In Vivo Study to Assess the Viability and Mass Effect of Fascia Injection in Comparison with Block Fascia Graft

Recently, fat injection has gained favor among plastic surgeons for soft tissue augmentation. However, fat injections lose 50% of their volume after 1 year. The profession is in need of an injectable bulking material that gives a long-lasting improvement. Using 30 male rats, this study investigated the stability of the size and structure of the injected fascia autograft and compared it with surgically transplanted fascia. The fascia graft was harvested from the back of the rat, big, and divided into two equal pieces. The first piece was minced into a paste and injected subcutaneously on the anterior surface of the right ear. The other piece was transplanted subcutaneously on the anterior surface of the left ear. The grafts were observed for any sign of resorption over 1 to 6 months.Grossly, injection and transplantation sites were palpable at the end of the observation periods. Microscopic examination showed that injected fascia maintains its histomorphologic structure.These findings indicate that the injected fascia graft is well tolerated, and the size of the graft remained stable. According to this study, fascia injection can result in bulking material that gives a long-lasting improvement, and can be a viable alternative to other methods.     

Use of combined intracorporal injection and a phosphodiesterase-5 inhibitor therapy for men with a suboptimal response to sildenafil and/or vardenafil monotherapy after radical retropubic prostatectomy

OBJECTIVE: To report experience with combined therapy using intracorporal injection (ICI) of alprostadil and oral phosphodiesterase 5 (PDE-5) inhibitors for the minimally invasive treatment of erectile dysfunction (ED) after radical prostatectomy (RP), as PDE-5 inhibitors are effective but a few patients may have a suboptimal response. PATIENTS AND METHODS: In a retrospective study, 34 men (aged 46-66 years) had a nerve-sparing retropubic RP and subsequent ED. Patients were titrated on sildenafil citrate or vardenafil to maximum doses. All had a suboptimal response after a maximum of eight doses of oral therapy and were then treated with ICI therapy using 15 or 20 microg alprostadil. Erectile function was assessed with the Sexual Health Inventory for Men (SHIM). RESULTS: Of the 32 patients who continued combined therapy, 22 (68%) had an improvement in erectile function after ICI therapy, as assessed by the SHIM score. On follow-up, 36% of these patients used ICI therapy only intermittently, instead of regularly, as they felt that this was adequate enough for good results. CONCLUSIONS: PDE-5 oral pharmacotherapy is the most commonly used effective therapy for ED but may not be as effective in patients who have radical surgery; the addition of testosterone patches may have side-effects or be considered a risk in patients with a history of prostate cancer. The use of ICI therapy as an adjunct or maintenance therapy to their oral medication may be another alternative in these patients.     

Inadvertent intrathecal injection of labetalol in a patient undergoing post-partum tubal ligation

After receiving a continuous spinal anesthetic for labor following an inadvertent dural puncture with a 17-gauge epidural needle, a morbidly obese parturient underwent post-partum tubal ligation 12 h after vaginal delivery. The patient received a total of 2 mL of 0.75% hyperbaric bupivacaine for the surgery. In response to moderate hypertension the patient received intravenous labetalol hydrochloride 20 mg. She subsequently was inadvertently administered approximately 15 mg of labetalol through the spinal catheter. The spinal catheter was removed immediately after the procedure. She suffered no apparent adverse neurologic effects.     

Basidiobolomycosis Following injection Injury

Summary: Basidiobolomycosis following intramuscular injection in a 6 year old female child is reported. Regional lymph nodes in the inguinal areas on both sides conforms to such findings in our previous cases, denoting that this infection is systemic. Simple oral potassium iodide (KI) has cured the disease without a relapse during follow up of nearly 3 years.
Zusammenfassung: Bei einem 6jährigen Mädchen entwickelte sich im Anschluß an eine intramuskuläre Injektion eine Basidiobolomykose. Ähnlich wie bei anderen Fäillen lag eine Beteiligung der regionalen Lymphknoten in beiden Leisten vor, wodurch eine systemische Ausbreitung angezeigt wird. Behandlung mit Kaliumjodid oral führte zur vollständigen Heilung ohne Rückfall bei dreijähriger Nachbeobachtungszeit.     

Intraspinal distribution and reaction in the grey matter with tetanus toxin of intracisternally injected anti-tetanus toxoid F (ab′)2 fragments

Anti-tetanus toxoid F(ab′)₂ fragments were purified using immune-affinity chromatography on tetanus toxoid-Sepharose. Fragments were labeled with¹²⁵I. Labeled or non-labeled fragments were injected into the intrathecal space of rats. The labeled fragments were found in the spinal cord outside but not inside neurons.Tetanus toxin was injected into a muscle and 36 h later labeled fragments were injected intracisternally. After another 24 h the label was elevated in the spinal cord half segments giving neural supply to the injected muscle and in these half-segments the label was concentrated around some α-motoneurons.[¹²⁵I]Tetanus toxin was injected into a muscle and at different times thereafter non-labeled fragments were injected intracisternally. The development of hindlimb rigidity but not the accumulation of [¹²⁵I]tetanus toxin in α-motoneurons was prevented by early intracisternal injection of fragments. Injection of fragments after the appearance of hindlimb rigidity did not revert the rigidity but prevented the further development of symptoms.It is concluded that an action of tetanus toxin inside α-motoneurons is of no importance for the development of motor symptoms in clinical tetanus. The data suggest that in order to evoke spinal symptoms of toxicity tetanus toxin has to reach interneurons by transneuronal migration. In the very early stages of clinical tetanus the intrathecal injection of fragments may be useful.     

