Kenalog
[The clinical application of triamcinolone to accelerate soft tissue expansion]

[Article in Chinese]

Liu W, Ji Y, Yang P.

Plastic Surgery Hospital of Chinese Academy of Medical Sciences, Beijing 100041.

OBJECTIVE: To speed up the expansion procedure. METHODS: Triamcinolone was injected during tissue expansion in 26 cases. RESULTS: The study proved that triamcinolone shortened the injection interval to 32 +/- 6 hours. The mean time of full expansion was shortened to 20 +/- 5 days in the experimental group. The injection interval and mean time of full expansion were 6 +/- 2 days and 42 +/- 8 days respectively in the control group (P < 0.01). The immediate retraction ratios of expanded skin of the two groups were 17% and 26% respectively. CONCLUSION: This new method is feasible in clinical application.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11263314&dopt=Abstract triamcinolone Kenalog



Kenalog
Complications of fluoroscopically guided interlaminar cervical epidural injections.

Botwin KP, Castellanos R, Rao S, Hanna AF, Torres-Ramos FM, Gruber RD, Bouchlas CG, Fuoco GS.

Florida Spine Institute, Clearwater, FL, USA.

OBJECTIVES: To assess the incidence of complications of fluoroscopically guided interlaminar cervical epidural injections. DESIGN: A retrospective cohort design study. SETTING: A multidisciplinary spine care center. PARTICIPANTS: One hundred fifty-seven consecutive patients with cervical radicular pain caused by cervical spondylosis or herniated nucleus pulposus confirmed by magnetic resonance imaging or computed tomography scanning. INTERVENTIONS: Fluoroscopically guided interlaminar cervical epidural injections were performed at the C7-T1 or C6-7 level using an 18-gauge, 9-mm Tuohy needle with 2mL of 1% lidocaine (Xylocaine) and 80-mg of triamcinolone acetonide (Kenalog). All injections were performed consecutively over a 12-month period by 1 of 5 physicians. MAIN OUTCOME MEASURES: An independent observer reviewed medical charts, which included a 24-hour postprocedure telephone call by an ambulatory surgery center nurse who asked a standardized questionnaire about complications after the injections. Also reviewed were physician notes regarding office follow-up consultations 3 weeks or less after the injections and epidurograms. RESULTS: The charts of 157 patients, who received 345 injections, were reviewed. Complications per injection included 23 increased neck pain (6.7%), 16 transient nonpositional headaches that resolved within 24 hours (4.6%), 6 episodes of insomnia the night of the injection (1.7%), 6 vasovagal reactions (1.7%), 5 facial flushing (1.5%), 1 fever the night of the procedure (0.3%), and 1 dural puncture (0.3%). The incidence of all complications per injection was 16.8%. CONCLUSIONS: Because all complications resolved without morbidity and no patient required hospitalization, fluoroscopically guided interlaminar cervical epidural injections may be a safe procedure for use in patients with cervical radicular pain.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=12736872&dopt=Abstract triamcinolone Kenalog



Kenalog
[Treatment of therapy refractory chronic otitis externa by local injection of triamcinolone acetate crystalline suspension. Initial experiences]

[Article in German]

Stuck BA, Riedel F, Hormann K.

Universitats-Hals-Nasen-Ohrenklinik, Klinikum Mannheim, 68135 Mannheim. boris.stuck hno.ma.uni-heidelberg.de

BACKGROUND AND OBJECTIVE: External otitis is characterized by otalgia, otorrhea, itching, and hearing loss. Treatment usually consists of local application of corticosteroids and antibiotics. Chronic external otitis is accompanied by thickening of the skin in the external auditory channel. This reduces the effect of the applied substances. Local injection of suitable drugs may support the conservative treatment. The aim of the study was to evaluate the efficacy of local injection of triamcinolone acetonide in the external auditory channel. PATIENTS/METHODS: Thirteen patients with external otitis resistant to conservative treatment received an injection of triamcinolone acetonide in the external auditory channel. The improvement achieved was assessed by clinical examination and questionnaires. RESULTS: The symptoms improved substantially in all patients; most of the patients were cured completely. CONCLUSIONS: Our results demonstrate that local injection of triamcinolone acetonide is effective in the management of chronic external otitis.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11320622&dopt=Abstract triamcinolone Kenalog



Kenalog
Temporomandibular joint osteoarthrosis. Histopathological study of the effects of intra-articular injection of triamcinolone acetonide.

Haddad IK.

