Kuras, O.; Barrio, M.; Royse, K.; Gal, F.; Meldrum, P.; Pezard, P.; Levannier, A.; Desroches, J.; Neyens, D.; Paris, J.; Henry, G.; Bakk, A.; Wertz, F.; Aker, E.; Børresen, M.

    2012-04-01

    The safety and acceptance of CO2 storage will depend on the ability to detect and quantify CO2 within and outside the storage complex. To determine sensitivity of CO2 monitoring systems with respect to CO2 distribution and leakage detection, the CO2 Field Lab project comprises two controlled CO2 injection tests in the shallow (100-300 m) and very shallow (20 m) subsurface of the glacial deposit that forms Svelvik ridge, 50 km south of Oslo. The CO2 displacement in the subsurface and at the surface has and will be monitored with an exhaustive set of techniques. Iteratively, observations and flow modeling will provide frequent updates of the CO2 distribution. The results will be upscaled to assess monitoring systems and requirements with the ultimate objective to provide guidelines to regulators, operators and technology providers for monitoring systems. The formation that comprises the laboratory is a glaciofluvial-glaciomarine terminal deposit formed during the Ski stage of the Holocene deglaciation. Nearby outcrops show that the formation is channeled and variably laminated with a significant variation in grain size and structure. Prior to the injection experiments, the site was characterized including 2D seismic and electric surveys, the drilling, logging and sampling of a 330 m deep appraisal well, core and flow line sample analyses, ground penetrating radar (GPR), a hydrodynamic appraisal, and geochemical and soil gas baseline surveys. These data were used to populate a geomodel. Flow modeling of the plume development included some variability in permeability and anisotropy, and various injection scenarios. Accordingly, the 20 m injection experiment was conducted in fall 2011 with a monitoring plan designed to spatially and temporally monitor the expected plume development. The monitoring equipment was thus distributed around the 20 m deep injection point of an inclined well. It included seven 6 m deep monitoring wells equipped with resistivity, sonic and

  6. Comparison of a Multiple Daily Insulin Injection Regimen (Glargine or Detemir Once Daily Plus Prandial Insulin Aspart and Continuous Subcutaneous Insulin Infusion (Aspart in Short-Term Intensive Insulin Therapy for Poorly Controlled Type 2 Diabetes Patients

    Directory of Open Access Journals (Sweden)

    Wen-shan Lv

    2013-01-01

    Full Text Available Aims. To examine the potential differences between multiple daily injection (MDI regimens based on new long-acting insulin analogues (glargine or detemir plus prandial insulin aspart and continuous subcutaneous insulin aspart infusion (CSII in patients with poorly controlled type 2 diabetes. Methods. Patients (n=119 with poorly controlled type 2 diabetes of a duration exceeding five years were randomly assigned into three groups: Group A treated with CSII using insulin aspart; Group B treated with glargine-based MDI and Group C treated with detemir-based MDI. Results. Good glycemic control was achieved by patients in Group A in a significantly shorter duration than patients in Groups B and C. Total daily insulin, basal insulin dose and dose per kg body weight in Group A were significantly less than those in Groups B and C. Daily blood glucose fluctuation in Group A was significantly less than that in Groups B and C. There were no differences between Groups B and C. Conclusions. Aspart-based CSII may achieve good blood glucose control with less insulin doses over a shorter period compared with glargine or detemir-based MDI. No differences between glargine- and detemir-based MDI were detected in poorly controlled subjects with type 2 diabetes.

  7. Simultaneous Treatment with Subcutaneous Injection of Golimumab and Intra-articular Injection of Triamcinolone Acetonide (K-Method in Patients with Rheumatoid Arthritis Undergoing Switching of Biologics: Retrospective Case–Control Study

    Directory of Open Access Journals (Sweden)

    Katsuaki Kanbe

    2016-01-01

    Full Text Available Background Tight control of severe rheumatoid arthritis (RA in patients with high disease activity, even when using biologics, is sometimes difficult using a treat-to-target strategy. Switching from one biologic to another is associated with lower efficacy than that in treatment-naive cases. We developed the K-method that involves simultaneous treatment with golimumab and intra-articular joint injection of triamcinolone acetonide (TA in patients undergoing switching of biologics. We performed this retrospective case–control study to investigate the efficacy of achieving an immediate treatment response using the K-method. Methods This study involved 20 patients with RA (control group, 10 patients; K-method group, 10 patients. Patients in the control group were switched to golimumab from other biologics without intra-articular injection of TA. The K-method involved injection of 1 mL of TA (40 mg/mL and 2 mL of 1% lidocaine hydrochloride into swollen or painful joints on the same day as golimumab treatment. A quick response one day after treatment was compared between the two groups according to the disease activity score 28 based on C-reactive protein (DAS28 CRP, clinical disease activity index (CDAI, simplified disease activity index (SDAI, European League Against Rheumatism (EULAR response, and remission rate. These parameters were investigated for 24 weeks. Results The K-method group showed significant improvements in DAS28 CRP, CDAI, and SDAI at one day, 12 weeks, and 24 weeks compared with the control group. The number of swollen and tender joints and the patient and doctor global visual analog scale scores were also significantly different between the two groups. The remission rates based on DAS28 CRP were 30% at one day, 50% at 12 weeks, and 60% at 24 weeks in the K-method group. The EULAR good/moderate response rates were 80% at one day, 90% at 12 weeks, and 90% at 24 weeks in the K-method group; however, these rates were only 10%, 40

  8. Simultaneous Treatment with Subcutaneous Injection of Golimumab and Intra-articular Injection of Triamcinolone Acetonide (K-Method) in Patients with Rheumatoid Arthritis Undergoing Switching of Biologics: Retrospective Case-Control Study.

    Science.gov (United States)

    Kanbe, Katsuaki; Chiba, Junji; Inoue, Yasuo; Taguchi, Masashi; Yabuki, Akiko; Deguchi, Tomohiko

    2016-01-01

    Tight control of severe rheumatoid arthritis (RA) in patients with high disease activity, even when using biologics, is sometimes difficult using a treat-to-target strategy. Switching from one biologic to another is associated with lower efficacy than that in treatment-naive cases. We developed the K-method that involves simultaneous treatment with golimumab and intra-articular joint injection of triamcinolone acetonide (TA) in patients undergoing switching of biologics. We performed this retrospective case-control study to investigate the efficacy of achieving an immediate treatment response using the K-method. This study involved 20 patients with RA (control group, 10 patients; K-method group, 10 patients). Patients in the control group were switched to golimumab from other biologics without intra-articular injection of TA. The K-method involved injection of 1 mL of TA (40 mg/mL) and 2 mL of 1% lidocaine hydrochloride into swollen or painful joints on the same day as golimumab treatment. A quick response one day after treatment was compared between the two groups according to the disease activity score 28 based on C-reactive protein (DAS28 CRP), clinical disease activity index (CDAI), simplified disease activity index (SDAI), European League Against Rheumatism (EULAR) response, and remission rate. These parameters were investigated for 24 weeks. The K-method group showed significant improvements in DAS28 CRP, CDAI, and SDAI at one day, 12 weeks, and 24 weeks compared with the control group. The number of swollen and tender joints and the patient and doctor global visual analog scale scores were also significantly different between the two groups. The remission rates based on DAS28 CRP were 30% at one day, 50% at 12 weeks, and 60% at 24 weeks in the K-method group. The EULAR good/moderate response rates were 80% at one day, 90% at 12 weeks, and 90% at 24 weeks in the K-method group; however, these rates were only 10%, 40%, and 40%, respectively, in the control

  9. Effect of Injection Site on Fault Activation and Seismicity during Hydraulic Fracturing

    Directory of Open Access Journals (Sweden)

    Zhaohui Chong

    2017-10-01

    Full Text Available Hydraulic fracturing is a key technology to stimulate oil and gas wells to increase production in shale reservoirs with low permeability. Generally, the stimulated reservoir volume is performed based on pre-existing natural fractures (NF. Hydraulic fracturing in shale reservoirs with large natural fractures (i.e., faults often results in fault activation and seismicity. In this paper, a coupled hydro-mechanical model was employed to investigate the effects of injection site on fault activation and seismicity. A moment tensor method was used to evaluate the magnitude and affected areas of seismic events. The micro-parameters of the proposed model were calibrated through analytical solutions of the interaction between hydraulic fractures (HF and the fault. The results indicated that the slip displacement and activation range of the fault first decreased, then remained stable with the increase in the distance between the injection hole and the fault (Lif. In the scenario of the shortest Lif (Lif = 10 m, the b-value—which represents the proportion of frequency of small events in comparison with large events—reached its maximum value, and the magnitude of concentrated seismic events were in the range of −3.5 to −1.5. The frequency of seismic events containing only one crack was the lowest, and that of seismic events containing more than ten cracks was the highest. The interaction between the injection-induced stress disturbance and fault slip was gentle when Lif was longer than the critical distance (Lif = 40–50 m. The results may help optimize the fracturing treatment designs during hydraulic fracturing.

  10. Predictivity of animal studies for human injection site reactions with parenteral drug products.

    Science.gov (United States)

    Engelhardt, Jeffery A

    2008-08-01

    The value and predictive power of nonclinical studies for potential effects of investigational medicinal products in humans is often debated. The subject of general predictivity of animal toxicity studies has been addressed on several occasions, with one of the most recent efforts being conducted by an ILSI Task Group [Olson H, et al. Concordance of the toxicity of pharmaceuticals in humans and animals. Regul Toxicol Pharmacol 2000; 32: 56-67]. This review provides a summary of the evaluation of cutaneous toxicity, its histopathological assessment, and experience of the biopharmaceutical industry with respect to injection site reactions with parenteral drug products with a pragmatic perspective on the predictivity of standard animal studies with respect to these responses in humans.

  11. Histological study of subcutaneous fat at NIR laser treatment of the rat skin in vivo

    Science.gov (United States)

    Yanina, I. Y.; Svenskaya, Yu. I.; Navolokin, N. A.; Matveeva, O. V.; Bucharskaya, A. B.; Maslyakova, G. N.; Gorin, D. A.; Sukhorukov, G. B.; Tuchin, V. V.

    2015-07-01

    The goal of this work is to quantify impact of in vivo photochemical treatment using indocyanine green (ICG) or encapsulated ICG and NIR laser irradiation through skin of rat with obesity by the follow up tissue sampling and histochemistry. After 1 hour elapsed since 1-min light exposure samples of rat skin with subcutaneous tissue of thickness of 1.5-2.5 mm were taken by surgery from rats within marked 4-zones of the skin site. For hematoxylin-eosin histological examination of excised tissue samples, fixation was carried out by 10%-formaldehyde solution. For ICG and encapsulated ICG subcutaneous injection and subsequent 1-min diode laser irradiation with power density of 8 W/cm2, different necrotic regions with lipolysis of subcutaneous fat were observed. The obtained data can be used for safe layer-by-layer laser treatment of obesity and cellulite.

  12. N2-CO2 co-injection field test at the Ketzin pilot CO2 storage site

    OpenAIRE

    Sebastian Fischer; Martin Zimmer; Alexandra Szizybalski; Christian Kujawa; B. Plessen; A. Liebscher; F. Moeller;  & the Ketzin Team

    2014-01-01

    In summer 2013, a four week N2-CO2 co-injection field test was conducted at the Ketzin pilot site. Major objectives were (i) demonstrating the technical feasibility of a continuous N2-CO2 co-injection scenario, (ii) monitoring wellhead and reservoir pressure, (iii) monitoring spreading and behavior of the CO2-N2 gas mixture in the reservoir, and (iv) analyzing potential chromatographic effects within the reservoir. 10,000 L (10 Nm3) of krypton (Kr) were injected as an additional conservative ...

  13. Thoracic duct lymphography by subcutaneous contrast agent ...

    African Journals Online (AJOL)

    A 4-year-old male Japanese Shiba Inu presented with recurrent chylothorax. The thoracic duct was successfully imaged using computed tomography after the injection of an iodine contrast agent into the subcutaneous tissue surrounding the anus. The thoracic duct was successfully ligated and pericardectomy performed via ...

  14. Subcutaneous administration of drugs in palliative care: results of a systematic observational study.

    Science.gov (United States)

    Bartz, Lena; Klein, Carsten; Seifert, Andreas; Herget, Iris; Ostgathe, Christoph; Stiel, Stephanie

    2014-10-01

    Especially in palliative care, safe and manageable administration of medication is essential. Subcutaneous drug administration is a possible alternative, when oral intake is hampered. However, evidence for this method is rare. This observational study assessed the clinical practice of subcutaneous drug administration, focusing on the evaluation of local reactions or complications to further develop recommendations. Over 14 months, patients in a specialized inpatient palliative care unit treated by the subcutaneous route were invited to participate in this clinical study. All subcutaneous medications including dosage and volume of injection, type of needles, and injection site were documented. The injection sites were systematically assessed including the subjective perceptions of patients for analysis of patient tolerability and acceptability. T-tests and Chi-squared tests of these variables were performed to calculate group differences between needles with vs. without complications (P medications were hydromorphone (59.0%), haloperidol (12.3%), and midazolam (8.3%). Complications were diagnosed most often on the third or fourth day of the needle in situ and occurred significantly more often in (fully) active patients and patients transferred or discharged at the end of treatment. The mean time of needle in situ was significantly lower (4.1 vs. 5.0 days) in complication cases than in noncomplication cases (t-test: P = 0.027). The results of this study acknowledge the clinical practice of subcutaneous administration of medication as a very flexible, broadly feasible, rather safe, and nonburdensome method. Nevertheless, this practice is not free from complications, needs appropriate nursing care, and requires standardized policies and procedures. Copyright © 2014 American Academy of Hospice and Palliative Medicine. Published by Elsevier Inc. All rights reserved.

  15. Cost-minimization of mabthera intravenous versus subcutaneous administration

    NARCIS (Netherlands)

    Bax, P.; Postma, M.J.

    2013-01-01

    Objectives: To identify and compare all costs related to preparing and administrating MabThera for the intravenous and subcutaneous formulations in Dutch hematological patients. The a priori notion is that the costs of subcutaneous MabThera injections are lower compared to intravenous infusion due

  16. Spatial distribution of soluble insulin in pig subcutaneous tissue

    DEFF Research Database (Denmark)

    Thomsen, Maria; Rasmussen, Christian Hove; Refsgaard, Hanne H F

    2015-01-01

    injections. Increasing the injected volume from 0.1ml to 1ml did not increase the intramuscular volume fraction, but gave a significantly higher volume fraction placed in the fascia separating the deep and superficial subcutaneous fat layers. Varying the injection speed from 25l/s up to 300l/s gave...

  17. Recurrent, giant subcutaneous leiomyosarcoma of the thigh

    Directory of Open Access Journals (Sweden)

    Gao Chuanping, MD

    2015-10-01

    Full Text Available We present a case of recurrent, massive subcutaneous leiomyosarcoma involving the left thigh in a 29-year-old male from Madagascar. The patient had earlier undergone local resection of subcutaneous leiomyosarcoma a half year before. After surgical intervention, local recurrence developed at this site and was rapidly growing. The patient was surgically treated with a 2-cm-wide margin local excision in our hospital. The patient has remained recurrence free at 1-year follow-up.

  18. Confirmation and 3D profiling of anabolic steroid esters in injection sites using imaging desorption electrospray ionisation (DESI) mass spectrometry

    NARCIS (Netherlands)

    Rijke, de E.; Hooijerink, H.; Sterk, S.S.; Nielen, M.W.F.

    2013-01-01

    In this study, desorption electrospray ionization (DESI) linear ion trap tandem mass spectrometry (MSn) was applied for the confirmation and 3D profiling of anabolic steroid esters in an injection site of bovine muscle. The spatial resolution of the DESI-MSn was demonstrated by scanning hormone

  19. Feline injection-site sarcoma / Sarcoma de aplicação felino

    Directory of Open Access Journals (Sweden)

    Julia Maria Matera

    2008-08-01

    Full Text Available The feline injection-site sarcoma (FIS is a challenge for the veterinarian and the affected cat’s owner. The injectable applications (vaccines, medications seems to be the reason for that neoplasia, more specifically, the inflammation caused by injury of given drugs or antigens to the health tissue. Generally the FIS presents a more aggressive behavior when compared to sarcoma not associated to application. The most effective treatment has not been established yet, but it is believed that a multimodality of therapies, surgery, radiotherapy, and chemotherapy would be the most indicated option. The knowledge of the illness in all of its aspects will supply to professionals colleges subsidies in relation to the best way to approach its diagnosis and treatment.O sarcoma de aplicação felino (SAF é atualmente um grande desafio para o médico veterinário e também para o proprietário do felino acometido. Aplicações injetáveis por via subcutânea ou intramuscular, como vacinas e medicações, aparecem como iniciadoras do processo de neogênese dessa neoplasia, mais precisamente a inflamação persistente, causada pela lesão ao tecido sadio decorrente do fármaco ou antígeno administrado. Geralmente o SAF apresenta comportamento mais agressivo quando comparado ao sarcoma não associado à aplicação. O tratamento mais eficaz ainda não está estabelecido, mas acredita-se que a multimodalidade de terapias, cirurgia, radioterapia e quimioterapia seja a opção mais indicada. O conhecimento da afecção em todos os seus aspectos irá fornecer aos colegas profissionais subsídios em relação a melhor maneira de abordá-la em termos de diagnóstico, tratamento e prevenção.

  20. Granisetron Injection

    Science.gov (United States)

    ... antagonists. It works by blocking serotonin, a natural substance in the body that causes nausea and vomiting. ... throat chest pain injection site redness, swelling, or warmth with or without fever (for the extended-release injection) injection site bleeding, bruising, or pain (for ...

  1. Glycemic Control During Continuous Subcutaneous Insulin Infusion Versus Multiple Daily Insulin Injections in Type 2 Diabetes: Individual Patient Data Meta-analysis and Meta-regression of Randomized Controlled Trials.

    Science.gov (United States)

    Pickup, John C; Reznik, Yves; Sutton, Alex J

    2017-05-01

    To compare glycemic control during continuous subcutaneous insulin infusion (CSII) and multiple daily insulin injections (MDI) in people with type 2 diabetes to identify patient characteristics that determine those best treated by CSII. Randomized controlled trials were selected comparing HbA1c during CSII versus MDI in people with type 2 diabetes. Data sources included Cochrane database and Ovid Medline. We explored patient-level determinants of final HbA1c level and insulin dose using Bayesian meta-regression models of individual patient data and summary effects using two-step meta-analysis. Hypoglycemia data were unavailable. Five trials were identified, with 287 patients randomized to receive MDI and 303 to receive CSII. Baseline HbA1c was the best determinant of final HbA1c: HbA1c difference (%) = 1.575 - (0.216 [95% credible interval 0.371-0.043] × baseline HbA1c) for all trials, but with largest effect in the trial with prerandomization optimization of control. Baseline insulin dose was best predictor of final insulin dose: insulin dose difference (units/kg) = 0.1245 - (0.382 [0.510-0.254] × baseline insulin dose). Overall HbA1c difference was -0.40% (-0.86 to 0.05 [-4.4 mmol/mol (-9.4 to 0.6)]). Overall insulin dose was reduced by -0.25 units/kg (-0.31 to -0.19) (26% reduction on CSII), and by -24.0 units/day (-30.6 to -17.5). Mean weight did not differ between treatments (0.08 kg [-0.33 to 0.48]). CSII achieves better glycemic control than MDI in people with poorly controlled type 2 diabetes, with ∼26% reduction in insulin requirements and no weight change. The best effect is in those worst controlled and with the highest insulin dose at baseline. © 2017 by the American Diabetes Association.

  2. New injection recommendations for patients with diabetes

    NARCIS (Netherlands)

    Frid, A.; Hirsch, L.; Gaspar, R.; Hicks, D.; Kreugel, G.; Liersch, J.; Letondeur, C.; Sauvanet, J. P.; Tubiana-Rufi, N.; Strauss, K.

    Aim: Injections administered by patients are one of the mainstays of diabetes management. Proper injection technique is vital to avoiding intramuscular injections, ensuring appropriate delivery to the subcutaneous tissues and avoiding common complications such as lipohypertrophy. Yet few formal

  3. The Efficacy of a Prevascularized, Retrievable Poly(D,L,-lactide-co-epsilon-caprolactone) Subcutaneous Scaffold as Transplantation Site for Pancreatic Islets

    NARCIS (Netherlands)

    Smink, Alexandra M; Li, Shiri; Hertsig, Don T; de Haan, Bart J; Schwab, Leendert; van Apeldoorn, Aart A; de Koning, Eelco; Faas, Marijke M; Lakey, Jonathan R T; de Vos, Paul

    Background. The liver as transplantation site for human pancreatic islets is a harsh microenvironment for islets and it lacks the ability to retrieve the graft. A retrievable, extrahepatic transplantation site that mimics the pancreatic environment is desired. Ideally, this transplantation site

  4. When local anesthesia becomes universal: Pronounced systemic effects of subcutaneous lidocaine in bullfrogs (Lithobates catesbeianus)

    DEFF Research Database (Denmark)

    Williams, Catherine; Alstrup, Aage Kristian Olsen; Bertelsen, Mads Frost

    2017-01-01

    Sodium channel blockers are commonly injected local anesthetics but are also routinely used for general immersion anesthesia in fish and amphibians. Here we report the effects of subcutaneous injection of lidocaine (5 or 50mgkg-1) in the hind limb of bullfrogs (Lithobates catesbeianus) on reflexes...... regained over 4h. Systemic sedative effects were not coupled to local anti-nociception, as a forceps pinch test at the site of injection provoked movement at the height of the systemic effect (tested at 81±4min). Amphibians are routinely subject to general anesthesia via exposure to sodium channel blockers...... such as MS222 or benzocaine, however caution should be exercised when using local injectable lidocaine in amphibians, as it appears to dose-dependently cause sedation, without necessarily preventing local nociception for the duration of systemic effects....

  5. Insite or Outside the Law: Examining the Place of Safe Injection Sites within the Canadian Legal System

    Directory of Open Access Journals (Sweden)

    Aidan Macdonald

    2011-01-01

    Full Text Available In response to the mounting number of HIV/AIDS and overdose deaths directly attributable to intravenous drug use during the 1980 and 1990’s, governments across the world began considering alternatives to traditional prohibitionist drug policies. These alternatives, generally described as harm reduction strategies involving needle exchange programs and safe injection sites, rapidly gained acceptance across Europe. By contrast, they encountered significant opposition in North America. This thesis summarily traces the history of Canadian drug law, describing the development and impact of the harm reduction movement in Canada and the establishment of the first and only safe injection site (SIS in North America (Insite. Employing a repressive formalist analysis of the application of federal drug laws, I then examine the role of the current Conservative government in contesting harm reduction strategies and refusing full legalization of Insite. I illustrate that through the strategic manipulation and discriminatory enforcement of drug laws and political gamesmanship relating to the criteria grounding Insite’s exemption from current drug laws, the government has failed to fulfill a set of fundamental social values with respect to Insite’s users and members of the downtown eastside of Vancouver. Interviews with injection drug users, workers at Insite and residents of the local community provide empirical support for the beneficial effects of safe injection sites, and expose the politics of the struggle for Insite’s continued existence. I also show how the Conservative anti-drug ideologues have led a resistance against classifying drug addiction as a health-related rather than criminal problem, despite significant scientific evidence to the contrary, and how this resistance has resulted in the further marginalization of injection drug users.

  6. Subcutaneous Zygomycosis Basidiobolomycosis

    Directory of Open Access Journals (Sweden)

    Sethuraman G

    2001-01-01

    Full Text Available Subcutaneous zygomycosis, also known as basidiobolomycosis, is a rare disease caused by the fungus Basidiobolus ranarum. Since its first description in 1954, may cases have been reported. In India, so far only few cases have been described. We report this entity in a 3 year- old female child who had firm to hard swelling of the right upper extremely and chest. Histopathology showed short aseptate hyphae surrounded by eosinophilic material within the granulomatous tissue response, in the subcutaneous tissue. She responded dramatically to saturated solution of potassium iodide.

  7. Effect of pre-cooling injection site on pain perception in pediatric dentistry: "A randomized clinical trial".

    Science.gov (United States)

    Ghaderi, Faezeh; Banakar, Shahin; Rostami, Shima

    2013-11-01

    Injection of local anesthesia is one of the most important reasons for development of avoidance behavior in children. Efforts have been performed to decrease pain perception of injection. The present research evaluated the effect of cooling the injection site on pain perception before infiltration of local anesthetics. A prospective single-blind crossover clinical trial was used to investigate pain perception in 50 healthy pediatric patients who needed bilateral buccal infiltration of local anesthetics for dental treatment. They received a topical anesthetic agent (Benzocaine) on one side (control) for 1 min and topical anesthetic agent plus one minute of ice pack on the other side (trial) prior to the injection. A dentist blind to the study assessed the patients' reaction during injection. Wilcoxon and Mann-Whitney U tests were used for statistical analysis. Statistical significance was defined at P control groups, respectively. The means of visual analogue scales (VAS) for the study and control groups were 42.20 ± 12.70 and 58.40 ± 16.83, respectively; with statistically significant differences between the two groups (P pain perceived by pediatric patients.

  8. Site-dependent differences in both prelamin A and adipogenic genes in subcutaneous adipose tissue of patients with type 2 familial partial lipodystrophy.

    Science.gov (United States)

    Araújo-Vilar, D; Lattanzi, G; González-Méndez, B; Costa-Freitas, A T; Prieto, D; Columbaro, M; Mattioli, E; Victoria, B; Martínez-Sánchez, N; Ramazanova, A; Fraga, M; Beiras, A; Forteza, J; Domínguez-Gerpe, L; Calvo, C; Lado-Abeal, J

    2009-01-01

    Type 2 familial partial lipodystrophy (FPLD2) is characterised by loss of fat in the limbs and buttocks and results from mutations in the LMNA gene. To evaluate the role of several genes involved in adipogenesis in order to better understand the underlying mechanisms of regional loss of subcutaneous adipose tissue (scAT) in patients with FPLD2. In total, 7 patients with FPLD2 and 10 healthy control participants were studied. A minimal model was used to calculate the insulin sensitivity (IS). scAT was obtained from abdomen and thigh by biopsy. Relative gene expression was quantified by real-time reverse transcription PCR in a thermal cycler. Prelamin A western blot analysis was carried out on scAT and prelamin A nuclear localisation was determined using immunofluorescence. Adipocyte nuclei were examined by electron microscopy. Patients with FPLD2 were found to have significantly lower IS. The expression of LMNA was similar in both groups. The expression of PPARG2, RB1, CCND3 and LPL in thigh but not in abdomen scAT was significantly reduced (67%, 25%, 38% and 66% respectively) in patients with FPLD2. Significantly higher levels of prelamin A were found in peripheral scAT of patients with FPLD2. Defects in the peripheral heterochromatin and a nuclear fibrous dense lamina were present in the adipocytes of patients with FPLD2. In FPLD2 participants, prelamin A accumulation in peripheral scAT is associated with a reduced expression of several genes involved in adipogenesis, which could perturb the balance between proliferation and differentiation in adipocytes, leading to less efficient tissue regeneration.

  9. Corrective Action Decision Document for Corrective Action Unit 322: Areas 1 and 3 Release Sites and Injection Wells Nevada Test Site, Nevada, Rev. No. 0

    Energy Technology Data Exchange (ETDEWEB)

    Robert Boehlecke

    2004-12-01

    This Corrective Action Decision Document has been prepared for Corrective Action Unit (CAU) 322, Areas 1 and 3 Release Sites and Injection Wells, Nevada Test Site, Nevada, in accordance with the ''Federal Facility Agreement and Consent Order'' (1996). Corrective Action Unit 322 is comprised of the following corrective action sites (CASs): (1) 01-25-01 - AST Release Site; (2) 03-25-03 - Mud Plant and AST Diesel Release; and (3) 03-20-05 - Injection Wells and BOP Shop. The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of a corrective action alternative for each CAS within CAU 322. Corrective action investigation activities were performed from April 2004 through September 2004, as set forth in the Corrective Action Investigation Plan. The purposes of the activities as defined during the data quality objectives process were: (1) Determine if contaminants of concern (COCs) are present; (2) If COCs are present, determine their nature and extent; and (3) Provide sufficient information and data to recommend appropriate corrective actions for the CASs. Analytes detected during the corrective action investigation were evaluated against appropriate preliminary action levels to identify contaminants of concern for each corrective action site. Radiological field measurements were compared to unrestricted release criteria. Assessment of the data generated from investigation activities revealed the following: (1) CAS 01-25-01 contains an AST berm contaminated with total petroleum hydrocarbons (TPH) diesel-range organics (DRO). (2) CAS 03-25-03 includes two distinct areas: Area A where no contamination remains from a potential spill associated with an AST, and Area B where TPH-DRO contamination associated with various activities at the mud plant was identified. The Area B contamination was found at various locations and depths. (3) CAS 03-25-03 Area B contains TPH-DRO contamination at various

  10. Subcutaneous encapsulated fat necrosis

    DEFF Research Database (Denmark)

    Aydin, Dogu; Berg, Jais O

    2016-01-01

    We have described subcutaneous encapsulated fat necrosis, which is benign, usually asymptomatic and underreported. Images have only been published on two earlier occasions, in which the necrotic nodules appear "pearly" than the cloudy yellow surface in present case. The presented image may help...

  11. Surface-downhole and crosshole geoelectrics for monitoring of brine injection at the Ketzin CO2 storage site

    Science.gov (United States)

    Rippe, Dennis; Bergmann, Peter; Labitzke, Tim; Wagner, Florian; Schmidt-Hattenberger, Cornelia

    2016-04-01

    The Ketzin pilot site in Germany is the longest operating on-shore CO2 storage site in Europe. From June 2008 till August 2013, a total of ˜67,000 tonnes of CO2 were safely stored in a saline aquifer at depths of 630 m to 650 m. The storage site has now entered the abandonment phase, and continuation of the multi-disciplinary monitoring as part of the national project "CO2 post-injection monitoring and post-closure phase at the Ketzin pilot site" (COMPLETE) provides the unique chance to participate in the conclusion of the complete life cycle of a CO2 storage site. As part of the continuous evaluation of the functionality and integrity of the CO2 storage in Ketzin, from October 12, 2015 till January 6, 2015 a total of ˜2,900 tonnes of brine were successfully injected into the CO2 reservoir, hereby simulating in time-lapse the natural backflow of brine and the associated displacement of CO2. The main objectives of this brine injection experiment include investigation of how much of the CO2 in the pore space can be displaced by brine and if this displacement of CO2 during the brine injection differs from the displacement of formation fluid during the initial CO2 injection. Geophysical monitoring of the brine injection included continuous geoelectric measurements accompanied by monitoring of pressure and temperature conditions in the injection well and two adjacent observation wells. During the previous CO2 injection, the geoelectrical monitoring concept at the Ketzin pilot site consisted of permanent crosshole measurements and non-permanent large-scale surveys (Kiessling et al., 2010). Time-lapse geoelectrical tomographies derived from the weekly crosshole data at near-wellbore scale complemented by six surface-downhole surveys at a scale of 1.5 km showed a noticeable resistivity signature within the target storage zone, which was attributed to the CO2 plume (Schmidt-Hattenberger et al., 2011) and interpreted in terms of relative CO2 and brine saturations (Bergmann

  12. Comparative cyto-histological study of needle tip aspirates and entry sites after intravitreal injection using different needle types.

    Directory of Open Access Journals (Sweden)

    Lyubomyr Lytvynchuk

    Full Text Available A comparison of the cellular content of needle tip aspirates and entry sites after transconjunctival intravitreal injection (IVI using different needle types was performed. White outbred rats and human cadaver eyes were used for IVI by hypodermic 27 gauge (G and 30G needles, and spinal anesthesia Pencan 27G needles. Aspiration of vitreous for quantitative morphological and cell cultivation analysis, as well as cyto-histological analysis of aspirates and entry sites were carried out. The most common cells in the aspirates from all needle types were conjunctival epithelial-, ciliary body non-pigmented epithelial- and sclerocyte-like cells and granular proteins. Crystallized vitreous specimens were present in each aspirate. The entry sites of hypodermic needles showed marked trauma in all wall layers of rat and human eyes accompanied by cellular destruction and hemorrhages. Pencan 27G needle caused less tissue trauma with partial reposition of sclerocytes. Transconjunctival IVIs with hypodermic 27G and 30G, and Pencan 27G needles result in trauma of all layers of the eyeball. The possible consequences of cellular content being cut and injected into the eye, as well as the entry site wound shape deserve future consideration and improvements.

  13. Evaluation of alternative designs for an injectable subsurface barrier at the Brookhaven National Laboratory Site, Long Island, New York

    Science.gov (United States)

    Moridis, George J.; Finsterle, Stefan; Heiser, John

    1999-10-01

    Two alternative designs for the demonstration emplacement of a viscous liquid barrier (VLB) at the Brookhaven National Laboratory (BNL), Long Island, New York, are investigated by means of numerical simulation. The application of the VLB technology at the BNL site involved a surface-modified colloidal silica (CS), which gels upon addition of an appropriate electrolyte. Lance injection was used for the CS barrier emplacement. The lance injections occur in three stages: primary, secondary, and tertiary. The geometry of the barrier is based on the wedge model. The first design is based on optimization principles and determines the parameters that maximize uniformity and minimize permeability by minimizing an appropriate objective function while meeting the design criteria. These include a maximum hydraulic conductivity of 10-7 cm/s and a minimum thickness of 1 m. The second design aims to meet the same criteria and reflects standard chemical grouting practices. The combined effects of the key design parameters (i.e., lance spacing, injection location and spacing, gel time, injection rate, and volume) on the barrier permeability are studied. The optimization-based design is shown to have a significantly better performance than the standard engineering design. The interpenetration of adjacent CS bulbs appears to be of critical importance in meeting the barrier specifications. The three-dimensional simulations show that the barrier performance depends heavily on the path by which the final state is achieved. The in situ field measurements of the barrier permeability are consistent with, and appear to validate, the model predictions.

  14. Drug release into hydrogel-based subcutaneous surrogates studied by UV imaging

    DEFF Research Database (Denmark)

    Ye, Fengbin; Larsen, Susan Weng; Yaghmur, Anan

    2012-01-01

    of the performance of drug delivery systems based on in vitro experiments. The objective of this study was to evaluate a UV imaging-based method for real-time characterization of the release and transport of piroxicam in hydrogel-based subcutaneous tissue mimics/surrogates. Piroxicam partitioning from medium chain...... triglyceride (MCT) into 0.5% (w/v) agarose or 25% (w/v) F127-based hydrogels was investigated by monitoring the concentration profiles of the drug in the gels. The effect of pH on piroxicam distribution and diffusion coefficients was studied. For both hydrogel systems, the diffusion of piroxicam in the gels...... upon the injection of aqueous or MCT solutions into an agarose-based hydrogel were investigated by UV imaging. The spatial distribution of piroxicam around the injection site in the gel matrix was monitored in real-time. The disappearance profiles of piroxicam from the injected aqueous solution were...

  15. Massive subcutaneous emphysema with pneumoscrotopenis ...

    African Journals Online (AJOL)

    Chest injury commonly leads to subcutaneous emphysema of the chest, neck and face. It is usually non-life threatening. Massive subcutaneous emphysema may occur and very rarely may spread to involve the scrotal sac and subcutaneous tissue planes of the penis to cause pneumoscrotopenis. This case report presents ...

  16. Subcutaneous bronchogenic cyst

    Directory of Open Access Journals (Sweden)

    Vivek Manchanda

    2010-01-01

    Full Text Available Bronchogenic cysts occur due to the anomalous development of the primitive tracheobronchial tree early in fetal life. They are usually present in middle mediastinum. Rarely, they have been found in other locations. We describe two patients with subcutaneous bronchogenic cysts located over manubrium sterni with special emphasis on the difficulties in pre-operative diagnosis. The two boys were managed by complete excision of the cysts. The children are well on follow-up.

  17. A Nodular Type of Subcutaneous Sarcoidosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Choi, Kyu Ho; Choi, Yun Sun; Kim, Byoung Suck; Joo, Jong Eun; Jung, Yoon Young; Cho, Young Kwon; An, Jin Kyung; Kim, Hyun Sook; Woo, Jung Joo [Eulji University Hospital, Daejeon (Korea, Republic of)

    2009-01-15

    Sarcoidosis is a granulomatous multisystemic disorder that rarely involves subcutaneous tissue. We describe the MR imaging findings of a subcutaneous sarcoidosis in a patient that presented with a nontender, palpable soft tissue mass on the left buttock, which was confirmed after surgical excision. The MR images showed the presence of a subcutaneous mass that breached the adjacent fascia with an irregular outline and homogeneous, slightly higher signal intensity than the surrounding muscle as seen on a T2-weighted image and with homogeneous enhancement after contrast injection. The lesion could not be differentiated from a sarcoma or a malignancy.

  18. Seismic modeling of the AVO/AVA response to CO2 injection at the Ketzin site, Germany

    OpenAIRE

    Ivanova, Alexandra; Bergmann, Peter; Kummerow, Juliane; Yang, Can; Lüth, Stefan; Juhlin, Christopher

    2013-01-01

    Over 64 kilotons of CO2 have been injected (May, 2013) into a heterogeneous sandstone reservoir (saline aquifer) at 630-650 m depth. 4D seismics have been applied to monitor CO2 at the Ketzin site. However, the obtained time-lapse seismic signals have been so far interpreted as being caused by fluid saturation changes only. Modeling of the AVO/AVA response allows us to study two kinds of effects: CO2-saturation- and pore-pressure-related effects. Our results indicate that it is rather infeasi...

  19. Production of gas from coal seams in the Upper Silesian Coal Basin in Poland in the post-injection period of an ECBM pilot site

    NARCIS (Netherlands)

    Bergen, F. van; Krzystolik, P.; Wageningen, N. van; Pagnier, H.; Jura, B.; Skiba, J.; Winthaegen, P.; Kobiela, Z.

    2009-01-01

    A pilot site for CO2 storage in coal seams was set-up in the Upper Silesian Coal Basin in Poland in the scope of the RECOPOL project, funded by the European Commission. About 760 tons CO2 were injected into the reservoir from August 2004 to June 2005. Breakthrough of the injected CO2 was

  20. Corrective Action Investigation plan for Corrective Action Unit 546: Injection Well and Surface Releases, Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Alfred Wickline

    2008-03-01

    Corrective Action Unit (CAU) 546 is located in Areas 6 and 9 of the Nevada Test Site, which is approximately 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 546 is comprised of two Corrective Action Sites (CASs) listed below: •06-23-02, U-6a/Russet Testing Area •09-20-01, Injection Well These sites are being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend corrective action alternatives. Additional information will be obtained by conducting a corrective action investigation (CAI) before evaluating corrective action alternatives and selecting the appropriate corrective action for each CAS. The results of the field investigation will support a defensible evaluation of viable corrective action alternatives that will be presented in the Corrective Action Decision Document. The sites will be investigated based on the data quality objectives (DQOs) developed on November 8, 2007, by representatives of the Nevada Division of Environmental Protection and U.S. Department of Energy (DOE), National Nuclear Security Administration Nevada Site Office. The DQO process has been used to identify and define the type, amount, and quality of data needed to develop and evaluate appropriate corrective actions for CAU 546.

  1. A local reaction at or near injection site: case definition and guidelines for collection, analysis, and presentation of immunization safety data.

