Transcatheter Arterial Sclerosing Embolization for the Treatment of Giant Propranolol-Resistant Infantile Hemangiomas in the Parotid Region

PurposeTo report the effectiveness and safety of transcatheter arterial sclerosing embolization (TASE) for the treatment of parotid infantile hemangiomas that did not respond appreciably to propranolol.Materials and MethodsA total of 21 infants (12 male and 9 female) with large propranolol-resistant infantile hemangiomas in the parotid region were enrolled in this study. During TASE, the feeding arteries of the lesions were embolized using pingyangmycin-lipiodol emulsion and polyvinyl alcohol particles (300–500 μm) to reduce the blood flow rate. All children were followed up as outpatients at 2 weeks and monthly thereafter. The curative effect was evaluated at the 1- and 3-month follow-up visits.ResultsNine lesions were located on the right side of the parotid gland, whereas 12 were located on the left side. The feeding arteries in all patients originated from branches of the external carotid artery. TASE was technically successful in all patients. The mean (± SD) maximal diameter of the hemangiomas significantly decreased from 6.50 cm ± 2.28 before treatment to 3.56 cm ± 1.84 at 1 month after TASE (P <. 05). Three months after TASE, the mean maximal diameter further significantly decreased to 1.94 cm ± 1.58 (P <. 05). During the follow-up period, 16 cases were rated as excellent and 5 as good; no recurrence or serious complications were noted. Minor side effects, such as slight pain, mild fever, and tissue swelling, were observed.ConclusionsTASE significantly decreased the size of the parotid hemangiomas with minor side effects during a short follow-up period.     

A Quantitative Comparison of Physical Accuracy and Numerical Stability of Lattice Boltzmann Color Gradient and Pseudopotential Multicomponent Models for Microfluidic Applications

The performances of the Color-Gradient (CG) and the Shan-Chen (SC) multicomponent Lattice Boltzmann models are quantitatively compared side-by-side on multiple physical flow problems where breakup, coalescence and contraction of fluid ligaments are important. The flow problems are relevant to microfluidic applications, jetting of microdroplets as seen in inkjet printing, as well as emulsion dynamics. A significantly wider range of parameters is shown to be accessible for CG in terms of density-ratio, viscosity-ratio and surface tension values. Numerical stability for a high density ratio $\mathcal{O}(1000)$ is required for simulating the drop formation process during inkjet printing which we show here to be achievable using the CG model but not using the SC model. Our results show that the CG model is a suitable choice for challenging simulations of droplet formation, due to a combination of both numerical stability and physical accuracy. We also present a novel approach to incorporate repulsion forces between interfaces for CG, with possible applications to the study of stabilized emulsions. Specifically, we show that the CG model can produce similar results to a known multirange potentials extension of the SC model for modelling a disjoining pressure, opening up its use for the study of dense stabilized emulsions.     

Effect of long‐chain triglyceride lipid emulsion on bupivacaine‐induced changes in electrophysiological parameters of rabbit Purkinje cells

Lipid emulsions are used in the reversal of local anesthetic toxicity. The aim of this study was to investigate the cellular electrophysiological effects of long‐chain triglyceride lipid emulsion (LCTE) on cardiac action potential characteristics and conduction disturbances induced by bupivacaine. Purkinje fibers were dissected from the left ventricle of New Zealand white rabbit hearts and superfused with either Tyrode's solution during 30 min (control group), with bupivacaine 10^?6 m , 10^?5 m , and 5.10^?5 m alone, or in the presence of LCTE 0.5%, in addition, LCTE at 0.1%, 0.5%, and 1% was perfused alone. Electrophysiological parameters were recorded using the conventional microelectrode technique (37 °C, 1 Hz frequency). Bupivacaine 5.10^?5 m ‐induced conduction blocks (8/8 preparations): LCTE 0.5% suppressed the bupivacaine 5.10^?5 m ‐induced conduction blocks (1/8 preparations). Exposure to bupivacaine 10^?6 m , 10^?5 m , and 5.10^?5 m resulted in a significant decrease in the maximal rate of depolarization (V_max) (respectively, 25%, 55%, 75%; P < 0.002 vs. control group). In the presence of LCTE 0.5%, bupivacaine 10^?6 m did not significantly decreased V_max (13%; P = 0.10 vs. control group). The decrease in V_max resulting from bupivacaine 10^?5 m alone was significantly less in the presence of LCTE 0.5% (P < 0.01 vs. bupivacaine 10^?5 m alone). Exposure to bupivacaine 10^?6 m , 10^?5 m , and 5.10^?5 m alone or in the presence of LCTE 0.5% resulted in a significant decrease in action potential duration measured at 50% and 90% repolarization (APD₅₀ and APD₉₀; P < 0.01 vs. control group). LCTE inhibited the Purkinje fibers conduction blocks induced by bupivacaine. Moreover, LCTE 0.5% attenuates the decrease in V_max induced by bupivacaine 10^?6 m and 10^?5 m .     

