The clinical efficacy and safety of topical propranolol hydrochloride gel in the treatment of superficial infantile hemangiomas (IHs) were assessed. Fifty-one cases of IHs from Oct. 2010 to Sept. 2011 were subjected to the topical propranolol hydrochloride gel intervention in Fuzhou General Hospital of Nanjing Military Commands, China. Changes in size, texture, color, peak systolic velocity of the hemangiomas, resistance index and adverse effects were observed. The results were evaluated by using Achauer system, and responses of IHs to pranpronolol were considered scale II (poor) in 4 patients (17.24%), scale II (moderate) in 18 patients (24.14%), scale III (good) in 22 patients (44.83%) and scale IV (excellent) in 7 patients (13.79%). The response of superficial hemangiomas was significantly better than other hemangiomas (P<0.05), and no differences in response were found among different primary sites (P>0.05). Our study indicates that topical application of 3% propranolol hydrochloride gel is effective and safe in treating IHs.
Female ; Gels ; administration & dosage ; Hemangioma ; drug therapy ; Humans ; Infant ; Infant, Newborn ; Male ; Propranolol ; administration & dosage

OBJECTIVETo investigate the clinical results of the treatment of severe infantile hemangioma with high-dose propranolol in Chinese.

METHODS56 cases with severe infantile hemangioma were treated with propranolol. Clinical evaluation, electrocardiography, and experimental examination of liver function and heart function were performed before treatment. The daily dose of propranolol was increased from 1 mg/kg at the first day to 1.5 mg/kg at the second day, and to 2 mg/kg at the third day. The propranolol was given twice a day. The treatment was lasted for six months. The patients were visited every month.

RESULTSThe lesion color was changed after 2-4 days of treatment in all the cases. All the lesions were dramatically improved after one month of treatment. The ulceration were healed, except one case. Until now, complete regression was achieved in 10 cases and marked improvement in 46 cases. Side effects were happened in 3 cases, including one case of abnormal liver function, one case of CK-MB increase and one case of continuous increase of CK-MB, LDH, ALT, GGT.

CONCLUSIONSHigh-dose Propranolol is very effective in the treatment of infantile hemangioma with minor side effects and short disease period. It might he used as the first-line treatment for infantile hemangioma.

China ; Female ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Propranolol ; administration & dosage ; therapeutic use ; Treatment Outcome

Child, Preschool ; Female ; Gels ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Propranolol ; administration & dosage ; adverse effects

In propranolol (1. 0mg) pretreated men atropine (0.5mg), ephedrine (20mg) and aramine (2mg) were administered respectively by intravenous route under the ether anesthesia. The results were as follows. 1) Five minutes after intravenous administration of propranolol, the three groups showed decrease of pulse rates, 9, 6 and 8 per minutes respectively, but blood pressure changes were not observed. 2) After intravenous administration of atropine (0.5mg) the decreased pulse rates were increased and blood pressure was elevated. 3) After intravenous administration of ephedrine(20mg) the decreased pulse rates were decreased and lowered blood pressure was lowered further. 4) After intravenous administration of aramine(2.0mg) the lowered blood pressure was elevated, but pulse rate changes were not observed. 5) Circulatory depression due to ether anesthesia after propranolol pretreatment, was corrected by treatment with atropine and aramine, but was not corrected by ephedrine.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure* ; Depression ; Ephedrine ; Ether* ; Heart Rate* ; Humans ; Male ; Metaraminol ; Propranolol*

To combat the cardiovascular depression in blood pressure and palserate induced by halothane anesthesia in healthy persons after administration of propranolol(1.0mg) by the intravenous route, atropnie sulfate(0.5mg), ephedrine Hcl(20mg) and aramine(1.0mg) were administered respectively i.v. The results were as follows: 1) After i.v. administration of atropine sulfate, systolic blood pressure was elevated by 15 mmHg, diastolic blood pressure was elevated by 13mmHg, and pulse rate was increased by 24 per minute. 2) After i.v. administration of ephedrine, systolic blood pressure was elevated by 27 mmHg, diastolic blood pressure was elevated by 17mmHg, but significant pulse rate change was not observed. 3) After i.v. administration of aramine, systolic blood pressure was elevated by 29mmHg, diastolic blood pressure was elevated by 19mmHg, but pulse rate was decreased by 8 per minute. 4) As shown in the above results, in the cardiovascular depression due to halothane anesthesia after propranolol intravenous administration, blood pressure and pulse rated were corrected by treatment with atropine sulfate. Ephedrine and aramine effected elevation of the blood pressure, but not the pulse rate.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure* ; Depression ; Ephedrine ; Halothane* ; Heart Rate* ; Humans ; Metaraminol ; Propranolol*