    Science.gov (United States)

    Gidudu, Jane; Kohl, Katrin S; Halperin, Scott; Hammer, Sandra Jo; Heath, Paul T; Hennig, Renald; Hoet, Bernard; Rothstein, Edward; Schuind, Anne; Varricchio, Frederick; Walop, Wikke

    2008-12-09

    The need for developing a case definition and guidelines for a local reaction at or near the injection site, methods for the development of the case definition and guidelines as an adverse event following immunization as well as the rationale for selected decisions about the case definition for a local reaction at or near the injection site are explained in the Preamble section. The case definition is structured in 2 levels of diagnostic certainty: level 1 includes any description of morphological or physiological change at or near the injection site that is described or identified by a healthcare provider. Level 2 is any description of morphological or physiological change at or near injection site that is described by any other person. In Guidelines section, the working group recommends to enable meaningful and standardized data collection, analysis, and presentation of information about a local reaction at or near the injection site. However, implementation of all guidelines might not be possible in all settings. The availability of information may vary depending upon resources, geographic region, and whether the source of information is a prospectively designed clinical trial, a post-marketing surveillance or epidemiologic study, or an individual report of a local reaction at injection site.

  2. Analysis of stress changes and fault stability related to CO2 injection at the Tomakomai offshore site

    Science.gov (United States)

    Kano, Y.; Funatsu, T.; Nakao, S.; Kusunose, K.; Ishido, T.; Lei, X.; Tosha, T.

    2013-12-01

    A carbon capture and storage demonstration project is planned at the Tomakomai offshore site, which is located in the southwestern part of Hokkaido, Japan. The project includes geological CO2 storage at a rate of 0.25 Mt/year for three and a half years and a coherent system of capture (from petroleum refineries) and transportation (Ministry of Economy, Trade and Industry, 2012). Two different reservoirs are candidates: one is the Moebetsu formation which is shallow, gently inclined and composed of relatively homogeneous sandstone, and another is the Takinoue T1 formation which is deep, sharply inclined, overpressured and composed of heterogeneous volcanic rocks. Effects of the CO2 injection are expected to be considerably different between these two reservoirs. As part of a safety assessment, Kano et al. (2013) investigated stress changes and corresponding fault stability in the deeper Takinoue T1 formation, based on an estimated initial stress field and numerically-simulated changes in fluid pressure caused by a planned CO2 injection. One of the important features was that the slip tendency becomes maximal near the top of the dipping Takinoue formation which is substantially shallower than the injection depth. This is thought to be due to a combination of the overpressure and heterogeneous structure. In this presentation we will report results of additional analysis and discuss different behaviours between the Takinoue and Moebetsu formations. Sensitivity to uncertain geomechanical properties such as the friction coefficient and the effects of poro-elastic stress development due to changes in fluid pressure and temperature are also discussed. This research was partly funded and supported by the Ministry of Economy, Trade and Industry. We would like to acknowledge Japan CCS Co., Ltd., for providing their survey and research data on the Tomakomai site. References: Ministry of Economy, Trade and Industry, 2012. CCS demonstration project at the Tomakomai site (in

  3. Corrective Action Decision Document for Corrective Action Unit 322: Areas 1 and 3 Release Sites and Injection Wells Nevada Test Site, Nevada, Revision 0 with ROTC 1

    Energy Technology Data Exchange (ETDEWEB)

    Boehlecke, Robert

    2004-12-01

    This Corrective Action Decision Document has been prepared for Corrective Action Unit (CAU) 322, Areas 1 and 3 Release Sites and Injection Wells, Nevada Test Site, Nevada, in accordance with the ''Federal Facility Agreement and Consent Order'' (1996). Corrective Action Unit 322 is comprised of the following corrective action sites (CASs): (1) 01-25-01 - AST Release Site; (2) 03-25-03 - Mud Plant and AST Diesel Release; and (3) 03-20-05 - Injection Wells and BOP Shop. The purpose of this Corrective Action Decision Document is to identify and provide the rationale for the recommendation of a corrective action alternative for each CAS within CAU 322. Corrective action investigation activities were performed from April 2004 through September 2004, as set forth in the Corrective Action Investigation Plan. The purposes of the activities as defined during the data quality objectives process were: (1) Determine if contaminants of concern (COCs) are present; (2) If COCs are present, determine their nature and extent; and (3) Provide sufficient information and data to recommend appropriate corrective actions for the CASs. Analytes detected during the corrective action investigation were evaluated against appropriate preliminary action levels to identify contaminants of concern for each corrective action site. Radiological field measurements were compared to unrestricted release criteria. Assessment of the data generated from investigation activities revealed the following: (1) CAS 01-25-01 contains an AST berm contaminated with total petroleum hydrocarbons (TPH) diesel-range organics (DRO). (2) CAS 03-25-03 includes two distinct areas: Area A where no contamination remains from a potential spill associated with an AST, and Area B where TPH-DRO contamination associated with various activities at the mud plant was identified. The Area B contamination was found at various locations and depths. (3) CAS 03-25-03 Area B contains TPH-DRO contamination at various

  4. Subcutaneous Phycomycosis in a Child

    Directory of Open Access Journals (Sweden)

    Manjiri R. Naniwadekar

    2009-11-01

    Full Text Available Subcutaneous phycomycosis is a rare entity. We hereby report a case of subcutaneous phycomycosis in 18 months old female child who presented with a painless, non-tender swelling on the thigh. Skin biopsy showed eosinophilic granuloma lying deep in the subcutaneous tissue, with sparse hyphae. Culture on Sabouraud's dextrose agar showed characteristic colonies. Patient was started on oral potassium iodide. The swelling was completely resolved after one month of treatment.

  5. Subcutaneous adipose tissue classification

    Directory of Open Access Journals (Sweden)

    A. Sbarbati

    2010-11-01

    Full Text Available The developments in the technologies based on the use of autologous adipose tissue attracted attention to minor depots as possible sampling areas. Some of those depots have never been studied in detail. The present study was performed on subcutaneous adipose depots sampled in different areas with the aim of explaining their morphology, particularly as far as regards stem niches. The results demonstrated that three different types of white adipose tissue (WAT can be differentiated on the basis of structural and ultrastructural features: deposit WAT (dWAT, structural WAT (sWAT and fibrous WAT (fWAT. dWAT can be found essentially in large fatty depots in the abdominal area (periumbilical. In the dWAT, cells are tightly packed and linked by a weak net of isolated collagen fibers. Collagenic components are very poor, cells are large and few blood vessels are present. The deep portion appears more fibrous then the superficial one. The microcirculation is formed by thin walled capillaries with rare stem niches. Reinforcement pericyte elements are rarely evident. The sWAT is more stromal; it is located in some areas in the limbs and in the hips. The stroma is fairly well represented, with a good vascularity and adequate staminality. Cells are wrapped by a basket of collagen fibers. The fatty depots of the knees and of the trochanteric areas have quite loose meshes. The fWAT has a noteworthy fibrous component and can be found in areas where a severe mechanic stress occurs. Adipocytes have an individual thick fibrous shell. In conclusion, the present study demonstrates evident differences among subcutaneous WAT deposits, thus suggesting that in regenerative procedures based on autologous adipose tissues the sampling area should not be randomly chosen, but it should be oriented by evidence based evaluations. The structural peculiarities of the sWAT, and particularly of its microcirculation, suggest that it could represent a privileged source for

  6. Mapping of production indices at Ceuta Field, Maracaibo Basin, using historical data to confirm development and injection sites

    Energy Technology Data Exchange (ETDEWEB)

    Ferrer, F.; Rhodes, E.; Noreno, J. (Moraven S.A., Caracas (Venezuela))

    1993-02-01

    Ceuta Field in the southeastern part of Maracaibo Basin, was discovered by exploration drilling in the 1970's. Now, as the field enters maturity and preparations are in progress for secondary recovery, a large amount of data has been screened prior to the location of additional development wells and the placement of injection sites. Reservoir data that include production histories, when combined with facies analysis have been used to assign production indices to individual reservoirs. These indices were mapped and productivity trends indicated flow unit geometries. This flow unit approach is strictly empirical and requires validation with another independent line of evidence. In the case of Area 8 within Ceuta Field, mappable flow units were compared with seismic attribute maps extracted from recently acquired 3-D seismic data. Comparison of flow unit maps with seismic attribute maps offered additional confidence in decisions concerning development and injection wells. Utilization of historical data to calibrate 3-D seismic data offered a direct detection method for the mapping of reservoir quality in this field. These interpretations were used to calibrate a simulation model for the Lower Eocene B reservoir unit within Area 8. This model predicts that the proposed waterflood project will increase reserves from 107.4 MMBO of primary production to a total of 209.6 MMBO for primary and secondary production. Recovery efficiency will increase from 17.4% to 34.0% after completion of the waterflood program.

  7. Masitinib demonstrates anti-proliferative and pro-apoptotic activity in primary and metastatic feline injection-site sarcoma cells.

    Science.gov (United States)

    Lawrence, J; Saba, C; Gogal, R; Lamberth, O; Vandenplas, M L; Hurley, D J; Dubreuil, P; Hermine, O; Dobbin, K; Turek, M

    2012-06-01

    Dysregulation of platelet-derived growth factor receptor (PDGFR) may play a role in feline injection-site sarcoma (ISS) cell growth and viability. Masitinib, a tyrosine kinase inhibitor approved for treatment of canine mast cell tumours, is highly selective for the PDGFR signalling pathway and may offer a new therapeutic approach for this disease. The in vitro effects of masitinib on growth, apoptosis and PDGFR signalling in two novel ISS cell lines were investigated. PDGFR expression was confirmed by Western blot in cell lines derived from a primary ISS tumour (JB) and a corresponding, histologically confirmed ISS lung metastasis (JBLM). Masitinib inhibited cell growth and PDGFR phosphorylation in both cell lines. Higher drug concentrations were required to inhibit growth than to modulate ligand-induced autophosphorylation of PDGFR. These in vitro data suggest that masitinib displays activity against both primary and metastatic ISS cell line and may aid in the clinical management of ISS. © 2011 Blackwell Publishing Ltd.

  8. Quantification of surgical margin length changes after excision of feline injection site sarcomas-A pilot study.

    Science.gov (United States)

    Terry, Jesse L; Milovancev, Milan; Nemanic, Sarah; Löhr, Christiane V

    2017-02-01

    To evaluate degree length change of lateral surgical margins at various stages of processing for histological examination and quantify the length change between grossly normal surgical margins (GNSM) and pathologist-reported histologic tumor-free margin (HTFM) in widely resected feline injection site sarcoma (FISS) specimens. Prospective clinical study. Five client-owned cats with injection site sarcomas. All cats underwent wide surgical excision (35-55 mm gross lateral margins, 2 fascial planes deep). Gross normal lateral margin measurements from tumor edge were recorded in 4 directions (cranial, caudal, dorsal, ventral) at 5 time points: intra-op (in vivo GNSM); immediately following excision (ex vivo GNSM); following formalin fixation (post-fixation GNSM); after trimming and mounting on glass slides (on-slide GNSM); and HTFM at the narrowest point from the HTFM from the same slides used for on-slide GNSM. Percent change in lateral margin length from in vivo measurements was quantified at each time point and compared using 1-way repeated measures ANOVA. The largest mean decrease in percent GNSM length occurred immediately after excision (in vivo to ex vivo GNSM = 29%; P = .016). Formalin fixation, trimming, and mounting on slides did not result in additional significant changes in length. Mean HTFM length was significantly decreased compared to both in vivo GNSM (33%; P = .014) and on-slide GNSM (7%; P = .024). Significant decreases in surgical margin length in FISS specimens occur immediately following excision (prior to formalin fixation). Subgross evaluation of tumor-free margins from on-slide GNSM to HTFM overestimates the actual (histologic) tumor-free margins. © 2016 The American College of Veterinary Surgeons.

  9. Elimination of scattered gamma rays from injection sites using upper offset energy windows in sentinel lymph node scintigraphy.

    Science.gov (United States)

    Yoneyama, Hiroto; Tsushima, Hiroyuki; Onoguchi, Masahisa; Konishi, Takahiro; Nakajima, Kenichi; Kinuya, Seigo

    2015-05-01

    The identification of sentinel lymph nodes (SLNs) near injection sites is difficult because of scattered gamma rays. The purpose of this study was to investigate the optimal energy windows for elimination of scattered gamma rays in order to improve the detection of SLNs. The clinical study group consisted of 56 female patients with breast cancer. While the energy was centred at 140 keV with a 20% window for Tc-99m, this energy window was divided into five subwindows with every 4% in planar imaging. Regions of interest were placed on SLNs and the background, and contrast was calculated using a standard equation. The confidence levels of interpretations were evaluated using a five-grade scale. The contrast provided by 145.6 keV±2% was the best, followed by 140 keV±2%, 151.2 keV±2%, 134.4 keV±2% and 128.8 keV±2% in that order. When 128.8 keV±2% and 134.4 keV±2% were eliminated from 140 keV±10% (145.6 keV±6%), the contrast of SLNs improved significantly. The confidence levels of interpretation and detection rate provided by the planar images with 140 keV±10% were 4.74±0.58 and 94.8%, respectively, and those provided by 145.6 keV±6% were 4.94±0.20 and 100%. Because lower energy windows contain many scattered gamma rays, upper offset energy windows, which exclude lower energy windows, improve the image contrast of SLNs near injection sites.

  10. Intravitreal injection

    Science.gov (United States)

    Antibiotic - intravitreal injection; Triamcinolone - intravitreal injection; Dexamethasone - intravitreal injection; Lucentis - intravitreal injection; Avastin - intravitreal injection; Bevacizumab - intravitreal injection; Ranibizumab - intravitreal injection; ...

  11. Early clinical experience with subcutaneous GR43175 in acute migraine

    DEFF Research Database (Denmark)

    Tfelt-Hansen, P; Brand, J; Dano, P

    1989-01-01

    In six European clinics 111 migraine patients were treated in a series of open dose-ranging studies with subcutaneous injections of 1 to 4 mg GR43175, a novel 5-HT 1-like receptor agonist. Response rates after 20-30 min were dose related and rose from 33% with 1 mg to 96% with 4 mg GR43175. Side ...

  12. Relationship between subcutaneous blood flow and absorption of lente type insulin

    DEFF Research Database (Denmark)

    Hildebrant, P; Mehlsen, J; Birch, K

    1987-01-01

    To study the relationship between the absorption of intermediate acting insulin and the local subcutaneous blood flow (SBF) 8 diabetic patients were given subcutaneous injections of 125I labeled human lente type insulin and 133Xenon in the abdominal wall. External measurements of the tracer...

  13. Evaluation of the analgesic effect of subcutaneous methadone after cesarean section

    Directory of Open Access Journals (Sweden)

    Mitra Jabalameli

    2014-01-01

    Full Text Available Background: Inadequate pain control has a significant role in maternal and neonatal health in early post-partum period which interferes with breastfeeding and has a negative influence on child normal growth. The aim of this study is evaluation of subcutaneous methadone effectiveness on post-operative pain control. Materials and Methods: Double blind randomized prospective clinical trial involving 60 term pregnancy patients through 2008 to 2009 Undergo cesarean. Inclusion criteria: Prime gravid candidate of elective cesarean and spinal anesthesia class 1 or 2. Known case of drug allergy and methadone interaction, addiction, uncontrolled medical disease excluded. Case group injected 10 mg of subcutaneous methadone in the site of incision before final suture. Morphine was a pain reliever in follow up examination. Data include mean of pain, nausea and vomiting, MAP, etc., collected and analyzed by independent-T test and Man Whitney test. Results: Although mean usage of morphine between groups was not significant statistically but the mean pain severity (P value < 0.05 and mean satisfactory (P value = 0.02 was statistically significant between groups. Other parameters were not statistically significant. Conclusion: We suggest subcutaneous methadone as a safe pain reliever in post cesarean section patients.

  14. Evaluation of the analgesic effect of subcutaneous methadone after cesarean section.

    Science.gov (United States)

    Jabalameli, Mitra; Kalantari, Forough

    2014-01-01

    Inadequate pain control has a significant role in maternal and neonatal health in early post-partum period which interferes with breastfeeding and has a negative influence on child normal growth. The aim of this study is evaluation of subcutaneous methadone effectiveness on post-operative pain control. Double blind randomized prospective clinical trial involving 60 term pregnancy patients through 2008 to 2009 Undergo cesarean. Prime gravid candidate of elective cesarean and spinal anesthesia class 1 or 2. Known case of drug allergy and methadone interaction, addiction, uncontrolled medical disease excluded. Case group injected 10 mg of subcutaneous methadone in the site of incision before final suture. Morphine was a pain reliever in follow up examination. Data include mean of pain, nausea and vomiting, MAP, etc., collected and analyzed by independent-T test and Man Whitney test. Although mean usage of morphine between groups was not significant statistically but the mean pain severity (P value < 0.05) and mean satisfactory (P value = 0.02) was statistically significant between groups. Other parameters were not statistically significant. We suggest subcutaneous methadone as a safe pain reliever in post cesarean section patients.

  15. Portable detectors for 125I-insulin absorption measurement during subcutaneous infusion with portable pumps.

    Science.gov (United States)

    Bojsen, J; Kølendorf, K; Deckert, T

    1984-04-01

    Programmed subcutaneous insulin infusion is a promising method for normalisation of the blood glucose concentration in insulin-dependent diabetics. To evaluate insulin availability the absorption rate from the depot is usually measured intermittently by radioactively-labelled insulin and stationary scintillation detectors. Small portable detectors are an alternative, however, and continuous absorption measurements could be made during normal life conditions. Contrary to conventional single injection therapy, the insulin depot initially expands during infusion treatment, changing the geometry during measurements. In the present study the methodological aspects and geometrical dependences were investigated. Simulated studies were made with various plane disc 125I sources in Perspex phantoms as well as 125I-insulin absorption studies in short-term subcutaneous infusion experiments with anaesthetised rabbits. Results from portable, end-window Geiger-Müller (GM) detectors fixed above the depots and close to the surfaces of phantom or skin were compared with results obtained by a conventional stationary NaI(Tl) detector 15 cm from the phantom or skin surface. With a 125I-insulin infusion site at 5 mm depth in the subcutaneous tissue of rabbits, an overall linear proportionality was found between the results obtained with a NaI(Tl) detector and a GM detector raised 15 mm above the skin surface inside the detector housing.

  16. Analysis of prognostic factors associated with injection-site sarcomas in cats: 57 cases (2001-2007).

    Science.gov (United States)

    Romanelli, Giorgio; Marconato, Laura; Olivero, Daniela; Massari, Federico; Zini, Eric

    2008-04-15

    To identify prognostic factors in cats with injection-site sarcomas (ISSs). Retrospective case series. 57 cats with ISSs. Medical records of cats were reviewed with regard to sex, age, anatomic site of tumor, tumor size, histologic grade, excision of a primary tumor versus excision of a recurrent ISS, use of excision alone versus excision plus adjuvant therapy, local tumor recurrence, and development of distant metastasis to predict overall survival time (ie, time from tumor excision to death). In univariate analyses, local recurrence and development of distant metastasis were significantly associated with survival time in cats. On multivariate analysis, development of distant metastasis remained a significant prognostic factor. Histologic grade was associated with distant metastasis, with cats having grade 3 tumors being significantly more likely to develop metastasis than cats with grade 1 and 2 tumors. Factors associated with local recurrence of ISSs were not identified. The development of distant metastasis, which may occur later during the course of the disease, was identified as a prognostic factor for overall survival time in cats with ISSs. In addition, cats with histologic grade 3 ISSs should be considered for further interventional studies with chemotherapy to prevent the high rate of distant metastasis.

  17. PRELIMINARY DATA REPORT: HUMATE INJECTION AS AN ENHANCED ATTENUATION METHOD AT THE F-AREA SEEPAGE BASINS, SAVANNAH RIVER SITE

    Energy Technology Data Exchange (ETDEWEB)

    Millings, M.

    2013-09-16

    A field test of a humate technology for uranium and I-129 remediation was conducted at the F-Area Field Research Site as part of the Attenuation-Based Remedies for the Subsurface Applied Field Research Initiative (ABRS AFRI) funded by the DOE Office of Soil and Groundwater Remediation. Previous studies have shown that humic acid sorbed to sediments strongly binds uranium at mildly acidic pH and potentially binds iodine-129 (I-129). Use of humate could be applicable for contaminant stabilization at a wide variety of DOE sites however pilot field-scale tests and optimization of this technology are required to move this technical approach from basic science to actual field deployment and regulatory acceptance. The groundwater plume at the F-Area Field Research Site contains a large number of contaminants, the most important from a risk perspective being strontium-90 (Sr-90), uranium isotopes, I-129, tritium, and nitrate. Groundwater remains acidic, with pH as low as 3.2 near the basins and increasing to the background pH of approximately 5at the plume fringes. The field test was conducted in monitoring well FOB 16D, which historically has shown low pH and elevated concentrations of Sr-90, uranium, I-129 and tritium. The field test included three months of baseline monitoring followed by injection of a potassium humate solution and approximately four and half months of post monitoring. Samples were collected and analyzed for numerous constituents but the focus was on attenuation of uranium, Sr-90, and I-129. This report provides background information, methodology, and preliminary field results for a humate field test. Results from the field monitoring show that most of the excess humate (i.e., humate that did not sorb to the sediments) has flushed through the surrounding formation. Furthermore, the data indicate that the test was successful in loading a band of sediment surrounding the injection point to a point where pH could return to near normal during the study

  18. Time series geophysical monitoring of permanganate injections and in situ chemical oxidation of PCE, OU1 area, Savage Superfund Site, Milford, NH, USA

    Science.gov (United States)

    Harte, Philip T.; Smith, Thor E.; Williams, John H.; Degnan, James R.

    2012-05-01

    In situ chemical oxidation (ISCO) treatment with sodium permanganate, an electrically conductive oxidant, provides a strong electrical signal for tracking of injectate transport using time series geophysical surveys including direct current (DC) resistivity and electromagnetic (EM) methods. Effective remediation is dependent upon placing the oxidant in close contact with the contaminated aquifer. Therefore, monitoring tools that provide enhanced tracking capability of the injectate offer considerable benefit to guide subsequent ISCO injections. Time-series geophysical surveys were performed at a superfund site in New Hampshire, USA over a one-year period to identify temporal changes in the bulk electrical conductivity of a tetrachloroethylene (PCE; also called tetrachloroethene) contaminated, glacially deposited aquifer due to the injection of sodium permanganate. The ISCO treatment involved a series of pulse injections of sodium permanganate from multiple injection wells within a contained area of the aquifer. After the initial injection, the permanganate was allowed to disperse under ambient groundwater velocities. Time series geophysical surveys identified the downward sinking and pooling of the sodium permanganate atop of the underlying till or bedrock surface caused by density-driven flow, and the limited horizontal spread of the sodium permanganate in the shallow parts of the aquifer during this injection period. When coupled with conventional monitoring, the surveys allowed for an assessment of ISCO treatment effectiveness in targeting the PCE plume and helped target areas for subsequent treatment.

  19. Mesotherapy and injection lipolysis.

    Science.gov (United States)

    Matarasso, Alan; Pfeifer, Tracy M

    2009-04-01

    The first part of this article familiarizes the reader with the evolution of mesotherapy, injection lipolysis, and the use of phosphatidylcholine and deoxycholate for subcutaneous fat reduction. There is an emphasis on the underlying basic science of fat metabolism and the biochemistry of phosphatidylcholine, so that practitioners will be able to understand future published research on these topics. The second half details some personal experience with injection lipolysis.

  20. Subcutaneous autologous serum therapy in chronic spontaneous urticaria

    Directory of Open Access Journals (Sweden)

    Kiran Vasant Godse

    2017-01-01

    Full Text Available Background: There is a felt need for trying newer therapeutic modalities in patients with chronic spontaneous urticaria, especially in the subset of patients classified as non-responders to antihistamines. Autologous serum therapy is an upcoming modality of treatment, and we decided to study its efficacy by subcutaneous route. Aims: To evaluate the effectiveness of subcutaneous autologous serum therapy (AST in CSU. Methods: This was a single blind, placebo-controlled parallel group, randomized, controlled study. Twenty-four patients with CSU (11M: 13 F were given subcutaneous AST and seventeen patients (7 M: 10F patients were given subcutaneous injection normal saline (placebo, along with levocetirizine in an on-demand basis in both groups. Results: Urticaria activity score (UAS came down from 35.74 to 7 at the end of 9 weeks and the patients' requirement of antihistamines also reduced remarkably from 5.8 to 1.7 per week in the serum group. Sub-cutaneous saline group did not show statistically significant fall in UAS. Saline group showed UAS 32.8 at zero week to 22.1 at the end of 9 weeks. DLQI showed significant fall in serum group, from 14.26 to 4 at the end of 9 weeks. Conclusion: Subcutaneous autoserum therapy is effective in treatment of CSU.

  1. Alpha-D-glucan nanoparticulate adjuvant induces a transient inflammatory response at the injection site and targets antigen to migratory dendritic cells.

    Science.gov (United States)

    Lu, Fangjia; Mosley, Yung-Yi C; Rodriguez Rosales, Randol J; Carmichael, Brooke E; Elesela, Srikanth; Yao, Yuan; HogenEsch, Harm

    2017-01-01

    Biodegradable nanoparticles with functionalized surfaces are attractive candidates as vaccine adjuvants. Nano-11 are cationic dendrimer-like α-D-glucan nanoparticles with a diameter of 70-80 nm. Mice injected with antigen formulated with Nano-11 developed antibody titers that were similar or greater than antigen with aluminum adjuvant. Utilizing an in vivo imaging system, Nano-11 was shown to remain at the injection site after administration and cleared gradually over the course of 3 weeks. Injection of Nano-11 induced a transient inflammatory response characterized by recruitment of a mixed population of inflammatory cells, predominantly monocytes and macrophages with relatively few neutrophils. Recruited Mac-2+macrophages efficiently phagocytized the majority of Nano-11 at the injection site. Fluorescently labeled Nano-11 was present in cells in the draining lymph nodes 1 day after injection, with the majority contained in migratory dendritic cells. Injection of ovalbumin adsorbed to Nano-11 resulted in an increase of ovalbumin-containing cells in draining lymph nodes. Nano-11 delivered more antigen to antigen-presenting cells on a per cell basis and demonstrated more specific targeting to highly immunopotentiating migratory dendritic cells compared with soluble or aluminum hydroxide adsorbed ovalbumin. These results support the efficacy of Nano-11 and its potential use as a next generation vaccine adjuvant.

  2. Corrective Action Investigation Plan for Corrective Action Unit 335: Area 6 Injection Well and Drain Pit, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    DOE/NV

    2000-12-01

    This Corrective Action Investigation Plan contains the U.S. Department of Energy, Nevada Operations Office's approach to collect the data necessary to evaluate corrective action alternatives appropriate for the closure of Corrective Action Unit (CAU) 335, Area 6 Injection Well and Drain Pit, under the Federal Facility Agreement and Consent Order. Corrective Action Unit 335 consists of three Corrective Action Sites (CASs). The CAU is located in the Well 3 Yard in Area 6 at the Nevada Test Site. Historical records indicate that the Drain Pit (CAS 06-23-03) received effluent from truck-washing; the Drums/Oil Waste/Spill (CAS 06-20-01) consisted of four 55-gallon drums containing material removed from the Cased Hole; and the Cased Hole (CAS 06-20-02) was used for disposal of used motor oil, wastewater, and debris. These drums were transported to the Area 5 Hazardous Waste Accumulation Site in July 1991; therefore, they are no longer on site and further investigation or remediation efforts are not required. Consequently, CAS 06-20-01 will be closed with no further action and details of this decision will be described in the Closure Report for this CAU. Any spills that may have been associated with this CAS will be investigated and addressed under CAS 06-20-02. Field investigation efforts will be focused on the two remaining CASs. The scope of the investigation will center around identifying any contaminants of potential concern (COPCs) and, if present, determining the vertical and lateral extent of contamination. The COPCs for the Drain Pit include: total volatile/ semivolatile organic compounds, total petroleum hydrocarbons (gasoline-and diesel-range organics), ethylene glycol monobutyl ether, polychlorinated biphenyls, total Resource Conservation and Recovery Act metals, and radionuclides. The COPCs for the Cased Hole include: total volatile/ semivolatile organic compounds, total petroleum hydrocarbons (diesel-range organics only), and total Resource Conservation

  3. 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.

  4. [Preliminary application of injectable calcium phosphate cement/poly (lactic-co-glycolic acid) microspheres for extraction site preservation].

    Science.gov (United States)

    Mai, Yuying; Wu, Huihuang; Mai, Zhisong; Li, Xinghong; Huang, Linhui; Liao, Hongbing

    2014-03-01

    To investigate the feasibility of extraction site preservation using injectable calcium phosphate cement (CPC) combine with poly (lactic-co-glycolic acid) (PLGA) microspheres. Immediate extraction defects models were created in canine mandibles, and the defects were filled with CPC/PLGA (experimental group, E) , Bio-Oss (positive control, P), non-treatment (blank control, B) respectively. Dogs were sacrificed after 4, 8, 12 weeks post operation. Statistical analysis were conducted using SPSS 19. of radiological observation showed that there were not significantly different between groups in 4 and 8 week (P > 0.05). After 12 week,E (114.9 ± 8.4) were not significantly different compared with P (117.4 ± 12.1) (P > 0.05) , both were significantly higher than B (95.0 ± 12.6) (P B[(78.7 ± 2.7)%] > E[(69.2 ± 1.8)%] (P < 0.05). At 8, 12 week, results of P[(94.0 ± 2.3)% and (93.5 ± 1.9) %] and E[ (94.7 ± 1.1) % and (96.0 ± 0.9) %] were better than those of B[ (76.8 ± 3.0)% and (87.0 ± 2.4)%] (P < 0.05). The effect of CPC/PLGA repair immediate alveolar ridge defects is the same as that of Bio-Oss, and CPC/PLGA can be used as a material in extraction site preservation.

  5. Acute toxicity of subcutaneously administered vitamin E isomers delta- and gamma-tocotrienol in mice.

    Science.gov (United States)

    Swift, Sibyl N; Pessu, Roli L; Chakraborty, Kushal; Villa, Vilmar; Lombardini, Eric; Ghosh, Sanchita P

    2014-01-01

    The toxicity of parenterally administered vitamin E isomers, delta-tocotrienol (DT3) and gamma-tocotrienol (GT3), was evaluated in male and female CD2F1 mice. In an acute toxicity study, a single dose of DT3 or GT3 was administered subcutaneously in a dose range of 200 to 800 mg/kg. A mild to moderately severe dermatitis was observed clinically and microscopically in animals at the injection site at doses above 200 mg/kg. The severity of the reaction was reduced when the drug concentration was lowered. Neither drug produced detectable toxic effects in any other tissue at the doses tested. Based on histopathological analysis for both DT3 and GT3, and macroscopic observations of inflammation at the injection site, a dose of 300 mg/kg was selected as the lowest toxic dose in a 30-day toxicity study performed in male mice. At this dose, a mild skin irritation occurred at the injection site that recovered completely by the end of the experimental period. At a dose of 300 mg/kg of DT3 or GT3, no adverse effects were observed in any tissues or organs. © The Author(s) 2014.

  6. Diluent choice for subcutaneous infusion: a survey of the literature and Australian practice.

    Science.gov (United States)

    Flowers, Charne; McLeod, Fiona

    2005-02-01

    Continuous subcutaneous infusion is a method frequently used in palliative care to manage patient symptoms. To deliver the dose required and prevent subcutaneous sites from becoming inflamed and painful, the drug is often diluted in a solution, most commonly sterile water for injection or sodium chloride. The use of sterile water for injection has been recommended for cyclizine yet beyond this example there appears to be limited clinical direction regarding diluent selection. Inconsistency or lack of guidelines can be problematic if a diluent that may enhance the effectiveness of a drug compared with an alternate is not used because of lack of knowledge or guidance. This investigation considered existing literature, drug databases and directories, and involved a survey of palliative care services to examine evidence and experience relating to diluent selection. A number of inconsistencies emerged in both the literature and practice. With the exception of five drugs for which only saline was recommended, there appeared to be an inclination to use water unless contraindicated. Given an increasing reliance on this method of symptom management, the absence of formal clinical evidence or recommendations and ambiguity in relation to the use of diluents highlights the need for these deficits to be addressed as quickly as possible.

  7. Risk of Injection-Site Abscess among Infants Receiving a Preservative-Free, Two-Dose Vial Formulation of Pneumococcal Conjugate Vaccine in Kenya.

    Directory of Open Access Journals (Sweden)

    Deron C Burton

    Full Text Available 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.

  8. 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

  9. Detecting near-the-injection-site sentinel nodes in head and neck melanomas with a high-resolution portable gamma camera.

    Science.gov (United States)

    Hellingman, Daan; de Wit-van der Veen, Linda J; Klop, W Martin C; Olmos, Renato A Valdés

    2015-01-01

    In head/neck melanomas, near-the-injection-site sentinel nodes (NIS-SNs) may be missed on planar lymphoscintigraphy and/or SPECT/CT. The aim of the present study is to establish the performance of a portable gamma camera (PGC) to detect NIS-SNs in a simulation phantom set-up, and subsequently in head/neck melanoma patients scheduled for a SN procedure. Five plastic Eppendorf tubes filled with technetium-99m-albumin nanocolloid were used to simulate 4 radiotracer deposit sites, as traditionally injected in melanoma patients, and 1 NIS-SN. A PGC was used with 2 pinhole collimators (2.5 and 4.0 mm). Image acquisition time was 1 minute with the camera positioned at various distances (range 1.5-15.5 cm). Results were compared with conventional lymphoscintigraphy and SPECT/CT acquired with a dual-head gamma camera as well with a gamma probe. Additionally, the same PGC setting was used in a case series of 3 patients with head/neck melanomas. The simulated NIS-SN was differentiated from the injection site at a distance of 3 mm with the 2.5-mm pinhole and at 5 mm with the 4-mm pinhole when the PGC was positioned at 1.5 cm distance. Planar lymphoscintigraphy, SPECT/CT, and the gamma probe depicted the NIS-SN separated from the injection site at distances of 7, 10, and 22 mm, respectively. In all 3 patients, 6 NIS-SNs were depicted with the PGC. A high-resolution PGC, positioned close to the skin, is able to detect SNs at distances of at least 3 mm from the injection site. A further clinical evaluation of this device to establish its added value in reducing false-negative procedures and potential recurrences is necessary.

  10. Subcutaneous granuloma annulare: radiologic appearance

    Energy Technology Data Exchange (ETDEWEB)

    Kransdorf, M.J. [Saint Mary`s Hospital, Richmond, VA (United States). Dept. of Radiol.]|[Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC (United States); Murphey, M.D. [Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC (United States)]|[Department of Radiology and Nuclear Medicine, Uniformed Services University of the Health Sciences, Bethesda, Maryland (United States)]|[Department of Radiology, School of Medicine, University of Maryland, Baltimore, Maryland (United States); Temple, H.T. [Department of Orthopedic Surgery, University of Virginia Health Sciences Center, Charlottesville, Virginia (United States)]|[Department of Orthopedic Pathology, Armed Forces Institute of Pathology, Washington, DC (United States)

    1998-05-01

    Objective. Granuloma annulare is an uncommon benign inflammatory dermatosis characterized by the formation of dermal papules with a tendency to form rings. There are several clinically distinct forms. The subcutaneous form is the most frequently encountered by radiologists, with the lesion presenting as a superficial mass. There are only a few scattered reports of the imaging appearance of this entity in the literature. We report the radiologic appearance of five cases of subcutaneous granuloma annulare. Design and patients. The radiologic images of five patients (three male, two female) with subcutaneous granuloma annulare were retrospectively studied. Mean patient age was 6.4 years (range, 2-13 years). The lesions occurred in the lower leg (two), foot, forearm, and hand. MR images were available for all lesions, gadolinium-enhanced imaging in three cases, radiographs in four, and bone scintigraphy in one. Results. Radiographs showed unmineralized nodular masses localized to the subcutaneous adipose tissue. The size range, in greatest dimension on imaging studies, was 1-4 cm. MR images show a mass with relatively decreased signal intensity on all pulse sequences, with variable but generally relatively well defined margins. There was extensive diffuse enhancement following gadolinium administration. Conclusion. The radiologic appearance of subcutaneous granuloma annulare is characteristic, typically demonstrating a nodular soft-tissue mass involving the subcutaneous adipose tissue. MR images show a mass with relatively decreased signal intensity on all pulse sequences and variable but generally well defined margins. There is extensive diffuse enhancement following gadolinium administration. Radiographs show a soft-tissue mass or soft-tissue swelling without evidence of bone involvement or mineralization. This radiologic appearance in a young individual is highly suggestive of subcutaneous granuloma annulare. (orig.) With 3 figs., 17 refs.

  11. Subcutaneous myiasis caused by Dermatobia hominis.

    Science.gov (United States)

    Logar, J; Beović, B; Triller, C; Rakovec, S

    2001-01-01

    A case of subcutaneous myiasis caused by the larvae of the Dermatobia hominis fly is described, involving the ankle region of a 25-y-old man who had returned from Peru. After removal of 4 larvae from the affected sites, the lesions healed in 2 weeks without further treatment. Because of the increasing number of people travelling to tropical America, physicians in Slovenia will have to consider Dermatobia myiasis in the differential diagnosis of furuncular lesions in patients with a relevant travel history.

  12. Diurnal variations in subcutaneous allergen immunotherapy reactions.

    Science.gov (United States)

    Bavishi, Aakash A; Grammer, Leslie C; Pongracic, Jacqueline; Rychlik, Karen; Kumar, Rajesh; Zee, Phyllis; Greenberger, Paul A; Fishbein, Anna B

    2017-01-01

    Circadian rhythms underlie many immune responses and allergic diseases. Subcutaneous immunotherapy (SCIT) can result in adverse reactions; however, it is unclear whether such reactions have a diurnal pattern. To assess whether the timing of SCIT affects the rate of adverse reactions. This study was a retrospective medical record review of adult patients (n = 289) who received SCIT at the Northwestern Medical Faculty Foundation, Chicago, Illinois, during a 10-year period (2004-2014). Injections were given in the outpatient setting. There were a total of 17,457 injections with 574 reactions. Covariates included age, sex, median income, asthma status, vial contents, number of injections, and previous immunotherapy reactions. Logistical regression was used to calculate the odds of having a reaction with time of SCIT administration as the primary determinate. Immunotherapy reactions occurred more frequently after afternoon or evening (pm) injections (328/8721 = 3.8%) vs morning (am) injections (246/8736 = 2.8%), (χ2 = 12.26, P < .01). Systemic reactions, defined as World Allergy Organization grade 1 or higher, did not have diurnal variation (59/8721 = 0.67% for pm vs am 56/8736 = 0.64% for morning; χ2 = 0.08; P = .77). pm injections resulted in higher odds of reaction compared with am injection in a fully adjusted logistic regression model (odds ratio = 1.43; 95% confidence interval, 1.20-1.70; P < .01). When considering time as 4 categories, the highest odds of reaction were noted for the period from 15:01 to 17:30 (odds ratio, 1.55; 95% confidence interval, 1.21-2.00; P < .01). pm injections of SCIT are associated with increased cutaneous reaction rates when compared with am injections. In patients experiencing bothersome local reactions, it may be beneficial to administer SCIT in the morning. Copyright © 2016 American College of Allergy, Asthma & Immunology. Published by Elsevier Inc. All rights reserved.

  13. Inflammatory responses following intramuscular and subcutaneous immunization with aluminum-adjuvanted or non-adjuvanted vaccines.

    Science.gov (United States)

    Kashiwagi, Yasuyo; Maeda, Mika; Kawashima, Hisashi; Nakayama, Tetsuo

    2014-06-05

    Aluminum-adjuvanted vaccines are administered through an intramuscular injection (IM) in the US and EU, however, a subcutaneous injection (SC) has been recommended in Japan because of serious muscle contracture previously reported following multiple IMs of antibiotics. Newly introduced adjuvanted vaccines, such as the human papillomavirus (HPV) vaccines, have been recommended through IM. In the present study, currently available vaccines were evaluated through IM in mice. Aluminum-adjuvanted vaccines induced inflammatory nodules at the injection site, which expanded into the intra-muscular space without any muscle degeneration or necrosis, whereas non-adjuvanted vaccines did not. These nodules consisted of polymorph nuclear neutrophils with some eosinophils within the initial 48h, then monocytes/macrophages 1 month later. Inflammatory nodules were observed 6 months after IM, had decreased in size, and were absorbed 12 months after IM, which was earlier than that after SC. Cytokine production was examined in the injected muscular tissues and AS04 adjuvanted HPV induced higher IL-1β, IL-6, KC, MIP-1, and G-CSF levels in muscle tissues than any other vaccine, but similar serum cytokine profiles were observed to those induced by the other vaccines. Currently available vaccines did not induce muscular degeneration or fibrotic scar as observed with muscle contracture caused by multiple IMs of antibiotics in the past. Copyright © 2014 Elsevier Ltd. All rights reserved.

