PURPOSE: Flat urothelial lesions such as high-grade dysplasia and carcinoma in situ and tiny papillary bladder tumors can be overlooked during the conventional cystoscopy. PDD is based on the detection of protoporphyrin IX(PpIX)-induced fluorescence in urothelial cancer epithelium through topical administration of 5-aminolevulinic acid (ALA). This study attempted to evaluate the diagnostic efficacy of PDD in urothelial neoplasms. MATERIALS AND METHODS: 41 patients with suspicion of bladder cancers were investigated by fluorescence-assisted transurethral resection. Intravesical instillation of ALA was done for PDD 2 hours prior to transurethral resection of bladder tumor. A total of 197 tissue samples were obtained from the fluorescing and non-fluorescing areas of the bladder. The correlation between fluorescence findings and histopathological diagnosis were investigated. RESULTS: All 74 samples which appeared malignant during the conventional cystoscopy were fluorescened strongly in the red, pathologically confirming the tumor. Additional 33 foci of carcinoma(CIS in 12, Ta in 5, T1 in 12, T2 in 4) which were invisible during routine cystoscopy could be detected only by PpIX-induced fluorescence. The sensitivity and specificity can be estimated at 97.0% and 32.3%, respectively. Low specificity may be due to the insufficient number of random biopsies of the normal bladder wall. CONCLUSIONS: PpIX-induced fluorescence with intravesical instillation of ALA is a feasible and efficient method for mapping the mucosa in the occult urothelial neoplasms. PDD might be helpful in complete resection of flat urothelial lesions and tiny papillary tumors and it would be able to provide helpful information for the appropriate further treatment.
Administration, Intravesical* ; Administration, Topical ; Biopsy ; Carcinoma in Situ ; Cystoscopy ; Diagnosis ; Epithelium ; Fluorescence ; Humans ; Mucous Membrane ; Sensitivity and Specificity ; Urinary Bladder ; Urinary Bladder Neoplasms

OBJECTIVES: The aim of this study was to investigate whether the ciliary activity of respiratory epithelium is affected in allergic rhinitis. METHODS: Twenty Wistar rats were divided into an unsensitized control group and sensitized allergic group. The sensitized group was immunized intraperitoneally with ovalbumin, followed by intranasal administration of ovalbumin. Allergy was determined by an increase in nasal symptoms, the number of tissue eosinophils and a positive result to a passive cutaneous anaphylaxis (PCA) test. Nasal, nasopharyneal, tracheal, and bronchial epithelial cells were obtained from both the control and allergic groups. Ciliary beat frequency (CBF) was measured using a video-computerized analysis technique in vitro. We compared the CBF of two groups in each site. We also evaluated the findings of the nasal mucosa of both groups with an scanning electron microscope. RESULTS: In vitro CBF measurement demonstrated that the CBF of the control and allergic groups did not differ significantly (p>0.05). CONCLUSION: CBF is not affected by respiratory allergy.
Administration, Intranasal ; Animals ; Eosinophils ; Epithelial Cells* ; Hypersensitivity ; Nasal Mucosa ; Ovalbumin ; Passive Cutaneous Anaphylaxis ; Rats* ; Rats, Wistar ; Respiratory Mucosa ; Rhinitis*

Lupoid leishmaniasis is a unique form of cutaneous leishmaniasis characterized by unusual clinical features and a chronic relapsing course, mostly caused by infection with Leishmania tropica. In this clinical form, 1-2 yr after healing of the acute lesion, new papules and nodules appear at the margin of the remaining scar. Herein, we describe a case of this clinical form that was resistant to 2 courses of treatments: systemic glucantime and then a combination therapy with allopurinol and systemic glucantime. However, marked improvement was seen after a combination therapy with topical trichloroacetic acid solution (50%) and systemic glucantime, and there were no signs of recurrence after 1 yr of follow-up.
Administration, Topical ; Adult ; Antiprotozoal Agents/administration & dosage/*therapeutic use ; Humans ; Leishmaniasis, Cutaneous/*drug therapy/pathology ; Male ; Meglumine/*therapeutic use ; Organometallic Compounds/*therapeutic use ; Trichloroacetic Acid/administration & dosage/*therapeutic use