The purpose of this study was to observe the additive effect of halothane anesthesia and propranolol, and also the effect of atropine and isoproterenol on the heart rate and the blood pressure after propranolol during halothane anesthesia in human-volunteers. The results were as follows: 1) In conscious patients, 10 minutes after intravenous administration of 1.0mg propranolol the heart rate was slower but there was no significant change in the blood pressure. 2) Twenty-thirty minutes after halothane anesthesia, the heart rate was slower by 6 to 8 beats per minute: systolic and diastolic blood pressure was lower by 20.4 torr and 10.5 torr, respectively. 3) 10 minutes after intravenous administration of 1.0mg propranolol during halothane anesthesia, the heart rate was decreased by 7.8, 7.0 per minute: systolic and diastolic blood pressure decreased by 6.7, 5.7 torr and 3.0, 3.9 torr in the atropine and isoproterenol group, respectively. 4) One minute after intravenous administration of atropine 0.5mg after propranolol 1.0mg during halothane anesthesia, the heart rate increased by 12.1 per minute and persisted so far 10 minutes, but the blood pressure did not increase. 5) One minute after intravenous administration of isoproterenol 0.025mg after propranolol 1.0mg during halothane anesthesia, the heart rate had markedly increased by 35, but normalized 10 minutes later. The systolic blood pressure was increased by 13.4 torr but normalized 10 minutes later. 6) The above results indicate: Atropine increases the heart rate which has been slowed with propranolol during halothane anesthesia: isoproterenol increases the heart rate and blood pressure but the duration of action was short. Therefore, authors considered that atropine is useful for the maintenance of heart rate, and continuous administration of isoproterenol for maintenance of blood pressure and heart rate after propranolol during halothane anesthesia.
Administration, Intravenous ; Anesthesia* ; Atropine* ; Blood Pressure* ; Halothane* ; Heart Rate* ; Heart* ; Humans ; Isoproterenol* ; Propranolol*

BACKGROUND AND OBJECTIVES: It has been assumed that salivary glands receive secretory fibers both from parasympathetic and sympathetic nerves. In fact, however, the existence of sympathetic secretory fibers in the cervical sympathetic nerve has not been established yet, because the salivary response to the cervical sympathetic stimulation is variable and short-lasting, and it tends to cease in spite of continued stimulation. This study investigated whether or not the cervical sympathetic nerve contains specific secretory fibers. MATERIALS AND METHODS: Salivary and blood flow responses to different frequency stimulation of the cervical sympathetic nerve, and often some autonomic drugs administration were observed from the submandibular gland in chloralose-anesthetized cats. RESULTS: 1) Low frequency stimulation (1-2 Hz) of the sympathetic nerve did not evoke salivary outflow and any change of blood flow, whereas high frequency stimulation of the nerve evoked salivary outflow and decrease of blood flow, in which salivary response tended to cease in spite of continued stimulation. 2) The salivary and blood flow responses to high frequency stimulation (20 Hz) of the nerve were not affected by the intravenous administration of propranolol, but were abolished by regitine. 3) Noradrenalin evoked salivary outflow and decreased blood flow which were not affected by the administration of propranolol but were abolished by regitine. 4) Isoproterenol increased blood flow but did not evoke salivary outflow, and the blood flow response was abolished by propranolol. CONCLUSION: These results suggest that the cervical sympathetic nerve does not contain specific secretory fibers and salivary outflow response to high frequency stimulation of the nerve may be due to either excitation of motor fibers innervating contractile elements of the excretory duct or chemical transmitters released from the vasomotor fibers.
Administration, Intravenous ; Animals ; Autonomic Agents ; Cats* ; Isoproterenol ; Phentolamine ; Propranolol ; Salivary Glands ; Submandibular Gland*

OBJECTIVETo prospectively assess the efficacy and safety or propranolol as a first-line treatment for problematic infantile haemangioma in China.

METHODSFrom Mar. 2009 to Feb. 2010, 78 patients with problematic infantile hemangioma were included in the prospective study. The characteristics of the tumor, including sex, age, site, complications, were recorded. The response to treatment at 1 week, at 1 month and at the end of treatment was evaluated. The efficacy of treatment was graded as no response, stabilization, or accelerated regression. The indications for treatment, side effects and relapse after treatment were documented. The mean follow-up period was 16.7 months (range, 12.1-23.6 months).

