PURPOSE: To evaluate the visual and anatomical outcomes for neovascular age-related macular degeneration with submacular hemorrhage after intravitreal injections of tenecteplase (TNK), anti-vascular endothelial growth factor (VEGF) and expansile gas. METHODS: This study was a retrospective clinical case series following 25 eyes of 25 patients. All patients received a triple injection using 0.05 mL TNK (50 µg), 0.05 mL anti-VEGF and 0.3 mL of perfluoropropane gas. Retreatment with anti-VEGF was performed as needed. Preoperative and postoperative best-corrected visual acuity and central retinal thickness were analyzed. RESULTS: The mean logarithm of the minimum angle of resolution of best-corrected visual acuity improved significantly from 1.09 ± 0.77 at baseline to 0.52 ± 0.60 at 12 months (p < 0.001). The mean central retinal thickness also improved significantly from 545 ± 156 at baseline to 266 ± 107 at 12 months (p < 0.001). A visual improvement of 0.3 logarithm of the minimum angle of resolution unit or more was achieved in 15 eyes (60%). During the 12 postoperative months, an average of 4.04 intravitreal anti-VEGF injections was applied. CONCLUSIONS: A triple injection of TNK, anti-VEGF, and a gas appears to be safe and effective for the treatment of submacular hemorrhage secondary to neovascular age-related macular degeneration.
Acute Disease ; Aged ; Aged, 80 and over ; Female ; Fibrinolytic Agents/administration & dosage ; Fluorescein Angiography ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Fundus Oculi ; Humans ; Intravitreal Injections ; Macula Lutea/*diagnostic imaging ; Male ; Middle Aged ; Retinal Hemorrhage/diagnosis/*drug therapy ; Retrospective Studies ; Tissue Plasminogen Activator/*administration & dosage ; Tomography, Optical Coherence ; Treatment Outcome ; Vascular Endothelial Growth Factor A/antagonists & inhibitors ; Visual Acuity

We report two cases of surgical removal of a retained subfoveal perfluorocarbon liquid (PFCL) bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade. Two patients underwent pars plana vitrectomy with PFCL injection for rhegmatogenous retinal detachment. In both cases, a retained subfoveal PFCL bubble was noticed postoperatively by funduscopy and optical coherence tomography. Both patients underwent surgical removal of the subfoveal PFCL through a therapeutic macular hole and gas tamponade. The therapeutic macular holes were completely closed by gas tamponade and the procedure yielded a good visual outcome (best-corrected visual acuity of 20 / 40 in both cases). In one case, additional intravitreal PFCL injection onto the macula reduced the size of the therapeutic macular hole and preserved the retinal structures in the macula. Surgical removal of a retained subfoveal PFCL bubble through a therapeutic macular hole combined with intravitreal PFCL injection and gas tamponade provides an effective treatment option.
Aged ; Female ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Fovea Centralis ; Humans ; Intravitreal Injections ; Retinal Perforations/diagnosis/physiopathology/*surgery ; Suction/*methods ; Tomography, Optical Coherence ; Visual Acuity ; Vitrectomy/*methods

OBJECTIVETo observe the effect of inhalation of aerosolized perfluorocarbon combined with tetramethylpyrazine on the hemodynamics and histopathology in a porcine model of acute lung injury.

METHODSNormal adult pigs were subjected to saline lavage of the bilateral lungs to induce acute lung injury and randomized subsequently into 3 groups for treatment with inhalation of perfluorocarbon, combined inhalation of perfluorocarbon and tetramethylpyrazine, or inhalation of tetramethylpyrazine. The changes of mean arterial pressure (MAP), PetCO(2), mPAP, CVP and PAWP were recorded at different time points following the lung injury, and the lung tissues were sampled for histological observations.

RESULTSThe MAP, mPAP, CVP and PAWP all increased significantly in the 3 groups after acute lung injury. Interventions with combined tetramethylpyrazine and perfluorocarbon inhalation significantly improved these indices as compared with inhalation of tetramethylpyrazine or perfluorocarbon alone (P<0.05). The pulmonary pathology was the mildest in the combined inhalation group, and the most severe in tetramethylpyrazine group.

CONCLUSIONCombined inhalation of perfluorocarbon and tetramethylpyrazine can effectively improve the oxygenation, reduce pulmonary arterial pressure?and ameliorate lung pathology in pigs with acute lung injury.