Department of Oral and Maxillofacial Surgery, King Hussein Medical Center, Royal Medical Services, Amman, Jordan. Fax: +962 (6) 533 1362 e-mail: hadaesa55 hotmail.com

OBJECTIVE: The aim of this study was to investigate the histopathological changes of human temporomandibular joint osteoarthrosis following intra-articular injection of triamcinolone acetonide, and compare the results to these of control group. METHODS: One hundred and forty nine patients who complained of temporomandibular joint dysfunction underwent non-surgical treatment for at least 6 months. Twenty three patients had high condylectomy as a treatment. Forty four patients received two intra-articular injections of triamcinolone acetonide. Histological study was carried out on 44 specimens from 41 patients, the histological changes were recorded for each specimen. RESULTS: Patients who received temporomandibular intra-articular injection of triamcinolone acetonide showed damage to the fibrous layer (100%), to the cartilage (64%) and to the bone (42%). In those cases treated by condylectomy there were changes in the fibrous layer (100%), in the cartilaginous layer (68%) and to the bony layer (32%). Analysis of the results showed that the changes seen in the steroid (triamcinolone acetonide) group were more obvious than the changes in the non-steroid group. CONCLUSION: The result of this study indicated that intra-articular injection of steroid (triamcinolone acetonide) into human osteoarthritic temporomandibular joints acts as a lytic agent.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11500733&dopt=Abstract triamcinolone Kenalog



Kenalog
Patch testing with serial dilutions of budesonide, its R and S diastereomers, and potentially cross-reacting substances.

Isaksson M, Bruze M, Lepoittevin JP, Goossens A.

Department of Occupational and Environmental Dermatology, Malmo University Hospital, Malmo, Sweden.

BACKGROUND: Budesonide, a marker for corticosteroid allergy, is a 1:1 mixture of 2 diastereomers, the R and S, present in all commercial formulations. Budesonide is said to cross-react with group B substances through the R and S diastereomer and some group D substances only through the S diastereomer. OBJECTIVE: To investigate the cross-reactivity pattern between the R and S diastereomers and 4 potentially cross-reacting substances, 2 from group B and 2 from group D. METHODS: By patch testing 10 patients hypersensitive to budesonide with a serial dilution of budesonide, the R and S diastereomer, triamcinolone acetonide, amcinonide, prednicarbate, and hydrocortisone-17-butyrate. RESULTS: Nine of 10 patients reacted to budesonide and the S diastereomer. Seven of 9 to the R diastereomer. Each of the 9 patients with S diastereomer allergy reacted to the group B and/or group D substances. Five patients reacted to triamcinolone acetonide, not to 1.0% but only to 0.0010% and 0.00010%. CONCLUSION: The R and S diastereomers can induce positive patch test reactions in budesonide-hypersensitive individuals. The potential of budesonide to cross-react with substances from group B and D might be explained by the presence of the 2 diastereomers. When patch testing with triamcinolone acetonide, much lower concentrations than recommended should be used. Copyright 2001 by W.B. Saunders Company

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11526524&dopt=Abstract triamcinolone Kenalog



Kenalog
[Study on type I and type III procollagen mRNA and in situ collagen proteins expressions in hypertrophic scars after intralesional Kenalog treatment]

[Article in Chinese]

Xu S, Guan B, Bao W.

Research Centre of Plastic Surgery, Third Clinical School of Beijing Medical University, Beijing 100083, PR China.

OBJECTIVE: This is to investigate the mechanism of effects of Kenalog on type I and III collagen syntheses and degradation in hypertrophic scars. METHODS: Intralesional injection of Kenalog was performed on 6 patients with hypertrophic scars. On the 3rd day and 7th day after the treatment, 6 samples from the 6 patients each were collected and type I and III collagen proteins and in situ procollagen mRNA expressions were studied by means of immunohistochemistry and molecular biology. RESULTS: On the 7th day after intralesional injection of Kenalog, type I collagen proteins reduced (P < 0.05) and type III collagen proteins did not reduced significantly (P > 0.05). On the 3rd day after intralesional injection of Kenalog, both type I and type III procollagen mRNA expressions were significantly inhibited and on the 7th day both procollagen mRNA expressions decreased further. CONCLUSIONS: Intralesional Kenalog may inhibit type I procollagen mRNA expression more than type III. Gene expressive intensions of type I and III procollagen were higher in hypertrophic scars than in normal skin.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=11593681&dopt=Abstract triamcinolone Kenalog