  14. Increased injection pain with darbepoetin-alpha compared to epoetin-beta in paediatric dialysis patients.

    Science.gov (United States)

    Schmitt, Claus Peter; Nau, Barbara; Brummer, Christiane; Rosenkranz, Joachim; Schaefer, Franz

    2006-12-01

    Darbepoetin-alpha is applicable at longer injection intervals. Our early experience in children on peritoneal dialysis suggested increased injection pain compared to epoetin-beta, possibly due to technical differences or patient anxiety. To verify a possible difference in the painfulness of the injected fluids per se, we performed a prospective, randomized, double-blind trial in 13 paediatric end-stage renal disease patients. They received three injections of equivalent doses of darbepoetin-alpha or epoetin-beta in 0.6 ml saline, using neutral syringes and 27G needles, at 4 week intervals. Pain perception was recorded immediately and after 30 min on a visual analogue scale (VAS, 0 = no pain, 10 = maximal pain; complemented by 5 faces for young children). The patients perceived more intense immediate injection pain with darbepoetin-alpha than with epoetin-beta (5.4 +/- 1 vs 2.3 +/- 0.6, P or =4 VAS points) with darbepoetin-alpha. After 30 min, the injection site was largely painless with both drugs. No significant local reactions occurred with either medication (0.3 +/- 0.1 vs 0.3 +/- 0.1 on a 5-score scale). Subcutaneous injections of darbepoetin-alpha are more painful than those of epoetin-beta in the majority of paediatric patients. The observed difference in painfulness is related to the nature of the injected compounds and may limit the subcutaneous applicability of darbepoetin-alpha in children.

  15. Effects of injection site on the accuracy of thermal washout right ventricular ejection fraction measurements in clinical and model investigations.

    Science.gov (United States)

    Imai, T; Katoh, K; Kani, H; Miyano, H; Fujita, T

    1991-02-01

    The purpose of this investigation was to improve the accuracy of measurement of thermal right ventricular ejection fraction (RVEF) using the modified Swan-Ganz catheter. Three serial ejection fractions (EFs) (EF1, 2, 3) and the mean were calculated, based on Holt's theory. RVEFs were compared between right ventricular (RV) and atrial (RA) injection in ten intensive care unit (ICU) patients using a modified catheter having RV and RA orifices (15 cm and 30 cm from the distal end, respectively), and paired duplicate (two patients) or triplicate (eight patients) measurements were performed. To determine what factors interfere with RVEF, a model heart (with diastolic volume of 150 ml) was constructed, in which model injection of cold water to the direct inflow tract (RA), to the direct mixing chamber (RV), or through the catheter running in the inflow tract were compared. When EFs were compared between RV and RA injection, those for the former were greater (RV vs RA in EF1 and EFmean: 0.46 +/- 0.15 vs 0.23 +/- 0.11 in EF1, and 0.45 +/- 0.13 vs 0.28 +/- 0.11 in EFmean, mean +/- SD, p less than 0.01). When the serial EFs were compared in each injection type, in the RV injection EF3 was the smallest as was EF1 in the RA injection. The same phenomenon was observed in the model as in the patients, and moreover when cold water was injected in RA through a catheter running through the circuit, EFs were greatly underestimated (EF1 = 0.29 +/- 0.02 at preset EF = 0.4). We conclude that these phenomena were caused by sluggish movement of the cold indicator from RA to RV when injected into RA, and by interference with the cooled cardiac chamber and catheter. Consequently, the first or second EFs obtained from RV injection might be closest to the actual values because of the least interference with those factors.

  16. Amyloidoma secondary to insulin injection: Cytologic diagnosis and pitfalls

    Directory of Open Access Journals (Sweden)

    Dianne Grunes

    2015-01-01

    Full Text Available Amyloidomas are rare tumors composed of deposits of amyloid protein not associated with systemic amyloidosis. They can present as an initial manifestation of a systemic disease process or can be a completely localized phenomenon. We present a case of amyloidoma associated with insulin injection site found incidentally in an 80-year-old male with multiple co-morbidities who presented with diverticulitis associated bleeding. A subcutaneous abdominal mass was found on physical examination. Imaging revealed a 5 cm Χ 1.6 cm homogenous subcutaneous lesion. A fine-needle aspiration (FNA and core biopsy were performed under ultrasound guidance to reveal amorphous material proven to be amyloidosis at insulin injection sites (AIns type amyloid. The patient had no treatment for this lesion and has had his care triaged to his more serious health problems. This is the first case of AIns type amyloidoma associated with insulin injection site reported in cytology literature. We highlight the cytologic findings and diagnostic pitfalls. As the incidence of diabetes is increasing, cytopathologists may encounter this lesion more often on FNA.

  17. Continuous atmospheric monitoring of the injected CO2 behavior over geological storage sites using flux stations: latest technologies and resources

    Science.gov (United States)

    Burba, George; Madsen, Rodney; Feese, Kristin

    2014-05-01

    Flux stations have been widely used to monitor emission rates of CO2 from various ecosystems for climate research for over 30 years [1]. The stations provide accurate and continuous measurements of CO2 emissions with high temporal resolution. Time scales range from 20 times per second for gas concentrations, to 15-minute, hourly, daily, and multi-year periods. The emissions are measured from the upwind area ranging from thousands of square meters to multiple square kilometers, depending on the measurement height. The stations can nearly instantaneously detect rapid changes in emissions due to weather events, as well as changes caused by variations in human-triggered events (pressure leaks, control releases, etc.). Stations can also detect any slow changes related to seasonal dynamics and human-triggered low-frequency processes (leakage diffusion, etc.). In the past, station configuration, data collection and processing were highly-customized, site-specific and greatly dependent on "school-of-thought" practiced by a particular research group. In the last 3-5 years, due to significant efforts of global and regional CO2 monitoring networks (e.g., FluxNet, Ameriflux, Carbo-Europe, ICOS, etc.) and technological developments, the flux station methodology became fairly standardized and processing protocols became quite uniform [1]. A majority of current stations compute CO2 emission rates using the eddy covariance method, one of the most direct and defensible micrometeorological techniques [1]. Presently, over 600 such flux stations are in operation in over 120 countries, using permanent and mobile towers or moving platforms (e.g., automobiles, helicopters, and airplanes). Atmospheric monitoring of emission rates using such stations is now recognized as an effective method in regulatory and industrial applications, including carbon storage [2-8]. Emerging projects utilize flux stations to continuously monitor large areas before and after the injections, to locate and

  18. A Systematic Review of Patients' Perspectives on the Subcutaneous Route of Medication Administration.

    Science.gov (United States)

    Ridyard, Colin H; Dawoud, Dalia M M; Tuersley, Lorna V; Hughes, Dyfrig A

    2016-08-01

    Subcutaneous injections allow for self-administration, but consideration of patients' perspectives on treatment choice is important to ensure adherence. Previous systematic reviews have been limited in their scope for assessing preferences in relation to other routes of administration. Our objective was to examine patients' perspectives on subcutaneously administered self-injectable medications when compared with other routes or methods of administration for the same medicines. Nine electronic databases were searched for publications since 2000 using terms pertaining to methods of administration, choice behavior, and adverse effects. Eligibility for inclusion was determined through reference to specific criteria by two independent reviewers. Results were described narratively. Of the 1726 papers screened, 85 met the inclusion criteria. Studies were focused mainly on methods of insulin administration for diabetes but also included treatments for pediatric growth disorders, multiple sclerosis, HIV, and migraine. Pen devices and autoinjectors were favored over administration with needle and syringe, particularly with respect to ergonomics, convenience, and portability. Inhalation appeared to be more acceptable than subcutaneous injection (in the case of insulin), but how subcutaneous infusion, intramuscular injection, and needle-free injection devices compare with subcutaneous injections in terms of patient preference is less certain. The review identified a number of studies showing the importance of the methods and routes of drug delivery on patient choice. However, studies were prone to bias, and further robust evidence based on methodologically sound approaches is required to demonstrate how patient choice might translate to improved adherence.

  19. Steam and hot air injection for thermal rehabilitation of contaminated sites; Wasserdampf- und Heissluftinjektion zur thermischen Sanierung kontaminierter Standorte

    Energy Technology Data Exchange (ETDEWEB)

    Schmidt, R.

    2001-07-01

    Thermal in situ rehabilitation technologies are a promising alternative to conventional methods of cleaning up contaminated sites. The fact that an increase in temperature changes the physical properties of materials makes it possible, in principle, to release large quantities of pollutants within short time periods. The use of pure steam or steam/air mixtures as fluid thermal carriers permits converting subterranean non-aqueous-phase pollutants into the gas phase through increased vapour pressure and transporting them to the surface by means of soil air aspiration for further treatment. The purpose of the present two-stage research project was to systematically develop a thermal in situ rehabilitation technology using steam as fluid heat carrier and use it for land rehabilitation operations on a pilot basis. In the first, fundamental project phase aspects of heat transport (Faerber, 1997) and pollutant behaviour (Betz, 1998)in homogenous porous media upon pure steam injection were explored at a laboratory and technical scale using containers of different sizes (1D, 2D, 3D). The results were used to derive application criteria for this technology. [German] Thermische In-situ-Sanierungstechnologien stellen bei der Reinigung kontaminierter Standorte eine vielversprechende Alternative zu konventionellen Verfahren dar. Die Veraenderung physikalischer Stoffeigenschaften mit steigender Temperatur ermoeglicht grundsaetzlich hohe Schadstoffaustraege innerhalb kurzer Zeitraeume. Beim Einsatz von reinem Wasserdampf oder Wasserdampf-Luft-Gemischen als Waermetraegerfluid koennen im Untergrund in nicht waessriger Phase vorliegende Schadstoffe hauptsaechlich wegen der erhoehten Dampfdruecke in die Gasphase ueberfuehrt, ueber eine Bodenluftabsaugung an die Oberflaeche transportiert und dann einer weiteren Behandlung zugefuehrt werden. Zielsetzung eines zweistufigen Forschungsvorhabens war die systematische Entwicklung einer thermischen In-situ-Sanierungstechnologie unter

  20. SUBCUTANEOUS BASIDIOBOLOMYCOSIS: A CASE REPORT

    African Journals Online (AJOL)

    2013-07-09

    Jul 9, 2013 ... E-mail: sackey@sky.com. Conflict of interest: None declared. SUMMARY. Basidiobolomycosis is an uncommon chronic deep fungal infection in which gradually enlarging granulomas form, usually in the subcutaneous fat tissues of the limbs, chest or trunk of immunocompetent hosts, primarily children.

  1. Pneumomediastinum and subcutaneous cervical emphysema ...

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2012-09-08

    Sep 8, 2012 ... department with a history of increasing difficulty with breathing and ... ward and commenced on intravenous antibiotics and high flow oxygen. He made remarkable improvement with complete resolution of subcutaneous emphysema on the 4th day ... the left lateral decubitus position.18 Our patient met most.

  2. Pyrexial therapy in subcutaneous phycomycosis

    Directory of Open Access Journals (Sweden)

    Reddy BSN

    1992-01-01

    Full Text Available A case of subcutaneous phycomycosis occurring in a 2 ½ year old child is reported for its rarity, clinical interest and paucity of literature. The condition failed to resolve with conventional antimycotics but improved with the administration of concomitant pyrexial therapy.

  3. Pneumomediastinum and subcutaneous cervical emphysema ...

    African Journals Online (AJOL)

    PROF. EZECHUKWU

    2012-09-08

    Sep 8, 2012 ... to trauma or pathological disease state3, with gastroin- testinal and respiratory diseases most commonly impli- cated.4,5. The respiratory disease commonly associated with pneu- momediastinum and subcutaneous cervical emphysema is bronchial asthma.6 Pneumonia, though a very com- mon childhood ...

  4. Improved Insulin Absorption by Means of Standardized Injection Site Modulation Results in a Safer and More Efficient Prandial Insulin TreatmentA Review of the Existing Clinical Data

    Science.gov (United States)

    Raz, Itamar; Bitton, Gabriel; Klonoff, David; Nagar, Ron; Hermanns, Norbert; Haak, Thomas

    2014-01-01

    Temperature changes on the surface of the skin lead to modifications of subcutaneous microcirculation. This phenomenon is employed in a standardized way by the InsuPad device to stabilize skin conditions before injections, which is associated with enhanced prandial insulin absorption. Three programmed warming cycles to 40°C within 50 minutes are resulting in faster insulin appearance in the plasma. Early standardized meal tolerance studies indicated a substantial improvement in postprandial glucose control when the same short-acting insulin analog dose was applied using InsuPad, and a dose reduction by 20% resulted in comparable glucose excursions. Similar results were obtained when patients applied the device under real-world conditions for 1 month. The InsuPad device was also tested in a prospective, controlled, parallel 3-month real-world study with 145 well-controlled but insulin-resistant patients with type 1 or type 2 diabetes. Patients were treated to target in both treatment arms (6.2 ± 0.5% in each group), with or without the device. However, patients with InsuPad needed 28% less prandial insulin, needed 12.5% less total insulin, and had 46% less confirmed hypoglycemic events (blood glucose insulin doses may result in a safer and more efficient treatment of type 1 or type 2 diabetes. PMID:25352633

  5. Tolerability and Plasma Drug Level Monitoring of Prolonged Subcutaneous Teicoplanin Treatment for Bone and Joint Infections.

    Science.gov (United States)

    El Samad, Youssef; Lanoix, Jean-Philippe; Bennis, Youssef; Diouf, Momar; Saroufim, Carlo; Brunschweiler, Benoit; Rousseau, Florence; Joseph, Cédric; Hamdad, Farida; Ait Amer Meziane, Mohamed; Routier, Simon; Schmit, Jean-Luc

    2016-10-01

    Teicoplanin is a key drug for the treatment of multiresistant staphylococcal bone and joint infections (BJI), yet can only be administered via a parenteral route. The objective of this study was to evaluate the safety and tolerability of subcutaneous (s.c.) teicoplanin for that indication over 42 days. Thirty patients with Gram-positive cocci BJI were included. Once the target of 25 to 40 mg/liter trough serum concentration was achieved, treatment was switched from an intravenous to an s.c. route. No discontinuation of teicoplanin related to injection site reaction and no severe local adverse event were observed. On multivariate analysis, better tolerability was observed at the beginning of treatment, in patients over 70 years old, and for dosages less than 600 mg. In conclusion, we recommend s.c. administration of teicoplanin when needed. Copyright © 2016, American Society for Microbiology. All Rights Reserved.

  6. Tolerability and Plasma Drug Level Monitoring of Prolonged Subcutaneous Teicoplanin Treatment for Bone and Joint Infections

    Science.gov (United States)

    Bennis, Youssef; Diouf, Momar; Saroufim, Carlo; Brunschweiler, Benoit; Rousseau, Florence; Joseph, Cédric; Hamdad, Farida; Ait Amer Meziane, Mohamed; Routier, Simon; Schmit, Jean-Luc

    2016-01-01

    Teicoplanin is a key drug for the treatment of multiresistant staphylococcal bone and joint infections (BJI), yet can only be administered via a parenteral route. The objective of this study was to evaluate the safety and tolerability of subcutaneous (s.c.) teicoplanin for that indication over 42 days. Thirty patients with Gram-positive cocci BJI were included. Once the target of 25 to 40 mg/liter trough serum concentration was achieved, treatment was switched from an intravenous to an s.c. route. No discontinuation of teicoplanin related to injection site reaction and no severe local adverse event were observed. On multivariate analysis, better tolerability was observed at the beginning of treatment, in patients over 70 years old, and for dosages less than 600 mg. In conclusion, we recommend s.c. administration of teicoplanin when needed. PMID:27458228

  7. Five-day regimen of intramuscular or subcutaneous self-administered adrenocorticotropic hormone gel for acute exacerbations of multiple sclerosis: a prospective, randomized, open-label pilot trial

    Directory of Open Access Journals (Sweden)

    Simsarian JP

    2011-07-01

    Full Text Available James P Simsarian, Carol Saunders, D Michelle SmithNeurology Center of Fairfax Ltd, Fairfax, VA, USABackground: Despite over 50 years of experience with adrenocorticotropic hormone (ACTH as a treatment for acute exacerbations of multiple sclerosis, there have been no trials examining the options of the 2–3-week dosing regimen or intramuscular injection protocol used in the original trials. At our clinic, we performed a small, prospective, randomized pilot study to examine the efficacy and safety of, and patient satisfaction with, a short (five-day self-administered ACTH dosing protocol for exacerbations of multiple sclerosis, and to compare the subcutaneous and intramuscular routes of administration.Methods: Patients for this study were recruited from an outpatient treatment clinic. Each patient self-administered natural ACTH gel 80 U/day by subcutaneous or intramuscular injection for five consecutive days and was evaluated at baseline and on days 7 and 14. Patient feedback was collected using the Patient Global Impression of Change (PGI-C, the primary efficacy measure, a patient global visual analog scale, the Expanded Disability Status Scale, a timed walk, the Nine-hole Peg Test, and the Clinical Global Impression of Change.Results: Of the 20 enrolled patients (mean age 39.5 years, 19 completed the study. On day 14, 61.1% of patients (11 of 18 with day 14 scores were treatment responders, and rated their condition as "very much improved" or "much improved" on the PGI-C. The intramuscular group had numerically more responders, but there was no significant difference in the proportion of responders between the intramuscular and subcutaneous groups at day 14 (P = 0.3. The intramuscular route of injection was associated with more injection site pain than the subcutaneous route.Conclusion: A shorter five-day course of intramuscular or subcutaneous ACTH gel may improve symptoms associated with acute exacerbations of multiple sclerosis. Larger

  8. Monitoring of injected CO2 at two commercial geologic storage sites with significant pressure depletion and/or re-pressurization histories: A case study

    Directory of Open Access Journals (Sweden)

    Dayanand Saini

    2017-03-01

    The monitoring technologies that have been used/deployed/tested at both the normally pressured West Hastings and the subnormally pressured Bell Creek storage sites appear to adequately address any of the potential “out of zone migration” of injected CO2 at these sites. It would be interesting to see if any of the collected monitoring data at the West Hastings and the Bell Creek storage sites could also be used in future to better understand the viability of initially subnormally pressured and subsequently depleted and re-pressurized oil fields as secure geologic CO2 storage sites with relatively large storage CO2 capacities compared to the depleted and re-pressurized oil fields that were initially discovered as normally pressured.

  9. Subcutaneous phaeohyphomycosis on the scrotum caused by Exophiala jeanselmei: case report.

    Science.gov (United States)

    Rossetto, André Luiz; Dellatorre, Gerson; Pérsio, Renan André; Romeiro, José Ceciliano de Menezes; Cruz, Rosana Cé Bella

    2010-01-01

    Subcutaneous phaeohyphomycosis is a disease caused by dematiaceous fungi that develops mainly in immunocompromised patients. Lesions are generally located on the lower limbs. The present report describes a case of phaeohyphomycosis in an immunocompetent patient in whom a subcutaneous abscess was located in an unusual site, on the left hemiscrotum. The abscess was treated successfully with oral fluconazole associated with surgical excision.

  10. Global transcriptional response to ISCOM-Matrix adjuvant at the site of administration and in the draining lymph node early after intramuscular injection in pigs.

    Science.gov (United States)

    Ahlberg, Viktor; Lövgren Bengtsson, Karin; Wallgren, Per; Fossum, Caroline

    2012-09-01

    ISCOM vaccines induce a balanced Th1/Th2 response, long-lasting antibody responses and cytotoxic T lymphocytes. The mode of action for the adjuvant component, the ISCOM-Matrix, is known to some extent but questions remain regarding its mechanism of action. The Affymetrix GeneChip® Porcine Genome Array was applied to study the global transcriptional response to ISCOM-Matrix in pigs at the injection site and in the draining lymph node 24h after i.m. injection. Gene enrichment analysis revealed inflammation, innate immunity and antigen processing to be central in the ISCOM-Matrix response. At the injection site, 594 genes were differentially expressed, including up-regulation of the cytokines osteopontin (SPP1), IL-10 and IL-18 and the chemokines CCL2, CCL19 and CXCL16. Of the 362 genes differentially expressed in the lymph node, IL-1β and CXCL11 were up-regulated whereas IL18, CCL15 and CXCL12 were down-regulated. ISCOM-Matrix also modulated genes for pattern recognition receptors at the injection site (TLR2, TLR4, MRC1, PTX3, LGALS3) and in the lymph node (TLR4, RIG-I, MDA5, OAS1, EIF2AK2, LGALS3). A high proportion of up-regulated interferon-regulated genes indicated an interferon response. Thus, several genes, genetic pathways and biological processes were identified that are likely to shape the early immune response elicited by ISCOM-based vaccines. Copyright © 2012 Elsevier Ltd. All rights reserved.

  11. A child with a long-standing, intensely itching subcutaneous nodule on a thigh: an uncommon (?) reaction to commonly used vaccines.

    Science.gov (United States)

    Bergfors, Elisabet; Lundmark, Katarzyna; Nyström Kronander, Ulla

    2013-01-24

    A 2-year-old girl presented with an intensely itching subcutaneous nodule on the front of a thigh. The nodule persisted for 10 months until it was excised. Subsequent investigation for malignancy and systemic disease showed no pathological findings. The diagnosis, persistent itching vaccination granuloma, was revealed by hazard almost 2 years after the onset of symptoms. Persistent itching subcutaneous nodules at the injection site for aluminium containing vaccines (mostly diphtheria-tetanus-pertussis combination vaccines for primary immunisation of infants) may appear with a long delay after the vaccination (months), cause prolonged itching (years) and are often associated with contact allergy to aluminium. The condition is poorly recognised in Health Care which may lead to prolonged symptoms and unnecessary investigations.

  12. Phase separation of in situ forming poly (lactide-co-glycolide acid) implants investigated using a hydrogel-based subcutaneous tissue surrogate and UV-vis imaging

    DEFF Research Database (Denmark)

    Sun, Yu; Jensen, Henrik; Petersen, Nickolaj J

    2017-01-01

    Phase separation of in situ forming poly (lactide-co-glycolide acid) (PLGA) implants with agarose hydrogels as the provider of nonsolvent (water) mimicking subcutaneous tissue was investigated using a novel UV-vis imaging-based analytical platform. In situ forming implants of PLGA-1-methyl-2......, water, to the in situ forming PLGA implants simulating the injection site environment. The resulting implant morphology depended on the stiffness of hydrogel matrix, indicating that the matrix in which implants are formed is of importance. Overall, the work showed that the UV-vis imaging-based platform...... with an agarose hydrogel mimicking the subcutaneous tissue holds potential in providing bio-relevant and mechanistic information on the phase separation processes of in situ forming implants....

  13. Closure Report for Corrective Action Unit 335: Area 6 Injection Well and Drain Pit, Nevada Test Site, Nevada

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office; Bechtel Nevada

    2003-06-01

    This Closure Report documents the activities undertaken to close Corrective Action Unit 335: Area 6 Injection Well and Drain Pit, according to the Federal Facility Agreement and Consent Order. Corrective Action Unit 335 was closed in accordance with the Nevada Division of Environmental Protection-approved Corrective Action Plan for Corrective Action Unit 335.

  14. Subcutaneous implants for long-acting drug therapy in laboratory animals may generate unintended drug reservoirs

    Directory of Open Access Journals (Sweden)

    Michael Guarnieri

    2014-01-01

    Full Text Available Background: Long-acting therapy in laboratory animals offers advantages over the current practice of 2-3 daily drug injections. Yet little is known about the disintegration of biodegradable drug implants in rodents. Objective: Compare bioavailability of buprenorphine with the biodegradation of lipid-encapsulated subcutaneous drug pellets. Methods: Pharmacokinetic and histopathology studies were conducted in BALB/c female mice implanted with cholesterol-buprenorphine drug pellets. Results: Drug levels are below the level of detection (0.5 ng/mL plasma within 4-5 days of implant. However, necroscopy revealed that interstitial tissues begin to seal implants within a week. Visual inspection of the implant site revealed no evidence of inflammation or edema associated with the cholesterol-drug residue. Chemical analyses demonstrated that the residues contained 10-13% of the initial opiate dose for at least two weeks post implant. Discussion: The results demonstrate that biodegradable scaffolds can become sequestered in the subcutaneous space. Conclusion: Drug implants can retain significant and unintended reservoirs of drugs.

  15. Ectopic development of skeletal muscle induced by subcutaneous transplant of rat satellite cells

    Directory of Open Access Journals (Sweden)

    M.G. Fukushima

    2005-03-01

    Full Text Available The present study analyzes the ectopic development of the rat skeletal muscle originated from transplanted satellite cells. Satellite cells (10(6 cells obtained from hindlimb muscles of newborn female 2BAW Wistar rats were injected subcutaneously into the dorsal area of adult male rats. After 3, 7, and 14 days, the transplanted tissues (N = 4-5 were processed for histochemical analysis of peripheral nerves, inactive X-chromosome and acetylcholinesterase. Nicotinic acetylcholine receptors (nAChRs were also labeled with tetramethylrhodamine-labeled alpha-bungarotoxin. The development of ectopic muscles was successful in 86% of the implantation sites. By day 3, the transplanted cells were organized as multinucleated fibers containing multiple clusters of nAChRs (N = 2-4, resembling those from non-innervated cultured skeletal muscle fibers. After 7 days, the transplanted cells appeared as a highly vascularized tissue formed by bundles of fibers containing peripheral nuclei. The presence of X chromatin body indicated that subcutaneously developed fibers originated from female donor satellite cells. Differently from the extensor digitorum longus muscle of adult male rat (87.9 ± 1.0 µm; N = 213, the diameter of ectopic fibers (59.1 µm; N = 213 did not obey a Gaussian distribution and had a higher coefficient of variation. After 7 and 14 days, the organization of the nAChR clusters was similar to that of clusters from adult innervated extensor digitorum longus muscle. These findings indicate the histocompatibility of rats from 2BAW colony and that satellite cells transplanted into the subcutaneous space of adult animals are able to develop and fuse to form differentiated skeletal muscle fibers.

  16. Subcutaneous emphysema during status astmaticus

    Energy Technology Data Exchange (ETDEWEB)

    Schwarz, E.

    1985-09-01

    Spontaneous subcutaneous accumulations of air in the soft parts of the thorax during an asthmatic crisis (status asthmaticus) are rarely seen. The pathomechanism of the phenomenon, which may lead to the formation of an emphysema of the soft parts via the pneumomediastinum, is discussed, and the possible complications which must be taken into account are pointed out. The value of radiological examination of the thorax in children suffering from asthma bronchiale, is explained briefly. (orig.).

  17. Epidural, paraspinal, and subcutaneous lipomatosis

    Energy Technology Data Exchange (ETDEWEB)

    Sener, R. Nuri [Department of Radiology, Ege University Hospital, Bornova, Izmir (Turkey)

    2003-09-01

    A unique case of idiopathic diffuse lipomatosis is reported. The patient was an 11-year-old boy with diffuse lipomatosis in the epidural space, paraspinal muscles, and thoracolumbar subcutaneous regions. Epidural lipomatosis involved the entire thoracolumbar spine and was associated with filar thickening and lipoma. In addition, paraspinal muscles, especially the erector spinae group, had diffuse fatty infiltration. The ultimate clinical effect of this fatty tissue was urinary dysfunction, radicular pain and hypoesthesia in both legs and difficulty walking. (orig.)

  18. An examination of injection drug use trends in Victoria and Vancouver, BC after the closure of Victoria's only fixed-site needle and syringe programme.

    Science.gov (United States)

    Ivsins, Andrew; Chow, Clifton; Macdonald, Scott; Stockwell, Tim; Vallance, Kate; Marsh, David C; Michelow, Warren; Duff, Cameron

    2012-07-01

    Needle and syringe programmes (NSPs) have been established as effective harm reduction initiatives to reduce injection drug use (IDU)-related risk behaviours, including sharing needles. On May 31, 2008, Victoria, BC's only fixed site NSP was shut down due to community and political pressure. This study examines and compares IDU trends in Victoria with those in Vancouver, BC, a city which has not experienced any similar disruption of IDU-related public health measures. Quantitative and qualitative data were collected by interviewer-administered questionnaires conducted with injection drug users (n=579) in Victoria and Vancouver between late 2007 and late 2010. Needle sharing increased in Victoria from under 10% in early 2008 to 20% in late 2010, whilst rates remained relatively low in Vancouver. Participants in Victoria were significantly more likely to share needles than participants in Vancouver. Qualitative data collected in Victoria highlight the difficulty participants have experienced obtaining clean needles since the NSP closed. Recent injection of crack cocaine was independently associated with needle sharing. The closure of Victoria's fixed site NSP has likely resulted in increased engagement in high-risk behaviours, specifically needle sharing. Our findings highlight the contribution of NSPs as an essential public health measure. Copyright © 2011 Elsevier B.V. All rights reserved.

  19. Hydrogeological characterization of shallow-depth zone for CO2 injection and leak test at a CO2 environmental monitoring site in Korea

    Science.gov (United States)

    Lee, S. S.; Kim, T. W.; Kim, H. H.; Ha, S. W.; Jeon, W. T.; Lee, K. K.

    2015-12-01

    The main goal of the this study is to evaluate the importance of heterogeneities in controlling the field-scale transport of CO2 are originated from the CO2 injected at saturated zone below the water table for monitoring and prediction of CO2 leakage from a reservoir. Hydrogeological and geophysical data are collected to characterize the site, prior to conducting CO2 injection experiment at the CO2 environmental monitoring site at Eumseong, Korea. The geophysical data were acquired from borehole electromagnetic flowmeter tests, while the hydraulic data were obtained from pumping tests, slug tests, and falling head permeability tests. Total of 13 wells to perform hydraulic and geophysical test are established along groundwater flow direction in regular sequence, revealed by the results of borehole electromagnetic flowmeter test. The results of geophysical tests indicated that hydraulic gradient is not identical with the topographic gradient. Groundwater flows toward the uphill direction in the study area. Then, the hydraulic tests were conducted to identify the hydraulic properties of the study site. According to the results of pumping and slug tests at the study site, the hydraulic conductivity values show ranges between 4.75 x 10-5 cm/day and 9.74 x 10-5 cm/day. In addition, a portable multi-level sampling and monitoring packer device which remains inflated condition for a long period developed and used to isolate designated depths to identify vertical distribution of hydrogeological characteristics. Hydrogeological information obtained from this study will be used to decide the injection test interval of CO2-infused water and gaseous CO2. Acknowledgement: Financial support was provided by "R&D Project on Environmental Mangement of Geologic CO2 Storage" from the KEITI (Project Number: 2014001810003).

  20. Challenges and recent advances in the subcutaneous delivery of insulin.

    Science.gov (United States)

    Guo, Xiaohui; Wang, Wei

    2017-06-01

    The morbidity of diabetes mellitus is increasing, and subcutaneous injection of exogenous insulin is well established as an effective therapeutic strategy for reducing complications associated with the disease. However, the pain that accompanies repeated injections is an important drawback, and can detrimentally affect the adherence to therapy. Recently, there have been great improvements in injection devices and techniques, including the development of microneedle systems and quantitative injection technologies, which have increased the accuracy of injection, decreased leakage of insulin to the skin surface, and reduced pain. Areas covered: This review highlights some limitations of current techniques for the injection of insulin and its analogs, and describes new methodologies and strategies that have been developed in an attempt to overcome these limitations. Furthermore, novel technologies currently under development that are potential future prospects for insulin delivery are discussed. Expert opinion: New technologies have provided easier and well-tolerated treatment regimens for diabetes patients. However, to further improve patients' satisfaction, self-regulated insulin delivery, automatic adjustment of needle length, memory function to the injection device, use of novel materials could be introduced into insulin injection. Intelligent control of insulin delivery and soluble microneedle arrays may be important areas of future research.

  1. 21 CFR 522.1462 - Naloxone hydrochloride injection.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Naloxone hydrochloride injection. 522.1462 Section... § 522.1462 Naloxone hydrochloride injection. (a) Specifications. Naloxone hydrochloride injection is an... antagonist in dogs. (2) It is administered by intravenous, intramuscular, or subcutaneous injection at an...

  2. Evaluation of sex, race, body mass index and pre-vaccination serum progesterone levels and post-vaccination serum anti-anthrax protective immunoglobulin G on injection site adverse events following anthrax vaccine adsorbed (AVA) in the CDC AVA human clinical trial.

    Science.gov (United States)

    Pondo, Tracy; Rose, Charles E; Martin, Stacey W; Keitel, Wendy A; Keyserling, Harry L; Babcock, Janiine; Parker, Scott; Jacobson, Robert M; Poland, Gregory A; McNeil, Michael M

    2014-06-12

    Anthrax vaccine adsorbed (AVA) administered intramuscularly (IM) results in fewer adverse events (AEs) than subcutaneous (SQ) administration. Women experience more AEs than men. Antibody response, female hormones, race, and body mass index (BMI) may contribute to increased frequency of reported injection site AEs. We analyzed data from the CDC AVA human clinical trial. This double blind, randomized, placebo controlled trial enrolled 1563 participants and followed them through 8 injections (AVA or placebo) over a period of 42 months. For the trial's vaccinated cohort (n=1267), we used multivariable logistic regression to model the effects of study group (SQ or IM), sex, race, study site, BMI, age, and post-vaccination serum anti-PA IgG on occurrence of AEs of any severity grade. Also, in a women-only subset (n=227), we assessed effect of pre-vaccination serum progesterone level and menstrual phase on AEs. Participants who received SQ injections had significantly higher proportions of itching, redness, swelling, tenderness and warmth compared to the IM study group after adjusting for other risk factors. The proportions of redness, swelling, tenderness and warmth were all significantly lower in blacks vs. non-black participants. We found arm motion limitation, itching, pain, swelling and tenderness were more likely to occur in participants with the highest anti-PA IgG concentrations. In the SQ study group, redness and swelling were more common for obese participants compared to participants who were not overweight. Females had significantly higher proportions of all AEs compared to males. Menstrual phase was not associated with any AEs. Female and non-black participants had a higher proportion of AVA associated AEs and higher anti-PA IgG concentrations. Antibody responses to other vaccines may also vary by sex and race. Further studies may provide better understanding for higher proportions of AEs in women and non-black participants. Published by Elsevier Ltd.

  3. An open-label trial of a sumatriptan auto-injector for migraine in patients currently treated with subcutaneous sumatriptan.

    Science.gov (United States)

    Landy, Stephen H; Tepper, Stewart J; Wein, Theodore; Schweizer, Edward; Ramos, Elodie

    2013-01-01

    To assess the ability of patients, during an acute migraine attack, to successfully self-inject a single dose of sumatriptan using a novel sumatriptan auto-injector (Alsuma(®)), and to evaluate the safety, tolerability, and effectiveness of this sumatriptan auto-injector during an acute migraine attack. This sumatriptan auto-injector is a single-use system for the rapid subcutaneous delivery of 6 mg of sumatriptan succinate in the acute management of migraine pain. This auto-injector was developed to address the clinical need for an easy-to-use and rapid-to-administer system that did not require any assembly during the time of an ongoing attack. This was an open-label, phase 3 trial conducted at 10 sites in the USA. Male or female adults, ages 18-60 years old, were eligible for study entry if they met International Headache Society criteria for migraine with or without aura, with at least 2 attacks per month, and if they reported use of subcutaneous injectable sumatriptan on at least 2 occasions within the previous 2 months. During the onset of a migraine attack of moderate-to-severe intensity, patients were asked to administer a 6-mg subcutaneous dose of sumatriptan using the auto-injector. Patients returned to the study site within 72 hours of the migraine for the post-treatment assessment visit. A total of 63 patients met entry criteria and received a dose of study medication (the intent-to-treat sample). Sixty-one patients (96.8%) reported injection in the thigh, and 2 patients (3.2%) reported injection in the arm. On the patient questionnaire, 100% of patients (95% confidence interval [CI] 94.3-100%) "agreed" or "agreed strongly" that the written instructions for the auto-injector were clear and easy to follow (30.2% "agreed"; 69.8% "agreed strongly"); 95.2% of patients (95% CI 86.7-99.0%) found that the auto-injector was easy to use (36.5% "agreed"; 58.7% "agreed strongly"), and 65.1% of patients (95% CI 52.0-76.7%) stated that they preferred the new auto

  4. Corrective Action Investigation Plan for Corrective Action Unit 322: Areas 1 and 3 Release Sites and Injection Wells, Nevada Test Site, Nevada: Revision 0, Including Record of Technical Change No. 1

    Energy Technology Data Exchange (ETDEWEB)

    U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office

    2003-07-16

    This Corrective Action Investigation Plan contains the U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office's approach to collect the data necessary to evaluate corrective action alternatives (CAAs) appropriate for the closure of Corrective Action Unit (CAU) 322, Areas 1 and 3 Release Sites and Injection Wells, Nevada Test Site, Nevada, under the Federal Facility Agreement and Consent Order. Corrective Action Unit 322 consists of three Corrective Action Sites (CASs): 01-25-01, AST Release (Area 1); 03-25-03, Mud Plant AST Diesel Release (Area 3); 03-20-05, Injection Wells (Area 3). Corrective Action Unit 322 is being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend corrective action alternatives. The investigation of three CASs in CAU 322 will determine if hazardous and/or radioactive constituents are present at concentrations and locations that could potentially pose a threat to human health and the environment. The results of this field investigation will support a defensible evaluation of corrective action alternatives in the corrective action decision document.

  5. Forward modeling of 4D seismic response to the CO2 injection at the Ketzin pilot site with the reflectivity method

    OpenAIRE

    Alexandra Ivanova; Monika Ivandic; Thomas Kempka; M. Diersch [Gil; P. Bergmann; S. Lueth

    2014-01-01

    When CO2 replaces brine as a free gas it is well known to affect the elastic properties of porous media considerably. 3D seismic time-lapse surveys (4D seismics) have proven to be a suitable technique for monitoring of injected CO2. Forward modeling of a 4D seismic response to the CO2 fluid substitution in a storage reservoir is an important step in such studies. In order to track the migration of CO2 at the Ketzin pilot site (Germany), 3D time-lapse seismic data were acquired by means of ...

  6. Magnetotelluric and Controlled-Source Electromagnetic Pre-Injection Study of Aquistore CO2 Sequestration Site, Near Estevan, Saskatchewan, Canada

    Science.gov (United States)

    Craven, J.; McLeod, J.; Ferguson, I. J.

