There are two major types of vascular birthmarks, hemangiomas, those demonstrating endothelial hyperplasia, and malformation, those with normal endothelial turnover. Venous malformations have previously been treated by surgical excision, where possible. Although not a panacea for all such tumors, the use of sclerosing agents is decidedly preferable in some cases to extirpation with a scapel. The method involves the direct injection of absolute alcohol into the lesion on the fluoroscopic guide. The effect of treatment is satisfactory and there appears tobe no long term complication. We report 2 cases of surgically irresectable and deep-seated venous malformation which were treated sclerotherapy using ethanol.
Ethanol ; Hemangioma ; Hyperplasia ; Sclerosing Solutions ; Sclerotherapy*

OBJECTIVETo compare the effect of Sodium Morrhuate on ECV-304 between its lipo- and normal preparation.

METHODSThe ECV-304 cell line was supplemented with Sodium Morrhuate and lipo-Sodium Morrhuate in order, and the result on morphology (microscope, Giemsa Staining and electron microscope), cell activity (MTT), and flow cytometer between the two preparation were compared.

RESULTSIn normal preparation group, cell's edema occurred. Chromatin was like catkins. Tumefaction and degeneration of mitochondrion and endoplasmic reticulum appeared. In lipo-Sodium Morrhuate group, the membrane was creased and processus appeared. Chromatin aggregates to the membrane of nucleus was like crescent, and then broken. The apoptotic body was formed. MTT changes showed that the curve of the normal preparation group was steep and the change time was short relatively, which cues the vital cells decreased sharply. The curve of lipo-Sodium Morrhuate group was gentle and the change time was long relatively, which cues the vital cells decreased slowly. The flow cytometer showed that typical apoptosis peak appeared.

CONCLUSIONThe normal preparation group shows an acute toxic effect on ECV-304 cell line, which result in a necrosis course, while lipo-Sodium Morrhuate shows a gradual releasing process, which may indicate a apoptosis course.

BACKGROUND: Parenteral tetracycline is no longer available for pleural sclerosing agent for pleurodesis in Korea due to the discontinuation of the production. The purposes of this study were to determine whether oral doxycycline (ODC) could be used as an effective sclerosing agent for pleurodesis, and to compare the effectiveness of ODC to other agents, such as homologous blood and talc. MATERIAL AND METHOD: Twenty male rats were divided into four groups (A to D). Following agents were given to each group intrapleurally; 10 ml/kg of 0.9% saline to group A, 10 mg/kg of ODC to group B, 2 ml/kg of homologous blood to group C, and 70 mg/kg of talc slurry to group D. All animals were sacrificed 28 days after instillation. The pleural spaces were assessed grossly and microscopically and were graded from 0 to 3, and the thicknesses of the pleura were measured. RESULT: The gross score of group A was 0.0, group B was 1.4+/-0.9, group C was 1.0+/-0.7, and group D was 2.2+/-0.8. Significant adhesion were examined in group B and D grossly (p<0.05). The pleural thickness of group A was 0.7+/-0.2 /10(2) mm, group B was 1.2+/-0.4 /10(2) mm, group C was 1.4+/-0.4 /10(2) mm, and group D was 3.5+/-0.9 /10(2) mm. Group D showed pleural thickening significantly (p<0.05). The microscopic score of group A was 1.0, group B was 1.7+/-0.5, group C was 1.5+/-0.4, and group D was 2.8+/-0.4. Group B and D showed significant inflammations and depositions of collagen (p<0.05). CONCLUSION: ODC showed significant pleurodesis grossly and microscopically, and homologous blood did not show adhesion. Talc was a significant sclerosing agent for pleurodesis causing extensive inflammation and collagen depisotion.
Animals ; Collagen ; Doxycycline* ; Humans ; Inflammation ; Korea ; Male ; Pleura ; Pleurodesis ; Rats* ; Sclerosing Solutions* ; Talc* ; Tetracycline

