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Anales Del Sistema Sanitario de Navarra 2004Traditional sclerotherapy with liquid sclerosants has been used for many years in the treatment of venous, lymphatic and low flow vascular malformations; it is efficient... (Review)
Review
Traditional sclerotherapy with liquid sclerosants has been used for many years in the treatment of venous, lymphatic and low flow vascular malformations; it is efficient only with those vascular malformations of reduced size as a pre or post-operational complement. The use of liquid sclerosants has the limitations of their dilution and progressive inactivation in a great haematic volume, the irregular distribution of the sclerosant on the endothelium, the handling of the sclerosant once injected and its imperceptibility to the echo-Doppler. In their turn, both ethanol and sodium morrhuate - the most habitually employed sclerosants - produce important secondary effects. On the contrary, the use of sclerosants, specifically polidocanol in microfoam form, significantly improves the procedure, since the microfoam displaces the blood instead of mixing and diluting itself in it, thus facilitating an homogeneous distribution of the sclerosant over the endothelial surface. Finally, the echogenicity of the microbubbles, which makes them directly visible, together with their manageable consistency, means that it can be distributed more easily throughout the treated area. We comment on our experience with 50 patients with venous or low flow vascular malformations, treated with this new form of sclerosant. Similarly, the use of OK-432 (picibanil) - as the recommended sclerosant treatment in lymphatic vascular, especially macrocystic, malformations - is reviewed and its protocol given.
Topics: Blood Vessels; Humans; Lymphatic System; Picibanil; Sclerosing Solutions; Sclerotherapy
PubMed: 15148517
DOI: No ID Found -
Acta Medica Okayama Dec 1980The effect of Picibanil, a streptococcal agent, on the development of liver injury after operations for urogenital cancer was studied retrospectively in the light of...
The effect of Picibanil, a streptococcal agent, on the development of liver injury after operations for urogenital cancer was studied retrospectively in the light of serum alanine aminotransferase (ALT) activity. The series comprised 32 cases receiving Picibanil and 33 controls with otherwise comparable clinical backgrounds. Picibanil reduced the incidence of postoperative ALT rise over 50 U/l within 6 weeks but increased it thereafter. The increase in ALT activity after 6 weeks was relatively small and was seen more often in patients given blood transfusions. It was interpreted as retardation and suppression of ALT rise and as being related to the induction of interferon or to immunopotentiation. Other antihepatotoxic effects of Picibanil, due to its antioxidant activity, for example, may also account for the prevention of the early postoperative rise in ALT activity.
Topics: Adult; Aged; Alanine Transaminase; Biological Products; Female; Humans; Liver Diseases; Male; Middle Aged; Picibanil; Postoperative Period; Urogenital Neoplasms
PubMed: 6451146
DOI: 10.18926/AMO/30526 -
Otolaryngologia Polska = the Polish... Jun 2021<b>Introduction:</b> Recurrent thyroglossal duct cyst after surgery is not a rare condition and first-line treatment has not been established...
<b>Introduction:</b> Recurrent thyroglossal duct cyst after surgery is not a rare condition and first-line treatment has not been established yet.<br/><br/> <b>Aim:</b> Evaluation of outcomes and complications of OK-432 treatment in patients with recurrent thyroglossal duct cyst after surgery. <br/><br/> <b>Material and methods:</b> This study is designed as a case series with planned data collection at Tohoku Medical and Pharmaceutical University and Fukase Clinic. Five patients with recurrent thyroglossal duct cyst after surgery received this therapy between January 2014 and February 2020 on an outpatient basis, without hospitalization. OK-432 solution was injected into the lesion using an 18- or 27-gauge needle, depending on the location and size of the lesion, as well as on possible complications.<br/> <br/> <b>Results:</b> Lesions showed marked reduction or total shrinkage in all patients, with no local scarring or deformity at the injection site. Side effects manifested as local pain at the site of injection and fever (37.5-38.5°C) observed in three patients, but the symptoms resolved within a few days.<br/> <br/> <b>Conclusions:</b> Since OK-432 therapy is simple, easy, safe and effective, it can be used as an alternative to surgery in the treatment of recurrent thyroglossal duct cyst after surgery.
Topics: Child; Humans; Picibanil; Thyroglossal Cyst
PubMed: 35175217
DOI: 10.5604/01.3001.0014.9073 -
Acta Oto-laryngologica May 2021Ranula is a rare benign cystic lesion in the floor of the mouth, which can herniate through the mylohyoid muscle and become a plunging ranula. Treatment for ranulas is... (Randomized Controlled Trial)
Randomized Controlled Trial
BACKGROUND
Ranula is a rare benign cystic lesion in the floor of the mouth, which can herniate through the mylohyoid muscle and become a plunging ranula. Treatment for ranulas is currently surgical excision of the sublingual gland. Sclerotherapy with OK-432 is a well-established treatment of lymphatic malformations, but not yet thoroughly evaluated on ranulas. Objectives: To evaluate sclerotherapy of ranulas with OK-432 in a randomized double-blinded trial.