    2016-12-01

    The Aquistore project is a large-scale CO2 sequestration operation at Estevan, southeast Saskatchewan, Canada. CO2 is being captured from the Boundary Dam power station, and injected to the base of the Phanerozoic Williston Basin, to be stored in a saline aquifer at 3.4 km depth. In this study, magnetotelluric (MT) and surface controlled-source electromagnetic (CSEM) methods are tested in a pre-injection setting at Aquistore for their applicability to sequestration monitoring goals. The MT and CSEM methods are complimentary in their ability to resolve structures at different scales using different current systems. Pre-injection MT soundings were conducted in 2013, 2014 and 2015 over a 2.5 km × 8.5 km area surrounding the Aquistore injection well. The Phanerozoic MT response is spatially uniform across the survey area. The resistivity structure of the Phanerozoic is one-dimensional from 0.001 to 10 s: the apparent resistivity decreases from 8 Ωm to 2 Ωm in this period range. Spectral and polarization analyses indicate that broadband noise in period bands of 0.05 to 1 s and 0.0077 to 0.0125 s recorded in 2014 is associated with a CO2 pipeline. At frequencies outside these bands, the MT responses define small differences between surveys (response from these datasets and constraints from a resistivity well-log, a representative 18-layer 1D resistivity model for the Williston Basin sedimentary sequence has been recovered. CSEM surveys in 2013 and 2015 used a 1 km, 30 A electric horizontal dipole source. Recordings of the radial electric field component were made along an inline receiver profile from 3.5 to 9.5 km offsets. Preliminary characterization of these recordings indicates that the transmitted signals are observable at each of the profile locations. Fréchet derivatives of the CSEM response indicate that response sensitivity to changes in the Williston Basin electrical properties is attainable at the level of the reservoir. Low induction number soundings

  7. Groundwater Chemistry Changes as a Result of CO2 Injection at the ZERT Field Site in Bozeman, Montana

    Energy Technology Data Exchange (ETDEWEB)

    Apps, J.A.; Birkholzer, J.T.; Spycher, N.; Zheng, L.; Herkelrath, W.N.; Kharaka, Y.K.; Thordsen, J.J.; Kakouros, E.; Beers, S; Gullickson, K.S.; Spangler, L.H.; Ambats, G.

    2009-11-01

    Combustion of fossil fuels produces CO{sub 2}, a common greenhouse gas linked to global climate change. Separation of CO{sub 2}from emissions produced by large industrial point sources like power plants, cement kilns and refineries, and injection deep nderground into geologic formations is one method of preventing CO{sub 2} releases into the atmosphere. This process is referred to as Carbon Capture and Storage (CCS). CCS is one of several solutions being considered to mitigate global climate change. Other solutions nclude increased energy efficiency, renewables, nuclear power, advanced coal, and plug-in hybrid electric vehicles.

  8. [Establishment of subcutaneously transplanted and metastatic neuroblastoma models in nude mice].

    Science.gov (United States)

    Lu, Hong-ting; Dong, Qian; Gao, Qiang; Hao, Xi-wei; Song, Hua; Zhao, Nan

    2010-04-01

    To establish a tumor-bearing nude mouse model of human neuroblastoma in order to study the mechanisms of neuroblastoma invasion and metastasis, and to investigate potential therapeutic modalities in the experimental animal models. A human neuroblastoma cell line was cultured in vitro. 1 x 10(7) cells undergoing exponential growth were collected in 0.1 ml of suspension and subcutaneously inoculated into the right flank next to the forelimb in nude mice. The biological characteristics of the developed tumors were observed, and histopathological and DNA microarray analyses were performed. The expressions of NSE in the subcutaneous tumor, metastatic tumor and the primary neuroblastoma tumor tissues from a pediatric patient were analyzed by immunohistochemistry. Tumors successfully grew in 36 out of 48 injected mice, with a total tumor-formation rate of 75.0%. Metastasis occurred in 10 cases, and the metastatic rate was 20.8%. Tumors in five injected mice grew locally without metastasis. These tumors had large volume and the tumor weight reached up to half of the body weight of the host animal. Four mice exhibited systemic metastasis without tumor growth at the primary inoculation site. There were six mice with locally growing tumor accompanied by metastasis. We have successfully established a human neuroblastoma xenograft model in nude mice with high tumor growth and metastatic rates. This model depicting the natural cell growth, local infiltration and distant metastasis characteristics of human neuroblastoma, providing an ideal animal model for in vivo studies of neuroblastoma. In addition, the results of this study indicate the heterogeneous nature of neuroblastoma, it may play an important role in metastasis of this tumor.

  9. Late Hematogenous Infection of Subcutaneous Implants in Rats

    Science.gov (United States)

    Gottenbos, B.; Klatter, F.; Van Der Mei, H. C.; Busscher, H. J.; Nieuwenhuis, P.

    2001-01-01

    Late biomaterial-centered infection is a major complication associated with the use of biomaterial implants. In this study biomaterials that had been implanted subcutaneously in rats were hematogenously challenged with bacteria 4 weeks after implantation. Bacteria were spread either by intravenous injection or by stimulation of bacterial translocation. It was found that none of the biomaterials was infected by hematogenous spread, whereas 5% of the implants were infected by perioperative contamination. We conclude that late hematogenous infection of subcutaneous biomaterials does not occur in the rat. For humans as well, there are growing doubts whether implants actually become infected through hematogenous routes; it is thought that late infections may be caused by delayed appearance of perioperatively introduced bacteria. PMID:11527814

  10. Subcutaneous Leiomyosarcoma of the Frenulum

    Directory of Open Access Journals (Sweden)

    D. Mendis

    2005-01-01

    Full Text Available Leiomyosarcomas of the penis are rare, with only 29 reported cases to date. We record the case of a patient who presented with a 2-year history of a seemingly indolent penile skin lesion. On histopathology of the local resection, a diagnosis of subcutaneous leiomyosarcoma was made. Specifically, leiomyosarcoma of the penile frenulum has not been clearly reported previously. The patient underwent a further excision to ensure an adequate resection margin and has had no disease recurrence at subsequent follow-up. Our case was of a lesion that, although clinically benign, was malignant and this possibility should be borne in mind when assessing patients.

  11. Desenvolvimento e Caracterização de um Modelo Experimental de Obesidade por Injeção Subcutânea de Glutamato Monossódico em Ratos/Development and Characterization of na Experimental Model of Obesity by Subcutaneous Injection of Monosodium Glutamate in Rats

    Directory of Open Access Journals (Sweden)

    Pedro Henrique Teixeira Junqueira

    2011-09-01

    Full Text Available Objetivo: Desenvolver e caracterizar um modelo experimental de obesidade em ratos. Materiais e Métodos: Foram utilizados 41 ratos da linhagem Wistar, recém-nascidos divididos em fêmeas e machos, nos respectivos grupos: controle, tratamento 4mg/g e tratamento 8mg/g, nos quais foram aplicadas injeções de soro fisiológico, glutamato monossódico a 4mg/g e a 8mg/g, respectivamente por via subcutânea, em dose única diária por via subcutânea pela manhã, durante os quatro primeiros dias de vida e acompanhados por 40 semanas. Após o tratamento, foram feitas análises laboratoriais (glicemia, colesterol total e frações e triglicérides de medidas corporais (comprimento, peso e circunferência abdominal e anatomopatológicas. Resultados: A análise dos parâmetros laboratoriais mostraram um aumento da glicemia e dos triglicérides e diminuição do HDL-colesterol. Houve alterações nas medidas corporais e IMC, sem alterar o perfil renal. Na análise histopatológica, foram observadas alterações inerentes à síndrome plurimetabólica, como esteatose hepática, aumento das ilhotas pancreáticas além de outros achados. Conclusão: A administração de glutamato monossódico em ratos nas doses de 4mg/g e 8mg/g foi capaz de induzir alterações em vários parâmetros laboratoriais e histopatológicos na determinação de síndrome metabólica e obesidade, sem obter uma relação direta entre dose e efeito esperado. Objective: To develop and characterize an experimental model of obesity in rats. Materials and Methods: 41 Wistar rats, divided in newborn females and males in their respective groups: control, treatment, treatment 4mg/g 8mg / g, which received injections of saline, monosodium glutamate to 4 mg / g and 8 mg / g, respectively subcutaneously once daily subcutaneously in the morning during the first four days and followed for 40 weeks. After treatment, laboratory tests were performed (blood glucose, total cholesterol and

  12. Injectable rhBMP-2-loaded chitosan hydrogel composite: osteoinduction at ectopic site and in segmental long bone defect.

    Science.gov (United States)

    Luca, Ludmila; Rougemont, Anne-Laure; Walpoth, Beat H; Boure, Ludovic; Tami, Andrea; Anderson, James M; Jordan, Olivier; Gurny, Robert

    2011-01-01

    Carriers for bone morphogenetic protein-2 (BMP-2) used in clinical practice still suffer from limitations such as insufficient protein retention. In addition, there is a clinical need for injectable carriers. The main objective of this study was to assess bone forming ability of rhBMP-2 combined either with chitosan hydrogel (rhBMP-2/CH) or chitosan hydrogel containing β-tricalcium phosphate (β-TCP) (rhBMP-2/CH/TCP). Formulations were first compared in a rat ectopic intramuscular bone formation model, and the optimal formulation was further evaluated in healing of 15-mm critical size defect in the radius of a rabbit. Three weeks after injection ectopically formed bone was analyzed by microcomputerized tomography (micro-CT) and histology. Significantly higher (4.7-fold) mineralized bone formation was observed in the rhBMP-2/CH/TCP group compared to rhBMP-2/CH group. In a pilot study, defect in a rabbit radius treated with rhBMP-2/CH/TCP showed incomplete regeneration at 8 weeks with composite leakage from the defect, indicating the need for formulation refinement when segmental defect repair is foreseen. Copyright © 2010 Wiley Periodicals, Inc.

  13. Presternal subcutaneous bronchogenic cyst in adolescence

    Science.gov (United States)

    Moon, Sung Mo; Lee, Sang Min; Kang, Haeyoun; Choi, Hye Jeong

    2017-01-01

    Abstract Subcutaneous bronchogenic cysts have been described rarely, particularly among adolescents. Only a few reports have described the ultrasonographic features of bronchogenic cysts, characterizing them as nonspecific cystic masses with or without internal echogenic foci or debris. Therefore, it is hard to differentiate subcutaneous bronchogenic cysts from other subcutaneous cystic tumors ultrasonographically. We report a case of presternal subcutaneous bronchogenic cyst in an 18-year-old man with unusual ultrasonographic findings. Ultrasonography revealed a small, oval, cystic mass containing a well-circumscribed, heterogeneously hypoechoic, egg-shaped lesion in the dependent portion of the mass within the subcutaneous fat layer overlying the sternum. Surgical excision was performed, and the cystic mass was diagnosed as a bronchogenic cyst. On pathological examination, the internal, heterogeneously hypoechoic, ball-like lesion was found to be mucous material within the cyst. To our knowledge, this is the first reported case of a presternal subcutaneous bronchogenic cyst presenting with a ball-like lesion inside of the cyst. This unusual ultrasonographic feature can be a clue to the diagnosis of subcutaneous bronchogenic cyst. In conclusion, if an anechoic cyst containing an internal, well-circumscribed, hypoechoic ball-like lesion is seen in the presternal subcutaneous fat layer, subcutaneous bronchogenic cyst should be considered in the differential diagnosis of subcutaneous cystic masses. PMID:28151916

  14. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids

    Science.gov (United States)

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-01-01

    Abstract The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No

  15. Corrective Action Decision Document/Closure Report for Corrective Action Unit 546: Injection Well and Surface Releases Nevada Test Site, Nevada, Revision 0

    Energy Technology Data Exchange (ETDEWEB)

    Alfred Wickline

    2008-12-01

    This Corrective Action Decision Document/Closure Report has been prepared for Corrective Action Unit 546, Injection Well and Surface Releases, at the Nevada Test Site, Nevada, in accordance with the Federal Facility Agreement and Consent Order (FFACO, 1996; as amended February 2008). Corrective Action Unit (CAU) 546 is comprised of two corrective action sites (CASs): • 06-23-02, U-6a/Russet Testing Area • 09-20-01, Injection Well The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation for closure of CAU 546. To achieve this, corrective action investigation (CAI) activities were performed from May 5 through May 28, 2008, as set forth in the Corrective Action Investigation Plan for Corrective Action Unit 546: Injection Well and Surface Releases, Nevada Test Site, Nevada (NNSA/NSO, 2008). The purpose of the CAI was to fulfill the following data needs as defined during the data quality objective (DQO) process: • Determine whether a contaminant of concern is present at a given CAS. • Determine whether sufficient information is available to evaluate potential corrective action alternatives at each CAS. The CAU 546 dataset from the investigation results was evaluated based on the data quality indicator parameters. This evaluation demonstrated the quality and acceptability of the dataset for use in fulfilling the DQO data needs. Because DQO data needs were met, and corrective actions have been implemented, it has been determined that no further corrective action (based on risk to human receptors) is necessary for the CAU 546 CASs. The U.S. Department of Energy, National Nuclear Security Administration Nevada Site Office provides the following recommendations: • No further corrective actions are needed for CAU 546 CASs. • No Corrective Action Plan is required. • A Notice of Completion to the U.S. Department of Energy, National Nuclear Security Administration Nevada Site

  16. Safety of subcutaneous microinjections (mesotherapy) in musicians.

    Science.gov (United States)

    Navarte, Danik Arana; Rosset-Llobet, Jaume

    2011-06-01

    Determine the safety and tolerance of mesotherapy as a technique for the treatment of musculoskeletal complaints in musicians. 67 patients (55.2% women) were subjected to a total of 267 mesotherapy sessions. A mesotherapy needle or normal needle was used randomly. The drugs employed were thiocolchicoside and diazepam as muscular relaxants, pentoxifylline or buflomedil as vasodilators, and piroxicam as an anti-inflammatory, as directed. A visual analogue scale was used to quantify the pain produced by the microinjections as well as the degree of immediate and midterm side effects as reported on a standard questionnaire. A mean of 155.5 microinjections were performed per session, of which 45.6% were perceived as painful by the patient with a mean severity of 4.3 out of 10. The pain reduced to 0.5 out of 10 after 24 hours. The most sensitive areas were the levator scapulae and splenius muscles. Systemic symptoms were reported by 5.99% of the musicians after the mesotherapy sessions (muscular weakness 1.5%, rash 1.5%, drowsiness 1.1% and itching 1.1%, being the most frequent). The mean severity of these symptoms was 2.77 out of 10. In all cases the symptoms had completely disappeared after 24 hours. No patient referred to signs of local or systemic infection. The application of drugs by means of subcutaneous injections (mesotherapy) in musicians is a technique that is safe, well tolerated, and without any severe complications.

  17. Assessment of self-injection experience in patients with rheumatoid arthritis: psychometric validation of the Self-Injection Assessment Questionnaire (SIAQ

    Directory of Open Access Journals (Sweden)

    Keininger Dorothy

    2011-01-01

    Full Text Available Abstract Background Subcutaneous self-injection of medication has benefits for the patient and healthcare system, but there are barriers such as dexterity problems and injection anxiety that can prevent self-injection being used effectively. An accurate method of evaluating patients' experiences with self-injection would enable assessment of their success in giving self-injections and the likelihood of them adhering to a self-injection regimen. The aim of this study was to develop a questionnaire to measure overall patient experience with subcutaneous self-injection (the Self-Injection Assessment Questionnaire [SIAQ], and to investigate its psychometric properties. Methods The construct validity and reliability of the SIAQ were tested in patients with rheumatoid arthritis who volunteered to inject certolizumab pegol using a standard syringe during an open-label multinational extension trial of the long-term safety and efficacy of this drug. The SIAQ PRE module was self-completed before the first self-injection, and the POST module was self-completed following each of three fortnightly self-injections. Results Ninety-seven patients completed the SIAQ. All items correlated well with their respective domains in confirmatory factor analysis. As predicted, compared with other participants, patients with very low scores (less than 3 out of 10 in PRE causal domains (Feelings about injections and Self-confidence were significantly less satisfied with their first self-injection, as were patients with a very low score in any POST causal domain (Self-confidence, Feelings about injections, Injection-site reactions and Ease of use, demonstrating known-groups validity. Causal domain scores generally correlated most strongly with the Satisfaction with self-injection domain, supporting convergent validity. The SIAQ demonstrated internal consistency and reproducibility; Cronbach's α and the test-retest coefficient were > 0.70 for all domains. Sensitivity and

  18. [Subcutaneous teicoplanin for children with infectious endocarditis].

    Science.gov (United States)

    Carpentier, E; Roméo, B; El Samad, Y; Geslin-Lichtenberger, L; Maingourd, Y; Tourneux, P

    2013-07-01

    Infectious endocarditis in children requires prolonged antibiotic therapy. In adults, antibiotics administrated subcutaneously such as teicoplanin are an alternative to intravenous treatment. We report the use of subcutaneous teicoplanin, after an initial antibiotic treatment administrated intravenously, for 2 children treated for infectious endocarditis following an initial cardiac surgery. Serum concentrations of teicoplanin were within the target range after the adaptation in the teicoplanin subcutaneous dosages. The treatment was effective for both cases. No specific side effects related to the treatment were reported. Subcutaneous administration could be used for prolonged antibiotic therapy for the treatment of infectious endocarditis in children, after an initial intravenous treatment. Variability of the bioavailability of antibiotics administrated subcutaneously requires regular testing. Prospective, randomized trials comparing intravenous and subcutaneous administration of teicoplanin should be conducted to assess the efficacy and safety of this treatment. Copyright © 2013 Elsevier Masson SAS. All rights reserved.

  19. Hyaluronidase facilitated subcutaneous immunoglobulin in primary immunodeficiency

    Directory of Open Access Journals (Sweden)

    Jolles S

    2013-09-01

    Full Text Available Stephen Jolles Department of Immunology, University Hospital of Wales, Cardiff, UK Abstract: Immunoglobulin (Ig-replacement therapy represents the mainstay of treatment for patients with primary antibody deficiency and is administered either intravenously (IVIg or subcutaneously (SCIg. While hyaluronidase has been used in clinical practice for over 50 years, the development of a high-purity recombinant form of this enzyme (recombinant human hyaluronidase PH20 has recently enabled the study of repeated and more prolonged use of hyaluronidase in facilitating the delivery of SC medicines. It has been used in a wide range of clinical settings to give antibiotics, local anesthetics, insulin, morphine, fluid replacement, and larger molecules, such as antibodies. Hyaluronidase has been used to help overcome the limitations on the maximum volume that can be delivered into the SC space by enabling dispersion of SCIg and its absorption into lymphatics. The rate of facilitated SCIg (fSCIg infusion is equivalent to that of IVIg, and the volume administered at a single site can be greater than 700 mL, a huge increase over conventional SCIg, at 20–40 mL. The use of fSCIg avoids the higher incidence of systemic side effects of IVIg, and it has higher bioavailability than SCIg. Data on the long-term safety of this approach are currently lacking, as fSCIg has only recently become available. fSCIg may help several areas of patient management in primary antibody deficiency, and the extent to which it may be used in future will depend on long-term safety data and cost–benefit analysis. Keywords: enzyme facilitated IgG infusion, recombinant human hyaluronidase PH20, subcutaneous immunoglobulin, intravenous immunoglobulin, primary immunodeficiency disease

  20. Subcutaneous Emphysema—Beyond the Pneumoperitoneum

    OpenAIRE

    Ott, Douglas E.

    2014-01-01

    Background: Subcutaneous emphysema and gas extravasation outside of the peritoneal cavity during laparoscopy has consequences. Knowledge of the circumstances that increase the potential for subcutaneous emphysema is necessary for safe laparoscopy. Methods: A literature review and a PubMed search are the basis for this review. Conclusions: The known risk factors leading to subcutaneous emphysema during laparoscopy are multiple attempts at abdominal entry, improper cannula placement, loose fitt...

  1. The duration of hyaluronidase and optimal timing of hyaluronic acid (HA) filler reinjection after hyaluronidase injection.

    Science.gov (United States)

    Kim, H J; Kwon, S B; Whang, K U; Lee, J S; Park, Y L; Lee, S Y

    2018-02-01

    Hyaluronidase injection is a commonly performed treatment for overcorrection or misplacement of hyaluronic acid (HA) filler. Many patients often wants the HA filler reinjection after the use of hyaluronidase, though the optimal timing of reinjection of HA filler still remains unknown. To provide the optimal time interval between hyaluronidase injections and HA filler reinjections. 6 Sprague-Dawley rats were injected with single monophasic HA filler. 1 week after injection, the injected sites were treated with hyaluronidase. Then, HA fillers were reinjected sequentially with differing time intervals from 30 minutes to 14 days. 1 hour after the reinjection of the last HA filler, all injection sites were excised for histologic evaluation. 3 hours after reinjection of HA filler, the appearance of filler material became evident again, retaining its shape and volume. 6 hours after reinjection, the filler materials restored almost its original volume and there were no significant differences from the positive control. Our data suggest that the hyaluronidase loses its effect in dermis and subcutaneous tissue within 3-6 hours after the injection and successful engraftment of reinjected HA filler can be accomplished 6 hours after the injection.

  2. Subcutaneous Emphysema, Pneumomediastinum, Pneumoretroperitoneum, and Pneumoscrotum: Unusual Complications of Acute Perforated Diverticulitis

    Directory of Open Access Journals (Sweden)

    S. Fosi

    2014-01-01

    Full Text Available Pneumomediastinum, and subcutaneous emphysema usually result from spontaneous alveolar wall rupture and, far less commonly, from disruption of the upper airways or gastrointestinal tract. Subcutaneous neck emphysema, pneumomediastinum, and retropneumoperitoneum caused by nontraumatic perforations of the colon have been infrequently reported. The main symptoms of spontaneous subcutaneous emphysema are swelling and crepitus over the involved site; further clinical findings in case of subcutaneous cervical and mediastinal emphysema can be neck and chest pain and dyspnea. Radiological imaging plays an important role to achieve the correct diagnosis and extension of the disease. We present a quite rare case of spontaneous subcutaneous cervical emphysema, pneumomediastinum, and pneumoretroperitoneum due to perforation of an occult sigmoid diverticulum. Abdomen ultrasound, chest X-rays, and computer tomography (CT were performed to evaluate the free gas extension and to identify potential sources of extravasating gas. Radiological diagnosis was confirmed by the subsequent surgical exploration.

  3. Administration and Burden of Subcutaneous Immunotherapy for Allergic Rhinitis in U.S. and Canadian Clinical Practice.

    Science.gov (United States)

    Blume, Steven W; Yeomans, Karen; Allen-Ramey, Felicia; Smith, Nancy; Kim, Harold; Lockey, Richard F; Nichol, Michael B

    2015-11-01

    Allergy immunotherapy (AIT) is the only available treatment that alters the natural course of allergies and has possible disease-modifying effects. AIT is administered primarily via subcutaneous injection delivered in a physician's office. Few studies have been conducted in the United States or Canada to evaluate the costs of subcutaneous immunotherapy (SCIT). To (a) describe SCIT administration processes, resources, and costs and (b) characterize the patient population receiving SCIT. A multisite, prospective, observational time and motion study was conducted. Injection and wait times were collected by a third-party observer on 1 visit for each patient. Extract preparation processes were also observed. Site staff reported on treatment protocols, administrative time, supplies, and patient medical history. Patients responded to questionnaires on demographics, reasons for treatment, medication use, productivity, and travel time. Costs were estimated by applying unit costs to the time observations and the patient- and staff-reported data. A total of 670 SCIT patients were enrolled at 6 sites in the United States and 6 sites in Canada. Average age in the United States was 41 years (SD = 18) and 44 years (15) in Canada, with 10% of the patients aged ≥ 65 years. Annual incomes were over $100,000 for 40% of U.S. patients and 30% of Canadian patients. U.S. patients had over 4 times as many different allergens in their SCIT treatments as Canadian patients, with a mean of 18 versus 4. The most common reasons reported for starting SCIT was a "desire to cure allergies once and for all" (73%) and that "symptoms are not improved by allergy medications" (60%). Percentages of patients taking allergy medications in the 4 weeks prior to observation were 86% in the United States and 66% in Canada: antihistamines 75% United States, 54% Canada; inhaled corticosteroids 32% United States, 22% Canada. The predominant comorbidity was asthma, 43% United States, 24% Canada. Site

  4. When local anesthesia becomes universal: Pronounced systemic effects of subcutaneous lidocaine in bullfrogs (Lithobates catesbeianus).

    Science.gov (United States)

    Williams, Catherine J A; Alstrup, Aage K O; Bertelsen, Mads F; Jensen, Heidi M; Leite, Cleo A C; Wang, Tobias

    2017-07-01

    Sodium channel blockers are commonly injected local anesthetics but are also routinely used for general immersion anesthesia in fish and amphibians. Here we report the effects of subcutaneous injection of lidocaine (5 or 50mgkg(-1)) in the hind limb of bullfrogs (Lithobates catesbeianus) on reflexes, gular respiration and heart rate (handled group, n=10) or blood pressure and heart rate via an arterial catheter (catheterized group n=6). 5mgkg(-1) lidocaine did not cause loss of reflexes or change in heart rate in the handled group, but was associated with a reduction in gular respiratory rate (from 99±7 to 81±17breathsmin(-1)). 50mgkg(-1) lidocaine caused a further reduction in respiratory rate to 59±15breathsmin(-1), and led to a progressive loss of righting reflex (10/10 loss by 40min), palpebral reflex (9/10 loss at 70min), and contralateral toe pinch withdrawal (9/10 loss at 70min). Reflexes were regained over 4h. Systemic sedative effects were not coupled to local anti-nociception, as a forceps pinch test at the site of injection provoked movement at the height of the systemic effect (tested at 81±4min). Amphibians are routinely subject to general anesthesia via exposure to sodium channel blockers such as MS222 or benzocaine, however caution should be exercised when using local injectable lidocaine in amphibians, as it appears to dose-dependently cause sedation, without necessarily preventing local nociception for the duration of systemic effects. Copyright © 2017 Elsevier Inc. All rights reserved.

  5. Corrective Action Investigation Plan for Corrective Action Unit 219: Septic Systems and Injection Wells, Nevada Test Site, Nevada, Rev. No.: 0

    Energy Technology Data Exchange (ETDEWEB)

    David A. Strand

    2005-01-01

    The Corrective Action Investigation Plan for Corrective Action Unit 219, Septic Systems and Injection Wells, has been developed in accordance with the ''Federal Facility Agreement and Consent Order'' (1996) that was agreed to by the State of Nevada, the U.S. Department of Energy, and the U.S. Department of Defense. The purpose of the investigation is to ensure that adequate data are collected to provide sufficient and reliable information to identify, evaluate, and select technically viable corrective actions. Corrective Action Unit 219 is located in Areas 3, 16, and 23 of the Nevada Test Site, which is 65 miles northwest of Las Vegas, Nevada. Corrective Action Unit 219 is comprised of the six Corrective Action Sites (CASs) listed below: (1) 03-11-01, Steam Pipes and Asbestos Tiles; (2) 16-04-01, Septic Tanks (3); (3) 16-04-02, Distribution Box; (4) 16-04-03, Sewer Pipes; (5) 23-20-01, DNA Motor Pool Sewage and Waste System; and (6) 23-20-02, Injection Well. These sites are being investigated because existing information on the nature and extent of potential contamination is insufficient to evaluate and recommend corrective action alternatives. Additional information will be obtained by conducting a corrective action investigation prior to evaluating corrective action alternatives and selecting the appropriate corrective action for each CAS. The results of the field investigation will support a defensible evaluation of viable corrective action alternatives that will be presented in the Corrective Action Decision Document.

  6. The effect of on-site and outreach-based needle and syringe programs in people who inject drugs in Kermanshah, Iran.

    Science.gov (United States)

    Nazari, Seyed Saeed Hashemi; Noroozi, Mehdi; Soori, Hamid; Noroozi, Alireza; Mehrabi, Yadollah; Hajebi, Ahmad; Sharifi, Hamid; Higgs, Peter; Mirzazadeh, Ali

    2016-01-01

    Needle and syringe programs (NSPs) are widely used to reduce harms associated with drug injecting. This study assessed the effect of facility-based (on-site services at drop-in centre) and outreach models of NSP on injection risk behaviours. Self-reported data from 455 people who injected drugs (PWID) during 2014 in Kermanshah, Iran, were examined to measure demographic characteristics and risk behaviors. Self-reported and program data were also assessed to identify their main source of injection equipment. Participants were divided into three sub-groups: facility-based NSP users, outreach NSP users and non-users (comparison group). Coarsened exact matching was used to make the three groups statistically equivalent based on age, place of residence, education and income, and groups were compared regarding the proportion of borrowing or lending of syringes/cookers, reusing syringes and recent HIV testing. Overall, 76% of participants reported any NSP service use during the two months prior to interview. Only 23% (95%CI: 17-27) reported outreach NSP as their main source of syringes. Using facility-based NSP significantly decreased recent syringe borrowing (OR: 0.27, 95%CI: 0.10-0.70), recent syringe reuse (OR: 0.38, 95%CI: 0.23-0.68) and increased recent HIV testing (OR: 2.60, 95%CI: 1.48-4.56). Similar effects were observed among outreach NSP users; in addition, the outreach NSP model significantly reduced the chance of lending syringes (OR: 0.31, 95%CI: 0.15-0.60), compared to facility-based NSP (OR: 1.25, 95%CI: 0.74-2.17). These findings suggest that the outreach NSP model is as effective as facility-based NSP in reducing injection risk behaviours and increasing the rate of HIV testing. Outreach NSP was even more effective than facility-based in reducing the lending of syringes to others. Scaling up outreach NSP is an effective intervention to further reduce transmission of HIV via needle sharing. Copyright © 2015 Elsevier B.V. All rights reserved.

  7. Sumatriptan Injection

    Science.gov (United States)

    Alsuma® Injection ... Imitrex® Injection ... Sumavel® Injection ... Sumatriptan injection is used to treat the symptoms of migraine headaches (severe, throbbing headaches that sometimes are accompanied by ...

  8. Frontal subcutaneous blood flow, and epi- and subcutaneous temperatures during scalp cooling in normal man

    DEFF Research Database (Denmark)

    Bülow, J; Friberg, L; Gaardsting, O

    1985-01-01

    during cooling and rewarming and to measure the effect of scalp cooling on subcutaneous scalp blood flow, subcutaneous blood flow and epi- and subcutaneous temperatures were measured in the frontal region at the hairline border before and during cooling with a cooling helmet, during spontaneous rewarming...

  9. Gentamicin concentrations in human subcutaneous tissue

    DEFF Research Database (Denmark)

    Lorentzen, Hanne; Kallehave, Finn Lasse; Kolmos, Hans Jørn Jepsen

    1996-01-01

    in human subcutaneous adipose tissue by a microdialysis technique. Seven healthy young volunteers each had four microdialysis probes placed in the fat (subcutaneous) layer of the abdominal skin. After the administration of a 240-mg gentamicin intravenous bolus, consecutive measurements of the drug...

  10. Facilitated subcutaneous immunoglobulin administration (fSCIg)

    DEFF Research Database (Denmark)

    Blau, Igor-Wolfgang; Conlon, Niall; Petermann, Robert

    2016-01-01

    and diverse medical needs that treatments for SID management should strive to meet. In this special report, we study the opportunities provided by facilitated subcutaneous immunoglobulin administration (fSCIg) to treat patients for whom the conventional routes (intravenous and subcutaneous) are sub...

  11. Gentamicin concentrations in human subcutaneous tissue

    DEFF Research Database (Denmark)

    Lorentzen, Hanne; Kallehave, Finn Lasse; Kolmos, Hans Jørn Jepsen

    1996-01-01

    Wound infections frequently originate from the subcutaneous tissue. The effect of gentamicin in subcutaneous tissue has, however, normally been evaluated from concentrations in blood or wound fluid. The aim of the present study was to investigate the pharmacokinetic properties of gentamicin in hu...... the presence of sufficient concentrations in the adipose tissue to be effective against common bacteria....

  12. Ultrasonographic Evaluation of Botulinum Toxin Injection Site for the Medial Approach to Tibialis Posterior Muscle in Chronic Stroke Patients with Spastic Equinovarus Foot: An Observational Study

    Directory of Open Access Journals (Sweden)

    Alessandro Picelli

    2017-11-01

    Full Text Available The tibialis posterior muscle is a frequent target for injection of botulinum toxin during the management of spastic equinovarus foot in adults with post-stroke spasticity. Although it is deep-seated, the needle insertion into the tibialis posterior muscle is usually performed using anatomical landmarks and safety information obtained from healthy subjects and cadavers. Our aim was to evaluate the botulinum toxin injection site for the medial approach to the tibialis posterior muscle in chronic stroke patients with spastic equinovarus foot. Forty-six patients were evaluated at the affected middle lower leg medial surface with ultrasonography according to the following parameters: tibialis posterior muscle depth, thickness, and echo intensity. As to the spastic tibialis posterior, we found a mean muscle depth of 26.5 mm and a mean muscle thickness of 10.1 mm. Furthermore we observed a median tibialis posterior muscle echo intensity of 3.00 on the Heckmatt scale. The tibialis posterior muscle thickness was found to be inversely associated with its depth (p < 0.001 and echo intensity (p = 0.006. Furthermore, tibialis posterior muscle depth was found to be directly associated with its echo intensity (p = 0.004. Our findings may usefully inform manual needle placement into the tibialis posterior for the botulinum toxin treatment of spastic equinovarus foot in chronic stroke patients.

  13. Effect of molecular weight (Mw) of N-(2-hydroxypropyl)methacrylamide copolymers on body distribution and rate of excretion after subcutaneous, intraperitoneal, and intravenous administration to rats

    Energy Technology Data Exchange (ETDEWEB)

    Seymour, L.W.; Duncan, R.; Strohalm, J.; Kopecek, J.

    1987-11-01

    A copolymer of N-(2-hydroxypropyl) methacrylamide (HPMA) and N-methacryloyltyrosinamide was prepared and fractionated using Sepharose 4B/6B (1:1) chromatography to produce eight HPMA copolymer fractions of narrow polydispersity and mean molecular weight (Mw) ranging from 12 to 778 kD. These fractions were radioiodinated and injected intravenously, subcutaneously, and intraperitoneally into rats. Their bloodstream-concentration profiles were monitored and rates of excretion assessed. Following intravenous administration the circulating blood volume available to the copolymers was not molecular-weight-dependent. A molecular-weight threshold limiting glomerular filtration was identified at approximately 45 kD, and preparations greater than this threshold were lost from the bloodstream only slowly by extravasation. Molecular weight did not influence the movement of copolymers from the peritoneal compartment to the bloodstream after intraperitoneal injection. The transfer rates observed could be accounted for by bulk phase lymphatic drainage alone, no transcapillary routes being implicated. Following subcutaneous administration the largest HPMA copolymer fraction (Mw = 778 kD, diameter approximately 30 nm) showed increased retention at the site of the injection, approximately 20% of the dose remaining there after 21 days. This could result from physical restriction of movement or from internalization into local phagocytic cells. The smaller copolymer fractions moved readily into the bloodstream whence they were either lost in the urine or they gradually penetrated into other tissues and organs. Long-term (21 days) body distribution of copolymers following both intraperitoneal and subcutaneous administration showed size-dependent accumulation in organs of the reticuloendothelial system.

  14. Outbreak of Nontuberculous Mycobacterial Subcutaneous Infections Related to Multiple Mesotherapy Injections▿

    Science.gov (United States)

    Carbonne, Anne; Brossier, Florence; Arnaud, Isabelle; Bougmiza, Iheb; Caumes, Eric; Meningaud, Jean-Paul; Dubrou, Sylvie; Jarlier, Vincent; Cambau, Emmanuelle; Astagneau, Pascal

    2009-01-01

    We describe an outbreak of severe subcutaneous infections due to nontuberculous mycobacteria following mesotherapy. Epidemiological studies and molecular comparisons of Mycobacterium chelonae strains from different patients and the environment suggested that contamination may be associated with inappropriate cleaning of the multiple-injection device with tap water. PMID:19386853

  15. Treatment with continuous subcutaneous insulin infusion is associated with lower arterial stiffness

    DEFF Research Database (Denmark)

    Vestergaard Rosenlund, Signe; Theilade, Simone; Hansen, Tine Willum

    2014-01-01

    AIMS: To investigate the relationship between arterial stiffness and insulin treatment mode [continuous subcutaneous insulin infusion (CSII) versus multiple daily injections (MDI)] in type 1 diabetes patients. METHODS: Cross-sectional study, from 2009 to 2011, including 601 Caucasian type 1...

  16. Reduction of nocturnal rise in bone resorption by subcutaneous GLP-2

    DEFF Research Database (Denmark)

    Henriksen, Dennis B; Alexandersen, Peter; Byrjalsen, Inger

    2004-01-01

    We have previously shown that a subcutaneous injection of glucagon-like peptide-2 (GLP-2) at 9 a.m. in fasting postmenopausal women results in a dose-dependent decrease in the serum concentration of fragments derived from the degradation of the C-terminal telopeptide region of collagen type I (s...

  17. The behavioural depression of hippocampal kindled rats is attenuated by subcutaneous and intracerebroventricular naltrexone

    NARCIS (Netherlands)

    Cottrell, G.A.; Nyakas, C.; Bohus, B.

    1984-01-01

    1. Two questions were asked: Does naltrexone attenuate the behavioural depression (BD) in other models of limbic epilepsy besides amygdala kindling? Does intracerebroventricular (ICV) administration produce the same effects as subcutaneous injection i.e., attenuation of the BD. 2. Male wistar

  18. Fat Graft Viability in the Subcutaneous Plane versus the Local Fat Pad

    Directory of Open Access Journals (Sweden)

    Ryan S. Constantine, BA

    2014-12-01

    Conclusions: Investigation into fat graft injection location indicates that there is no statistically significant difference in angiogenesis signals between the subcutaneous plane and the local fat pad in the athymic rat model. Further research should aim to continue to close the gap between clinical practice and basic scientific understanding of fat grafting.

  19. Murine xenograft model demonstrates significant radio-sensitising effect of liposomal doxorubicin in a combination therapy for Feline Injection Site Sarcoma.

    Science.gov (United States)

    Petznek, H; Kleiter, M; Tichy, A; Fuchs-Baumgartinger, A; Hohenadl, C

    2014-10-01

    Therapy of cats suffering from feline injection site sarcomas (FISS) is still a challenging problem, as the recurrence rate after surgery is up to 70%. Four FISS-derived primary tumour cell lines and corresponding xenograft tumour mouse models were established to evaluate the efficacy of a concomitant chemo-/radiation therapy with doxorubicin. In vitro, strongly depending upon the timing of administration, pre-treatment with 0.25 µmol doxorubicin resulted in a significant enhancement of radiation-induced (3.5 Gy) tumour cell death. This result was confirmed in vivo, where only the combined chemo-/radiation therapy resulted in a significant reduction in tumour growth compared to the respective mono-therapies with either doxorubicin or radiation. These results support the use of the concomitant chemo-/radiation therapy for adjuvant treatment of FISS, particularly in advanced or recurrent disease where surgery alone is no longer feasible. Copyright © 2014 Elsevier Ltd. All rights reserved.

  20. Subcutaneous Emphysema—Beyond the Pneumoperitoneum

    Science.gov (United States)

    2014-01-01

    Background: Subcutaneous emphysema and gas extravasation outside of the peritoneal cavity during laparoscopy has consequences. Knowledge of the circumstances that increase the potential for subcutaneous emphysema is necessary for safe laparoscopy. Methods: A literature review and a PubMed search are the basis for this review. Conclusions: The known risk factors leading to subcutaneous emphysema during laparoscopy are multiple attempts at abdominal entry, improper cannula placement, loose fitting cannula/skin and fascial entry points, use of >5 cannulas, use of cannulas as fulcrums, torque of the laparoscope, increased intra-abdominal pressure, procedures lasting >3.5 hours, and attention to details. New additional risk factors acting as direct factors leading to subcutaneous emphysema risk and occurrence are total gas volume, gas flow rate, valveless trocar systems, and robotic fulcrum forces. Recognizing this spectrum of factors that leads to subcutaneous emphysema will yield greater patient safety during laparoscopic procedures. PMID:24680136

  1. 21 CFR 522.300 - Carfentanil citrate injection.

    Science.gov (United States)

    2010-04-01

    ... 21 Food and Drugs 6 2010-04-01 2010-04-01 false Carfentanil citrate injection. 522.300 Section 522....300 Carfentanil citrate injection. (a) Specifications. Each milliliter of sterile aqueous solution..., shoulder, back, or hindquarter. Avoid intrathoracic, intra-abdominal, or subcutaneous injection. To reverse...