Intracranial application of substances in the unrestrained, awake rat by pressure injection through glass micropipettes

A method is described which allows intracranial injection of drug solutions through glass micropipettes (tip diameter 15 micron) in the freely moving rat by use of air pressure. Compared with conventional injection methods through steel cannulae this method has the advantages of (1) minimal destruction of brain tissue, (2) precise injection of small volumes of solutions (1 nl to several microliters), (3) simultaneous recording of local EEG activity, and (4) usage of multipipette assemblies.     

Peptides with CCK-like activity administered intracranially elicit satiety in sheep

Cholecystokinin (CCK) peptides and receptors have been shown to be present in the brain as well as in gastrointestinal organs. While functions for peripheral CCK are well recognized, those for central CCK peptides are only now being investigated. We have shown previously that CCK-octapeptide (CCK-OP) is a very potent and specific suppressor of feeding when administered in the cerebral ventricles of sheep. In the present study the objective was to determine the relative potency of several CCK analogues in inhibiting feeding when administered as 75 min continuous injections into the lateral cerebral ventricles of 2-hr fasted sheep. In comparing feeding response during CCK-OP injections to that during caerulein injections, it was found that feed intakes were similar only at an equal molar dose (0.638 pmole/min); whereas three times as much CCK-33 (1.91 pmoles/min) as CCK-OP (0.638 pmoles/min) was required to produce similar feed intakes. Both caerulein (0.638 pmoles/min) and CCK-33 (1.91 pmoles/min) caused significant decreases in feeding compared to control (sCSF). Desulfated CCK-OP had no effect on feeding at a dose (0.638 pmoles/min) that causes 80–100% decreases in feeding when the C-7 tyrosine is sulfated. Feed intake was significantly less with 2.55 pmoles/min CCK-OP than with an equal dose of desulfated CCK-OP. These results concur with those of previous studies on specific CCK receptors in the pancreas and in the brain, and therefore support the concept of specific CCK receptors in brain having a role in satiety.     

Plasma angiotensin II levels and water intake following beta-adrenergic stimulation, hypovolemia, cellular dehydration and water deprivation.

A comparison of the effects of extracellular and intracellular thirst stimuli on plasma levels of angiotensin II was made in rats. The administration of polyethylene glycol and isoproterenol elicited a strong drinking response and resulted in a significant increase in plasma angiotensin II. There was a significant correlation between the volume of water intake and plasma angiotensin II levels following the injection of polyethylene glycol but not following isoproterenol. Drinking was also elicited by the administration of hypertonic saline but there was no increase in plasma angiotensin II. The results suggest that endogenously released angiotensin II contributes to extracellular thirst but not to intracellular thirst.     

Topographical analysis of the actions of 2-(N,N-dipropyl)amino-5,6-dihydroxytetralin to cause biting behaviour and locomotor hyperactivity from the striatum of the guinea-pig

The dopamine agonist, 2-(N,N-dipropyl)amino-5,6-dihydroxytetralin, was injected at 78 different locations within and around the striatum of the guinea-pig. Injection sites were selected at anterior 10.0, 8.0 and 6.0mm to the inter-aural line, ±2.5, ±3.5 and ±4.5 mm lateral from the midline and 1–10 mm below guide cannulae placed to penetrate 0.75 mm into the cerebral cortex. All animals were observed for the development of biting behaviour and hyperactivity. Four important distinctions could be made between the loci of tetralin action to induce biting and hyperactivity. The most striking distinction was the development of marked hyperactivity in the absence of any consistent biting at the most lateral placements (±4.5 mm) in the entire rostral-caudal plane. Secondly, within the lateral regions the dorsal locations were the more sensitive (in contrast to the more marked development of biting in the ventro-medial caudate) and, thirdly, even in those medial planes where the ventral locations sustained the most consistent biting, induction of hyperactivity was most marked from the more dorsal locations which failed to sustain a consistent biting. Fourthly, the most rostrally located injections, even at the medial sites, produced marked hyperactivity but only modest biting responses. Finally, it should be noted that both hyperaetivity and biting could be induced from extrastriatal sites, although the delayed onset may reflect the need for diffusion. This data would indicate a differential distribution of striatal sites capable of mediating biting and hyperactivity. Specific, but differential, blockade of these responses by the neuroleptic agents fluphenazine and tiapride (atropine, methysergide, dl-propranolol and piperoxan were ineffective) may indicate that dopamine mechanisms at the two sites may have differing characteristics.