The patients with prolonged air leak after lung resection surgery were generally treated by pleurodesis with sclerosing agents such as talc, tetracyclin, doxycyclin, bleomycin, vibramycin, and OK432. However, for the case like dead space resulted by incomplete reexpansion of the remaining lung, chemical pleurodesis has shown to be not as effective as expected. If the patients keep the chest tube for long period of time, the risk of thoracic empyema would increase. Most thoracic surgeons have experienced prolonged airleak which developed after lung resection. Pleurodesis with autoblood was reported as an effective method in treatment of patients with prolonged airleak. The mechanism of blood pleurodesis may be direct obliteration of BPF and reduction of dead space by clot. Therefore we successfully treated the two patients with prolonged airleak using the autoblood plus OK432 or vibramycin.
Bleomycin ; Chest Tubes ; Doxycycline ; Empyema, Pleural ; Humans ; Lung ; Picibanil ; Pleurodesis* ; Pneumothorax ; Sclerosing Solutions* ; Talc

Noncommunicating hydrocele in adult is the most frequently encountered mass of the scrotum. Traditionally surgery had been considered as the most effective method of treatment. Sclerotherapy, however, may provide an alternative means of treatment for patients who are poor surgical or anesthetic risks and those who refuse surgery. In recent years, a number of sclerosing agents including tetracycline have been introduced, but those were found to produce various kinds of complications or frequent recurrences. Alcohol was also proved to have sclerosing effect by Bean who used it in the treatment of simple renal cysts with good results. This study was designed to determine the feasibility of sclerotherapy with alcohol for noncommunicating hydroceles. 95% or 75% sterile alcohol and tetracycline were injected into the spaces of tunica vaginalis of male rats to produce fibrous adhesion. At second week after injection, There was no significant difference in successful adhesion rates between alcohol injection group (71.9%) and tetracycline injection group(75%). 95% alcohol seemed more effective than 75% alcohol. There was no specific change or damage in the testicular parenchyme or surrounding scrotal wall. This result suggests the clinical applicability of alcohol in the management of noncommunicatinghydroceles.
Adult ; Animals ; Ethanol* ; Humans ; Male ; Rats* ; Recurrence ; Sclerosing Solutions ; Sclerotherapy ; Scrotum ; Testis* ; Tetracycline

PURPOSE: To evaluate the effectiveness of foam sclerotherapy, we compared the clinical data and results of foam sclerotherapy with conventional sclerotherapy. METHOD: Ninety-three cases of varicose veins were retrospectively reviewed; these were treated by sclerotherapy from January 2000 to September 2005 (women: 82 cases, men: 12 cases, mean age: 43.7 years old). The enrolled cases were divided into the conventional sclerotherapy (CS) group (n=53) and the foam sclerotherapy (FS) group (n=40) according to the applied technique. We assessed the results with the disappearance scoring scale (DSS) and the satisfaction scoring scale (SSS). RESULT: In DSS, complete disappearance was reported as 28.3% by physicians and 30.2% by the patients in CS group and as 47.5% and 52.5% in the FS group, respectively. On the SSS, a satisfaction score scale above 3 (4: Good, 5: Very good) was reported for 79.1% in the CS group and 90.0% in the FS group, retrospectively. The average amounts of sclerosants used were significantly lower in the FS group (1.2+/-0.4 vials) than in the CS group (2.1+/-0.5 vials)(P=0.001). Post injection complications were retrospectively observed in 16.1% of all the patients, in 20.7% of the CS group and in 10.0% of the FS group. CONCLUSION: Sclerotherapy is a very effective and sufficient treatment for telangiectases or reticular varicose veins. Especially, foam sclerotherapy is more effective than conventional liquid sclerotherapy for the clinical results and the patient satisfaction, and it shows a with lower incidence of complications.
Humans ; Incidence ; Lower Extremity* ; Male ; Patient Satisfaction ; Retrospective Studies ; Sclerosing Solutions ; Sclerotherapy* ; Telangiectasis ; Varicose Veins*

PURPOSE: To evaluate the effectiveness of foam sclerotherapy, we compared the clinical data and results of foam sclerotherapy with conventional sclerotherapy. METHOD: Ninety-three cases of varicose veins were retrospectively reviewed; these were treated by sclerotherapy from January 2000 to September 2005 (women: 82 cases, men: 12 cases, mean age: 43.7 years old). The enrolled cases were divided into the conventional sclerotherapy (CS) group (n=53) and the foam sclerotherapy (FS) group (n=40) according to the applied technique. We assessed the results with the disappearance scoring scale (DSS) and the satisfaction scoring scale (SSS). RESULT: In DSS, complete disappearance was reported as 28.3% by physicians and 30.2% by the patients in CS group and as 47.5% and 52.5% in the FS group, respectively. On the SSS, a satisfaction score scale above 3 (4: Good, 5: Very good) was reported for 79.1% in the CS group and 90.0% in the FS group, retrospectively. The average amounts of sclerosants used were significantly lower in the FS group (1.2+/-0.4 vials) than in the CS group (2.1+/-0.5 vials)(P=0.001). Post injection complications were retrospectively observed in 16.1% of all the patients, in 20.7% of the CS group and in 10.0% of the FS group. CONCLUSION: Sclerotherapy is a very effective and sufficient treatment for telangiectases or reticular varicose veins. Especially, foam sclerotherapy is more effective than conventional liquid sclerotherapy for the clinical results and the patient satisfaction, and it shows a with lower incidence of complications.
Humans ; Incidence ; Lower Extremity* ; Male ; Patient Satisfaction ; Retrospective Studies ; Sclerosing Solutions ; Sclerotherapy* ; Telangiectasis ; Varicose Veins*