Complications Following Antidotal Use of Intravenous Lipid Emulsion Therapy

The primary objective is to identify and describe the complications associated with the use of intravenous lipid emulsion (ILE) therapy as an antidote for lipophilic drug toxicity. This study is a retrospective chart review of patients treated with ILE at two academic medical centers between 2005 and 2012. Based on previously reported complications, we hypothesized that pancreatitis, ARDS, and lipemia-induced laboratory interference might occur. Clinical definitions of these complications were defined a priori. Subjects treated with ILE who did not develop at least one complication were excluded. A total of nine patients were treated with ILE during the study period, six of whom experienced potential complications as a result of the ILE. Two patients developed pancreatitis, and four patients had lipemia-induced interference of interpretation of laboratory studies, despite ultracentrifugation. Laboratory interference precluded one patient from being an organ donor. Three patients developed ARDS; although temporally associated, a causal relationship between ILE and the development of ARDS cannot be clearly established. As ILE is increasingly used for less severe cases of drug toxicity, clinicians should be aware of potential complications associated with its use. A risk–benefit assessment for the use of ILE should be implemented on a case-by-case basis.     

肝囊型包虫病药物治疗疗效标准的研究

目的　进一步研究和评价囊型包虫病药物治疗的疗效判定标准。　方法　采用前瞻性随机对照观察的研究方法。对 4 9例肝囊型包虫病病人进行了研究 ,其中治疗组 31例为经过不同时间阿苯达唑乳剂治疗的病人。对照组 18例为未经任何治疗的病人。以外科手术、粗针穿刺抽吸和常规细针穿刺的方法采集包虫囊内容物观察其性状。囊壁组织石腊切片观察组织学变化。收集原头节通过镜下形态及活动的观察、染料排斥试验、犬胆汁激活试验及接种小鼠腹腔 6个月后剖检观察有无包虫囊生长的方法判定囊内原头节的死活。结合 CT及 B超影像特征进行比较评价。　结果　治疗组病人中87.1% (2 1/ 31)的包虫囊 B超影像显示不同程度的退行变性 ,育囊率为 2 2 .6 %。对照组病人包虫囊的 B超影像显示退行变性的占 11.1% (2 / 18) ,育囊率为 6 1.1%。治疗组判定为痊愈的 15例病人的育囊率为 13.3% (2 / 15 )。疗效标准与 B超影像反映的包虫囊变性死亡的过程一致 ,与寄生虫学和囊壁组织学变化趋势相符。177例停药后随访 1～ 4年的肝囊型包虫病病人的转归证明了这一标准的可靠性。　结论　本研究提出的以 B超影像为基础的肝囊型包虫病药物治疗疗效指标反映了包虫囊在药物作用下从正常生长到变性死亡的过程 ,是一个比较客观、合理的疗效标     

丁酸氯维地平静脉注射乳剂在大鼠体内的药动学研究

目的研究两种丁酸氯维地平制剂在大鼠体内的药动学特点。方法将24只大鼠随机均分为4组,分别静脉滴注低、中、高剂量的丁酸氯维地平受试制剂及参比制剂,采用HPLC法测定全血中的丁酸氯维地平,计算药动学参数,评价其在大鼠体内的药动学特点。结果丁酸氯维地平低、中、高剂量受试制剂和参比制剂在大鼠血浆中的主要药动学参数为:Cmax分别为46.16±10.65、82.99±9.34、177.80±38.32、80.31±3.04 ng·m L-1;AUC0-t分别为2.309±0.628、4.221±0.988、9.339±1.759、3.968±0.411 min·μg·m L-1;t1/2分别为12.20±4.65、16.74±6.93、15.13±4.81、18.34±4.43 min。结论丁酸氯维地平受试制剂和参比制剂在大鼠体内药动学参数差异无统计学意义,受试制剂在0.36~3.24 mg·kg-1剂量范围内呈非线性动力学特征。     

难溶性药物logP值对纳米脂肪乳载药特性的影响

目的 考察难溶性药物油/水分配系数(log P值)对纳米脂肪乳载药量、体外释药特性、相分布等载药特性的影响。 方法 选取6种难溶性药物:尼莫地平(NIM)、多西紫杉醇(DTX)、姜黄素(CUR)、紫杉醇(PTX)、替尼泊苷(TEN)、水飞蓟宾(SLB),分别考察其log P值与PEG400中溶解度、载药纳米脂肪乳的载药量、粒径、Zeta电位、体外释药特性以及相分布等的关系。 结果 随着log P值的增加,药物在PEG400中的溶解度呈先上升后下降的趋势,在纳米脂肪乳中的载药量增高,体外释放速率减慢,在油相中的分布增加,在乳化剂层的分布减小;药物log P值与载药纳米脂肪乳的粒径及Zeta电位无关。 结论 可综合考虑药物的log P值及PEG400中的溶解度,用以初步判断纳米脂肪乳的载药特性。     

鸦胆子油乳注射液及配置后静脉输液的室温稳定性研究

目的 考察说明书中贮存条件要求冷藏,且须临用前即配即用的鸦胆子油乳注射液的原液和稀释后的静脉输液在室温(25 ℃)下的稳定性,为该药品的临床管理与使用提供依据。方法 模拟临床给药剂量和给药时间,考察性状、pH、渗透压、颗粒细度和油酸含量在室温下放置不同时间点的变化。结果 在室温下,鸦胆子油乳注射液原液放置72 h质量稳定,配置后静脉输液(30 mL∶250 mL 0.9%生理盐水)在24 h内各项理化指标均无明显变化。结论 鸦胆子油乳注射液在医院内部的短时间药物配送无需严格实施冷链管理;配置后静脉输液室温放置24 h稳定,无需“即配即用”。