  2. Subcutaneous Fascial Bands—A Qualitative and Morphometric Analysis

    Science.gov (United States)

    Li, Weihui; Ahn, Andrew C.

    2011-01-01

    Background Although fascial bands within the subcutaneous (SQ) layer are commonly seen in ultrasound images, little is known about their functional role, much less their structural characteristics. This study's objective is to describe the morphological features of SQ fascial bands and to systematically evaluate the bands using image analyses tools and morphometric measures. Methods In 28 healthy volunteers, ultrasound images were obtained at three body locations: the lateral aspect of the upper arm, medial aspect of the thigh and posterior aspect of lower leg. Using image analytical techniques, the total SQ band area, fascial band number, fascial band thickness, and SQ zone (layer) thickness were determined. In addition, the SQ spatial coherence was calculated based on the eigenvalues associated with the largest and smallest eigenvectors of the images. Results Fascial bands at these sites were contiguous with the dermis and the epimysium forming an interconnected network within the subcutaneous tissue. Subcutaneous blood vessels were also frequently encased by these fascial bands. The total SQ fascial band area was greater at the thigh and calf compared to the arm and was unrelated to SQ layer (zone) thickness. The thigh was associated with highest average number of fascial bands while calf was associated with the greatest average fascial band thickness. Across body regions, greater SQ zone thickness was associated with thinner fascial bands. SQ coherence was significantly associated with SQ zone thickness and body location (calf with statistically greater coherence compared to arm). Conclusion Fascial bands are structural bridges that mechanically link the skin, subcutaneous layer, and deeper muscle layers. This cohesive network also encases subcutaneous vessels and may indirectly mediate blood flow. The quantity and morphological characteristics of the SQ fascial band may reflect the composite mechanical forces experienced by the body part. PMID:21931632

  3. Subcutaneous fascial bands--a qualitative and morphometric analysis.

    Science.gov (United States)

    Li, Weihui; Ahn, Andrew C

    2011-01-01

    Although fascial bands within the subcutaneous (SQ) layer are commonly seen in ultrasound images, little is known about their functional role, much less their structural characteristics. This study's objective is to describe the morphological features of SQ fascial bands and to systematically evaluate the bands using image analyses tools and morphometric measures. In 28 healthy volunteers, ultrasound images were obtained at three body locations: the lateral aspect of the upper arm, medial aspect of the thigh and posterior aspect of lower leg. Using image analytical techniques, the total SQ band area, fascial band number, fascial band thickness, and SQ zone (layer) thickness were determined. In addition, the SQ spatial coherence was calculated based on the eigenvalues associated with the largest and smallest eigenvectors of the images. Fascial bands at these sites were contiguous with the dermis and the epimysium forming an interconnected network within the subcutaneous tissue. Subcutaneous blood vessels were also frequently encased by these fascial bands. The total SQ fascial band area was greater at the thigh and calf compared to the arm and was unrelated to SQ layer (zone) thickness. The thigh was associated with highest average number of fascial bands while calf was associated with the greatest average fascial band thickness. Across body regions, greater SQ zone thickness was associated with thinner fascial bands. SQ coherence was significantly associated with SQ zone thickness and body location (calf with statistically greater coherence compared to arm). Fascial bands are structural bridges that mechanically link the skin, subcutaneous layer, and deeper muscle layers. This cohesive network also encases subcutaneous vessels and may indirectly mediate blood flow. The quantity and morphological characteristics of the SQ fascial band may reflect the composite mechanical forces experienced by the body part.

  4. Subcutaneous fascial bands--a qualitative and morphometric analysis.

    Directory of Open Access Journals (Sweden)

    Weihui Li

    Full Text Available BACKGROUND: Although fascial bands within the subcutaneous (SQ layer are commonly seen in ultrasound images, little is known about their functional role, much less their structural characteristics. This study's objective is to describe the morphological features of SQ fascial bands and to systematically evaluate the bands using image analyses tools and morphometric measures. METHODS: In 28 healthy volunteers, ultrasound images were obtained at three body locations: the lateral aspect of the upper arm, medial aspect of the thigh and posterior aspect of lower leg. Using image analytical techniques, the total SQ band area, fascial band number, fascial band thickness, and SQ zone (layer thickness were determined. In addition, the SQ spatial coherence was calculated based on the eigenvalues associated with the largest and smallest eigenvectors of the images. RESULTS: Fascial bands at these sites were contiguous with the dermis and the epimysium forming an interconnected network within the subcutaneous tissue. Subcutaneous blood vessels were also frequently encased by these fascial bands. The total SQ fascial band area was greater at the thigh and calf compared to the arm and was unrelated to SQ layer (zone thickness. The thigh was associated with highest average number of fascial bands while calf was associated with the greatest average fascial band thickness. Across body regions, greater SQ zone thickness was associated with thinner fascial bands. SQ coherence was significantly associated with SQ zone thickness and body location (calf with statistically greater coherence compared to arm. CONCLUSION: Fascial bands are structural bridges that mechanically link the skin, subcutaneous layer, and deeper muscle layers. This cohesive network also encases subcutaneous vessels and may indirectly mediate blood flow. The quantity and morphological characteristics of the SQ fascial band may reflect the composite mechanical forces experienced by the body part.

  5. A woman with juxta-articular nodules—An uncommon form of subcutaneous granuloma annulare

    Directory of Open Access Journals (Sweden)

    Lili Wang

    2014-06-01

    Full Text Available Granuloma annulare is a benign inflammatory dermatosis that is most common in children and young adults. The subcutaneous form of granuloma annulare, which occurs mainly on the extremities in children, is rare. Lesions usually occur as painless subcutaneous nodules without inflammation of the cutaneous surface; the most frequent sites are the legs, buttocks, and scalp. Nevertheless, we present a case of subcutaneous granuloma annulare confined to the dorsa of the hand joints and right knee in a 51-year-old woman.

  6. Efficacy and safety of subcutaneous rituximab versus intravenous rituximab for first-line treatment of follicular lymphoma (SABRINA): a randomised, open-label, phase 3 trial.

    Science.gov (United States)

    Davies, Andrew; Merli, Francesco; Mihaljević, Biljana; Mercadal, Santiago; Siritanaratkul, Noppadol; Solal-Céligny, Philippe; Boehnke, Axel; Berge, Claude; Genevray, Magali; Zharkov, Artem; Dixon, Mark; Brewster, Michael; Barrett, Martin; MacDonald, David

    2017-06-01

    patients are no longer being recruited, but some patients are still being followed up. Between Feb 15, 2011, and May 15, 2013, 410 patients were randomly assigned, 205 to intravenous rituximab and 205 to subcutaneous rituximab. Investigator-assessed overall response at the end of induction was 84·9% (95% CI 79·2-89·5) in the intravenous group and 84·4% (78·7-89·1) in the subcutaneous group. The frequency of adverse events was similar in both groups (199 [95%] of 210 in the intravenous group vs 189 [96%] of 197 in the subcutaneous group); the frequency of adverse events of grade 3 or higher was also similar (116 [55%] vs 111 [56%]). The most common grade 3 or higher adverse event was neutropenia, which occurred in 44 patients (21%) in the intravenous group and 52 (26%) in the subcutaneous group. Serious adverse events occurred in 72 patients (34%) in the intravenous group and 73 (37%) in the subcutaneous group. Administration-related reactions occurred in 73 patients (35%) in the intravenous group and 95 (48%) patients in the subcutaneous group (mainly grade 1 or 2 local injection-site reactions). Intravenous and subcutaneous rituximab had similar efficacy and safety profiles, and no new safety concerns were noted. Subcutaneous administration does not compromise the anti-lymphoma activity of rituximab when given with chemotherapy. F Hoffmann-La Roche. Copyright © 2017 Elsevier Ltd. All rights reserved.

  7. Enhanced characterization of faults and fractures at EGS sites by CO2 injection coupled with active seismic monitoring, pressure-transient testing, and well logging

    Science.gov (United States)

    Oldenburg, C. M.; Daley, T. M.; Borgia, A.; Zhang, R.; Doughty, C.; Jung, Y.; Altundas, B.; Chugunov, N.; Ramakrishnan, T. S.

    2016-12-01

    Faults and fractures in geothermal systems are difficult to image and characterize because they are nearly indistinguishable from host rock using traditional seismic and well-logging tools. We are investigating the use of CO2 injection and production (push-pull) in faults and fractures for contrast enhancement for better characterization by active seismic, well logging, and push-pull pressure transient analysis. Our approach consists of numerical simulation and feasibility assessment using conceptual models of potential enhanced geothermal system (EGS) sites such as Brady's Hot Spring and others. Faults in the deep subsurface typically have associated damage and gouge zones that provide a larger volume for uptake of CO2 than the slip plane alone. CO2 injected for push-pull well testing has a preference for flowing in the fault and fractures because CO2 is non-wetting relative to water and the permeability of open fractures and fault gouge is much higher than matrix. We are carrying out numerical simulations of injection and withdrawal of CO2 using TOUGH2/ECO2N. Simulations show that CO2 flows into the slip plane and gouge and damage zones and is driven upward by buoyancy during the push cycle over day-long time scales. Recovery of CO2 during the pull cycle is limited because of buoyancy effects. We then use the CO2 saturation field simulated by TOUGH2 in our anisotropic finite difference code from SPICE-with modifications for fracture compliance-that we use to model elastic wave propagation. Results show time-lapse differences in seismic response using a surface source. Results suggest that CO2 can be best imaged using time-lapse differencing of the P-wave and P-to-S-wave scattering in a vertical seismic profile (VSP) configuration. Wireline well-logging tools that measure electrical conductivity show promise as another means to detect and image the CO2-filled fracture near the injection well and potential monitoring well(s), especially if a saline-water pre

  8. Geological and Geotechnical Site Investigation for the Design of a CO2 Rich Flue Gas Direct Injection and Storage Facility

    Energy Technology Data Exchange (ETDEWEB)

    Metz, Paul; Bolz, Patricia

    2013-03-25

    With international efforts to limit anthropogenic carbon in the atmosphere, various CO{sub 2} sequestration methods have been studied by various facilities worldwide. Basalt rock in general has been referred to as potential host material for mineral carbonation by various authors, without much regard for compositional variations due to depositional environment, subsequent metamorphism, or hydrothermal alteration. Since mineral carbonation relies on the presence of certain magnesium, calcium, or iron silicates, it is necessary to study the texture, mineralogy, petrology, and geochemistry of specific basalts before implying potential for mineral carbonation. The development of a methodology for the characterization of basalts with respect to their susceptibility for mineral carbonation is proposed to be developed as part of this research. The methodology will be developed based on whole rock data, petrography and microprobe analyses for samples from the Caledonia Mine in Michigan, which is the site for a proposed small-scale demonstration project on mineral carbonation in basalt. Samples from the Keweenaw Peninsula will be used to determine general compositional trends using whole rock data and petrography. Basalts in the Keweenaw Peninsula have been subjected to zeolite and prehnite-pumpellyite facies metamorphism with concurrent native copper deposition. Alteration was likely due to the circulation of CO{sub 2}-rich fluids at slightly elevated temperatures and pressures, which is the process that is attempted to be duplicated by mineral carbonation.

  9. Pharmacokinetics and tolerability of sumatriptan after single-dose administration of a fixed-dose combination tablet of sumatriptan/naproxen sodium 85/500 mg followed two hours later by subcutaneous sumatriptan 4- or 6-mg injection: a randomized, open-label, three-period crossover study in healthy volunteers.

    Science.gov (United States)

    Berges, Alienor; Walls, Christine; Lener, Shelly E; McDonald, Susan A

    2010-06-01

    Rescue medication options that are consistent with the product labeling for sumatriptan/naproxen sodium (S/N) and that have been permitted in >or=1 clinical trial include the use of a second tablet of S/N, sumatriptan tablets (to a total daily dose of 200 mg), and naproxen sodium tablets (within the maximum limits recommended in the labeling). Sumatriptan subcutaneous (SC) injection might be especially useful as rescue medication mostly because of its rapid onset of activity. The aim of this study was to assess the pharmacokinetics and tolerability of sumatriptan SC used as rescue medication after the administration of oral S/N for the treatment of migraine. This randomized, open-label, 3-period crossover study compared the exposure to sumatriptan (Cmax and AUC to 14 hours after the administration of the second dose [AUC(0-14)]) between 3 treatment regimens: an initial dose of S/N 85/500 mg followed 2 hours later by sumatriptan 4 or 6 mg SC (S/N + S4 and S/N + S6, respectively) (test), or sumatriptan 100 mg PO (2 tablets administered 2 hours apart) (S100 + S100) (reference). Healthy adults aged 18 to 55 years were randomly assigned to receive all 3 regimens in a randomized sequence. On day 1 of each treatment period, continuous cardiovascular monitoring (ECG telemetry), serial 12-lead ECG, and serial blood pressure (BP) measurements were conducted 1 hour before to 10 hours after the administration of the first dose. Blood samples for pharmacokinetic assessment were collected up to 14 hours after the administration of the first dose. Adverse events (AEs) were monitored from the time of consent until study completion. Participants returned to the clinic for pharmacokinetic blood sampling (for S/N + S4 and S/N + S6) and for tolerability assessment at 24, 48, and 72 hours after S/N administration. A total of 30 healthy adults were randomized. Five withdrew prematurely (3, withdrawn consent; 1, AE; and 1, protocol deviation). Half of the subjects were men, the mean age

  10. Continuous subcutaneous insulin infusion: practical issues

    Directory of Open Access Journals (Sweden)

    Banshi D Saboo

    2012-01-01

    Full Text Available The growing number of individuals with diabetes mellitus has prompted new way of treating these patients, continuous subcutaneous insulin infusion (CSII or insulin pump therapy is an increasingly form of intensive insulin therapy. An increasing number of individuals with diabetes mellitus individuals of all ages have started using insulin pump therapy. Not everyone is a good candidate for insulin pump therapy, and the clinician needs to be able to determine which patients are able to master the techniques required and to watch for the adverse reactions that may develop. Insulin pump increases quality of life of patient with diabetes mellitus with increasing satisfaction with treatment and decrease impact of diabetes mellitus. Manual errors by insulin pump users may lead to hypo or hyperglycemia, resulting into diabetic ketoacidosis (DKA sometimes. Some of practical aspect is associated with insulin pump therapy such as selection of candidates, handling of pump and selection of site, and pump setting, henceforth this review is prepared to explore and solve the practical problems or issues associated with pump therapy.

  11. Phase II study of radiation- plus immuno-therapy with subcutaneous (s. c.) Interleukin 2 (IL2) and Interferon alpha 2b (IFN) for treatment of lung metastases from different primary sites

    Energy Technology Data Exchange (ETDEWEB)

    Mantovani, G.; Bianchi, A.; Contini, L.; Curreli, L.; Esu, S.; Ghiani, M. [Cagliari Univ. (Italy). Dept. of Medical Oncology; Cossu, F.; Mura, V. [Cagliari Univ. (Italy). Dept. of Radiation Therapy; Del Giacco, G.S. [Cagliari Univ. (Italy). Dept. of Internal Medicine

    1994-12-31

    Since June 1991, 16 patients with lung metastases from different primary sites (6 colorectal ca., 6 head and neck ca., 2 endometrial ca., 1 ovarian ca., and 1 cervical ca.) have been included in trial. The treatment schedule consisted of radiation therapy (RT) of the most prominent lesion(s): 2 fractions of 250 cGy on days 1 and 2 (a total of 1000 cGy), the administration of IL 2 (Proleukin) at (4.8) by (10{sup 6}) IU/sqm s. c. every 12 hours on days 3 and 4, followed by 2.(4) (10{sup 6}) I U/sqm every 12 hours on days 5,6,7,8-12, 15-19 and alfa 2b IFN (3) (10{sup 6}) IU/sqm on days 5,7,8, 10,12,15,17,19. This schedule was repeated after a rest period of 2 weeks in patients achieving PR or SD. Out of the 16 patients, 10 completed 1 cycle of treatment, 5 patients 2 cycles and 1 pt 3 cycles. Out of the 16 patients, 10 were treated with RT in only 1 area, whereas 6 patients were treated in different areas. The responses to treatment could be evaluated in all 16 patients and the follow-up was carried out monthly for a maximum of 17 months. Seven patients achieved CR on the treated (RT) area (mean duration: 1. 3 months; range 1-2), 4 patients achieved PR (mean duration 1.8 months; range 1-3), 2 patients achieved SD (mean duration 1.5 months; range 1-2), 3 patients had PD. Altogether 23 metastatic sites were treated with RT, reaching a maximum of 4 sites. 3/16 patients are still alive at november `93.

  12. Acute dermatomyositis associated with generalized subcutaneous edema.

    Science.gov (United States)

    Lee, Ki-Hong; Lim, Sung-Ryoun; Kim, Yeon-Joo; Lee, Kyung-Ju; Myung, Dae-Seong; Jeong, Hae-Chang; Yoon, Woong; Lee, Shin-Seok; Park, Yong-Wook

    2008-06-01

    Generalized subcutaneous edema is an uncommon manifestation of inflammatory myopathy. We report a 48-year-old female patient who presented with severe generalized edema, an erythematous skin rash, dysphagia and proximal muscle weakness. She was diagnosed with dermatomyositis from the clinical signs, increased muscle enzymes, electromyographic findings and a muscle biopsy. Magnetic resonance imaging revealed increased signal intensity in the muscular and subcutaneous layers. The conditions causing generalized edema were excluded. It was concluded that the generalized edema was secondary to dermatomyositis. Aggressive treatments with high-dose glucocorticoids and immunosuppressive agents were used to control the severe subcutaneous edema.

  13. The safety of high-dose buprenorphine administered subcutaneously in cats.

    Science.gov (United States)

    Sramek, M K; Haas, M C; Coleman, G D; Atterson, P R; Hamlin, R L

    2015-10-01

    The safety of a proprietary formulation of buprenorphine hydrochloride administered subcutaneously (SC) to young cats was investigated in a blinded, randomized study. Four cohorts of eight cats aged approximately 4 months were administered saline, 0.24, 0.72 or 1.20 mg/kg/day buprenorphine SC for nine consecutive days, representing 0×, 1×, 3× and 5× of the intended dose. Cats were monitored daily for evidence of clinical reactions, food and water intake and adverse events (AEs). Physical examinations, clinical pathology, vital signs and electrocardiograms (ECGs) were evaluated at protocol-specified time points. Complete necropsy and histopathologic examinations were performed following humane euthanasia. Four buprenorphine-treated cats experienced AEs during the study, two unrelated and two related to study drug administration. The two cats with AEs considered related to drug administration had clinical signs of hyperactivity, difficulty in handling, disorientation, agitation and dilated pupils in one 0.24 mg/kg/day cat and one 0.72 mg/kg/day cat. All of these clinical signs were observed simultaneously. There were no drug-related effects on survival, injection response, injection site inspections, body weight, food or water consumption, bleeding time, urinalysis, respiration rate, heart rate, ECGs, blood pressures, body temperatures, macroscopic examinations or organ weights. Once daily buprenorphine s.c. injections at doses of 0.24, 0.72 and 1.20 mg/kg/day for 9 consecutive days were well tolerated in young domestic cats. © 2015 The Authors. Journal of Veterinary Pharmacology and Therapeutics Published by John Wiley & Sons Ltd.

  14. Botulinum toxin injection: a review of injection principles and protocols

    Directory of Open Access Journals (Sweden)

    David E. Rapp

    2007-04-01

    Full Text Available Despite the favorable outcomes seen using botulinum toxin (BTX for voiding dysfunction using BTX, a standardized technique and protocol for toxin injection is not defined. We reviewed the current literature on intravesical BTX injection for DO (detrusor overactivity. Specific attention was placed on defining optimal injection protocol, including dose, volume, and injection sites. In addition, we sought to describe a standard technique to BTX injection.

  15. Dental Students’ Preference with regard to Tactile or Visual Determination of Injection Site for an Inferior Alveolar Nerve Block in Children: A Crossover Randomized Clinical Trial

    Directory of Open Access Journals (Sweden)

    Nahid Ramazani

    2016-08-01

    Full Text Available Objectives: Instruction of local anesthesia injection in an important part of dental education curricula. This study was performed to compare dental students’ preference with regard to tactile or visual determination of injection site for an inferior alveolar nerve block (IANB in children.Materials and Methods: This crossover randomized clinical trial was conducted on dental students of Zahedan Dental School who took the first practical course of pediatric dentistry in the first academic semester of 2013-14 (n=42. They were randomly divided into two groups. During the first phase, group I was instructed to find the needle insertion point for an IANB via tactile method and group II was instructed to do it visually. In the second phase, the groups received instructions for the alternate technique. Both instructions were done using live demonstrations by the same instructor and immediately after instruction the learners practiced an IANB using the taught method. A five-point Likert scale questionnaire was then filled out by the students. The preference score was determined by calculating the mean of item scores. Data were analyzed using Mann-Whitney U and Wilcoxon Singed Rank tests in SPSS 19 at P=0.05 level of significance.Results: Thirty-eight students completed the study. By using the visual method to perform an IANB, students gained a significantly higher mean preference score (P=0.020. There was a significant difference in the preference of male students (P=0.008.Conclusions: Instruction of IANB by visual identification of needle insertion point is more desirable by students. 

  16. Adalimumab Injection

    Science.gov (United States)

    Humira® Injection ... Adalimumab injection is used alone or with other medications to relieve the symptoms of certain autoimmune disorders (conditions in ... some areas of the body) in adults. Adalimumab injection is in a class of medications called tumor ...

  17. Oxacillin Injection

    Science.gov (United States)

    Oxacillin injection is used to treat infections caused by certain bacteria. Oxacillin injection is in a class of medications called penicillins. ... works by killing bacteria.Antibiotics such as oxacillin injection will not work for colds, flu, or other ...

  18. Rituximab Injection

    Science.gov (United States)

    Rituximab injection (Rituxan) and rituximab and hyaluronidase human injection (Rituxin Hycela) are used alone or with other medications to ... that begins in the white blood cells). Rituximab injection is also used with another medication to treat ...

  19. Fluorouracil Injection

    Science.gov (United States)

    Adrucil® Injection ... Fluorouracil injection comes as a solution (liquid) to be given intravenously (into a vein) by a doctor or nurse ... you are feeling during your treatment with fluorouracil injection.

  20. Ondansetron Injection

    Science.gov (United States)

    Zofran® Injection ... Ondansetron injection is used to prevent nausea and vomiting caused by cancer chemotherapy and surgery. Ondansetron is in a ... medications: or any of the ingredients in ondansetron injection. Ask your pharmacist for a list of the ...

  1. Romiplostim Injection

    Science.gov (United States)

    ... or may tell you to stop taking these medications if romiplostim injection works well for you.Romiplostim injection does not ... will give you the manufacturer's patient information sheet (Medication ... romiplostim injection. Read the information carefully and ask your doctor ...

  2. Metabolic effects of growth hormone administered subcutaneously once or twice daily to growth hormone deficient adults

    DEFF Research Database (Denmark)

    Laursen, Torben; Jørgensen, Jens Otto Lunde; Christiansen, Jens Sandahl

    1994-01-01

    Abstract OBJECTIVE: The aim of this study was to compare the metabolic effects of GH administered subcutaneously either once or twice daily. The actions of GH might depend upon a pulsatile pattern of serum GH. Pulsatile and continuous intravenous delivery of GH, however, induce similar short......-term metabolic effects in GH deficient patients. An improved growth response is obtained in GH deficient children when a fixed weekly GH dose is administered by daily subcutaneous injections instead of twice or thrice-weekly intramuscular injections. A more pulsatile pattern and serum GH levels above zero might...... be achieved by further increasing the injection frequency. Increased daytime GH levels might, however, adversely affect the circadian patterns of metabolic indices, which have been demonstrated to be more successfully reproduced by evening compared with morning GH administration. DESIGN AND MEASUREMENTS...

  3. Iron-dextran injection into the substantia nigra in rats decreases striatal dopamine content ipsilateral to the injury site and impairs motor function.

    Science.gov (United States)

    Bueno-Nava, Antonio; Gonzalez-Pina, Rigoberto; Alfaro-Rodriguez, Alfonso

    2010-06-01

    Iron chloride injections into the rat SNc can cause chronic decreases in striatal dopamine (DA) levels. However, changes in striatal DA content after iron-dextran injection into rat SNc have not been completely elucidated. The aim of this work was to measure striatal DA concentrations after iron-dextran injection into the SNc. We divided 40 male Wistar rats into five groups, including control, saline injected then sacrificed 7 days or 30 days later, and iron-dextran injected then sacrificed 7 days or 30 days later. Striatal DA content was measured in control animals and in all animals sacrificed 7 days or 30 days after injection, and motor performance was assessed in iron-dextran and saline injected groups 30 days after injection. The striatal DA levels were determined using HPLC. There were significant (P iron-dextran treated rats compared to control and saline-injected rats. There were no significant differences in DA concentration between the sham-operated (i.e., saline-injected) and control rats. We also observed motor deficits in the iron-dextran injected rats. The striatal DA reduction observed after iron-dextran injection may be attributable to iron-induced oxidative injury in the SNc. Motor deficits, in turn, may be explained by subsequent disturbances in striatal and cortical dopaminergic neuromodulation.

  4. A Trp53fl/flPtenfl/fl mouse model of undifferentiated pleomorphic sarcoma mediated by adeno-Cre injection and in vivo bioluminescence imaging.

    Directory of Open Access Journals (Sweden)

    Marisa R Buchakjian

    Full Text Available Genetic mouse models of soft tissue sarcoma provide critical insights into disease pathophysiology, which are oftentimes unable to be extracted from human tumor samples or xenograft models. In this study we describe a mouse model of soft tissue sarcoma mediated by adenoviral-Cre recombinase injection into Trp53fl/fl/Ptenfl/fl lox-stop-lox luciferase mice. Injection of adenovirus expressing Cre recombinase, either subcutaneously or intramuscularly in two experimental groups, results in viral infection and gene recombination with 100% penetrance within the first 24 hours following injection. Luciferase expression measured by real-time bioluminescence imaging increases over time, with an initial robust increase following viral injection, followed by a steady rise over the next several weeks as primary tumors develop and grow. Intramuscular injections were more commonly associated with evidence of systemic viral distribution than subcutaneous injections. All mice developed soft tissue sarcomas at the primary injection site, with histological examination identifying 93% of tumors as invasive pleomorphic sarcomas based on microscopic morphology and immunohistochemical expression of sarcoma markers. A lymphocytic infiltrate was present in 64% of the sarcomas in this immunocompetent model and 71% of tumors expressed PD-L1. This is the first report of a viral-Cre mediated Trp53/Pten mouse model of undifferentiated pleomorphic sarcoma. The bioluminescence imaging feature, along with high penetrance of the model and its immunological characteristics, makes it suited for pre-clinical studies of soft tissue sarcoma.

  5. Massive Subcutaneous Emphysema in Robotic Sacrocolpopexy

    Science.gov (United States)

    Celik, Hatice; Cremins, Angela; Jones, Keisha A.

    2013-01-01

    The advent of robotic surgery has increased the popularity of laparoscopic sacrocolpopexy. Carbon dioxide insufflation, an essential component of laparoscopy, may rarely cause massive subcutaneous emphysema, which may be coincident with life-threatening situations such as hypercarbia, pneumothorax, and pneumomediastinum. Although the literature contains several reports of massive subcutaneous emphysema after a variety of laparoscopic procedures, we were not able to identify any report of this complication associated with laparoscopic or robotic sacrocolpopexy. Massive subcutaneous emphysema occurred in 3 women after robotic sacrocolpopexy in our practice. The patients had remarkable but reversible physical deformities lasting up to 1 week. A valveless endoscopic dynamic pressure system was used in all 3 of our cases. Our objective is to define the risk of massive subcutaneous emphysema during robotic sacrocolpopexy in light of these cases and discuss probable predisposing factors including the use of valveless endoscopic dynamic pressure trocars. PMID:23925018

  6. Frontal subcutaneous blood flow, and epi- and subcutaneous temperatures during scalp cooling in normal man

    DEFF Research Database (Denmark)

    Bülow, J; Friberg, L; Gaardsting, O

    1985-01-01

    Cooling of the scalp has been found to prevent hair loss following cytostatic treatment, but in order to obtain the hair preserving effect the subcutaneous temperature has to be reduced below 22 degrees C. In order to establish the relationship between epicutaneous and subcutaneous temperatures...... epicutaneous and subcutaneous temperatures could be demonstrated with the regression equation: s = 0.9 c + 4.9 (r = 0.99). In eight of the 10 subjects the subcutaneous temperature could be reduced below 22 degrees C with the applied technique. It is concluded that the hair preserving effect of scalp cooling...

  7. Corrective Action Decision Document/Closure Report for Corrective Action Unit 219: Septic Systems and Injection Wells, Nevada Test Site, Nevada, Rev. No.: 0

    Energy Technology Data Exchange (ETDEWEB)

    David Strand

    2006-05-01

    This Corrective Action Decision Document/Closure Report has been prepared for Corrective Action Unit (CAU) 219, Septic Systems and Injection Wells, in Areas 3, 16, and 23 of the Nevada Test Site, Nevada, in accordance with the ''Federal Facility Agreement and Consent Order'' (1996). Corrective Action Unit 219 is comprised of the following corrective action sites (CASs): (1) 03-11-01, Steam Pipes and Asbestos Tiles; (2) 16-04-01, Septic Tanks (3); (3) 16-04-02, Distribution Box; (4) 16-04-03, Sewer Pipes; (5) 23-20-01, DNA Motor Pool Sewage and Waste System; and (6) 23-20-02, Injection Well. The purpose of this Corrective Action Decision Document/Closure Report is to provide justification and documentation supporting the recommendation for closure of CAU 219 with no further corrective action beyond the application of a use restriction at CASs 16-04-01, 16-04-02, and 16-04-03. To achieve this, corrective action investigation (CAI) activities were performed from June 20 through October 12, 2005, as set forth in the CAU 219 Corrective Action Investigation Plan and Record of Technical Change No. 1. A best management practice was implemented at CASs 16-04-01, 16-04-02, and 16-04-03, and corrective action was performed at CAS 23-20-01 between January and April 2006. In addition, a use restriction will be applied to CASs 16-04-01, 16-04-02, and 16-04-03 to provide additional protection to Nevada Test Site personnel. The purpose of the CAI was to fulfill the following data needs as defined during the data quality objective (DQO) process: (1) Determine whether contaminants of concern (COCs) are present. (2) If COCs are present, determine their nature and extent. (3) Provide sufficient information and data to complete appropriate corrective actions. The CAU 219 dataset from the investigation results was evaluated based on the data quality indicator parameters. This evaluation demonstrated the quality and acceptability of the dataset for use in fulfilling

  8. Bilateral single-site intracerebral injection of a nonpathogenic herpes simplex virus-1 vector decreases anxiogenic behavior in MPS VII mice

    Directory of Open Access Journals (Sweden)

    Wenpei Liu

    Full Text Available Genetic diseases of the brain usually have pathologic lesions distributed throughout, thus requiring global correction. Herpes simplex virus-1 (HSV-1 vectors may be especially useful for gene delivery in these disorders since they can spread trans-synaptically along neuronal pathways to distal sites from a localized injection. We have previously shown that a nonpathogenic HSV-1 (strain 1716, which is deleted in the ICP34.5 gene, and expressing the lysosomal enzyme β-glucuronidase (GUSB from the latency-associated transcript (LAT promoter, spreads within the brains of GUSB-deficient mucopolysaccharidosis VII mice to reverse the pathognomonic storage lesions throughout the diseased brain. In this study, we tested the ability of the 1716 LAT-GUSB vector to improve behavioral deficits. The treatment significantly decreased anxiogenic behaviors associated with the mutation, as indicated by open-field behavior and decreased neophobia in a novel object-recognition task. The treated mice also exhibited an improvement in cognitive function associated with the cerebral cortex in a familiar object test. The results indicate the functional therapeutic potential of the 1716 LAT-GUSB vector.

  9. Ibandronate Injection

    Science.gov (United States)

    Boniva® Injection ... Ibandronate injection is used to treat osteoporosis (a condition in which the bones become thin and weak and break ... Ibandronate injection comes as a solution (liquid) to be injected into a vein by a doctor or nurse in ...

  10. Tocilizumab Injection

    Science.gov (United States)

    ... or the syringe and do not inject the medication.You may inject tocilizumab injection on the front of the thighs or anywhere ... your doctor about the risks of receiving this medication.Tocilizumab injection may cause other side effects. Call your doctor ...

  11. Certolizumab Injection

    Science.gov (United States)

    ... package or the syringe. Do not inject the medication.You may inject certolizumab injection anywhere on your stomach or thighs except your ... your doctor about the risks of receiving this medication.Certolizumab injection may cause other side effects. Call your doctor ...

  12. Sarilumab Injection

    Science.gov (United States)

    ... for RA or who could not take these medications. Sarilumab injection is in a class of medications called interleukin- ... are any problems and do not inject the medication.You may inject sarilumab injection on the front of the thighs or anywhere ...

  13. Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation

    Directory of Open Access Journals (Sweden)

    Tolga Karakan

    2012-01-01

    Full Text Available Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

  14. Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation

    OpenAIRE

    Tolga Karakan; Erim Ersoy; Metin Hasçiçek; Berat Cem Özgür; Serkan Özcan; Arif Aydın

    2012-01-01

    Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

  15. Injection of Vaseline under Penis Skin for the Purpose of Penis Augmentation.

    Science.gov (United States)

    Karakan, Tolga; Ersoy, Erim; Hasçiçek, Metin; Ozgür, Berat Cem; Ozcan, Serkan; Aydın, Arif

    2012-01-01

    Penile foreign body injection is an uncommon entity produced by penile paraffin, mineral oil, and vaseline injections for the purpose of penile enlargement. Generally, penile subcutaneous and glandular injections for penile augmentation are performed by a nonmedical person, under unacceptable conditions. It will be an aim to share our experiences about penile vaseline injection.

  16. Field demonstration of an active reservoir pressure management through fluid injection and displaced fluid extractions at the Rock Springs Uplift, a priority geologic CO2 storage site for Wyoming

    Energy Technology Data Exchange (ETDEWEB)

    Jiao, Zunsheng [Univ. of Wyoming, Laramie, WY (United States)

    2017-04-05

    This report provides the results from the project entitled Field Demonstration of Reservoir Pressure Management through Fluid Injection and Displaced Fluid Extraction at the Rock Springs Uplift, a Priority Geologic CO2 Storage Site for Wyoming (DE-FE0026159 for both original performance period (September 1, 2015 to August 31, 2016) and no-cost extension (September 1, 2016 to January 6, 2017)).

  17. Sympathetic reflex control of subcutaneous blood flow in tetraplegic man during postural changes

    DEFF Research Database (Denmark)

    Skagen, K; Jensen, K; Henriksen, O

    1982-01-01

    to the labelled area. Leg blood flow was unaltered by proximal blockade but could be blocked by local infiltration in the labelled area with lignocaine in low doses. 4. Head-up tilt of tetraplegic patients induced vasoconstriction in the subcutaneous tissue of the forearm, which could be prevented by proximal......1. The effect of head-up tilt upon subcutaneous blood flow in the distal arm and leg was studied in 12 patients with complete traumatic spinal cord transection at the cervical level. 2. Blood flow was measured by the local 133Xe washout technique. 3. Leg lowering induced a 47% decrease in blood...... flow in the distal leg. During head-up tilt (45 degrees) blood flow in the leg decreased by 48%. In the arm remaining at heart level blood flow decreased by 37% during tilt and this vasoconstriction could be prevented by nervous blockade with lignocaine injected subcutaneously 5 cm proximally...

  18. A rare presentation of subcutaneous granuloma annulare in an adult patient; A case report

    Directory of Open Access Journals (Sweden)

    Waleed Alajroush

    2016-07-01

    Full Text Available We are reporting a 33-year old woman with multiple skin-colored, firm, non-tender nodules of varying sizes (ranging between 1 and 1.5 cm, with limited mobility and normal overlying skin. They were distributed mainly on the palmer side of the fingers. History and laboratory examination indicated lack of systemic diseases such as diabetes, rheumatoid arthritis, and tuberculosis. Histopathologic examination confirmed the subcutaneous granuloma annulare (SGA diagnosis by showing a normal epidermis with palisading granulomas (histocytes and giant cells surrounding small areas of connective tissue degeneration (central necrobiosis and mucin accumulation in the reticular dermis and subcutaneous tissues. The patient responded well to two-session course of intra-lesional steroid injections. SGA should be considered by dermatologists in the differential diagnosis of subcutaneous nodules even without concomitant systemic disease and with rare presentation.

  19. Subcutaneous Fat Necrosis of the Newborn: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Yi, Kyung Sik; Cho, Bum Sang; Bae, Il Hun; Lee, Seung Young; Jeon, Min Hee; Lee, Ok Jun; Kim, Mi Jung [Chungbuk National University College of Medicine, Cheongju (Korea, Republic of)

    2007-09-15

    Subcutaneous fat necrosis in the newborn is an uncommon transient disorder of the subcutaneous adipose tissue that develops after birth. We describe the characteristic ultrasonography and CT findings of a case of pathologically confirmed subcutaneous fat necrosis located at the subcutaneous fat layer of the neck, back, and shoulders with a review of the literature

  20. Subcutaneous Immunotherapy Improves the Symptomatology of Allergic Rhinitis

    Directory of Open Access Journals (Sweden)

    Lourenço, Edmir Américo

    2015-10-01

    Full Text Available Introduction The relevance of allergic rhinitis is unquestionable. This condition affects people's quality of life and its incidence has increased over the last years. Objective Thus, this study aims to analyze the effectiveness of subcutaneous injectable immunotherapy in cases of nasal itching, sneeze, rhinorrhea and nasal congestion in allergic rhinitis patients. Methods In the present study, the same researcher analyzed the records of 281 patients. Furthermore, the researchers identified allergens through puncture cutaneous tests using standardized extracts containing acari, fungi, pet hair, flower pollen, and feathers. Then, the patients underwent treatment with subcutaneous specific immunotherapy, using four vaccine vials for desensitization, associated with environmental hygiene. The authors analyzed conditions of nasal itching, sneeze, rhinorrhea, and nasal congestion throughout the treatment, and assigned them with a score ranging from zero (0, meaning absence of these symptoms to three (3, for severe cases. The symptoms were statistically compared in the beginning, during, and after treatment. Results In this study, authors analyzed the cases distribution according to age and the evolution of symptomatology according to the scores, comparing all phases of treatment. The average score for the entire population studied was 2.08 before treatment and 0.44 at the end. These results represent an overall improvement of ∼79% in symptomatology of allergic rhinitis in the studied population. Conclusion The subcutaneous immunotherapy as treatment of allergic rhinitis led to a reduction in all symptoms studied, improving the quality of life of patients, proving itself as an important therapeutic tool for these pathological conditions.

  1. Frontal subcutaneous blood flow, and epi- and subcutaneous temperatures during scalp cooling in normal man

    DEFF Research Database (Denmark)

    Bülow, J; Friberg, L; Gaardsting, O

    1985-01-01

    Cooling of the scalp has been found to prevent hair loss following cytostatic treatment, but in order to obtain the hair preserving effect the subcutaneous temperature has to be reduced below 22 degrees C. In order to establish the relationship between epicutaneous and subcutaneous temperatures d...