Acute Lung Injury ; drug therapy ; etiology ; pathology ; Administration, Inhalation ; Animals ; Drug Therapy, Combination ; Fluorocarbons ; administration & dosage ; Hemodynamics ; drug effects ; Lung ; pathology ; Phytotherapy ; Pyrazines ; administration & dosage ; Swine

The shortage of healthy blood resource and the problem of virus infection have urged the study of blood substitute. The technologies of modified hemoglobin, perfluorocarbons and Hb-vesicles have been developing quickly, and some of which have already been formed into large-scale preparation and production. However, there is no completed evaluation system for the blood substitute at present, and it is still hard to estimate the function of blood substitute completely. This article takes the evaluation of the blood substitute as a key point, discusses the evaluation parameters of blood substitute, and presents the physical and chemical property, the availability and safety as well as the preservation condition of the blood substitute. The data concerned are based on the studies in China and abroad and referred to the latest progress all over the world.
Animals ; Blood Substitutes ; administration & dosage ; standards ; Chemical Phenomena ; Erythrocytes ; drug effects ; metabolism ; Fluorocarbons ; administration & dosage ; adverse effects ; Hemoglobins ; administration & dosage ; adverse effects ; Humans ; Quality Control

PURPOSE: This study was designed to evaluate the efficacy of fluid-gas exchange for the treatment of postvitrectomy retinal detachment. METHODS: We retrospectively reviewed the records of 33 consecutive patients (35 eyes) who underwent fluid-gas exchange treatment for postvitrectomy retinal detachment using the two-needle pars plana approach technique. RESULTS: The retinal reattachment rate was 80.0% after complete intravitreal gas disappearance following the fluid-gas exchange; the overall success rate was 65.7%. Visual acuity was improved or stable in 80.0% of cases; a two-line or greater vision improvement or a best-corrected visual acuity of 0.4 or better occurred in 62.9% of cases. The success rates for superior retinal detachments and posterior pole retinal detachments were 76.5% and 85.7%, respectively. CONCLUSIONS: Fluid-gas exchange represents a simple and cost-effective alternative outpatient procedure for retinal reattachment without reoperation for the treatment of superior and posterior pole retinal detachments.
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Female ; Fluorocarbons/*administration & dosage ; Follow-Up Studies ; Humans ; Injections ; Laser Coagulation/methods ; Male ; Middle Aged ; Ophthalmoscopy ; Postoperative Care/*methods ; Retinal Detachment/diagnosis/etiology/*therapy ; Retrospective Studies ; Sulfur Hexafluoride/*administration & dosage ; Time Factors ; Treatment Outcome ; Visual Acuity ; Vitrectomy/*adverse effects ; Vitreous Body ; Young Adult

OBJECTIVETo prepare polyelectrolyte multilayer film-coated microbubble ultrasound contrast agent (UCA) and evaluate its effects in contrast imaging on normal rabbit's liver parenchyma.

METHODSPerfluorocarbon (PFC) -containing microbubble UCA (ST68-PFC) were prepared by sonication-based on surfactants (Span 60 and Tween 80). Subsequently, the resulting ST68-PFC microbubbles were coated using oppositely charged polylysine (PLL) and alginate (Alg) by microbubble-templated layer-by-layer self-assembly technique via electrostatic interaction. The enhancement effects in contrast imaging on normal rabbit's liver parenchyma were assessed.

RESULTSThe obtained microbubble UCA exhibited a narrow size distribution. The polyelectrolytes were successfully assembled onto the surface of ST68-PFC microbubbles. In vivo experiment showed that polyelectrolyte multilayer film-coated UCA effectively enhanced the imaging of rabbit's liver parenchyma.

CONCLUSIONSThe novel microbubble UCA obtained via layer-by-layer self-assembly, when enabling more functions, has no obvious difference in enhancement effects compared with the premodified microbubbles. The polymers with chemically active groups (such as amino group and carboxyl group) can be used as the outermost layer for the attachment of targeting ligands to microbubbles, which allows the selective targeting of the microbubbles to desired sites.

Alginates ; chemistry ; Animals ; Contrast Media ; administration & dosage ; chemistry ; Fluorocarbons ; chemistry ; Glucuronic Acid ; chemistry ; Hexuronic Acids ; chemistry ; Liver ; diagnostic imaging ; Microbubbles ; Polylysine ; chemistry ; Rabbits ; Ultrasonography

Administration, Inhalation ; Animals ; Disease Models, Animal ; Female ; Fluorine ; blood ; Fluorocarbons ; adverse effects ; pharmacokinetics ; Male ; Rabbits ; Rats

OBJECTIVETo develop a method for quantitative collection of exhaled gas in anesthetized dogs at given time following intravenous administration of octafluoropropane (OFP)-containing human albumin micropheres for assessing the gas kinetics of OFP.