The paper is to report the study of pharmacokinetics of transdermal administered nicotine in the brain of freely moving rat by using microdialysis with stable labeled isotope as internal standard. The pharmacokinetic behavior of nicotine in Sprague Dawley rat brain was investigated after intranasal administration (3.75 mg). Brain fluid samples were collected by intracerebral microdialysis with DL-nicotine as internal standard. Concentrations of nicotine and DL-nicotine in the sample were measured by HPLC-MS/MS. Main pharmacokinetic parameters were calculated and analyzed by Das 2.0 pharmacokinetic software. The recovery of nicotine and the delivery of DL-nicotine were the same. The fate of absorption and distribution was two compartment model and the values of t1/2alpha was 170.31 min, t1/2beta was 263.30 min and the AUC(0-infinity) was 2.75 x 10(5) microg x L(-1) min separately. DL-nicotine can be used to calibrate the recovery of nicotine, and the new method of stable isotope microdialysis can be used to study the pharmacokinetics of freely moving rat. It will make sense for the treatment of addiction of tobacco and provide a new thought for the research of pharmacokinetics-pharmacodynamic combination.
Administration, Cutaneous ; Administration, Intranasal ; Animals ; Area Under Curve ; Brain ; metabolism ; Chromatography, High Pressure Liquid ; Deuterium ; Female ; Isotope Labeling ; methods ; Male ; Microdialysis ; methods ; Nicotine ; administration & dosage ; pharmacokinetics ; Rats ; Rats, Sprague-Dawley ; Tandem Mass Spectrometry

Chlorhexidine is widely used as an antiseptic and disinfectant in medical and nonmedical environments. Although the sensitization rate seems to be low, its ubiquitous use raises the possibility of sensitization in many patients and medical care workers. We describe a patient with anaphylaxis during digital rectal examination with chlorhexidine jelly. Urticaria, angioedema, dyspnea, and hypotension developed within a few minutes of the rectal examination. The patient fully recovered after treatment with epinephrine and corticosteroids. Skin tests for chlorhexidine were undertaken 5 weeks later, showing positive prick and intradermal skin tests. Within 30 min of the skin test, the patient complained of febrile sensation, chest tightness, angioedema, and urticaria on the face and trunk. An enzyme allergosorbent test for latex was negative. We present this case to alert clinicians about hypersensitivity to chlorhexidine that could potentially be life-threatening. We suggest that chlorhexidine should be recognized as a causative agent of anaphylaxis during procedural interventions.
Administration, Topical ; Adrenal Cortex Hormones/administration & dosage ; Anaphylaxis/*chemically induced/drug therapy ; Anti-Infective Agents, Local/administration & dosage/*adverse effects ; Chlorhexidine/administration & dosage/*adverse effects ; *Digital Rectal Examination ; Epinephrine/administration & dosage ; Humans ; Male ; Middle Aged ; Sympathomimetics/administration & dosage

OBJECTIVETo observe the effects of the external application of Qiyu oil gauze (QYOG) for promoting post-operational healing in patients with anal fistula and to explore its mechanism of action so as to provide a beneficial scientific basis for its wide use.

METHODSSixty patients with anal fistula scheduled to receive simple low anal fistulectomy were equally assigned, according to the sequence of hospitalization, to the tested group and the control group, and their wounds were classified according to longitudinal diameter into three grades (Grade I with a diameter below 2 cm; Grade II, 2-5 cm; and Grade III, over 5 cm). After the operation was completed and the operational wound was sterilized with benzalkonium bromide, the wound substratum was packed with QYOG in the test group and with vaseline gauze in the control group. The packing gauze was changed every day till the wound was healed. The healing time of the patients was observed, and the number of capillaries and positive cell percentages of vascular endothelial growth factor (VEGF), basic fibroblast growth factor (bFGF), and epidermal growth factor (EGF) in wound granulation tissues were counted on the 5th day after the operation.

RESULTSThe wound healing time was 17.80+/-5.46 days in the test group, which was significantly shorter than that in the control group (21.90+/-6.32 days, P<0.01). The number of capillaries and positive cell percentages of VEGF and bFGF in wound granulation tissues on the 5th day in the tested group were higher than those in the control group (P<0.01), though the difference in EGF between the two groups was insignificant (P>0.05).

CONCLUSIONQYOG could shorten the wound healing time after anal fistulectomy, which suggests that it participates in the stimulation of wound granulation tissues to produce VEGF and bFGF, and thus promotes capillary genesis and improves blood circulation in wounds so as to promote wound healing.