  2. Comparison of subcutaneous and intraperitoneal staphylococcal infections in normal and complement-deficient mice.

    Science.gov (United States)

    Easmon, C S; Glynn, A A

    1976-02-01

    From a comparison of the effects produced by injecting different strains of Staphylococcus aureus either subcutaneously or intraperitoneally into normal, complement-deficient, or complement-depleted mice, it was possible to assess the pathogenic significance of various staphylococcal virulence factors and the defensive role of complement components in the two sites of infection. In skin lesions the inflammation-suppressing factor found in the cell walls of strain PS80 played a major role. In contrast, in intraperitoneal infection the antiphagocytic capsule of the Smith diffuse and M strains was more important. All strains used produced alpha-hemolysin, which is the ultimate lethal agent in intraperitoneal infection but is only one factor in the production of dermonecrosis. The severity of the skin lesions was inversely related to the amount of early fluid exudate rather than to the rate of bacterial growth, whereas in the peritoneum increased bacterial growth was associated with increased mortality. Both C3 and C5 were needed in the production of fluid exudate in response to staphylococcal skin infection. C3 appeared to be more important in the increased exudate formed in immune mice. In the peritoneum the opsonic and chemotactic actions for complement were important as shown by the results in cobra venom-treated normal mice and in C5-deficient B10D2 old-line mice.

  3. FAST: towards safe and effective subcutaneous immunotherapy of persistent life-threatening food allergies

    Directory of Open Access Journals (Sweden)

    Zuidmeer-Jongejan Laurian

    2012-03-01

    Full Text Available Abstract The FAST project (Food Allergy Specific Immunotherapy aims at the development of safe and effective treatment of food allergies, targeting prevalent, persistent and severe allergy to fish and peach. Classical allergen-specific immunotherapy (SIT, using subcutaneous injections with aqueous food extracts may be effective but has proven to be accompanied by too many anaphylactic side-effects. FAST aims to develop a safe alternative by replacing food extracts with hypoallergenic recombinant major allergens as the active ingredients of SIT. Both severe fish and peach allergy are caused by a single major allergen, parvalbumin (Cyp c 1 and lipid transfer protein (Pru p 3, respectively. Two approaches are being evaluated for achieving hypoallergenicity, i.e. site-directed mutagenesis and chemical modification. The most promising hypoallergens will be produced under GMP conditions. After pre-clinical testing (toxicology testing and efficacy in mouse models, SCIT with alum-absorbed hypoallergens will be evaluated in phase I/IIa and IIb randomized double-blind placebo-controlled (DBPC clinical trials, with the DBPC food challenge as primary read-out. To understand the underlying immune mechanisms in depth serological and cellular immune analyses will be performed, allowing identification of novel biomarkers for monitoring treatment efficacy. FAST aims at improving the quality of life of food allergic patients by providing a safe and effective treatment that will significantly lower their threshold for fish or peach intake, thereby decreasing their anxiety and dependence on rescue medication.

  4. The Optimal Timing for Pancreatic Islet Transplantation into Subcutaneous Scaffolds Assessed by Multimodal Imaging

    Directory of Open Access Journals (Sweden)

    Andrea Gálisová

    2017-01-01

    Full Text Available Subcutaneously implanted polymeric scaffolds represent an alternative transplantation site for pancreatic islets (PIs with the option of vascularisation enhancement by mesenchymal stem cells (MSC. Nevertheless, a proper timing of the transplantation steps is crucial. In this study, scaffolds supplemented with plastic rods were implanted into diabetic rats and two timing schemes for subsequent transplantation of bioluminescent PIs (4 or 7 days after rod removal were examined by multimodal imaging. The cavities were left to heal spontaneously or with 10 million injected MSCs. Morphological and vascularisation changes were examined by MRI, while the localisation and viability of transplanted islets were monitored by bioluminescence imaging. The results show that PIs transplanted 4 days after rod removal showed the higher optical signal and vascularisation compared to transplantation after 7 days. MSCs slightly improved vascularisation of the graft but hindered therapeutic efficiency of PIs. Long-term glycaemia normalisation (4 months was attained in 80% of animals. In summary, multimodal imaging confirmed the long-term survival and function of transplanted PIs in the devices. The best outcome was reached with PIs transplanted on day 4 after rod removal and therefore the suggested protocol holds a potential for further applications.

  5. Augmented reality based real-time subcutaneous vein imaging system.

    Science.gov (United States)

    Ai, Danni; Yang, Jian; Fan, Jingfan; Zhao, Yitian; Song, Xianzheng; Shen, Jianbing; Shao, Ling; Wang, Yongtian

    2016-07-01

    A novel 3D reconstruction and fast imaging system for subcutaneous veins by augmented reality is presented. The study was performed to reduce the failure rate and time required in intravenous injection by providing augmented vein structures that back-project superimposed veins on the skin surface of the hand. Images of the subcutaneous vein are captured by two industrial cameras with extra reflective near-infrared lights. The veins are then segmented by a multiple-feature clustering method. Vein structures captured by the two cameras are matched and reconstructed based on the epipolar constraint and homographic property. The skin surface is reconstructed by active structured light with spatial encoding values and fusion displayed with the reconstructed vein. The vein and skin surface are both reconstructed in the 3D space. Results show that the structures can be precisely back-projected to the back of the hand for further augmented display and visualization. The overall system performance is evaluated in terms of vein segmentation, accuracy of vein matching, feature points distance error, duration times, accuracy of skin reconstruction, and augmented display. All experiments are validated with sets of real vein data. The imaging and augmented system produces good imaging and augmented reality results with high speed.

  6. Comparative Analysis of the Cell Fates of Induced Schwann Cells from Subcutaneous Fat Tissue and Naïve Schwann Cells in the Sciatic Nerve Injury Model

    Directory of Open Access Journals (Sweden)

    Mingzi Zhang

    2017-01-01

    Full Text Available Purpose. The fate and function of the induced Schwann cells (iSCs like cells from adipose tissue have not been critically evaluated in vivo after transplantation. The objective of this study is to compare the fate of iSCs with naïve SCs (nSCs after transplantation into the lesion sites of sciatic nerve, respectively. Methods. Adipose-derived stem cells from eGFP-expressing transgenic rat’s subcutaneous fat were induced to iSCs in vitro. iSCs were injected to the sciatic nerve lesion area after crush injury and the cells fate was comparatively analyzed with that of nSCs from the same rat. Results. At 12 weeks after transplantation, nSCs were detected only in the restricted area of cell transplantation site but iSCs were widely distributed all over the sciatic nerve. Based on double fluorescence observations, both iSCs and naïve ones were colocalized with P0-expressing myelin sheath, outbound by laminin-expressing basal membrane, and terminated at contactin-associated protein-expressing doublets. However, some of iSCs were also differentiated to the fibrocyte/fibroblast-like cells. In the histological analysis of repaired sciatic nerves, axon density was higher in iSC-received group than in the nSCs group and normal sciatic nerve. Conclusion. iSCs induced from subcutaneous fat tissues have higher engraftment and migration capacity than nSCs.

  7. [What are the reasons for patient preference? A comparison between oral and subcutaneous administration].

    Science.gov (United States)

    Quante, M; Thate-Waschke, I; Schofer, M

    2012-09-01

    Today there are different subcutaneous and three oral applicable medications for prevention of venous thromboembolism after knee and hip replacement. It is a general opinion that patients will prefer oral administration. However, until today there has been no study that analysed patient preferences and motives for deciding on the kind of administration. These data would be of interest since the consideration of patient preferences could improve adherence. The present study analysed patient preferences regarding oral or subcutaneous administration of medication after elective hip or knee replacement surgery. The results will have implications for clinical practice and for decision-making concerning the kind of administration. This prospective, multi-centric, observational study was conducted in six emergency hospitals and six rehabilitation hospitals. 178 current hip and knee replacement patients undergoing thromboprophylaxis and at least one further oral medication were interviewed. Subjective assessment data of patients were collected on study-specific questionnaires (epidemiological data, amount and background of general oral medication, details on subcutaneous thromboprophylaxis, preference of administration, causes for preference). 71.91 % of the interviewed patients preferred the daily intake of a tablet, whereas only 14.61 % favoured the daily subcutaneous injection. Main causes for the preference of oral administration were easier (86.6 % of nominations) and less complex (73.1 % of nominations) handling. 70.9 % reported that one more oral application would be unproblematic. Painlessness of oral administration was relevant for 65.7 %. Causes for preferring subcutaneous administration were "safety" (55.3 % of nominations) and an assumption of a generally better effectivity of subcutaneous (47.4 % of nominations) administration. Subjective discomfort induced by subcutaneus administration increased with the time interval since surgery. Less than 5 % of patients

  8. Subcutaneous epinephrine vs nebulized salbutamol in asthma.

    Science.gov (United States)

    Sharma, A; Madan, A

    2001-12-01

    This study was conducted to compare the efficacy of the subcutaneous epinephrine with nebulized salbutamol. Fifty asthmatic children in the age range of 6-14 years were divided into two equal groups. Group I children were given subcutaneous epinephrine and Group II were nebulized with salbutamol. Patients were observed at 15, 20, 30, 60, 120, 180 and 240 minute intervals. Both the groups had comparable mean increase in peak expiratory flow rate (PEFR %) (Group I 27.7 +/- 0.7; Group II 28.8 +/- 0.06, p >0.05). In Group I there was significant increase in systolic blood pressure, 30 minutes after the start of treatment, however it settled on its own by 60 minutes. Both the groups had satisfactory improvement in clinical parameters which continued upto 4 hours after start of treatment. Subcutaneous epinephrine can be safely used if nebulizers are not available.

  9. Geochemical effects of CO2 injection on produced water chemistry at an enhanced oil recovery site in the Permian Basin of northwest Texas, USA: Preliminary geochemical and Li isotope results

    Science.gov (United States)

    Pfister, S.; Gardiner, J.; Phan, T. T.; Macpherson, G. L.; Diehl, J. R.; Lopano, C. L.; Stewart, B. W.; Capo, R. C.

    2014-12-01

    Injection of supercritical CO2 for enhanced oil recovery (EOR) presents an opportunity to evaluate the effects of CO2 on reservoir properties and formation waters during geologic carbon sequestration. Produced water from oil wells tapping a carbonate-hosted reservoir at an active EOR site in the Permian Basin of Texas both before and after injection were sampled to evaluate geochemical and isotopic changes associated with water-rock-CO2 interaction. Produced waters from the carbonate reservoir rock are Na-Cl brines with TDS levels of 16.5-34 g/L and detectable H2S. These brines are potentially diluted with shallow groundwater from earlier EOR water flooding. Initial lithium isotope data (δ7Li) from pre-injection produced water in the EOR field fall within the range of Gulf of Mexico Coastal sedimentary basin and Appalachian basin values (Macpherson et al., 2014, Geofluids, doi: 10.1111/gfl.12084). Pre-injection produced water 87Sr/86Sr ratios (0.70788-0.70795) are consistent with mid-late Permian seawater/carbonate. CO2 injection took place in October 2013, and four of the wells sampled in May 2014 showed CO2 breakthrough. Preliminary comparison of pre- and post-injection produced waters indicates no significant changes in the major inorganic constituents following breakthrough, other than a possible drop in K concentration. Trace element and isotope data from pre- and post-breakthrough wells are currently being evaluated and will be presented.

  10. Hypertrophic Obesity and Subcutaneous Adipose Tissue Dysfunction

    Directory of Open Access Journals (Sweden)

    Anna Meiliana

    2014-08-01

    Full Text Available BACKGROUND: Over the past 50 years, scientists have recognized that not all adipose tissue is alike, and that health risk is associated with the location as well as the amount of body fat. Different depots are sufficiently distinct with respect to fatty-acid storage and release as to probably play unique roles in human physiology. Whether fat redistribution causes metabolic disease or whether it is a marker of underlying processes that are primarily responsible is an open question. CONTENT: The limited expandability of the subcutaneous adipose tissue leads to inappropriate adipose cell expansion (hypertrophic obesity with local inflammation and a dysregulated and insulin-resistant adipose tissue. The inability to store excess fat in the subcutaneous adipose tissue is a likely key mechanism for promoting ectopic fat accumulation in tissues and areas where fat can be stored, including the intra-abdominal and visceral areas, in the liver, epi/pericardial area, around vessels, in the myocardium, and in the skeletal muscles. Many studies have implicated ectopic fat accumulation and the associated lipotoxicity as the major determinant of the metabolic complications of obesity driving systemic insulin resistance, inflammation, hepatic glucose production, and dyslipidemia. SUMMARY: In summary, hypertrophic obesity is due to an impaired ability to recruit and differentiate available adipose precursor cells in the subcutaneous adipose tissue. Thus, the subcutaneous adipose tissue may be particular in its limited ability in certain individuals to undergo adipogenesis during weight increase. Inability to promote subcutaneous adipogenesis under periods of affluence would favor lipid overlow and ectopic fat accumulation with negative metabolic consequences. KEYWORDS: obesity, adipogenesis, subcutaneous adipose tissue, visceral adipose tissue, adipocyte dysfunction.

  11. Application of a new NMR well logging porosity/permeability calibration to the Arbuckle injection zone of the Wellington CO2 demonstration site

    Science.gov (United States)

    Mason, H. E.; Smith, M. M.; Hao, Y.; Carroll, S.

    2016-12-01

    Carbonate reservoirs hold significant potential for carbon capture and storage (CCS) projects. Target formations for carbon dioxide (CO2) storage must have suitable porosity and permeability properties to ensure adequate long term storage. Of these, permeability can be difficult to estimate in carbonate reservoirs due to the orders of magnitude differences in pore sizes, and the complex geometry of existing pore networks or those developed due to reactive CO2 acidified fluids. One of the primary methods for assessing porosity and permeability of reservoirs is down well nuclear magnetic resonance (NMR) logging tools. Our work has been focused on constraining new porosity/permeability relationships in carbonate rocks using micro X-ray computed tomography (µXRCT) to characterize the pore networks to inform on the observed NMR relaxation behavior. This effort has shown that standard NMR methodologies can produce permeability estimates for carbonate rocks that differ by several orders of magnitude from directly measured values. Our new calibrations have rectified these discrepancies by identifying and accounting for the main properties of these rocks that contribute the measured NMR relaxation properties. Properties such as mineralogy, Fe and Mn content, pore geometry, and pore network tortuosity all contribute to the relaxation behavior observed by NMR and are now accomodated in this new calibration procedure. This work has led to new understanding of the properties of these rock types that control the permeability measured by NMR well logging. In this presentation, we apply the results of a lab measured calibration of porosity and permeability to a high resolution NMR well log produced for the Arbucke injection zone of the Wellington CO2 demonstration sites. This application illustrates the applicability of this new calibration method for carbonate reservoirs and helps advance our understanding of the permeability and porosity relationships in these complex rock

  12. Combined subcutaneous, intrathoracic and abdominal splenosis.

    Science.gov (United States)

    Javadrashid, Reza; Paak, Neda; Salehi, Ahad

    2010-09-01

    We report a case of combined subcutaneous, intrathoracic, and abdominal splenosis who presented with attacks of flushing, tachycardia and vague abdominal pain. The patient's past medical history included a splenectomy due to abdominal trauma and years later, a lung lobectomy due to recurrent pneumonia. An enhancing solid mass adjacent to the upper pole of the left kidney and nodular pleural based lesions in the left hemi-thorax along with nodular lesions in subcutaneous tissue of the left chest wall suggested possible adrenal malignancy with multiple metastases. Histopathologic examination demonstrated benign lesions of ectopic splenic tissue.

  13. Tacrolimus Injection

    Science.gov (United States)

    Tacrolimus injection is used along with other medications to prevent rejection (attack of the transplanted organ by ... who have received kidney, liver, or heart transplants. Tacrolimus injection should only be used by people who ...

  14. Naltrexone Injection

    Science.gov (United States)

    Vivitrol® ... Naltrexone injection is used along with counseling and social support to help people who have stopped drinking large amounts of alcohol to avoid drinking again. Naltrexone injection is also used along with counseling and social ...

  15. Cefazolin Injection

    Science.gov (United States)

    Cefazolin injection is used to treat certain infections caused by bacteria including skin, bone, joint, genital, blood, heart valve, ... pneumonia), biliary tract, and urinary tract infections. Cefazolin injection also may be used before, during, and sometimes ...

  16. Mipomersen Injection

    Science.gov (United States)

    Mipomersen injection is used to decrease levels of cholesterol and other fatty substances in the blood in people who ... that removes LDL from the blood), but mipomersen injection should not be used along with this treatment. ...

  17. Denosumab Injection

    Science.gov (United States)

    Denosumab injection (Prolia) is used to treat osteoporosis (a condition in which the bones become thin and weak and ... not respond to other medications for osteoporosis. Denosumab injection (Prolia) is also used to treat bone loss ...

  18. Ampicillin Injection

    Science.gov (United States)

    Ampicillin injection is used to treat certain infections that are caused by bacteria such as meningitis (infection of the ... heart, urinary tract, and gastrointestinal tract infections. Ampicillin injection is in a class of medications called penicillins. ...

  19. Cefotetan Injection

    Science.gov (United States)

    Cefotetan injection is used to treat infections of the lungs, skin, bones, joints, stomach area, blood, female reproductive organs, and urinary tract. Cefotetan injection is also used before surgery to prevent infections. ...

  20. Eculizumab Injection

    Science.gov (United States)

    Eculizumab injection is used to treat paroxysmal nocturnal hemoglobinuria (PNH: a type of anemia in which too many red ... oxygen to all parts of the body). Eculizumab injection is also used to treat atypical hemolytic uremic ...

  1. Tigecycline Injection

    Science.gov (United States)

    Tigecycline injection used to treat certain serious infections including community acquired pneumonia (a lung infection that developed in a ... area between the chest and the waist). Tigecycline injection should not be used to treat pneumonia that ...

  2. Estrogen Injection

    Science.gov (United States)

    ... estradiol cypionate and estradiol valerate forms of estrogen injection are used to treat hot flushes (hot flashes; ... consider a different treatment. These forms of estrogen injection are also sometimes used to treat the symptoms ...

  3. Ceftazidime Injection

    Science.gov (United States)

    Ceftazidime injection is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) ... female genital tract, and urinary tract infections. Ceftazidime injection is in a class of medications called cephalosporin ...

  4. Tobramycin Injection

    Science.gov (United States)

    Tobramycin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of ... lungs, skin, bones, joints, and urinary tract. Tobramycin injection is in a class of medications called aminoglycoside ...

  5. Cefoxitin Injection

    Science.gov (United States)

    Cefoxitin injection is used to treat infections caused by bacteria including pneumonia and other lower respiratory tract (lung) infections; ... organs, blood, bone, joint, and skin infections. Cefoxitin injection may also be used before and during surgery, ...

  6. Naloxone Injection

    Science.gov (United States)

    Naloxone injection and naloxone prefilled auto-injection device (Evzio) are used along with emergency medical treatment to reverse the life-threatening effects of a known or suspected opiate (narcotic) ...

  7. Cyanocobalamin Injection

    Science.gov (United States)

    Cyanocobalamin injection is used to treat and prevent a lack of vitamin B12 that may be caused by any ... organs) and permanent damage to the nerves. Cyanocobalamin injection also may be given as a test to ...

  8. Dulaglutide Injection

    Science.gov (United States)

    Dulaglutide injection is used with a diet and exercise program to control blood sugar levels in adults with type ... medications did not control levels well enough. Dulaglutide injection is not used to treat type 1 diabetes ( ...

  9. Mitoxantrone Injection

    Science.gov (United States)

    Mitoxantrone injection is used to decrease the number of symptom episodes and slow the development of disability in patients with certain forms of multiple sclerosis (MS). Mitoxantrone injection is also used together with steroid medications to ...

  10. Testosterone Injection

    Science.gov (United States)

    ... and testosterone pellet (Testopel) are forms of testosterone injection used to treat symptoms of low testosterone in ... are low before you begin to use testosterone injection. Testosterone enanthate (Delatestryl) and testosterone pellet (Testopel) are ...

  11. Cefepime Injection

    Science.gov (United States)

    Cefepime injection is used to treat certain infections caused by bacteria including pneumonia, and skin, urinary tract, and kidney infections. Cefepime injection is used in combination with metronidazole (Flagyl) to ...

  12. Ranitidine Injection

    Science.gov (United States)

    Ranitidine injection is used in people who are hospitalized to treat certain conditions in which the stomach produces too ... were not successfully treated with other medications. Ranitidine injection is also used on a short-term basis ...

  13. Gentamicin Injection

    Science.gov (United States)

    Gentamicin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of ... lungs, skin, bones, joints, and urinary tract. Gentamicin injection is in a class of medications called aminoglycoside ...

  14. Meropenem Injection

    Science.gov (United States)

    Meropenem injection is used to treat skin and abdominal (stomach area) infections caused by bacteria and meningitis (infection of ... children 3 months of age and older. Meropenem injection is in a class of medications called antibiotics. ...

  15. Pralatrexate Injection

    Science.gov (United States)

    Pralatrexate injection is used to treat peripheral T-cell lymphoma (PTCL; a form of cancer that begins in a ... come back after treatment with other medications. Pralatrexate injection has not been shown to help people who ...

  16. Tesamorelin Injection

    Science.gov (United States)

    Tesamorelin injection is used to decrease the amount of extra fat in the stomach area in adults with human ... fat in certain areas of the body). Tesamorelin injection is not used to help with weight loss. ...

  17. Daptomycin Injection

    Science.gov (United States)

    Daptomycin injection is used alone or in combination with other medications to treat certain blood infections in adults or ... children 1 year of age and older . Daptomycin injection is in a class of medications called cyclic ...

  18. Albiglutide Injection

    Science.gov (United States)

    Albiglutide injection is used with a diet and exercise program to control blood sugar levels in adults with type ... medications did not control levels well enough. Albiglutide injection is not used to treat type 1 diabetes ( ...

  19. Cefuroxime Injection

    Science.gov (United States)

    Cefuroxime injection is used to treat certain infections caused by bacteria including pneumonia and other lower respiratory tract (lung) ... blood, bone, joint, and urinary tract infections. Cefuroxime injection may also be used before, during, and sometimes ...

  20. Hydrocortisone Injection

    Science.gov (United States)

    Hydrocortisone injection is used to treat symptoms of low corticosteroid levels (lack of certain substances that are usually produced ... also used to treat severe allergic reactions. Hydrocortisone injection is used in the management of multiple sclerosis ( ...

  1. Aztreonam Injection

    Science.gov (United States)

    Aztreonam injection is used to treat certain infections that are caused by bacteria, including respiratory tract (including pneumonia and ... area) infections, that are caused by bacteria. Aztreonam injection also may be used before, during, and sometimes ...

  2. Peramivir Injection

    Science.gov (United States)

    Peramivir injection is used to treat some types of influenza infection ('flu') in people who have had symptoms of ... flu for no longer than 2 days. Peramivir injection is in a class of medications called neuraminidase ...

  3. Vancomycin Injection

    Science.gov (United States)

    Vancomycin injection is used alone or in combination with other medications to treat certain serious infections such as endocarditis ( ... of the lungs, skin, blood, and bones. Vancomycin injection is in a class of medications called glycopeptide ...

  4. Amikacin Injection

    Science.gov (United States)

    Amikacin injection is used to treat certain serious infections that are caused by bacteria such as meningitis (infection of ... lungs, skin, bones, joints, and urinary tract. Amikacin injection is in a class of medications called aminoglycoside ...

  5. Diphenhydramine Injection

    Science.gov (United States)

    Diphenhydramine injection is used to treat allergic reactions, especially for people who are unable to take diphenhydramine by mouth. ... is used also to treat motion sickness. Diphenhydramine injection is also used alone or along with other ...

  6. Abaloparatide Injection

    Science.gov (United States)

    ... injection may cause osteosarcoma (bone cancer) in laboratory rats. It is not known whether abaloparatide injection increases ... too have too much calcium in the blood, hyperparathyroidism (condition in which the body produces too much ...

  7. Doxycycline Injection

    Science.gov (United States)

    ... may have been exposed to anthrax in the air. Doxycycline injection is in a class of medications ... decrease the effectiveness of hormonal contraceptives (birth control pills, patches, rings, or injections). Talk to your doctor ...

  8. Trastuzumab Injection

    Science.gov (United States)

    Trastuzumab injection is used along with other medications or after other medications have been used to treat ... has spread to other parts of the body. Trastuzumab injection is also used during and after treatment ...

  9. Ganciclovir Injection

    Science.gov (United States)

    Ganciclovir injection is used to treat cytomegalovirus (CMV) retinitis (eye infection that can cause blindness) in people ... in transplant recipients at risk for CMV infection. Ganciclovir injection is in a class of medications called ...

  10. Metronidazole Injection

    Science.gov (United States)

    Metronidazole injection is used to treat certain skin, blood, bone, joint, gynecologic, and abdominal (stomach area) infections ... spinal cord), and certain respiratory infections, including pneumonia. Metronidazole injection is also to prevent infection when used ...

  11. Dexrazoxane Injection

    Science.gov (United States)

    ... side effects that may be caused by chemotherapy medications. Dexrazoxane injection (Zinecard) is used to prevent or decrease heart ... your doctor about the risks of receiving this medication.Dexrazoxane injection may cause other side effects. Call your doctor ...

  12. Methylnaltrexone Injection

    Science.gov (United States)

    ... the bowel from the effects of opioid (narcotic) medications. ... questions about how to prepare or inject this medication.Methylnaltrexone injection comes in prefilled syringes and in vials to ...

  13. Lacosamide Injection

    Science.gov (United States)

    ... of seizures in people who cannot take oral medications. Lacosamide injection is in a class of medications called anticonvulsants. ... doctor.Do not let anyone else use your medication. Lacosamide injection is a controlled substance. Prescriptions may be refilled ...

  14. Alirocumab Injection

    Science.gov (United States)

    ... your dose depending on your response to this medication.Alirocumab injection helps to control cholesterol levels, but does not ... prefilled syringe or prefilled dosing pen containing alirocumab injection.

  15. Mepolizumab Injection

    Science.gov (United States)

    ... asthma is not controlled with their current asthma medication. Mepolizumab injection is in a class of medications called monoclonal ... want to decrease the doses of your other medications gradually.Mepolizumab injection is not used to treat a sudden attack ...

  16. Romidepsin Injection

    Science.gov (United States)

    ... already been treated with at least one other medication given by mouth or by injection. Romidepsin injection is in a class of medications called histone deacetylase (HDAC) inhibitors. It works by ...

  17. Avelumab Injection

    Science.gov (United States)

    ... or after it was treated with other chemotherapy medications. Avelumab injection is in a class of medications called monoclonal ... avelumab based on your body's response to this medication.Avelumab injection may cause serious reactions during the infusion of ...

  18. Etanercept Injection

    Science.gov (United States)

    ... dose. You also should not mix any other medications with etanercept injection.If your medication comes in a prefilled syringe or automatic injection device, use each syringe or device only once ...

  19. Busulfan Injection

    Science.gov (United States)

    Busulfex® Injection ... Busulfan injection is used to treat a certain type of chronic myelogenous leukemia (CML; a type of cancer of ... of 16 doses) before bone marrow transplant.Busulfan injection may cause seizures during therapy with the medication. ...

  20. Self injection of foreign materials into the penis.

    Science.gov (United States)

    Ahmed, U; Freeman, A; Kirkham, A; Ralph, D J; Minhas, S; Muneer, A

    2017-02-01

    Injection of the subcutaneous tissues of the penis for enlargement of penile girth has been practised for many years by laypeople and medical practitioners alike. However, with recognition of the complications, the practice has died out. We report a series of five patients who presented having injected foreign materials into the subcutaneous tissues of their penises, including paraffin and mineral oils. Our patients had a variable time course of presentation ranging from 1 day following injection to over 26 years. Self-injection of the subcutaneous tissues of the penis is an unusual presentation for a penile mass but should be considered as a differential diagnosis in patients with a long latent period to presentation or with characteristic magnetic resonance imaging and histological appearances.

  1. Sensitivity analysis of the impacts of operational and geologic conditions on Area of Review (AOR, Post Injection Site Care (PISC and Risk associated with CO2 Sequestration in South-region of United States

    Directory of Open Access Journals (Sweden)

    Danilo Andrés Arcentales Bastidas

    2017-12-01

    Full Text Available For anthropogenic carbon dioxide (CO2 capture is important to consider: gas storage’s formation capacity, saturation and pressure plume size after injection; including the risks associated with CO2 leakage and faults reactivation. A formation with a reasonable pore volume would be a good candidate for CO2 storage, however, not all high porosity formations have the ability to store large amounts of gas over a long period of time. That's the biggest concern when it refers to CO2 capture. Saturation and pressure plume size during CO2 injection as well as site monitoring after injection were simulated in this research, using CRD field reservoir models. The application of Pareto diagrams and surface responses allowed us to determine the most important parameters that affected the saturation and pressure plume, quantifying the correlation between different parameters of adjusted and dimensioned historical models.

  2. Transmissible Venereal Tumor with Subcutaneous and Bone ...

    African Journals Online (AJOL)

    A five year old entire mixed breed dog was admitted to the University of Nairobi's small animal clinic with a 5-months history of subcutaneous masses. Physical examination revealed firm and mobile masses in the subcuticular tissues, on the mandible and the transverse processes of the lumbar vertebrae. Visual inspection ...

  3. Radiological case: subcutaneous and mediastinal enfisema

    OpenAIRE

    Nascimento, J.; Gomes, M.; Moreira, C.; Macedo, F.

    2012-01-01

    ABSTRACT We present the case of a 5 year old asmathic girl admitted to the hospital for acute non traumatic edema and crepitus of the face, neck and upper thorax. Thoracic x-ray (not shown) and thoracic and neck CT were performed, showing extensive subcutaneous and mediastinal enfisema. These are rare complications of asthma. The imaging features are described.

  4. Case Report Pneumomediastinum and Subcutaneous Emphysema ...

    African Journals Online (AJOL)

    wheezing and neck pain. He was diagnosed asthmatic at the age of eleven and had been admitted on a few occasions for acute exacerbations in the prior ten years. He had salbutamol tablets regularly. At this index presentation, he was noted to have subcutaneous swelling and crepitus over the neck and upper anterior ...

  5. Anthropometrical Profile, Skinfold Tickness and Subcutaneous Fat ...

    African Journals Online (AJOL)

    Background: The threatening health problems resulting from excess subcutaneous fat depositions have been reported by the world Health Organization. Also noteworthy is that childhood obesity is a pointer to adult obesity. This necessitated a study on the anthropometrical profiles of adolescents of Southeast Nigeria using ...

  6. Case Report: Pneumomediastinum and subcutaneous cervical ...

    African Journals Online (AJOL)

    The occurrence of pneumomediastinum and subcutaneous cervical emphysema as complications of childhood pneumonia is very unusual. They results most often from respiratory manoeuvres that produce high intrathoracic pressure. Although they are largely benign, pneumomediastinum can cause compression of major ...

  7. Intravenous and subcutaneous immunoglobulin G replacement therapy.

    Science.gov (United States)

    Bonilla, Francisco A

    2016-11-01

    Human polyclonal immunoglobulin G (IgG) for therapeutic use has been available for decades. This drug was developed for treatment of antibody deficiency (replacement therapy), although its use has expanded into many anti-inflammatory and immunomodulatory applications in recent years. This review focuses on IgG prescribing for replacement therapy. IgG for replacement is most often administered via the intravenous IgG (IVIG) or subcutaneous IgG (SCIG) routes. IVIG is usually administered every 34 weeks, and SCIG is usually administered weekly, although variations may be considered in all cases. Recently, a new product became available that uses hyaluronidase to facilitate absorption of large doses of SCIG less frequently (every 34 weeks, as with IVIG). There are important differences between the pharmacokinetics of these three routes of administration. IVIG therapy leads to high peaks and low troughs between infusions. IgG concentration fluctuates much less over time with SCIG. Hyaluronidase-facilitated SCIG is intermediate. SCIG may have lower bioavailability in comparison with IVIG and may require higher doses over time; this is not true for hyaluronidase SCIG. However, there are large variations in IgG half-life among individuals and with different products. Therefore, individualization of therapy is essential. Mild systemic flu-like adverse effects may affect up to 2025% of patients who receive IVIG, smaller fractions may experience more-severe symptoms, whereas anaphylaxis is exceedingly rare. General flu-like systemic adverse effects are minimal with SCIG (intermediate with hyaluronidase SCIG), but transient (24 hours), mild, local inflammatory symptoms at infusion sites are relatively common with both forms. Additional rare but important complications of IgG therapy include thrombotic events and hemolysis that can be seen at high doses with any route of administration. Renal adverse effects may occur with IVIG as well. The variety of IgG products and routes of

  8. Ecchymosis and/or haematoma formation after prophylactic administration of subcutaneous enoxaparin in the abdomen or arm of the critically ill patient.

    Science.gov (United States)

    Jareño-Collado, R; Sánchez-Sánchez, M M; Fraile-Gamo, M P; García-Crespo, N; Barba-Aragón, S; Bermejo-García, H; Sánchez-Izquierdo, R; Sánchez-Muñoz, E I; López-López, A; Arias-Rivera, S

    Ecchymosis and/or haematoma are the most common adverse events after subcutaneous administration of low molecular weight heparin. There is no strong recommendation as to the puncture site. To evaluate the adverse events, ecchymosis and/or haematoma after the administration of prophylactic subcutaneous enoxaparin in the abdomen vs the arm in the critically ill patient. A randomised, two-arm clinical trial (injection in the abdomen vs the arm), performed between July 2014 and January 2017, in an 18-bed, polyvalent intensive care unit. Patients receiving prophylactic enoxaparin, admitted >72h, with no liver or haematological disorders, a body mass index (BMI) >18.5, not pregnant, of legal age and with no skin lesions which would impede assessment were included. We excluded patients who died or who were transferred to another hospital before completing the evaluation. We gathered demographic and clinical variables, and the onset of ecchymosis and/or haematomas at the injection site after 12, 24, 48 and 72hours. A descriptive analysis was undertaken, with group comparison and logistic regression. The study was approved by the ethics committee with the signed consent of patients/families. 301 cases (11 excluded): 149 were injected in the abdomen vs 141 in the arm. There were no significant differences in demographic and clinical variables, BMI, enoxaparin dose or antiplatelet administration [ecchymosis, abdomen vs arm, n(%): 66(44) vs 72(51), P=.25] [haematoma abdomen vs arm, n(%): 9(6) vs 14(10), P=.2]. Statistical significance was found in the size of the haematomas after 72h: [area of haematoma (mm 2 ) abdomen vs arm, median (IQR): 2(1-5.25) vs 20(5.25-156), P=.027]. In our patient cohort, prophylactic subcutaneous enoxaparin administered in the abdomen causes fewer haematomas after 72hours, than when administered in the arm. The incidence rate of ecchymosis and haematoma was lower than the published incidence in critically ill patients, although patients receiving

  9. Deuterium MR spectroscopy at 4.7 T. Quantification of tumour and subcutaneous tissue blood flow in animal models

    DEFF Research Database (Denmark)

    Wirestam, R; Larsen, V.A.; Stubgaard, M

    1995-01-01

    Deuterium MR spectroscopy was used for the determination of tissue blood flow (TBF). The tracer D2O was injected into the tissue of interest, and tracer washout was followed using a 4.7 T spectroscopy/imaging unit. Normal subcutaneous tissue in rats was studied, as well as tissue influenced...

  10. Olivine dissolution in the presence of heterotrophic bacteria (Pseudomonas reactants) extracted from Icelandic groundwater of the CO2 injection pilot site

    Science.gov (United States)

    Shirokova, Liudmila; Pokrovsky, Oleg; Benezeth, Pascale; Gerard, Emmanuelle; Menez, Benedicte; Alfredsson, Helgi

    2010-05-01

    This work is aimed at experimental modeling of the effect of heterotrophic bacteria on dissolution of important rock-forming mineral, olivine, at the conditions of CO2 storage and sequestration. Heterotrophic aerobic gram-negative bacteria were extracted from deep underground water (HK31, 1700 m deep and, t = 25-30°C) of basaltic aquifer located within the Hellisheidi CO2 injection pilot site (Iceland). Following this sampling, we separated, using culture on nutrient agar plates, four different groups of gram-negative aerobic bacteria. The enzymatic activity of studied species has been evaluated using Biolog Ecoplates and their genetic identification was performed using 18-S RNA analysis. The optimal growth conditions of bacteria on Brain Hearth Broth nutrient have been determined as 5 to 37°C and growth media pH varied from 7.0-8.2. Culturing experiments allowed determining the optimal physico-chemical conditions for bacteria experiments in the presence of basic Ca, Mg-containing silicates. Olivine (Fo92) was chosen as typical mineral of basalt, widely considered in carbon dioxide sequestration mechanisms. Dissolution experiments were performed in constant-pH (7 to 9), bicarbonate-buffered (0.001 to 0.05 M) nutrient-diluted media in batch reactors at 0-30 bars of CO2 in the presence of various biomass of Pseudomonas reactants. The release rate of magnesium, silica and iron was measured as a function of time in the presence of live, actively growing, dead (autoclaved or glutaraldehyde-treated) cells and bacteria exometabolites. Both nutrient media diluted 10 times (to 100 mg DOC/L) and inert electrolyte (NaCl, no DOC) were used. Our preliminary results indicate that the pH and dissolved organic matter are the first-order parameters that control the element release from olivine at far from equilibrium conditions. The SEM investigation of reacted surfaces reveal formation of surface roughness with much stronger mineral alteration in the presence of live bacteria

  11. Needle-free subcutaneous sumatriptan (Sumavel DosePro): bioequivalence and ease of use.

    Science.gov (United States)

    Brandes, Jan Lewis; Cady, Roger K; Freitag, Fred G; Smith, Timothy R; Chandler, Patricia; Fox, Anthony W; Linn, Lawrence; Farr, Stephen J

    2009-01-01

    Subcutaneous (s.c.) injection of sumatriptan is currently associated with needle aversion in some patients, and sharps disposal issues. To investigate whether a needle-free system can deliver s.c. sumatriptan. If so, to examine whether needle-free administration is bioequivalent to a 26-gauge needle-based auto-injector. Lastly, to assess the needle-free system for clinical acceptability and ease of use during migraine attacks. Two clinical trials. Study A: Pharmacokinetics and bioequivalence was studied in normal adult volunteers (n = 57 total), directly comparing needle-free (Sumavel DosePro) with needle-based (Imitrex STATdose System) administration of 6 mg s.c. sumatriptan. An incomplete, randomized, partial factorial, crossover design was used. Each subject received 2 administrations of each product, at 2 of the 3 anatomical sites (abdomen, thigh or arm). There were appropriate "washout" periods between each. Pharmacokinetic sampling was at standard time points, and tests for bioequivalence then followed. Study B: The term "ease of use" was used for clinical acceptability and utility of the needle-free system when it was assessed among 52 outpatients treating migraine attacks. Instructional materials were used as would be provided after ordinary prescription. The primary endpoint was successful use of the needle-free system to administer sumatriptan at the first attempt, including appropriate injection site selection. Second and subsequent uses of the needle-free system were also documented. For administration sites in the thigh and the abdomen, but not the arm, the needle-free and needle-based systems were bioequivalent (for all pharmacokinetic endpoints the mean ratios between the 2 devices were always between 90.1% and 115%). Among outpatients treating a migraine attack with the needle-free system, 51 of 52 on first attempt used the needle-free system successfully when treating a migraine attack. Sumavel DosePro needle-free delivery system is a new

  12. Local and distant chemical burns due to cetrimide injection in a massive dose

    Directory of Open Access Journals (Sweden)

    S Kumar

    1990-01-01

    Full Text Available Sixty ml of 20% cetrimide shampoo solution was injected subcutaneously around the left elbow by a drug addict to commit suicide. Edema, blisters with skip areas and, cellulitis were noted within 6 hours, not only around the site of the injection but also upto the wrist and the pectoral region. Muscles were protected by the tough deep fascia. There was no systemic toxidcity despite receiving at least 4 times the reported fatal dose. The patient was treated with multiple fasciotomies, broad spectrum antibiotics, an atory drugs, iunb elevation and daily dressings, followed by secondary suturing of fasciotomy wounds when the limb edema regressed. The cutaneous bums healed without needing skin grafts.

  13. Injection compositions

    Directory of Open Access Journals (Sweden)

    Crnogorac Luka

    2016-01-01

    Full Text Available This paper provides a brief overview of the methods and materials for injection in underground construction, with a focus on the use of new injection compounds for this purpose. The aim is to draw attention to the possibility of applying new materials for injection that are present in the world, which would facilitate the work, significantly shorten time of work and downtime.