PURPOSE: To evaluate histopathologic change in the liver after injection of various kinds of sclerosants, andto thus determine whether 50% acetic acid, a new sclerosant, is suitable for percutaneous intrahepatic injection. MATERIALS AND METHODS: Four kinds of clinically available sclerosants were used : 50% acetic acid, 99% ethanol,10% phenol, and hot saline. Each group consisted of ten rats, and 0.1ml of each sclerosant was directly injectedinto the liver. After two days and one week, gross and histopathologic findings of resected liver in the area oftissue necrosis, as well as the degree of extrahepatic peritoneal adhesion, were assessed in each group. RESULTS:In all groups, the main pathologic changes were acute necrosis with inflammation after two days and secondaryregenerative fibrosis after week. In the 50% acetic acid injection group, the degree of necrosis was more severeand the mean diameter of the necrotic area was greater ; this latter was not, however, significantly wider than inthe 99% ethanol injection group, though was significantly wider than in the 10% phenol and hot saline injectiongroup. CONCLUSION: When used for percutaneous injection, 50% acetic acid, caused more tissue necrosis than 99%ethanol, 10% phenol, or hot saline. We therefore conclude that this acid may be useful for percutaneousintrahepatic injection of a hepatic tumor.
Acetic Acid* ; Animals ; Ethanol ; Fibrosis ; Inflammation ; Liver ; Necrosis ; Phenol ; Rats ; Sclerosing Solutions*

Renal cyst is a common renal disease. It rarely produces symptoms, and thus rarely require treatment. But the treatment is necessary when the cyst is symptomatic or complicated. The possible approach includes surgical unroofing or cyst puncture with or without intracystic injection of sclerosing agents. Thus we evaluated the efficacies of treatments in renal cystic disease. Cystic diseases were treated with percutaneous aspiration in 18 cases, percutaneous aspiration with sclerosing therapy in 26 cases. Overall efficacies were 22.2% with aspiration only and 95% with combined sclerosing therapy without no specific complications. Sclerosing therapy is relatively safe, less hazardous to the patient and shows high success rate in the treatment of cyst. We concluded that combined percutaneous cystic aspiration and sclerosing therapy was the best treatment of renal cystic disease. We assessed cystic fluid of 34 cases of simple renal cyst and 3 cases of polycystic kidney. The cystic fluid were analyzed for color, lipid profile, glucose, lactic acid dehydrogenase, amylase, electrolytes, culture and cell cytology. All aspirates of simple cyst were similar to composition of transudate. But aspirates of polycystic kidney were different from simple cyst.
Amylases ; Electrolytes ; Exudates and Transudates ; Glucose ; Humans ; Lactic Acid ; Oxidoreductases ; Polycystic Kidney Diseases ; Punctures ; Sclerosing Solutions ; Sclerotherapy

Injection of the tissue adhesive Histoacryl (N-butyl-2-cyanoacrylate, enbucrilate) has been more effective than conventional sclerosants in the treatment of active upper G-I bleeding. Histoacryl is an effective sclerosant that is polymerized immediately after contact with blood, and has been used for the treatment of bleeding gastric and esophageal varices. We present here a case of infarction of the caudate lobe that developed after an injection of a Histoacryl -Lipiodol mixture for the hemostasis of duodenal ulcer bleeding.
Duodenal Ulcer* ; Enbucrilate* ; Esophageal and Gastric Varices ; Hemorrhage* ; Hemostasis ; Infarction* ; Liver* ; Polymers ; Sclerosing Solutions ; Tissue Adhesives