MATERIALS AND METHODS
20 patients with plunging or intraoral ranula were randomized to two double-blinded injections with OK-432 or saline. Effect on the ranula and evaluation of symptoms and QOL were investigated.
RESULTS
Treatment response differed significantly between OK-432 and placebo, = .041(student's T-test). All patients with intraoral ranulas had a complete response, but only 1/4 of the patients with plunging ranula. The inflammatory reaction after injection with OK-432 caused a mild to moderate impact on QOL. No serious complications were observed.
CONCLUSION
This study suggests that sclerotherapy with OK-432 in ranula is a very effective treatment for intraoral ranulas, but possibly less useful in plunging ranulas.
SIGNIFICANCE
This is a limited study, but we believe that sclerotherapy with OK-432 should be recommended as primary treatment at least for intraoral ranulas.
Topics: Adolescent; Adult; Antineoplastic Agents; Child; Double-Blind Method; Female; Humans; Injections, Intralesional; Male; Middle Aged; Picibanil; Prospective Studies; Ranula; Sclerotherapy; Young Adult
PubMed: 33775200
DOI: 10.1080/00016489.2021.1889660 -
Journal of Pediatric Surgery May 2022Sclerotherapy is frequently employed in treating lymphatic malformations (LMs), and multiple agents, practitioners and strategies exist. This review investigates the...
PURPOSE
Sclerotherapy is frequently employed in treating lymphatic malformations (LMs), and multiple agents, practitioners and strategies exist. This review investigates the reported efficacy and safety of sclerosants in the pediatric population.
METHODS
Adhering to PRISMA guidelines, multiple databases were queried without linguistic or temporal restriction. Inclusion criteria were patients aged 0-18 exclusively receiving injection sclerotherapy for the treatment of LMs with follow-up data. Data abstracted included agent, dose, anatomic site and key outcome measures including complications (major/minor) and resolution rates (>95% reduction in volume). Critical appraisal was undertaken using the MINORS tool.
RESULTS
Forty-eight studies met the inclusion criteria with a mean MINORS score of 0.65 ± 0.08. Included studies yielded 886 patients, across nearly 30 years. The overall observed rate of success was 89%, with variable follow-up across publications (6 weeks - 10 years). Most reported LMs were macrocystic (82%) and had a higher resolution rate than mixed/microcytic variants (89%, 71%, 34%, p<0.01) For head/neck LMs, rates of complete regression for OK-432, bleomycin, and doxycycline were 67% ± 27% (n = 26), 91% ± 53% (n = 34) and 85% ± 16% (n = 52) respectively. Major complications were most commonly reported with OK-432, including airway compromise or subsequent operation.
CONCLUSIONS
In pediatric patients treated for LM by sclerotherapy, complication rates were low. Macrocystic lesions respond well but success rates were modest at best for microcystic disease. Differences in agent utilization were noted between high and low resourced contexts; despite its lack of federal approval, OK-432 was the most reported agent. Further prospective research is warranted. LOE: 3a.
Topics: Child; Humans; Infant; Lymphatic Abnormalities; Neck; Picibanil; Retrospective Studies; Sclerosing Solutions; Sclerotherapy; Treatment Outcome
PubMed: 35151497
DOI: 10.1016/j.jpedsurg.2021.12.056 -
Obstetrics and Gynecology May 2007To evaluate OK-432, a preparation of Streptococcus pyogenes, in the treatment of early fetal chylothorax.
OBJECTIVE
To evaluate OK-432, a preparation of Streptococcus pyogenes, in the treatment of early fetal chylothorax.
METHODS
A prospective study of all fetuses (n=7) with persistent early chylothorax (gestational ages 16-21 weeks) referred to the tertiary center of fetal medicine in Denmark in 2003-2005. Fetuses were injected with 0.2-1.0 mg of OK-432 into the pleural cavity. The treatment was repeated if there were persistent or increasing pleural effusions after 1-3 weeks. The main outcome measures included remission of pleural effusions and fetal and infant morbidity and mortality.
RESULTS
Total remission of pleural effusions was obtained in all fetuses after one or two intrapleural injections of OK-432. No adverse effects of the treatment were observed. No fetus developed hydrops, and all experienced an uncomplicated third trimester. All children were born healthy without pleural effusions, lung hypoplasia, or hydrops.