  14. Subcutaneous implantable defibrillator: State-of-the art 2013

    OpenAIRE

    Akerström, Finn; Arias, Miguel A; Pachón, Marta; Puchol, Alberto; Jiménez-López, Jesús

    2013-01-01

    The subcutaneous implantable cardioverter-defibrillator (S-ICD) has recently been approved for commercial use in Europe, New Zealand and the United States. It is comprised of a pulse generator, placed subcutaneously in a left lateral position, and a parasternal subcutaneous lead-electrode with two sensing electrodes separated by a shocking coil. Being an entirely subcutaneous system it avoids important periprocedural and long-term complications associated with transvenous implantable cardiove...

  15. Subcutaneous Implants of Buprenorphine-Cholesterol-Triglyceride Powder in Mice

    Directory of Open Access Journals (Sweden)

    L. DeTolla

    2014-01-01

    Full Text Available Subcutaneous drug implants are convenient systems for the long-term delivery of drugs in animals. Lipid carriers are logical tools because they generally allow for higher doses and low toxicity. The present study used an US Food and Drug Administration Target Animal Safety test system to evaluate the safety of a subcutaneous implant of a cholesterol-triglyceride-buprenorphine powder in 120 BALB/c mice. Mice were evaluated in 4- and 12-day trials with 1- and 5-fold doses of the intended 3 mg/kg dose of drug. One male mouse treated with three 3 mg/kg doses and surgery on days 0, 4, and 8 died on day 9. The cause of death was not determined. In the surviving 119 mice there was no evidence of skin reaction at the site of the implant. Compared to control animals treated with saline, weight measurements, clinical pathology, histopathology, and clinical observations were unremarkable. These results demonstrate that the lipid carrier is substantially safe. Cholesterol-triglyceride-drug powders may provide a valuable research tool for studies of analgesic and inflammatory drug implants in veterinary medicine.

  16. Phase separation of in situ forming poly (lactide-co-glycolide acid) implants investigated using a hydrogel-based subcutaneous tissue surrogate and UV-vis imaging.

    Science.gov (United States)

    Sun, Yu; Jensen, Henrik; Petersen, Nickolaj J; Larsen, Susan W; Østergaard, Jesper

    2017-10-25

    Phase separation of in situ forming poly (lactide-co-glycolide acid) (PLGA) implants with agarose hydrogels as the provider of nonsolvent (water) mimicking subcutaneous tissue was investigated using a novel UV-vis imaging-based analytical platform. In situ forming implants of PLGA-1-methyl-2-pyrrolidinone and PLGA-triacetin representing fast and slow phase separating systems, respectively, were evaluated using this platform. Upon contact with the agarose hydrogel, the phase separation of the systems was followed by the study of changes in light transmission and absorbance as a function of time and position. For the PLGA-1-methyl-2-pyrrolidinone system, the rate of spatial phase separation was determined and found to decrease with increasing the PLGA concentration from 20% to 40% (w/w). Hydrogels with different agarose concentrations (1% and 10% (w/v)) were prepared for providing the nonsolvent, water, to the in situ forming PLGA implants simulating the injection site environment. The resulting implant morphology depended on the stiffness of hydrogel matrix, indicating that the matrix in which implants are formed is of importance. Overall, the work showed that the UV-vis imaging-based platform with an agarose hydrogel mimicking the subcutaneous tissue holds potential in providing bio-relevant and mechanistic information on the phase separation processes of in situ forming implants. Copyright © 2017 Elsevier B.V. All rights reserved.

  17. Randomized clinical trial to assess pain and bruising in medicines administered by means of subcutaneous and intramuscular needle injection: Is it necessary to have needles changed? Ensayo clínico aleatorio para evaluación del dolor y hematoma durante la administración de medicamentos por vía subcutánea e intramuscular: ¿Es necesario cambiar las agujas? Ensaio clínico randomizado para avaliação de dor e hematoma em administração de medicamentos por via subcutânea e intramuscular: há necessidade de troca de agulhas?

    Directory of Open Access Journals (Sweden)

    Luiz Carlos Ribeiro Lamblet

    2011-10-01

    Full Text Available This clinical trial aimed at comparing the intensity of pain and bruising by subcutaneous and intramuscular injections using and retractable fixed syringes and needles and syringes with no needles combined, at a public hospital in Sao Paulo, for six months. We evaluated the perception of pain in case of intramuscular (n=1000 and subcutaneous injections (n=240. In subcutaneous application, bruise formation was also verified. Pain and bruising scores were higher in the group with no needles combined (pEste ensayo clínico tuvo como objetivo comparar la intensidad del dolor y hematoma de inyecciones por vía subcutánea e intramuscular utilizando jeringas y agujas fijas retráctiles y jeringas con agujas no conjugadas, en un hospital público en la ciudad de Sao Paulo, durante seis meses. Fue evaluada la percepción del dolor de la inyección intramuscular (n=1000 y la subcutánea (n=240. En la aplicación por vía subcutánea se verificó también la formación de hematoma. La puntuación del dolor y hematoma fue mayor en el Grupo con agujas no conjugadas (pEste ensaio clínico teve como objetivo comparar a intensidade da dor e hematoma consequentes a injeções por via subcutânea e intramuscular, utilizando seringas e agulhas fixas retráteis e seringas com agulhas não conjugadas, em hospital público na cidade de São Paulo, durante seis meses. Foi avaliada a percepção da dor na injeção intramuscular (n=1.000 e na subcutânea (n=240. Na aplicação por via subcutânea, verificou-se também a formação de hematoma. A pontuação de dor e hematoma foi maior no grupo com agulhas não conjugadas (p<0,001 e p<0,029, respectivamente. O poder do teste em relação à escala de dor foi de 0,98. Recomenda-se o uso de agulha fixa retrátil na aplicação de injeções intramusculares e subcutâneas. Registro de ensaio clínico nº NCT01271608.

  18. Subcutaneous filariasis: An unusual case report

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    Valand Arvindbhai

    2007-01-01

    Full Text Available Wuchereria bancrofti presented in subcutaneous nodule is a very rare presentation. Wuchereria bancrofti first reported by Bancrofti in Brisbane in 1876 and the name filaria Bancrofti was given in 1877 and the generic name was given in 1878. A 15-year-old male patient′s known case of pulmonary Koch′s with incidentally detected subcutaneous nodule on right arm pit, cytology from the nodule shows many sheathed microfilaria along with segment of an adult female worm. Wet mount peripheral blood smear shows nocturnal motile microfilaria. The Wuchereria bancrofti is known to be associated with pulmonary Koch′s. Nocturnal motility and cytomorphological features differentiate Wuchereria bancrofti from Wuchereria loa loa . After giving diethyl carbamazine (DEC 6 mg/kg for 21 days without disturbing anti Koch′s treatment schedule and microfilaria disappeared from peripheral blood.

  19. Primary Sonographic Diagnosis of Subcutaneous Cysticercosis

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    M E Shivu

    2011-01-01

    Full Text Available We present the case of a 40-year-old woman with a small diffuse swelling on the left side of her face. She was diagnosed with intramuscular cysticercosis in the masseter muscle (case of disseminated cysticercosis involving the muscular system and subcutaneous tissues with surrounding phlegmon on high-resolution ultrasound and managed conservatively. To our knowledge, the imaging findings of disseminated muscular cysUcercosis have been reported before only a few numbers of times. In this case, the correct diagnosis was made on the basis of high-resolution sonography of the subcutaneous tissue and muscles. It showed multiple oval to circular, predominantly anechoic lesions, which were around 1 cm in diameter. Most of these cystic lesions showed a hyperechoic focus within suggestive of a scolex. There was no increased vascularity surrounding the lesions. Thus, sonography can primarily make the correct diagnosis of disseminated muscular cysticercosis if such lesions are seen. In endemic areas, cysticercosis should be considered one of the differential diagnosis of the subcutaneous swellings.

  20. Incorporating a Generic Model of Subcutaneous Insulin Absorption into the AIDA v4 Diabetes Simulator 3. Early Plasma Insulin Determinations

    Science.gov (United States)

    Lehmann, Eldon D.; Tarín, Cristina; Bondia, Jorge; Teufel, Edgar; Deutsch, Tibor

    2009-01-01

    Introduction AIDA is an interactive educational diabetes simulator that has been available without charge via the Internet for over 12 years. Recent articles have described the incorporation of a novel generic model of insulin absorption into AIDA as a way of enhancing its capabilities. The basic model components to be integrated have been overviewed, with the aim being to provide simulations of regimens utilizing insulin analogues, as well as insulin doses greater than 40 IU (the current upper limit within the latest release of AIDA [v4.3a]). Some preliminary calculated insulin absorption results have also recently been described. Methods This article presents the first simulated plasma insulin profiles from the integration of the generic subcutaneous insulin absorption model, and the currently implemented model in AIDA for insulin disposition. Insulin absorption has been described by the physiologically based model of Tarín and colleagues. A single compartment modeling approach has been used to specify how absorbed insulin is distributed in, and eliminated from, the human body. To enable a numerical solution of the absorption model, a spherical subcutaneous depot for the injected insulin dose has been assumed and spatially discretized into shell compartments with homogeneous concentrations, having as its center the injection site. The number of these compartments will depend on the dose and type of insulin. Insulin inflow arises as the sum of contributions to the different shells. For this report the first bench testing of plasma insulin determinations has been done. Results Simulated plasma insulin profiles are provided for currently available insulin preparations, including a rapidly acting insulin analogue (e.g., lispro/Humalog or aspart/Novolog), a short-acting (regular) insulin preparation (e.g., Actrapid), intermediate-acting insulins (both Semilente and neutral protamine Hagedorn types), and a very long-acting insulin analogue (e.g., glargine/Lantus), as

  1. Omalizumab Injection

    Science.gov (United States)

    ... want to decrease the doses of your other medications gradually.Omalizumab injection is not used to treat a sudden attack ... your doctor about the risks of using this medication.Omalizumab injection may cause other side effects. Call your doctor ...

  2. Elotuzumab Injection

    Science.gov (United States)

    ... or that had improved after treatment with other medications but later returned. Elotuzumab injection is in a class of medications called monoclonal ... your doctor about the risks of receiving this medication.Elotuzumab injection may cause other side effects. Call your doctor ...

  3. Colistimethate Injection

    Science.gov (United States)

    ... have, and how well you respond to the medication.You may receive colistimethate injection in a hospital or you may administer the medication at home. If you will be receiving colistimethate injection at home, your healthcare provider will show you ...

  4. Carfilzomib Injection

    Science.gov (United States)

    ... on how well your body responds to the medication.Carfilzomib injection may cause a severe or life-threatening reactions ... if you are allergic to carfilzomib, any other medications, or any of the ingredients in carfilzomib injection. Ask your pharmacist for a list of the ...

  5. Vedolizumab Injection

    Science.gov (United States)

    ... that has not improved when treated with other medications. Vedolizumab injection is in a class of medications called integrin ... to the medication. You may be given other medications to treat reactions to vedolizumab injection. Tell your doctor or nurse immediately if you ...

  6. Leucovorin Injection

    Science.gov (United States)

    ... accidentally received an overdose of methotrexate or similar medications. Leucovorin injection is also used to treat anemia (low level ... is also used with 5-fluorouracil (a chemotherapy medication) to treat ... intestine). Leucovorin injection is in a class of medications called folic ...

  7. THE CELLULAR TRANSFORMATION OF INJECTED COLLOIDAL IRON COMPLEXES INTO FERRITIN AND HEMOSIDERIN IN EXPERIMENTAL ANIMALS

    Science.gov (United States)

    Richter, Goetz W.

    1959-01-01

    As revealed by electron microscopy and electron diffraction, the physical state of ferric hydroxide micelles contained in iron-dextran, saccharated iron oxide, and hydrous ferric oxide ("ferric hydroxide") differs notably from the state of the ferric hydroxide in ferritin or hemosiderin. By virtue of this difference one can trace the intracellular transformation of colloidal iron, administered parenterally, into ferritin and hemosiderin. One hour after intraperitoneal injection of iron-dextran or saccharated iron oxide into mice, characteristic deposits were present in splenic macrophages, in sinusoidal endothelial cells of spleen and liver, and in vascular endothelial cells of various renal capillaries. Four hours after injection, small numbers of ferritin molecules were identifiable about intracellular aggregates of injected iron compounds; and by the 6th day, ferritin was abundant in close proximity to deposits of injected iron compounds. The latter were frequently situated in cytoplasmic vesicles delimited by single membranes. These vesicles were most frequently found in tissue obtained during the first 6 days after injection; and in certain of the vesicles ferritin molecules surrounded closely packed aggregates of injected material. Much unchanged ferric hydroxide was still present in macrophages and vascular endothelial cells 3 to 4 weeks after injection. While electron microscopy left no doubt about the identity of injected ferric hydroxide on the one hand, and of ferritin or hemosiderin on the other, histochemical tests for iron failed in this respect. Precipitation of ferric hydroxide (hydrous ferric oxide) from stabilized colloidal dispersions of iron-dextran was brought about in vitro by incubation with minced mouse tissue (e.g. liver), but not by incubation with mouse serum or blood. Subcutaneous injections of hydrous gel of ferric oxide into mice initially produced localized extracellular precipitates. Most of the material was still extracellular 16

  8. Administering Multiple Injectable Vaccines During a Single Visit-Summary of Findings From the Accelerated Introduction of Inactivated Polio Vaccine Globally.

    Science.gov (United States)

    Dolan, Samantha B; Patel, Manish; Hampton, Lee M; Burnett, Eleanor; Ehlman, Daniel C; Garon, Julie; Cloessner, Emily; Chmielewski, Elizabeth; Hyde, Terri B; Mantel, Carsten; Wallace, Aaron S

    2017-07-01

    In 2013, the World Health Organization's (WHO's) Strategic Advisory Group of Experts (SAGE) recommended that all 126 countries using only oral polio vaccine (OPV) introduce at least 1 dose of inactivated polio vaccine (IPV) into their routine immunization schedules by the end of 2015. In many countries, the addition of IPV would necessitate delivery of multiple injectable vaccines (hereafter, "multiple injections") during a single visit, with infants receiving IPV alongside pentavalent vaccine (which covers diphtheria, tetanus, and whole-cell pertussis; hepatitis B; and Haemophilus influenzae type b) and pneumococcal vaccine. Unanticipated concerns emerged from countries over acceptability of multiple injections, sites of administration, and safety. We contextualized the issues surrounding multiple injections by documenting concerns associated with administration of ≥3 injections, existing evidence in the published literature, and findings of a systematic review on administration practices and techniques. Concerns associated with multiple-injection visits were documented from meetings and personal communications with immunization program managers. Published literature on the acceptability of multiple injections by providers and caregivers was summarized, and a systematic review of the literature on administration practices was completed on the following topics: spacing between injection sites (ie, vaccine spacing), site of injection, route of injection, and procedural preparedness. WHO and United Nations Children's Fund data from 2013-2015 were used to assess multiple-injection visits included in national immunization schedules. Healthcare provider and caregiver attitudes and practices indicated concerns about infant pain, potential adverse effects, and uncertainty about vaccine effectiveness with multiple-injection visits. Published literature reinforced the record of safety and acceptance of the recommended schedule of IPV by the SAGE, but the evidence was

  9. Monitoring field scale CO2 injection from time-lapse seismic and well log, integrating with advanced rock physics model at Cranfield EOR site

    Science.gov (United States)

    Ghosh, Ranjana

    2017-10-01

    Causes and effects of global warming have been highly debated in recent years. Nonetheless, injection and storage of CO2 (CO2 sequestration) in the subsurface is becoming increasingly accepted as a viable tool to reduce the amount of CO2 from the atmosphere, which is a primary contributor to global warming. Monitoring of CO2 movement with time is essential to ascertain that sequestration is not hazardous. A method is proposed here to appraise CO2 saturation from seismic attributes using differential effective medium theory modified for pressure (PDEM). The PDEM theory accounts pressure-induced fluid flow between cavities, which is a very important investigation in the CO2-sequestered regime of heterogeneous microstructure. The study area is the lower Tuscaloosa formation at Cranfield in Mississippi, USA, which is one of the active enhanced oil recovery (EOR), and CO2 capture and storage (CCS) fields. Injection well (F1) and two observation wells (F2 and F3) are present close (within 112 m) to the detailed area of study for this region. Since the three wells are closely situated, two wells, namely injection well F1 and the furthest observation well F3, have been focused on to monitor CO2 movement. Time-lapse (pre- and post-injection) log, core and surface seismic data are used in the quantitative assessment of CO2 saturation from the PDEM theory. It has been found that after approximately 9 months of injection, average CO2 saturations in F1 and F3 are estimated as 50% in a zone of thickness 25 m at a depth of 3 km.

  10. Monitoring field scale CO2 injection from time-lapse seismic and well log, integrating with advanced rock physics model at Cranfield EOR site

    Science.gov (United States)

    Ghosh, Ranjana

    2017-12-01

    Causes and effects of global warming have been highly debated in recent years. Nonetheless, injection and storage of CO2 (CO2 sequestration) in the subsurface is becoming increasingly accepted as a viable tool to reduce the amount of CO2 from the atmosphere, which is a primary contributor to global warming. Monitoring of CO2 movement with time is essential to ascertain that sequestration is not hazardous. A method is proposed here to appraise CO2 saturation from seismic attributes using differential effective medium theory modified for pressure (PDEM). The PDEM theory accounts pressure-induced fluid flow between cavities, which is a very important investigation in the CO2-sequestered regime of heterogeneous microstructure. The study area is the lower Tuscaloosa formation at Cranfield in Mississippi, USA, which is one of the active enhanced oil recovery (EOR), and CO2 capture and storage (CCS) fields. Injection well (F1) and two observation wells (F2 and F3) are present close (within 112 m) to the detailed area of study for this region. Since the three wells are closely situated, two wells, namely injection well F1 and the furthest observation well F3, have been focused on to monitor CO2 movement. Time-lapse (pre- and post-injection) log, core and surface seismic data are used in the quantitative assessment of CO2 saturation from the PDEM theory. It has been found that after approximately 9 months of injection, average CO2 saturations in F1 and F3 are estimated as 50% in a zone of thickness 25 m at a depth of 3 km.

  11. A five-patient satisfaction pilot study of calcium hydroxylapatite injection for treatment of aging hands.

    Science.gov (United States)

    Marmur, Ellen S; Al Quran, Hanadi; De Sa Earp, Ana Paula; Yoo, Jane Y

    2009-12-01

    The process of skin aging is not limited to the face but involves every part of the body, including the hands. A common manifestation of aging of the hands is the loss of volume, which occurs as the skin loses its subcutaneous fat. Injectable dermal fillers have surfaced as a popular method to address such deficiencies. To report the use of calcium hydroxylapatite (CaHA) to address lost volume. Five female subjects with soft tissue deficiency of the dorsa of the hands were enrolled at Mount Sinai Medical Center. A solution of CaHA with 2% lidocaine in amounts of 0.3 to 1.0 mL was injected interdigitally at each of three to five insertion sites; the sites were massaged and molded up to three times to ensure an optimal cosmetic end point. Subjects were seen for a follow-up visit after 1, 4, 16, and 24 weeks. With a single injection, all subjects reached their correction goals without requiring any touch-ups. At the 24-week visit, the subjects retained the filling effect, with no adverse events and high patient satisfaction. CaHA, a new, easily injectable, safe dermal filler, has emerged as an excellent option for soft tissue augmentation in aging hands.

  12. Subcutaneous mucor zygomycosis with potential life-threatening visceral complication

    Directory of Open Access Journals (Sweden)

    Angeline

    2013-01-01

    Full Text Available A mass in right supraclavicular fossa in a diabetic patient mimicking tuberculosis (TB adenitis that ultimately proved to be subcutaneous zygomycosis. A high degree of clinical suspicion is needed for diagnosis especially when these lesions occur at typical sites for the more common indolent infections like TB. This case is being presented not only because of its rarity, but to emphasize the role of early diagnosis and appropriate treatment to prevent serious complications due to proximity to major structures. Fluconazole was used despite not being the ideal drug, solely due to cost constraints. Our patient responded well. However, we do emphasize that response to fluconazole is the exception rather than the rule.

  13. Subcutaneous Implants of a Cholesterol-Triglyceride-Buprenorphine Suspension in Rats

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    M. Guarnieri

    2017-01-01

    Full Text Available A Target Animal Safety protocol was used to examine adverse events in male and female Fischer F344/NTac rats treated with increasing doses of a subcutaneous implant of a lipid suspension of buprenorphine. A single injection of 0.65 mg/kg afforded clinically significant blood levels of drug for 3 days. Chemistry, hematology, coagulation, and urinalysis values with 2- to 10-fold excess doses of the drug-lipid suspension were within normal limits. Histopathology findings were unremarkable. The skin and underlying tissue surrounding the drug injection were unremarkable. Approximately 25% of a cohort of rats given the excess doses of 1.3, 3.9, and 6.5 mg/kg displayed nausea-related behavior consisting of intermittent and limited excess grooming and self-gnawing. These results confirm the safety of cholesterol-triglyceride carrier systems for subcutaneous drug delivery of buprenorphine in laboratory animals and further demonstrate the utility of lipid-based carriers as scaffolds for subcutaneous, long-acting drug therapy.

  14. A novel subcutaneous infusion delivery system based on osmotic pump: in vitro and in vivo evaluation.

    Science.gov (United States)

    Gong, Wei; Ma, Rui; Mei, Danyu; Jing, Pei; Dong, Xiao; Li, Bingsheng; Yang, Yanfang; Du, Lina; Mei, Xing-Guo; Hu, Fu-Qiang

    2014-02-01

    An economical, convenient portable drug delivery system combining osmotic pump with subcutaneous infusion was developed, which was composed of three primary components: water chamber, osmotic pump chamber and support base. Ceftriaxone sodium (CRO) was selected as the model drug and osmotic pump tablets were prepared. The influence of osmotic agents on drug release profiles was evaluated. As the adjustment made by the osmotic agents was limited, the compositions of semipermeable membrane were investigated to determine significant associations of factors based on orthogonal design. The in vitro release profiles of the optimum formulation achieved to the predetermined value (15 ± 3 min for the initial release time T(i) and 5.75 ± 0.25 h for the extent release time T(e)). The pharmacokinetic profiles of this drug delivery system were evaluated in Beagle dogs. In vivo results demonstrated that the osmotic pump subcutaneous infusion administration was equivalent to intravenous injection administration in terms of bioavailability. Moreover, constant drug plasma levels with minimized fluctuations could be achieved with this osmotic pump subcutaneous infusion system, compared with intravenous injection.

  15. [Combined effects of injected 1-29 GRF and diet energy level in lactating goats].

    Science.gov (United States)

    Sauvant, D; Kann, G; Hervieu, J; Mandran, N; Disenhaus, C

    1990-01-01

    Subcutaneous injections of 1-29 GRF and diet energy level were studied in 48 dairy goats using a 2 x 2 factorial design. Energy and GRF effects were additive on milk production and some interactions were observed on the milk fat and protein contents. Subcutaneous injections seemed to be less efficient in promoting milk secretion than the intravenous route used in a previous trial.

  16. Sonographic Appearance of Dermal and Subcutaneous Sarcoidosis: A Case Report

    Energy Technology Data Exchange (ETDEWEB)

    Jang, Ja Yoon; Bae, Young A; Hong, Hyeok Jin; Kwon, Kye Won [Dept. of Radiology, Bundang Jesaeng General Hospital, Seongnam (Korea, Republic of)

    2012-08-15

    Sarcoidosis is a systemic granulomatous disease of unknown origin that mainly involves lung and skin, but rarely involves subcutaneous tissue. While some studies have reported on CT or MR imaging findings of subcutaneous sarcoidosis, there is only one report on sonographic findings of subcutaneous sarcoidosis, recently published in the US. Familiarity with ultrasonographic findings of subcutaneous sarcoidosis might be helpful for the early diagnosis in patient with palpable nodules and image follow-up for subcutaneous sarcoidosis. Here we report on the sonographic appearance of subcutaneous sarcoidosis involving dermal and subcutaneous tissue over axilla and sole, a case diagnosed as sarcoidosis and improved by steroid treatment, along with a review of the relevant literature.

  17. Reasons for discontinuation of subcutaneous biologic therapy in the treatment of rheumatoid arthritis: a patient perspective

    Directory of Open Access Journals (Sweden)

    Bolge SC

    2015-01-01

    Full Text Available Susan C Bolge,1 Amir Goren,2 Neeta Tandon1 1Health Economics and Outcomes Research, Janssen Scientific Affairs, LLC, Horsham, PA, USA; 2Health Outcomes Practice, Kantar Health, New York, NY, USA Objective: To examine reasons why rheumatoid arthritis patients discontinued subcutaneous (SQ anti-tumor necrosis factor (anti-TNF treatment in the past 12 months, so as to help inform successful, uninterrupted therapy.Methods: Data were collected in March and April 2011 using self-reported, internet-based questionnaires. Study inclusion criteria comprised: rheumatoid arthritis diagnosis; discontinuation of SQ anti-TNF medication (adalimumab, certolizumab, etanercept, or golimumab within the past 12 months; aged ≥18 years; United States residency; and consent to participate. Patients reported primary and other reasons for discontinuation of their most recently discontinued anti-TNF.Results: Questionnaires from 250 patients were analyzed; 72.8% were female, 80.8% were white, and median age was 51 years. Patients had discontinued etanercept (n=109, adalimumab (n=98, certolizumab (n=24, or golimumab (n=19 within the past 12 months. When prompted about their primary reason for discontinuation, lack of effectiveness (40.8% was cited most often, followed by injection experience (18.4%. Combining prompted primary and other reasons for discontinuation, 60.8% of patients reported lack of effectiveness, while 40.8% reported injection experience, which included: pain/burning/discomfort after injection (14.4%; pain/burning/discomfort during injection (13.2%; injection reactions such as redness/swelling after injection (12.4%; dislike of self-injection (11.6%; dislike of frequency of injection (10.4%; and fear of injection/needles (6.8%. Conclusion: From the patient perspective, there are unmet needs with regard to the effectiveness and injection experience associated with SQ anti-TNF medications, which may lead to discontinuation. Treatment options with a

  18. Subcutaneous axillary and scalp metastases from non-gynecological retroperitoneal leiomyosarcoma: an unusual presentation after surgical resection

    Directory of Open Access Journals (Sweden)

    Simrandeep Kaur

    2015-12-01

    Full Text Available Retroperitoneal leiomyosarcomas are rare sarcomas, with an incidence of less than 2 per million population. Cutaneous metastases from sarcoma account for only 1-2.6% of metastatic skin lesions. Cutaneous and subcutaneous metastasis from retroperitoneal leiomyosarcoma is a very rare entity. We present a case of 72-year-old male with scalp nodule and subcutaneous swelling in left posterior axillary fold. Fine needle aspiration cytology from both these sites revealed a sarcoma, which was positive for Smooth Muscle Actin and negative for S100 on cell block immunohistochemistry (IHC. The past history revealed surgical resection of a retroperitoneal mass in 2010 which was diagnosed on histopathology and IHC as leiomyosarcoma. A final diagnosis of metastatic deposits from leiomyosarcoma was made. Retroperitoneal leiomyosarcoma presenting as scalp and subcutaneous metastasis is an unusual presentation. Adequate clinical history and a high index of clinical suspicion is required to detect cutaneous and subcutaneous metastatic deposits occurring five years after surgical resection.

  19. A Randomized Trial Comparing the Pharmacokinetics, Safety, and Tolerability of DFN-02, an Intranasal Sumatriptan Spray Containing a Permeation Enhancer, With Intranasal and Subcutaneous Sumatriptan in Healthy Adults.

    Science.gov (United States)

    Munjal, Sagar; Gautam, Anirudh; Offman, Elliot; Brand-Schieber, Elimor; Allenby, Kent; Fisher, Dennis M

    2016-10-01

    monodose, 10.2 minutes for DFN-02 multidose, and 2.0 hours for commercially available intranasal sumatriptan 20 mg. Compared with 4 and 6 mg subcutaneous sumatriptan, DFN-02's median tmax (10 minutes) was significantly earlier (15 minutes; P subcutaneous sumatriptan, these exposure metrics were about 50% larger (AUC0-2 : 67.17 ng*hour/mL; AUC0-∞ : 103.78 ng*hour/mL; Cmax : 72.75 ng/mL). Inter-subject variability of AUC0-2 , AUC0-∞ , and Cmax was 42-58% for DFN-02, 15-22% for 4 mg subcutaneous sumatriptan, and 15-25% for 6 mg subcutaneous sumatriptan. DDM exposure was low (mean Cmax : 1.63 ng/mL), tmax was 30 minutes, and it was undetectable by 4 hours. There were no serious adverse events, discontinuations due to adverse events, or remarkable findings for vital signs, physical examinations (including nasal and injection site examinations), or clinical laboratory assessments. The overall incidence of adverse events was comparable across treatments, and all treatment-related events were mild in severity. Adverse events occurring in ≥10% of subjects were dysgeusia (19%), headache (18%), nausea (15%), paresthesia (15%), and dizziness (12%). In healthy subjects, DFN-02, an intranasal spray containing 10 mg sumatriptan plus DDM, had a more rapid absorption profile than commercially available intranasal sumatriptan 20 mg, and systemic exposure from a single-dose administration of DFN-02 was similar to 4 mg SC sumatriptan and two-thirds that of 6 mg SC sumatriptan. With DFN-02, plasma sumatriptan peaked 5 minutes earlier than with both subcutaneous formulations. Systemic exposure to sumatriptan was similar with DFN-02 and 4 mg subcutaneous sumatriptan; both yielded lower systemic exposure than 6 mg subcutaneous sumatriptan. Systemic exposure to DFN-02's excipient DDM was short-lived. DFN-02's safety and tolerability appear to be comparable to subcutaneous sumatriptan. Addition of a permeation enhancer improved the absorption profile compared with commercially available

  20. Midazolam Injection

    Science.gov (United States)

    ... injection is in a class of medications called benzodiazepines. It works by slowing activity in the brain ... you have recently stopped drinking large amounts of alcohol or if you have or have ever had ...

  1. Oxytocin Injection

    Science.gov (United States)

    Oxytocin injection is used to begin or improve contractions during labor. Oxytocin also is used to reduce bleeding after childbirth. ... other medications or procedures to end a pregnancy. Oxytocin is in a class of medications called oxytocic ...

  2. Fluconazole Injection

    Science.gov (United States)

    ... and fungal infections of the eye, prostate (a male reproductive organ), skin and nails. Fluconazole injection is ... Motrin, others) and naproxen (Aleve, Anaprox, Naprelan); oral contraceptives (birth control pills); oral medication for diabetes such ...

  3. Ifosfamide Injection

    Science.gov (United States)

    ... intravenously (into a vein) by a doctor or nurse in a medical facility. It may be injected ... for allergies or hay fever; medications for nausea; opioid (narcotic) medications for pain; rifampin (Rifadin, Rimactane); sedatives; ...

  4. Furosemide Injection

    Science.gov (United States)

    Furosemide injection is used to treat edema (fluid retention; excess fluid held in body tissues) caused by ... fluid in the lungs), kidney, and liver disease. Furosemide is in a class of medications called diuretics (' ...

  5. Pembrolizumab Injection

    Science.gov (United States)

    ... or lightheadedness fainting change in the amount or color of urine changes in vision feeling confused Pembrolizumab injection may cause other side effects. Call your doctor if you have any unusual ...

  6. Botox Injections

    Science.gov (United States)

    ... LEARN logo to transfer to the LEARN Portal Botox Injections The American Academy of Facial Plastic and Reconstructive Surgery recommends persons considering Botox® treatment to: Check the physician’s credentials: The physician ...

  7. Epinephrine Injection

    Science.gov (United States)

    ... refrigerate epinephrine injection or leave it in your car, especially in hot or cold weather. If the ... to your pharmacist or contact your local garbage/recycling department to learn about take-back programs in ...

  8. Nivolumab Injection

    Science.gov (United States)

    Nivolumab injection is used alone or in combination with ipilimumab (Yervoy) to treat certain types of melanoma ( ... has worsened after treatment with other chemotherapy medications. Nivolumab is in a class of medications called monoclonal ...

  9. Cidofovir Injection

    Science.gov (United States)

    Cidofovir injection is used along with another medication (probenecid) to treat cytomegaloviral retinitis (CMV retinitis) in people ... body's response to the medication.You must take probenecid tablets by mouth with each dose of cidofovir. ...

  10. Palivizumab Injection

    Science.gov (United States)

    ... the skin swelling of the lips, tongue, or face difficulty swallowing difficult, rapid, or irregular breathing bluish-tinged skin, lips, or fingernails muscle weakness or floppiness loss of consciousness Palivizumab injection may cause other side effects. Call ...

  11. Acyclovir Injection

    Science.gov (United States)

    ... It is also used to treat first-time genital herpes outbreaks (a herpes virus infection that causes sores ... in the body. Acyclovir injection will not cure genital herpes and may not stop the spread of genital ...

  12. Haloperidol Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Haloperidol injection is also used to control motor ... and the laboratory. Your doctor may order certain lab tests to check your body's response to haloperidol ...

  13. Risperidone Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Risperidone extended-release injection is used alone or ... and the laboratory. Your doctor may order certain lab tests to check your body's response to risperidone ...

  14. Aripiprazole Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Aripiprazole extended-release injection (Abilify Maintena) is also ... and the laboratory. Your doctor may order certain lab tests to check your body's response to aripiprazole ...

  15. Olanzapine Injection

    Science.gov (United States)

    ... of interest in life, and strong or inappropriate emotions). Olanzapine injection is used to treat episodes of ... and the laboratory. Your doctor may order certain lab tests to check your body's response to olanzapine ...

  16. Bendamustine Injection

    Science.gov (United States)

    ... Avelox), norfloxacin (Noroxin), and ofloxacin (Floxin); fluvoxamine (Luvox); omeprazole (Prilosec); and ticlopidine (Ticlid). Your doctor may need ... injection. You should use birth control to prevent pregnancy in yourself or your partner during your treatment ...

  17. Pegloticase Injection

    Science.gov (United States)

    ... doctor if you have glucose-6-phosphate dehydrogenase (G6PD) deficiency (an inherited blood disease). Your doctor may test you for G6PD deficiency before you start to receive pegloticase injection. If ...

  18. Leuprolide Injection

    Science.gov (United States)

    ... the body and causes pain, heavy or irregular menstruation [periods], and other symptoms). Leuprolide injection (Lupron Depot) ... itching in women spotting (light vaginal bleeding) or menstruation (periods) decrease in size of testicles decrease in ...

  19. Lixisenatide Injection

    Science.gov (United States)

    ... gov/Drugs/DrugSafety/ucm085729.htm) to obtain the Medication Guide. ... exenatide (Bydureon, Byetta), liraglutide (Saxenda, Victoza), any other medications, or any of the ingredients in lixisenatide injection. Ask your pharmacist or check the Medication Guide ...

  20. Tisagenlecleucel Injection

    Science.gov (United States)

    ... htm) or the manufacturer's website to obtain the Medication Guide. ... your doctor about the risks of receiving this medication.Tisagenlecleucel injection may cause other side effects. Call your doctor ...

  1. Meperidine Injection

    Science.gov (United States)

    ... htm) or the manufacturer's website to obtain the Medication Guide. ... and during surgery or other medical procedures. Meperidine injection is in a class of medications called opiate (narcotic) analgesics. It works by changing ...

  2. Multifocal scalp abscess with subcutaneous fat necrosis and scarring alopecia as a complication of scalp mesotherapy.

    Science.gov (United States)

    Kadry, Razan; Hamadah, Issam; Al-Issa, Abdullah; Field, Lawrence; Alrabiah, Fahad

    2008-01-01

    Over the past several years, there has been a growing interest in the treatment method termed mesotherapy. Marketed for nonsurgical fat melting, skin rejuvenation, and hair regrowth, this technique has become increasingly popular and, in the public's view, it is considered to be a relatively benign intervention method. Mesotherapy was introduced over 50 years ago by M. Pistor, a French physician who utilized this technique initially as a novel analgesic therapeutic method for a variety of rheumatologic disorders. Since its introduction, the basic principal of locally injecting subcutaneous doses of varying chemicals has been expanded and is now utilized for the aforementioned cosmetic concerns. With its increased popularity, there has been an increase in the number of reported side effects resulting from mesotherapeutic intervention. We report multifocal scalp abscesses with subcutaneous fat necrosis as a direct result of mesotherapy; therefore, requiring extensive surgical repair.

  3. Subcutaneous absorption kinetics of two highly concentrated preparations of recombinant human growth hormone

    DEFF Research Database (Denmark)

    Laursen, Torben; Jørgensen, Jens Otto Lunde; Susgaard, Søren

    1993-01-01

    hours. Samples were taken every 30 minutes for 6 hours and then hourly. MAIN OUTCOME MEASURES: Bioavailability (F) and absorption dynamics of human GH were measured. The relative absorption fractions estimated from the areas under the individual serum concentration curves from 0 to 24 hours......Abstract OBJECTIVE: The relative bioavailability of two highly concentrated (12 IU/ml) formulations of biosynthetic human growth hormone (GH) administered subcutaneously was compared. DESIGN: A randomized, crossover study. Conventional GH therapy was withdrawn 72 hours before each study period...... of signs of endogenous GH secretion. INTERVENTIONS: At the start of each study period, GH 3 IU/m2 was injected subcutaneously. The two formulations, PenFill and PenSet, differ in the buffers used and in the relative content of mannitol and glycine. Serum profiles of GH were monitored frequently for 24...

  4. Surgical management of subcutaneous Colletotrichum gloeosporioides

    Science.gov (United States)

    Allton, David R; Parvez, Najma; Ranganath, Sangeetha; Jinadatha, Chetan

    2015-01-01

    A 52-year-old male patient with a history of sarcoidosis and over 10 years of chronic low-dose glucocorticoid use, cirrhosis and type 2 diabetes mellitus presented with two painful, enlarging subcutaneous nodules ultimately identified as Colletotrichum gloeosporioides. Two attempts at needle aspiration of the larger nodule resulted in rapid reaccumulation. Complete surgical excision of both nodules resulted in complete resolution without the use of any concomitant antifungals. Patient had no recurrence at 2 years of follow-up. PMID:25737220

  5. Switching between intravenous and subcutaneous trastuzumab

    DEFF Research Database (Denmark)

    Gligorov, Joseph; Curigliano, Giuseppe; Müller, Volkmar

    2017-01-01

    AIM: To assess the safety and tolerability of switching between subcutaneous (SC) and intravenous (IV) trastuzumab in the PrefHer study (NCT01401166). PATIENTS AND METHODS: Patients with HER2-positive early breast cancer completed (neo)adjuvant chemotherapy and were randomised to receive four....... Rates of clinically important events, including grade ≥3 AEs, serious AEs, AEs leading to study drug discontinuation and cardiac AEs, were low and similar between treatment arms (safety signals for trastuzumab were observed. CONCLUSIONS: PrefHer revealed...... that switching from IV to SC trastuzumab (hand-held syringe or SID) or vice versa did not impact the known safety profile of trastuzumab....