METHODSOFP-containing albumin micropheres were administered intravenously at 0.4, 0.8 and 1.2 ml/kg, respectively, in anesthetized and ventilated dogs. The exhaled air samples were analyzed by gas chromatography-tandem mass spectrometry (GC-MS-MS).

RESULTSThe correlation curve between the area under curve (AUC) and administered dose was roughly linear (Y=1162.5X-417.38, r square=0.949 9). The total recovery rate was (119.49-/+27.62)% which was not significantly different from the rate of 100% (P>0.05). GC-MS-MS was accurate, sensitive, precise and applicable for OFP determination.

CONCLUSIONThe sampling method is useful for characterizing OFP pharmacokinetics in dogs, and also applicable for studying the pharmacokinetics of other gas-containing drugs.

Albumins ; administration & dosage ; analysis ; pharmacokinetics ; Animals ; Dogs ; Exhalation ; Female ; Fluorocarbons ; administration & dosage ; analysis ; pharmacokinetics ; Gas Chromatography-Mass Spectrometry ; methods ; Humans ; Injections, Intravenous ; Male ; Microspheres ; Reproducibility of Results

AIMTo develop a method for direct determination of perfluoropropane in canine whole blood and to study its pharmacokinetics after a suspension of perfluoropropane-containing albumin microcapsules was administered intravenously.

METHODSPerfluoropropane-containing albumin microcapsule suspension was administered intravenously to anesthetized canines at the dosage of 0.6 mL x kg(-1). Whole blood samples were collected and added directly into the purging glass tube in Tekmar 3000 Purge and Trap Concentrator coupled with a GC-MS for the determination of perfluoropropane. The pharmacokinetic parameters of perfluoropropane were calculated by non-compartment model statistics.

RESULTSThe linear range was 0.0168-4.03 mg x L(-1). The main pharmacokinetic parameters of perfluoropropane was obtained as follows: mean residence time (MRT) was (63 +/- 5) s, T1/2 was (44 +/- 4) s, Tmax was 30 s, Cmax was (2.20 +/- 0.20) mg x L(-1), AUC0-infinity was (96 +/- 11) mg x s x L(-1).

CONCLUSIONThe method is sensitive, specific and simple. It can be used to determine fluorocarbon contained in microcapsule ultrasound contrast agents for studying its pharmacokinetics.

Albumins ; Animals ; Area Under Curve ; Capsules ; Dogs ; Fluorocarbons ; administration & dosage ; blood ; pharmacokinetics ; Gas Chromatography-Mass Spectrometry ; methods ; Injections, Intravenous

OBJECTIVETo establish of acute respiratory distress syndrome (ARDS) model in canine after inhalation of perfluoroisobutylene (PFIB), and to observe the progressing of lung injury, and to study the mechanisms of injury.

METHODSA device of inhalation of PFIB for canine was made. The concentration of PFIB was 0.30 - 0.32 mg/L. Serum IL-6 and IL-8 were dynamically measured. Clinical manifestations, pathology of organs in canine were observed.

RESULTS(1) During inhalation, the concentration of PFIB remained stable; (2) After inhalation, blood arterial oxygen partial pressure fell gradually, and eventually met the criteria for diagnosing ARDS; (3) The level of IL-8 in serum rises significantly after inhalation (P < 0.05), whereas that of IL-6 was not obviously altered (P > 0.05); (4) Within 6 hours after inhalation, no abnormality in canine was observed, but afterwards symptoms gradually appeared, and typical breath of ARDS, such as high frequency and lower level could be seen in later phase; (5) Pathological examination showed severe congestion, edema and atelectasis in most part of both lungs, and signs of anoxia in other organs.

CONCLUSIONS(1) The device designed is capable of ensuring control of inhalation of PFIB; (2) Exposure to PFIB for 30 mins, canines all met the criteria for diagnosing ARDS 22 hours after inhalation, therefore the modeling is successful; (3) PFIB specifically damages the lung by causing excessive inflammation.

Administration, Inhalation ; Animals ; Disease Models, Animal ; Dogs ; Female ; Fluorocarbons ; toxicity ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Lung ; drug effects ; pathology ; Male ; Random Allocation ; Respiratory Distress Syndrome, Adult ; blood ; chemically induced