Administration, Topical ; Adult ; Bandages ; Drugs, Chinese Herbal ; administration & dosage ; Female ; Granulation Tissue ; drug effects ; Humans ; Male ; Middle Aged ; Plant Oils ; administration & dosage ; Postoperative Care ; methods ; Rectal Fistula ; drug therapy ; rehabilitation ; surgery ; Time Factors ; Treatment Outcome ; Wound Healing ; drug effects ; physiology

Administration, Cutaneous ; Administration, Topical ; Betamethasone Valerate ; therapeutic use ; China ; Clobetasol ; therapeutic use ; Cohort Studies ; Diabetes Mellitus ; epidemiology ; Ethnic Groups ; statistics & numerical data ; Female ; Glucocorticoids ; therapeutic use ; Humans ; Hyperlipidemias ; epidemiology ; India ; Lichen Planus ; drug therapy ; epidemiology ; Malaysia ; Male ; Middle Aged ; Multivariate Analysis ; Prognosis ; Proportional Hazards Models ; Retrospective Studies ; Risk Factors ; Singapore ; epidemiology ; Triamcinolone ; therapeutic use

Administration, Topical ; Humans ; Labyrinth Diseases ; drug therapy

To evaluate effects of the topical administration of non-steroidal antiinflammatory drug on anterior uveitis, suprofen eye drop was instilled into the left eye of 10 pigmented rabbits and then experimental anterior uveitis was induced by injecting 750 mocro gram/kg endotoxin of Shigella flexneri serotype 1A into their peritoneal cavities. The pupillary diameters were measured, and cell and flare gradings were recorded in 20 eyes of 10 rabbits for one week at an interval of 12 hours for the first day and then daily. Differences between the treatment and control groups were investigated. All the above parameters showed greatest changes at 12 or 24 hours after the injection of endotoxin and became normal by one week. The treatment and the control groups demonstrated statistically significant difference at 12 hours, day 1, and day 2 as for pupillary diameter and at day 1 and day 2 as for cell and at 12 hours and day 1 as for flare. Thus, it is concluded that prostaglandin plays a role in miosis and the appearance of inflammatory cells and flare in anterior uveitis and the topical administration of non-steroidal anti-inflammatory drug can alleviate signs of anterior uveitis. The specific relationship between leucotriene B4 and polymorphonuclear leucocytes influx was not demonstrated.
Administration, Topical ; Miosis ; Rabbits ; Shigella flexneri ; Suprofen ; Uveitis, Anterior*

The outcomes of microvascular surgery may be jeopardized by factors that reduce the blood flow across the freshly the performed anastomosis Arterial vasospasm is one of such factors causing the failure of an anastomosis. Vascular spasm has treated by systemic or topical administration of pharmacologic agents. However, despite the works done to prevent and elucidate the cause of vasospasm, a apasmolytic agent Capable of consistently protecting against it or reversing it has not been found. Vascular freezing as an powerful spasmolytic maneuver has recently been reported. The purpose of the present study was to determine optimal vascular freezing time. The effect of vascular freezing time was examined on the relief of arterial vasospasm. The vascular was freezing was performed on the artery of rats whit hand-held liquid nitrogen oxide spray. the artery was frozen for 5, 15,or 30 seconds. Vascular spasm and patency were evaluated immediately after and 1, 3, 7, 14, and 56 days after the freezing. Femaral arteries were havested at 1, 3, 7, 14, and 56 days after freezing for histologc examination The results obtained were as follows : 1. immediately after the freezing-thawing, the vasospasm was relieved and not induced by spasmogenic induction manipulation in all groups. 2. Immediately after the freezing-thawing, the artery become dialated, the diameter of which was slightly more than the intial, ranging between 0-17% and the diameter of 5-second group was smaller than those of 15-and 30-second group(P<0.05). 3. One to 56 days after freezing, arteral diameter was still 1-22% larger than the initial and there was no significant difference among groups. 4. One to 56 days after the freezing, vasospasm was not induced by spasmogenic induction manipulation in all groups. 5. One day after the freezing, almost all the vessel wall died and the normal architeture of the layer was deranged in all group. The shorter was the duration of freezing, the more early was the healing of artery occurred, 6. Fifty-six days after the freezing, cellularity was increased and the architecture was regenerated, There was no significant differance among groups. It was suggested that vascular freezing for 5 seconds is useful to relieve the vasospasm and to lessen the injury of artery.
Administration, Topical ; Animals ; Arteries ; Freezing* ; Nitrogen ; Rats* ; Spasm