  6. Cutaneous and Subcutaneous Metastases From Atypical Laryngeal Carcinoids: Case Report and Review of the Literature.

    Science.gov (United States)

    Wang, Kui-Rong; Jia, Yuan-Jing; Zhou, Shui-Hong; Wang, Qin-Ying; Bao, Yang-Yang; Feng, Zhi-Ying; Yao, Hong-Tian; Fan, Jun

    2016-02-01

    The incidence of cutaneous and subcutaneous metastases from atypical laryngeal carcinoids is approximately 20%. However, the pathogenesis and natural history of, and prognostic factors for, the condition remain poorly understood. We reported a 54-year-old female presented with cutaneous and subcutaneous metastases from atypical laryngeal carcinoid. Laryngoscopy revealed a 0.5 × 1.5-cm reddish mass on the laryngeal surface of the epiglottis. Under general anesthesia, a biopsy sample was obtained via suspension laryngoscopy. Routine pathology revealed atypical laryngeal carcinoid. Immunohistochemical staining of the sections of primary tumor was positive for cytokeratin, chromogranin A, synaptophysin, hypoxia-inducible factor-1α, P53, and CD56. GLUT-1, p-Akt, and PI3K were negative. The Ki-67 index was 15%. Supraglottic laryngectomy and selective right-neck dissection were performed. After 6 months, the patient complained of pain in the right wall of the chest; multiple cutaneous and subcutaneous nodules were evident at that site and in the abdomen. An abdominal nodule was biopsied and pathology revealed that the atypical metastatic carcinoid had metastasized to both cutaneous and subcutaneous areas of the abdomen. Chemotherapy was then prescribed. Currently, the intrathecal drug delivery system remains in place. No local recurrence has been detected. Furthermore, we systematically reviewed clinical manifestations of the disease, pathogenesis, prognostic factors, and treatment. The metastasis rate (cutaneous and subcutaneous) was approximately 12.2%. Thirty patients (62.5%) with cutaneous and subcutaneous metastases exhibited contemporaneous lymph node invasion. The 3-, 5-, and 10-year survival rates were 44.0%, 22.0%, and 13.0%, respectively. The prognosis of patients with atypical laryngeal carcinoids was poor. Relevant prognostic factors included the level of p53, human papilloma virus status, certain hypoxic markers, and distant metastasis. No optimal

  7. Head-to-head, randomised, crossover study of oral versus subcutaneous methotrexate in patients with rheumatoid arthritis: drug-exposure limitations of oral methotrexate at doses ≥15 mg may be overcome with subcutaneous administration.

    Science.gov (United States)

    Schiff, Michael H; Jaffe, Jonathan S; Freundlich, Bruce

    2014-08-01

    To compare the relative bioavailability, safety and tolerability of oral methotrexate (MTX) and subcutaneous (SC) MTX administered via an auto-injector (MTXAI) in patients with rheumatoid arthritis (RA). In this randomised, multicenter, open-label, three-way crossover study, patients ≥18 years with adult RA undergoing treatment with MTX for ≥3 months were assigned to receive MTX 10, 15, 20 and 25 mg weekly in a random sequence of three treatments: oral, SC into the abdomen and SC into the thigh. For 24 h after administration of each treatment, blood samples were collected for pharmacokinetic analysis and injection sites were assessed. Forty-seven patients completed the study. Systemic exposure of oral MTX plateaued at doses ≥15 mg/week. In contrast, SC MTX demonstrated a linear increase in systemic exposure that was greater than oral MTX at each dose. No unexpected AEs were noted for either formulation. Unlike oral MTX, the systemic exposure of SC MTX did not plateau over the doses studied, particularly at doses ≥15 mg/week. In this study, higher systemic MTX exposure was not associated with increases in AEs. Patients with an inadequate clinical response to oral MTX may benefit from higher drug exposure by switching to SC MTX. NCT01618968. 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.

  8. In-situ air injection, soil vacuum extraction and enhanced biodegradation: A case study in a JP-4 jet fuel contaminated site

    Energy Technology Data Exchange (ETDEWEB)

    Cho, Jong Soo; DiGiulio, D.C.; Wilson, J.T. [National Risk Management Lab., Ada, OK (United States)

    1997-12-31

    The US Environmental Protection Agency (US EPA) and the US Coast Guard (USCG) conducted a joint demonstration of in situ remediation of a JP-4 jet fuel spill at the USCG Support Center in Elizabeth City, North Carolina. The jet fuel was trapped beneath a clay layer that extended from the surface to a depth of 1.5 in. The water table was 2.0 in below land surface, and jet fuel extended from a depth of 1.0 to 3.5 in. Air was injected under pressure to depress the water table and bring the entire spill into the unsaturated zone, where hydrocarbons could be removed by volatilization and biodegradation. The injected air was recovered through soil vacuum extraction (SVE) at the treatment area. To document actual removal of hydrocarbons, core samples were acquired in August 1992 before air injection, and September 1994 at the end of the demonstration. The spill originally contained 3600 kg of JP-4. Between the core sampling events, only 55 % of the total petroleum hydrocarbons were removed, but more than 98% of benzene was removed. The initial goal was to reduce the concentration of total petroleum hydrocarbons (TPH) to concentrations less than 100 mg/kg soil. This was not accomplished within 18 months of operation. During the period of operation, ground water was monitored for the concentration of benzene, toluene, ethylbenzene, and the xylene isomers (BTEX), and methyl tertiary butyl ether (MTBE). The concentration of BTEX and MTBE in the subsurface was reduced to a very low level, but concentrations of benzene and MTBE in ground water did not meet the EPA drinking water standards in the most heavily impacted wells. The effluent gas from SVE was monitored for the concentration of total hydrocarbon vapors. 12 refs., 7 figs., 5 tabs.

  9. Psychopathology and Continuous Subcutaneous Insulin Infusion in Type 1 Diabetes

    Directory of Open Access Journals (Sweden)

    Francesco Rotella

    2013-01-01

    Full Text Available Aim. Continuous subcutaneous insulin infusion (CSII is used as an option in patients with diabetes failing to multiple daily injections (MDI. Psychological factors may play a relevant role in the failure to attain therapeutic goals in patients on MDI. This could lead to an overrepresentation of psychopathology in patients treated with CSII. Methods. A consecutive series of 100 patients with type 1 diabetes was studied, collecting main clinical parameters and assessing psychopathology with the self-reported questionnaire Symptom Checklist 90-revised. Patients on CSII were then compared with those on MDI. Results. Of the 100 enrolled patients, 44 and 56 were on CSII and MDI, respectively. Among men, those on CSII were younger than those on MDI; conversely, no difference in age was observed in women. Women on CSII showed higher scores on most Symptom Checklist 90 subscales than those on MDI, whereas no differences were observed in men. Conclusion. Women with type 1 diabetes treated with CSII display higher levels of psychopathology than those on MDI. This is probably the consequence of the fact that patients selected for CSII are those failing to MDI. Higher levels of psychopathology could represent a limit for the attainment and maintenance of therapeutic goals with CSII.

  10. The need for chemical compatibility studies of subcutaneous medication combinations used in palliative care.

    Science.gov (United States)

    Rose, Marie; Currow, David C

    2009-01-01

    When a person with a life-limiting illness is unable to swallow, the subcutaneous route of administration is a widely used way of administering many medications, either as repeated bolus injections or by continuous infusions to complement transdermal, sublingual, or rectal routes of administration. To optimize symptom control as changes are made from other routes of administration to subcutaneous delivery, basic principles for ensuring optimal net clinical benefit (therapeutic benefit and minimizing side effects) must be understood as fully as science will allow. Despite the widespread use of combinations of injectable medications in this clinical setting and the availability of the technology to do the studies, the limited work done suggests that there may be significant drug loss with some combinations of medications without any visual or physical changes apparent. Work needs to be done urgently to evaluate a wide range of medication combinations used extensively in hospice and palliative care for chemical compatibility, while ensuring the work that has been done in other areas (anesthetics, chronic pain) is adopted into practice as results become available. Almost all of these medications are off-patent and there is therefore no financial incentive for the pharmaceutical industry to do the studies on medications now produced generically. Other sources of funding need to be identified. At best, it is likely that optimal symptom control is at times compromised in palliative care without chemical compatibility data for combinations of injectable medications and, at worst, toxicity is generated unknowingly.

  11. Final height in girls with Turner's syndrome treated with once or twice daily growth hormone injections

    OpenAIRE

    Sas, T.; Keizer-Schrama, S; Stijnen, T.; van Teunenbroek, A; Hokken-Koelega, A.; Waelkens, J.; Massa, G.; Vulsma, T.; Gerver, W; Reeser, H; de Waal, H E D.-v.; Jansen, M.; Drop, S.; The, D.

    1999-01-01

    OBJECTIVES—To study final height in girls with Turner's syndrome treated with once or twice daily injections of growth hormone (GH) in combination with low dose ethinyl oestradiol.
DESIGN—Until final height was reached, the effect of fractionated subcutaneous injections given twice daily was compared with once daily injections of a total GH dose of 6 IU/m2/day. Twice daily injections were given as one third in the morning and two thirds at bedtime. All girls concurrently ...

  12. The effects of CO2 injection on Geochemistry and Aquifer properties investigated at a hypothetical storage site in the north German basin

    Science.gov (United States)

    Graupner, B. J.; Li, D.; Benisch, K.; Mitiku, A. B.; Beyer, C.; Bauer, S.

    2012-04-01

    The storage of CO2 in deep saline aquifers is one of the major options for carbon dioxide sequestration. With the injection of CO2 in the underground a CO2 phase will migrate through the target reservoir controlled by the pressure gradient and buoyancy. Over the time CO2 dissolves in water and stimulates geochemical reactions like mineral dissolution due to the acidic conditions that might be followed by mineral precipitation again. Mineral dissolution and precipitation affects the porosity and permeability and thus feeds back on multiphase flow. To evaluate the behaviour of the storage system the coupled simulator OGS-Eclipse-ChemApp was developed, which provides the coupled multiphase flow and reactive transport simulation under conditions typical for CO2 injection. The open-source scientific software OpenGeoSys (OGS) was used in this investigation to simulate CO2 injection into a saline formation. To represent the hydraulic and geochemical alteration during CO2 sequestration under reservoir conditions, OGS was coupled to the widely used multiphase flow simulator ECLIPSE for modelling multiphase flow. Geochemical reactions are considered with an already existing interface between OGS and PhreeqC. Furthermore changes in porosity and permeability were considered. ECLIPSE and OGS are coupled using an operator splitting approach. Results of the multiphase flow simulation are passed for each time step from ECLIPSE to OGS where transport of dissolved species is calculated. Transport of components can be considered with OGS in the CO2 as well as in the water phase. Transport in the water phase is of major interest for reactive transport simulations. Subsequently, equilibrium geochemical reactions at each node of the OGS FEM model grid can be calculated using ChemApp. Changes in the brine concentration of dissolved inorganic carbon due to chemical reactions are transferred back to the multiphase flow simulator, which calculates the new phase equilibrium in the next time

  13. EXPERIMENTAL SUBCUTANEOUS CYSTICERCOSIS BY Taenia crassiceps IN BALB/c AND C57BL/6 MICE

    Directory of Open Access Journals (Sweden)

    Íria Márcia PEREIRA

    2016-01-01

    Full Text Available SUMMARY Human cysticercosis is one of the most severe parasitic infections affecting tissues. Experimental models are needed to understand the host-parasite dynamics involved throughout the course of the infection. The subcutaneous experimental model is the closest to what is observed in human cysticercosis that does not affect the central nervous system. The aim of this study was to evaluate macroscopically and microscopically the experimental subcutaneous cysticercosis caused by Taenia crassiceps cysticerci in BALB/c and C57BL/6 mice. Animals were inoculated in the dorsal subcutaneous region and macroscopic and microscopic aspects of the inflammatory process in the host-parasite interface were evaluated until 90 days after the inoculation (DAI. All the infected animals presented vesicles containing cysticerci in the inoculation site, which was translucent at 7 DAI and then remained opaque throughout the experimental days. The microscopic analysis showed granulation tissue in BALB/c mice since the acute phase of infection evolving to chronicity without cure, presenting 80% of larval stage cysticerci at 90 DAI. While C57BL/6 mice presented 67% of final stage cysticerci at 90 DAI, the parasites were surrounded by neutrophils evolving to the infection control. It is possible to conclude that the genetic features of susceptibility (BALB/c or resistance (C57BL/6 were confirmed in an experimental subcutaneous model of cysticercosis.

  14. Subcutaneous Implants of a Cholesterol-Triglyceride-Buprenorphine Suspension in Rats

    OpenAIRE

    Guarnieri, M.; Brayton, C.; Sarabia-Estrada, R.; Tyler, B.; McKnight, P.; DeTolla, L.

    2017-01-01

    A Target Animal Safety protocol was used to examine adverse events in male and female Fischer F344/NTac rats treated with increasing doses of a subcutaneous implant of a lipid suspension of buprenorphine. A single injection of 0.65 mg/kg afforded clinically significant blood levels of drug for 3 days. Chemistry, hematology, coagulation, and urinalysis values with 2- to 10-fold excess doses of the drug-lipid suspension were within normal limits. Histopathology findings were unremarkable. The s...

  15. Liraglutide Injection

    Science.gov (United States)

    ... stroke, or death in adults with type 2 diabetes mellitus and heart and blood vessel disease. Liraglutide injection ( ... helps move sugar from the blood into other body tissues where it is used for ... appetite and cause weight loss.Over time, people who have diabetes and ...

  16. Obinutuzumab Injection

    Science.gov (United States)

    ... other chemotherapy medication(s). Obinutuzumab injection is in a class of medications called monoclonal antibodies. It works by killing cancer cells. ... office or hospital. Your doctor will select a schedule to give you obinutuzumab ... certain side effects. Your doctor will give you other medications to ...

  17. Ipilimumab Injection

    Science.gov (United States)

    (ip'' i lim' ue mab)Ipilimumab injection may cause severe or life-threatening side effects. This includes ... In case of overdose, call your local poison control center at 1-800-222-1222. If the victim has collapsed or is not breathing, call local emergency services at ...

  18. Isavuconazonium Injection

    Science.gov (United States)

    ... fungal infections such as invasive aspergillosis (a fungal infection that begins in the lungs and spreads through the bloodstream to other organs) and invasive mucormycosis (a fungal infection that usually begins in the sinuses, brain, or lungs). Isavuconazonium injection is in a class of medications ...

  19. [ANSYS simulation of subcutaneous pustule electrical characteristics].

    Science.gov (United States)

    Liu, Baohua; Wang, Xuan; Zhu, Honglian; Wang, Guoyong

    2011-12-01

    With the growing number of clinical surgery, post-operative surgical wound infection has become a very difficult clinical problem. In the treatments of it, non-invasive test of wound infection and healing status has a significance in clinical medicine practice. In this paper, beginning with the electrical properties of skin tissue structure and on the basis of the electromagnetism and the human anatomy, using the finite element analysis software, we applied safe voltage on the 3D skin model, performed the subcutaneous pustule simulation study and gained the relational curve between depth and radius of the pustule model. The simulation results suggested that the method we put forward could be feasible, and it could provide basis for non-invasive detection of wound healing and wound infection status.

  20. Irreversible muscle damage in bodybuilding due to long-term intramuscular oil injection.

    Science.gov (United States)

    Banke, I J; Prodinger, P M; Waldt, S; Weirich, G; Holzapfel, B M; Gradinger, R; Rechl, H

    2012-10-01

    Intramuscular oil injections generating slowly degrading oil-based depots represent a controversial subject in bodybuilding and fitness. However they seem to be commonly reported in a large number of non-medical reports, movies and application protocols for 'site-injections'. Surprisingly the impact of long-term (ab)use on the musculature as well as potential side-effects compromising health and sports ability are lacking in the medical literature. We present the case of a 40 year old male semi-professional bodybuilder with systemic infection and painful reddened swellings of the right upper arm forcing him to discontinue weightlifting. Over the last 8 years he daily self-injected sterilized sesame seed oil at numerous intramuscular locations for the purpose of massive muscle building. Whole body MRI showed more than 100 intramuscular rather than subcutaneous oil cysts and loss of normal muscle anatomy. 2-step septic surgery of the right upper arm revealed pus-filled cystic scar tissue with the near-complete absence of normal muscle. MRI 1 year later revealed the absence of relevant muscle regeneration. Persistent pain and inability to perform normal weight training were evident for at least 3 years post-surgery. This alarming finding indicating irreversible muscle mutilation may hopefully discourage people interested in bodybuilding and fitness from oil-injections. The impact of such chronic tissue stress on other diseases like malignancy remains to be determined. © Georg Thieme Verlag KG Stuttgart · New York.

  1. Sciatic nerve palsy associated with intramuscular quinine injections ...

    African Journals Online (AJOL)

    The purpose of this paper is to show that, in children, gluteal injection of quinine dihydrochloride (QDH) may result in damage to the sciatic nerve. Forty-six children were seen with foot drop following intramuscular injections in the same limb. They were analyzed for the type of injection, injection site, route of injection, the ...

  2. Simulation of a Potential CO2 Storage in the West Paris Basin: Site Characterization and Assessment of the Long-Term Hydrodynamical and Geochemical Impacts Induced by the CO2 Injection

    Directory of Open Access Journals (Sweden)

    Estublier Audrey

    2017-07-01

    Full Text Available This article presents the preliminary results of a study carried out as part of a demonstration project of CO2 storage in the Paris Basin. This project funded by ADEME (French Environment and Energy Management Agency and several industrial partners (TOTAL, ENGIE, EDF, Lafarge, Air Liquide, Vallourec aimed to study the possibility to set up an experimental infrastructure of CO2 transport and storage. Regarding the storage, the objectives were: (1 to characterize the selected site by optimizing the number of wells in a CO2 injection case of 200 Mt over 50 years in the Trias, (2 to simulate over time the CO2 migration and the induced pressure field, and (3 to analyze the geochemical behavior of the rock over the long term (1,000 years. The preliminary site characterization study revealed that only the southern area of Keuper succeeds to satisfy this injection criterion using only four injectors. However, a complementary study based on a refined fluid flow model with additional secondary faults concluded that this zone presents the highest potential of CO2 injection but without reaching the objective of 200 Mt with a reasonable number of wells. The simulation of the base scenario, carried out before the model refinement, showed that the overpressure above 0.1 MPa covers an area of 51,869 km2 in the Chaunoy formation, 1,000 years after the end of the injection, which corresponds to the whole West Paris Basin, whereas the CO2 plume extension remains small (524 km2. This overpressure causes brine flows at the domain boundaries and a local overpressure in the studied oil fields. Regarding the preliminary risk analysis of this project, the geochemical effects induced by the CO2 injection were studied by simulating the fluid-rock interactions with a coupled geochemical and fluid flow model in a domain limited to the storage complex. A one-way coupling of two models based on two domains fitting into each other was developed using dynamic boundary

  3. Treatment of diabetic ketoacidosis with subcutaneous insulin lispro: a review of the current evidence from clinical studies.

    Science.gov (United States)

    Vincent, M; Nobécourt, E

    2013-09-01

    Low-dose intravenous infusions of regular insulin, usually initiated in the emergency department and continued in the intensive care unit (ICU), are the standard care for patients with diabetic ketoacidosis (DKA) to ensure rapid resolution of hyperglycaemia and ketoacidosis. Several studies have evaluated whether subcutaneous injections of the rapid-acting analogue insulin lispro may be an alternative to intravenous insulin infusion for avoiding ICU admissions of uncomplicated DKA cases. This review summarizes the current clinical evidence for the effectiveness and safety of subcutaneous insulin lispro injections in non-severe DKA patients. Relevant studies were identified by a systematic literature search through the PubMed database. To date, four small randomized studies (156 patients overall; three studies in adults and one in paediatric patients with diabetes) have directly compared subcutaneous insulin lispro injections every 1-2h vs continuous intravenous infusions of regular insulin. Patients with severe complications were excluded. In all studies, the mean time to resolution of DKA was similar in both treatment groups [range (three studies): lispro 10-14.8h; regular insulin 11-13.2h]. The mean time to resolution of hyperglycaemia, total insulin doses required, number of hospitalization days and number of hypoglycaemic episodes were similar in both treatment groups; no severe complications or DKA recurrences were reported, and one study showed a 39% cost reduction for the insulin lispro group. In patients with mild-to-moderate DKA, subcutaneous injections of insulin lispro every 1-2h offer a feasible alternative to continuous intravenous infusions of regular insulin, and should now be evaluated in larger, more appropriately powered studies. Copyright © 2013. Published by Elsevier Masson SAS.

  4. 21 CFR 522.2100 - Selenium, vitamin E injection.

    Science.gov (United States)

    2010-04-01

    ... (CONTINUED) ANIMAL DRUGS, FEEDS, AND RELATED PRODUCTS IMPLANTATION OR INJECTABLE DOSAGE FORM NEW ANIMAL DRUGS... inflammation, pain and lameness associated with certain arthropathies in dogs. (ii) The drug is administered...) Limitations. For subcutaneous or intramuscular use only. Discontinue use 14 days before treated animals are...

  5. Treatment of indolent primary cutaneous B-cell lymphomas with subcutaneous interferon-alfa.

    Science.gov (United States)

    Vandersee, Staffan; Terhorst, Dorothea; Humme, Daniel; Beyer, Marc

    2014-04-01

    Interferon-alfa is used in the treatment of primary cutaneous B-cell lymphoma (PCBCL). Therapy with interferon-alfa has thus far been reported solely in case reports and small case series, mostly describing intralesional use. We sought to evaluate efficacy, response rate, time to response, duration of response, and safety of subcutaneously administered interferon-alfa for the treatment of cutaneous B-cell lymphoma. We conducted a retrospective chart analysis of patients given the diagnosis of PCBCL and treated with interferon-alfa subcutaneously at a tertiary referral center. Fifteen patients with indolent subtypes of PCBCL were identified. The overall response rate was 66.7%; all responding patients went into complete remission. Response was not significantly associated with the maximum tolerated dose. Within the median follow-up time of 40 months, 90% of the responders experienced a relapse; median duration of response was 15.5 months. Adverse events were predominantly mild and in no case led to cessation of therapy. Retrospective nature of the analysis and small number of patients because of scarcity of the disease are limitations. Treatment of indolent PCBCL with subcutaneously injected interferon-alfa demonstrated good response rates and tolerability. Response was not dose dependent. Relapses were observed in nearly all responding patients raising the question of interferon-alfa maintenance therapy in PCBCL. Copyright © 2013 American Academy of Dermatology, Inc. Published by Mosby, Inc. All rights reserved.

  6. Comparison of nebulized terbutaline and subcutaneous epinephrine in the treatment of acute asthma.

    Science.gov (United States)

    Uden, D L; Goetz, D R; Kohen, D P; Fifield, G C

    1985-03-01

    Nineteen children who presented for treatment of acute asthma symptoms were studied. They were randomized to receive either subcutaneous epinephrine 0.01 mg/kg (0.3 mg maximum) or nebulized terbutaline 1 mg in 2 mL normal saline. The drugs were administered using the double-blind method. Each patient received either subcutaneous epinephrine with concurrent nebulized normal saline or nebulized terbutaline with a concurrent subcutaneous injection of normal saline. Depending on the patient's clinical status, up to three doses of the same drug and placebo were administered. Pulmonary functions (FEV1, FVC, FEF25-75), heart rate, respiratory rate, and pulmonary index were obtained before treatment, at 20 minutes, and at one hour after the final treatment. Except for the baseline respiratory rate, the mean number of treatments, pulmonary index, heart rate, and respiratory rate (at 20 minutes and one hour) were not statistically different. Pulmonary functions were not significantly different at any time. The one-hour post-treatment pulmonary functions (percentage of predicted normal) for terbutaline and epinephrine were FEV1, 49.2 +/- 18.4% and 49.4 +/- 16.9%; FVC, 72.7 +/- 23.4% and 62.7 +/- 21.6%; and FEF25-75, 31.8 +/- 18.6% and 39.0 +/- 12.2%, respectively. The data presented support our hypothesis that terbutaline by nebulization is at least as effective as epinephrine in the management of children with similar degrees of pulmonary obstruction.

  7. Response of immune response genes to adjuvants poly [di(sodium carboxylatoethylphenoxy)phosphazene] (PCEP), CpG oligodeoxynucleotide and emulsigen at intradermal injection site in pigs.

    Science.gov (United States)

    Magiri, R B; Lai, K; Chaffey, A M; Wilson, H L; Berry, W E; Szafron, M L; Mutwiri, G K

    2016-07-01

    Understanding the mechanisms by which adjuvants mediate their effects provide critical information on how innate immunity influences the development of adaptive immunity. Despite being a critical vaccine component, the mechanisms by which adjuvants mediate their effects are not fully understood and this is especially true when they are used in large animals. This lack of understanding limits our ability to design effective vaccines. In the present study, we administered polyphosphazene (PCEP), CpG oligodeoxynucleotides (CpG), emulsigen or saline via an intradermal injection into pigs and assessed the impact on the expression of reported 'adjuvant response genes' over time. CpG induced a strong upregulation of the chemokine CXL10 several 'Interferon Response Genes', as well as TNFα, and IL-10, and a down-regulation of IL-17 genes. Emulsigen upregulated expression of chemokines CCL2 and CCL5, proinflammatory cytokines IL-6 and TNFα, as well as TLR9, and several IFN response genes. PCEP induced the expression of chemokine CCL2 and proinflammatory cytokine IL-6. These results suggest that emulsigen and CpG may promote recruitment of innate immune cells and Th1 type cytokine production but that PCEP may promote a Th-2 type immune response through the induction of IL-6, an inducer of B cell activity and differentiation. Copyright © 2016 Elsevier B.V. All rights reserved.

  8. Targeted two-photon photodynamic therapy for the treatment of subcutaneous tumors

    Science.gov (United States)

    Spangler, Charles W.; Starkey, Jean R.; Meng, Fanqing; Gong, Aijun; Drobizhev, Mikhail; Rebane, Aleksander; Moss, B.

    2005-04-01

    Photodynamic therapy (PDT) has developed into a mature technology over the past several years, and is currently being exploited for the treatment of a variety of cancerous tumors, and more recently for age-related wet macular degeneration of the eye. However, there are still some unresolved problems with PDT that are retarding a more general acceptance in clinical settings, and thus, for the most part, the treatment of most cancerous rumors still involves some combination of invasive surgery, chemotherapy and radiation treatment, particularly subcutaneous tumors. Currently approved PDT agents are activated in the Visible portion of the spectrum below 700 nm, Laser light in this spectral region cannot penetrate the skin more than a few millimeters, and it would be more desirable if PDT could be initiated deep in the Near-infrared (NIR) in the tissue transparency window (700-1000 nm). MPA Technologies, Inc. and Rasiris, Inc. have been co-developing new porphyrin PDT designed to have greatly enhanced intrinsic two-photon cross-sections (>800 GM units) whose two-photon absorption maxima lie deep in the tissue transparency window (ca. 780-850 nm), and have solubility characteristics that would allow for direct IV injection into animal models. Classical PDT also suffers from the lengthy time necessary for accumulation at the tumor site, a relative lack of discrimination between healthy and diseased tissue, particularly at the tumor margins, and difficulty in clearing from the system in a reasonable amount of time post-PDT. We have recently discovered a new design paradigm for the delivery of our two-photon activated PDT agents by incorporating the porphyrins into a triad ensemble that includes a small molecule targeting agent that directs the triad to over-expressed tumor receptor sites, and a NIR one-photon imaging agent that allows the tracking of the triad in terms of accumulation and clearance rates. We are currently using these new two-photon PDT triads in efficacy

  9. Continuous subcutaneous insulin infusion therapy in type 1 diabetes ...

    African Journals Online (AJOL)

    2013-01-14

    Jan 14, 2013 ... Guidelines: Continuous subcutaneous insulin infusion pump therapy in type 1 diabetes. 15. 2013 Volume 18 No 1. JEMDSA. Introduction. The first external insulin pump device to deliver continuous subcutaneous insulin infusion (CSII or “insulin pump”) therapy was used more than 30 years ago.

  10. The comparison of the intestinal adaptation effects of subcutaneous ...

    African Journals Online (AJOL)

    Aim: Insulin has been reported to have positive effects on intestinal adaptation after short bowel syndrome when applicated oral or subcutaneously. The purpose of this study is to compare the intestinal adaptation effects of subcutaneous and oral routes of insulin in rats with short bowel syndrome. Materials and Methods: ...

  11. Hypercalcemia in Association With Subcutaneous Fat Necrosis of ...

    African Journals Online (AJOL)

    The case of a four weeks-old girl with subcutaneous fat necrosis and associated hypercalcemia is presented. Subcutaneous Fat Necrosis of the New born (SCFN) is an uncommon disorder which is rarely complicated with life threatening hypercalcemia. Though it is reported from many parts of the world this is the first case ...

  12. Adjuvant immunotherapy of feline injection-site sarcomas with the recombinant canarypox virus expressing feline interleukine-2 evaluated in a controlled monocentric clinical trial when used in association with surgery and brachytherapy

    Directory of Open Access Journals (Sweden)

    D. Jas

    2015-01-01

    Full Text Available The objective of this randomised, controlled, parallel-group monocentric clinical trial was to assess the efficacy (at low and high dose and the safety (at high dose of a recombinant canarypox virus (ALVAC® expressing feline interleukin 2 (IL-2. ALVAC IL-2 was administered to cats as an adjunct treatment of feline fibrosarcoma in complement to surgery and brachytherapy (reference treatment. Seventy-one cats with a first occurrence of feline fibrosarcoma were referred to the Veterinary Oncology Centre for post-surgical radiotherapy. They were randomly assigned to three treatment groups: reference treatment group (23 cats, ALVAC IL-2 low dose group (25 cats and ALVAC IL-2 high dose group (23 cats. Two dosages of ALVAC IL-2 were used to assess both safety (high dose and efficacy (high and low doses. The treatment consisted of six consecutive doses of ALVAC IL-2 administered subcutaneously at the tumour site on Day 0 (one day before brachytherapy treatment, Day 7, Day 14, Day 21, Day 35 and Day 49. All cats were evaluated for relapse (i.e. local tumour recurrence and/or metastasis every three months for at least one year (ALVAC IL-2 high dose group or two years (reference treatment and ALVAC IL-2 low dose groups by complete physical examination and regular CT scans. ALVAC IL-2 treatment was well tolerated and adverse effects were limited to mild local reactions. ALVAC IL-2 treatment resulted in a significant longer median time to relapse (>730 days in the ALVAC IL-2 low dose group than in the reference treatment group (287 days, and a significant reduction of the risk of relapse by 56% at one year (ALVAC IL-2 treatment groups versus reference treatment group and 65% at two years (ALVAC IL-2 low dose treatment group versus reference treatment group.

  13. Immunotherapy with concurrent subcutaneous GM-CSF, low-dose IL-2 and IFN-alpha in patients with progressive metastatic renal cell carcinoma

    NARCIS (Netherlands)

    Verra, N.; Jansen, R.; Groenewegen, G.; Mallo, H.; Kersten, M. J.; Bex, A.; Vyth-Dreese, F. A.; Sein, J.; van de Kasteele, W.; Nooijen, W. J.; de Waal, M.; Horenblas, S.; de Gast, G. C.

    2003-01-01

    The purpose of the study was to determine toxicity, efficacy and immunologic effects of concurrent subcutaneous injections of low-dose interleukin-2 (LD-IL-2), granulocyte-monocyte colony-stimulating factor (GM-CSF) and interferon-alpha 2b (IFNalpha) in progressive metastatic renal cell carcinoma.

  14. Flavopiridol Induces Apoptosis via Mitochondrial Pathway in B16F10 Murine Melanoma Cells and a Subcutaneous Melanoma Tumor Model

    OpenAIRE

    Gokce, Ozlem; Dogan Turacli, Irem; Ilke Onen, Hacer; Erdem, Ozlem; Erguven Kayaa, Elif; Ekmekci, Abdullah

    2016-01-01

    Flavopiridol is a cyclin-dependent kinase (CDK) inhibitor that promotes cell cycle arrest. We aimed to examine the anti-proliferative effects of the flavopiridol and oxaliplatin combination on p16INK4A deficient melanoma cells B16F10 and also its apoptotic effects on a subcutaneously injected B16F10 allograft melanoma tumor model. Flavopiridol and oxaliplatin treated B16F10 cell viability was determined by MTT assay. C57BL6 mice were injected with B16F10 cells and treated with flavopiridol af...

  15. Pilot project Muehlacker - Simulated on-site sanitation by steam injection on TUBA-procedure (thermally enhanced soil vapour extraction). Final report; Modellvorhaben Muehlacker - Modellhafte In-Situ-Sanierung durch Dampfinjektion nach dem TUBA-Verfahren. Abschlussbericht

    Energy Technology Data Exchange (ETDEWEB)

    Theurer, T.; Koschitzky, H.P.; Faerber, A.

    2001-11-09

    At the University of Stuttgart, the remediation technology TUBA (thermally enhanced soil vapour extraction, Thermisch unterstuetzte Bodenluftabsaugung) has been developed. The subsurface is heated by the injection of saturated steam or a mixture of steam and air. Residual contamination of the subsurface can mostly be completely evaporated and removed in the gaseous phase. After one successful remediation of a BTEX-contamination in a pilot study at the site of the former gaswork Plauen, plans were made to test the remediation technology at the site of a former hazardous waste disposal site in Muehlacker/Enzkreis, a 'model site' of the state of Baden-Wuerttemberg, Germany. At the site, an extensive contamination of chlorinated hydrocarbons, perched in deep layers of low permeability, had happened. Low permeability of the contaminated subsurface at the site resulted in a challenge for steam injection, since high injection pressure is mandatory for an acceptable rate of steam flow. Additionally, water was held in the subsurface by capillary forces, resulting in a further reduction of permeability for the steam. The planning and implementation of the pilot-scale remediation of a selected section of the subsurface at the Muehlacker site, the experience during operation, especially as under the difficult circumstances, and the successful remediation of the target zone are presented in detail. A cost analysis, comparing to the conventional technique 'cold' soil vapour extraction (SVE), shows the TUBA remediation scheme to be economic and efficient. (orig.) [German] An der Universitaet Stuttgart wurde das Verfahren TUBA (Thermisch unterstuetzte Bodenluftabsaugung) entwickelt. Dabei wird durch die Injektion von Sattdampf oder eines Wasserdampf-Luft-Gemisches der Boden erwaermt. Im Boden vorhandener Schadstoff kann in der Regel vollstaendig verdampft und in der Gasphase abtransportiert werden. Nach einem erfolgreichen Piloteinsatz des Verfahrens am

  16. Dexamethasone prolongs local analgesia after subcutaneous infiltration of bupivacaine microcapsules in human volunteers

    DEFF Research Database (Denmark)

    Holte, Kathrine; Werner, Mads U; Lacouture, Peter G

    2002-01-01

    BACKGROUND: The addition of small amounts of dexamethasone to extended-release formulations of bupivacaine in microcapsules has been found to prolong local analgesia in experimental studies, but no clinical data are available. METHODS: In a double-blinded study, 12 healthy male volunteers were...... randomized to receive simultaneous subcutaneous injections of bupivacaine microcapsules with dexamethasone and bupivacaine microcapsules without dexamethasone in each calf. Local analgesia was assessed with a validated human pain model; main parameters evaluated were thermal, mechanical, and pain detection...... curve [AUC]) were considered best estimate of analgesia. Safety evaluations were performed daily for the first week and at 2 weeks, 6 weeks, and 6 months after injection. RESULTS: The addition of dexamethasone significantly prolonged local analgesia of bupivacaine microcapsules without influence...

  17. Pharmacokinetics of Single-bolus Subcutaneous Cefovecin in C57BL/6 Mice.

    Science.gov (United States)

    Sanders, Kevin L; Bas, Esperanza; Cox, Sherry K; Rothen, Daniel E

    2017-09-01

    Because of its extended half-life, cefovecin is a broad-spectrum cephalosporin antibiotic commonly used to treat dermatitis in dogs and cats. A single injection in dogs can yield an effective plasma concentration for as long as 14 d, depending on the strain of Staphylococcus and for as long as 7 d in cats for the treatment of Pasteurella multocida. In the laboratory animal setting, C57BL/6 mice are commonly affected with dermatologic conditions that make these animals unsuitable for experiments. Therefore, we performed this pharmacokinetic study to determine whether cefovecin would be of benefit in mice. Plasma levels of the drug were determined by HPLC. For this study, single-bolus subcutaneous dosages of 8 and 40 mg/kg were assessed. The results showed that the dosage of 40 mg/kg achieved a maximal plasma concentration of 411.54 μg/mL with a half-life of 0.84 h, whereas 8 mg/kg yielded 78.18 μg/mL and 1.07 h respectively. The pharmacokinetic results suggest that cefovecin is not suitable as a long-acting antibiotic after a single subcutaneous bolus injection in mice for the treatment of dermatitis or any other bacteria sensitive to this medication.

  18. Confirming therapeutic target of protopine using immobilized β2-adrenoceptor coupled with site-directed molecular docking and the target-drug interaction by frontal analysis and injection amount-dependent method.

    Science.gov (United States)

    Liu, Guangxin; Wang, Pei; Li, Chan; Wang, Jing; Sun, Zhenyu; Zhao, Xinfeng; Zheng, Xiaohui

    2017-07-01

    Drug-protein interaction analysis is pregnant in designing new leads during drug discovery. We prepared the stationary phase containing immobilized β 2 -adrenoceptor (β 2 -AR) by linkage of the receptor on macroporous silica gel surface through N,N'-carbonyldiimidazole method. The stationary phase was applied in identifying antiasthmatic target of protopine guided by the prediction of site-directed molecular docking. Subsequent application of immobilized β 2 -AR in exploring the binding of protopine to the receptor was realized by frontal analysis and injection amount-dependent method. The association constants of protopine to β 2 -AR by the 2 methods were (1.00 ± 0.06) × 10 5 M -1 and (1.52 ± 0.14) × 10 4 M -1 . The numbers of binding sites were (1.23 ± 0.07) × 10 -7 M and (9.09 ± 0.06) × 10 -7 M, respectively. These results indicated that β 2 -AR is the specific target for therapeutic action of protopine in vivo. The target-drug binding occurred on Ser 169 in crystal structure of the receptor. Compared with frontal analysis, injection amount-dependent method is advantageous to drug saving, improvement of sampling efficiency, and performing speed. It has grave potential in high-throughput drug-receptor interaction analysis. Copyright © 2017 John Wiley & Sons, Ltd.

  19. Two rare cases of intrathoracic splenosis and subcutaneous splenosis: Spleen scintigraphy avoided the need for invasive procedures

    Energy Technology Data Exchange (ETDEWEB)

    Kim Ji Min; Lee, Sang Mi; Lyu, Ji Won; Lee, Moon Soo [Soonchunhyang University College of Medicine, Cheonan Hospital, Cheonan (Korea, Republic of); Choi, Ji Youn [Dept. of Nuclear Medicine, Seonam University College of Medicine, Myongji Hospital, Goyang (Korea, Republic of)

    2016-03-15

    Splenosis is defined as the acquired heterotopic autotransplantation of splenic tissue in other sites of the body after splenic rupture, usually due to either traumatic or iatrogenic causes. It is often found incidentally and is usually asymptomatic. These implants are not limited to the left upper quadrant of the abdomen, however, and splenosis in other locations can mimic various pathologic entities. There are several reports on abdominal splenosis, but intrathoracic and subcutaneous splenosis are rare. We report two cases of intrathoracic and subcutaneous splenosis that were diagnosed using spleen scintigraphy, avoiding the need for an invasive procedure.

  20. Two Rare Cases of Intrathoracic Splenosis and Subcutaneous Splenosis: Spleen Scintigraphy Avoided the Need for Invasive Procedures.

    Science.gov (United States)

    Kim, Ji Min; Lee, Sang Mi; Choi, Jiyoun; Lyu, Jiwon; Lee, Moon Soo

    2016-03-01

    Splenosis is defined as the acquired heterotopic autotransplantation of splenic tissue in other sites of the body after splenic rupture, usually due to either traumatic or iatrogenic causes. It is often found incidentally and is usually asymptomatic. These implants are not limited to the left upper quadrant of the abdomen, however, and splenosis in other locations can mimic various pathologic entities. There are several reports on abdominal splenosis, but intrathoracic and subcutaneous splenosis are rare. We report two cases of intrathoracic and subcutaneous splenosis that were diagnosed using spleen scintigraphy, avoiding the need for an invasive procedure.