CONCLUSION
Persistent early chylothorax is a condition with a high mortality rate and no established treatment option. Use of OK-432 is a promising therapy for selected fetuses with persistent chylothorax early in the second trimester.
Topics: Antineoplastic Agents; Chylothorax; Female; Fetal Diseases; Humans; Picibanil; Pregnancy; Pregnancy Outcome; Pregnancy Trimester, Second
PubMed: 17470587
DOI: 10.1097/01.AOG.0000259907.91973.69 -
Archives of Disease in Childhood Apr 2000Over a period of seven years, 15 patients (aged from birth to 15 years; median 22 months) with lymphangioma were treated with OK-432; they received a mean of three...
Over a period of seven years, 15 patients (aged from birth to 15 years; median 22 months) with lymphangioma were treated with OK-432; they received a mean of three injections each. Ten received OK-432 as first line treatment; five were treated after surgery (three had a residual lymphangioma after incomplete removal and two had a late recurrence). OK-432 proved to be effective for primitive as well as for residual and recurrent lymphangioma. Seven cases were macrocystic; complete regression was obtained in all. Five cases were microcystic: two had more than 50% regression, and three less than 50%. Three cases were mixed, with both large and microscopic cysts: one had more than 50% regression, and two less than 50%. These last two cases underwent surgery after the sclerosing treatment. The results obtained were excellent in 100% of macrocystic cases; a shrinkage in size was obtained in all microcystic cases. OK-432 is therefore proposed as a first line option for treatment of lymphangiomas.
Topics: Adolescent; Antineoplastic Agents; Child; Child, Preschool; Head and Neck Neoplasms; Humans; Infant; Infant, Newborn; Lymphangioma; Picibanil; Radiography; Sclerotherapy
PubMed: 10735841
DOI: 10.1136/adc.82.4.316 -
Cancer Chemotherapy and Biological... 1999
Review
Topics: Antibodies, Monoclonal; Humans; Immunologic Factors; Mycobacterium bovis; Neoplasms; Picibanil; Proteoglycans
PubMed: 10800485
DOI: No ID Found -
Cancer Detection and Prevention.... 1987Picibanil (OK432), a pharmaceutical preparation of a low virulent Su strain of Streptococcus pyogenes, possesses cell regulatory activity particularly in its ability to...
Picibanil (OK432), a pharmaceutical preparation of a low virulent Su strain of Streptococcus pyogenes, possesses cell regulatory activity particularly in its ability to augment natural killer (NK) cell activity and to activate macrophages to exert a tumoricidal effect both in vitro and in vivo. It is effective in retarding and/or inhibiting the growth of three different tumors: MBL-2 lymphoma, M109 alveolar adenocarcinoma, and B16 melanoma. The antitumor effect is mediated through regulation of NK cells and macrophages, possibly by its ability to stimulate the production and secretion of interferon and interleukin 1 and 2. It is a very effective adjuvant for tumor cell vaccines that elicit cytotoxic T-cell responses. Following cytoreductive chemotherapy (Cytoxan) Picibanil treatment leads to an earlier reconstitution of both bone marrow cellularity and differentiation to granulocyte-macrophage colonies.
Topics: Animals; Biological Products; Bone Marrow Cells; Cell Line; Colony-Forming Units Assay; Cyclophosphamide; Cytotoxicity, Immunologic; Hematopoietic Stem Cells; In Vitro Techniques; Killer Cells, Natural; Macrophage Activation; Male; Melanoma, Experimental; Mice; Mice, Inbred BALB C; Mice, Inbred C57BL; Picibanil; Poly I-C; Polylysine
PubMed: 3480058
DOI: No ID Found -
European Archives of... Apr 2003A 36-year-old man was admitted who had a 2-month history of swelling of the right submandibular area and the right side of the mouth floor. He had undergone operations...
A 36-year-old man was admitted who had a 2-month history of swelling of the right submandibular area and the right side of the mouth floor. He had undergone operations for right plunging ranula with a lesion on the floor of the mouth twice 7 years ago. Under fluoroscopic guidance, the contents of the cyst were aspirated as much as possible and injected with the same amount of OK-432 solution (Picibanil 0.1 mg; 10 ml) twice with 3-week intervals. Examination after 6 weeks showed that the cystic mass seen before therapy had disappeared completely, and no recurrence was encountered after 1 year. We here report a case in which a successful sclerotherapy with OK-432 for recurrent plunging ranula after surgery was performed.
Topics: Adult; Antineoplastic Agents; Humans; Male; Picibanil; Ranula; Recurrence; Sclerosing Solutions; Sclerotherapy
PubMed: 12709809
DOI: 10.1007/s00405-002-0482-x