RESULTSOral therapy was initiated at mean age of 3.7 months (range, 1.1-9.2 months) as first-line therapy. The mean age at the end of treatment was 11.2 months (range, 5.2-22.3 months). The treatment was lasted for 7.6 months (range, 2. 1-18.3 months). One week after treatment beginning, the hemangioma growth was controlled in all the patients. The accelerated regression was achieved in 88.5% (69/78) of patients after one week of treatment, and 98.7% (77/78) of patients after 1 month of treatment and at the end of treatment. Ulceration was occurred in 14 cases before treatment, which was healed after treatment for 2 months. Minor side effects were happened in 15.4% (12/78) of patients. Rebound growth of lesion was noticed in 35.9% (28/78) of patients.

CONCLUSIONSPropranolol is effective in the treatment of infantile hemangioma with minor side effect. We suggest it should be used as the first-line treatment.

Female ; Follow-Up Studies ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Propranolol ; administration & dosage ; therapeutic use ; Prospective Studies ; Treatment Outcome

In order to observe the effect on cardiovascular depression due to ether, halothane or penthrane anesthesia with pretreatment of propranolol (1mg) , change in the blood pressure and pulse rate were measured after intravenous administration of atropine(0.5mg), ephedrine(20mg) or aramine(2mg) to healthy volunteers. The results were as follos, 1) In conscious patients, intravenous administration of propranolol(1mg) caused a statistically significant decrease in pulse rate but no significant change in the blood pressure. 2) The atropine group showed that blood pressure increased by 33/23(p<0.01), 15/13(p<0.01) and 3/4(NS) mmHg, and pulse rate also increased by 20(p<0.01), 24(p<0.05), 11(p<0.05) per min. respectively during ether, halothane and penthrane anesthesia. 3) The ephedrine group showed that blood pressure decreased by 5/0(NS) during ether anesthesia, and increased by 27/17(p<0.01) and 30/15(p<0.01) mmHg during halothane and penthrane anesthesia respectively. Pulse rate decreased by 7(p<0.05) per min. during ether anesthesia but showed no significant change during halothane and Penthrane anesthesia. 4) The aramine group showed that blood pressure increased by 70/34(p<0.01), 29/19(p<0.01) and 28/19Ip<0.001) mmHg during ether, halothane and Penthrane anesthesia respectively. Pulse rate increased by 7(NS) per min. during ether anesthesia and decreased by 8(p<0.05) per min. during halothane and Penthrane anesthesia respectively. 5) The above results have shown that atropine caused effective correction of the cardiovascular depression induced by ether, halothane and Penthrane anesthesia with pretreatment of propranolol. Ephedrine showed futher depression and aramine effected elevation of the blood pressure.
Administration, Intravenous ; Anesthesia* ; Atropine ; Blood Pressure ; Depression ; Ephedrine ; Ether* ; Halothane* ; Healthy Volunteers ; Heart Rate* ; Humans ; Metaraminol ; Methoxyflurane* ; Propranolol*

OBJECTIVETo evaluate the efficacy and safety of 1% propranolol ointment in the treatment of superficial infantile hemangiomas (IHs).

METHODSA retrospective chart review was performed on 49 children (34 female and 15 male) with a median age of 4.1 months (range, 1-10 months). A total of 58 superficial IHs were treated with 1% propranolol ointment. Topical propranolol was applied three times daily for a mean duration of 21.1 weeks (range, 5-59 weeks). Changes in the size, texture, and color of the tumor were monitored and recorded at regular intervals. The treatment response was evaluated using a 3-point scale system: good, partial, and no response. Adverse effects after medication were evaluated and managed accordingly.

RESULTSOf the 49 cases, 26 (53.1%) demonstrated good response, 17 (34.7%) showed a partial response, and 6 (12.2%) had no response. The total effective rate was 87.8% . No systemic complication was observed in any of the patients.

CONCLUSIONSTopical therapy with 1% propranolol ointment may be a safe and effective method for the treatment of superficial IHs and can be used as an adjuvant treatment measure during the wait-and-see period.

Female ; Hemangioma ; drug therapy ; Humans ; Infant ; Male ; Ointments ; Propranolol ; administration & dosage ; therapeutic use ; Skin Neoplasms ; drug therapy ; Treatment Outcome