Kenalog
Local steroid therapy in cutaneous hemangiomas.

Gangopadhyay AN, Sharma SP, Gopal SC, Gupta DK, Panjawani K, Sinha JK.

Division of Pediatric Surgery and Plastic Surgery, Banaras Hindu University, Varanasi.

OBJECTIVES: To evaluate the efficacy of intralesional triamcinolone in enhancing regression in various type of hemangiomas. SETTING: Outpatients department of a teaching hospital Subjects: One hundred and five patients with rapidly growing surface hemangioma. The age ranged from 1 month to 15 months (mean 7 months). INTERVENTION: Intralesional triamcinolone administered at monthly intervals, ranging from single injection to 7 injections (mean 3.6 injections). MAIN OUTCOME MEASURE: Regression of the hemangioma. RESULTS: The overall response rate was 88.6% (excellent 51.4%, and good 37.2%). Maximum response was observed in children below 1 year of age (> 90%), lesions over the face (92.8%) and strawberry hemangiomas (99.9%). CONCLUSION: Intralesional administration of triamcinolone devoid of systemic side effects and an effective initial modality for rapidly growing hermangiomas.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8772948&dopt=Abstract triamcinolone Kenalog



Kenalog
Steroid-regulated growth of DDT1MF-2 cells is profoundly influenced by culture conditions.

Lamb DJ, Ray M.

Scott Department of Urology, Baylor College of Medicine, Houston, Texas 77030, USA.

DDT1MF-2 cells provide an ideal model for studying tumor-growth-stimulation by steroids. These cells progress to a rapidly proliferating, androgen-independent state after prolonged culture without androgen. After brief culture in different lots of fetal bovine serum (FBS), some lots induced a permanent state of hormone-independence in cells that had been androgen-responsive. To test the hypothesis that factors influenced androgen-responsive growth even after removal of serum, hormone-responsive DDT1MF-2 cells (7000 cells/well) were plated in medium Dulbecco's Modified Eagle Medium/F-12 Nutrition Mixture (1:1)/1% ITS with (a) 0.1% FBS, (b) 0.1% NuSerum (c) 0.1% Hyclone, or (d) MCDB-110/0.1% ITS with 5 ng/ml bFGF. On Days 2-8, medium was replaced with D-MEM/F12/ITS with 10 nM testosterone (T), 10 nM triamcinolone acetonide (TA), or ethanol (control) and the cells counted. While testosterone induced a 1.4-fold increase in cell growth after exposure to FBS or NuSerum, maximal testosterone effect (3-6-fold increase) was observed after Hyclone. Hydroxyflutamide antagonized the fivefold increase in growth observed with testosterone, with a slight decrease of growth with cAMP for cells plated in Hyclone. Androgen-independent cells were unaffected by testosterone, hydroxyflutamide, or 8Br-cAMP [medium (a)]. Maximal inhibition by triamcinolone acetonide (0.25 of control) was observed with medium (d). The effect of testosterone and triamcinolone acetonide on secretion of mitogenic activity into conditioned medium was also evaluated. Although conditioned media from control and testosterone-treated cells were mitogenic in a dose-dependent manner, the media from cells treated with triamcinolone acetonide and testosterone+TA conditioned medium was not mitogenic--but, of note, it was not growth inhibitory.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8826092&dopt=Abstract triamcinolone Kenalog



Kenalog
Simultaneous determination of triamcinolone acetonide and hydrocortisone in human plasma by high-performance liquid chromatography.

Doppenschmitt SA, Scheidel B, Harrison F, Surmann JP.

ACC, Analytical Clinical Concepts GmbH, Pfungstadt, Germany.

A validated HPLC method for the simultaneous determination of triamcinolone acetonide and hydrocortisone has been established to monitor the plasma levels of the compounds in healthy volunteers following intramuscular (i.m.) administration of triamcinolone acetonide. Plasma (1.0 ml) was extracted with dichloromethane after addition of the internal standard, fluocortolone. The compounds were separated using a LiChrospher RP 18 column and detected by UV absorbance. Specificity, linearity, as well as the repeatability, intermediate precision and accuracy of the method were established. The limit of quantification was 0.6 ng/ml for triamcinolone acetonide (C.V. = 8.7%, R.E. = 2.6%, n = 6) and 2.0 ng/ml for hydrocortisone (C.V. = 8.3%, R.E. = 2.8%, n = 6). Data on the stability of triamcinolone acetonide in human plasma are presented. Recovery of the compounds and the internal standard have been studied. The results of quality control samples (n = 126) determined during routine analysis of volunteer samples are described. Plasma levels of triamcinolone acetonide after i.m. administration of 40 mg of triamcinolone acetonide are presented.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8832428&dopt=Abstract triamcinolone Kenalog



Kenalog
Transdermal iontophoretic delivery of triamcinolone acetonide: a preliminary study in hairless rats.

Shigeki S, Murakami T, Kiyonaka G, Yata N, Ikuta Y.

Department of Orthopedic Surgery, Institute of Pharmaceutical Sciences, Hiroshima University School of Medicine, Japan.

Transdermal iontophoretic delivery of triamcinolone acetonide was examined using a commercially available iontophoretic system (Phoresor, Iomed) in hairless rats. A drug electrode containing triamcinolone acetonide 10 mg dissolved in 1 ml of N,N-dimethylacetamide and water (7/3 v/v) was connected to the positive pole of a Phoresor (set at 4 mA) and direct current was applied for 10, 30, or 90 minutes. The amount delivered to the skin tissues increased with time at a constant rate. Even after the drug electrode had been removed, triamcinolone acetonide was retained in the local skin tissues beneath where it had been for about 24 hours after 30 minutes iontophoresis. These results suggest that the iontophoresis with an organic solvent used as a drug vehicle is useful to increase transdermal absorption of compounds that do not dissolve completely in water.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8885011&dopt=Abstract triamcinolone Kenalog



Kenalog
Regulation of rat hepatic sulfotransferase gene expression by glucocorticoid hormones.

Runge-Morris M, Rose K, Kocarek TA.

Institute of Chemical Toxicology, Wayne State University, Detroit, MI 48201, USA.

Because hormones have been implicated in the molecular regulation of the sulfotransferase multigene family, the effects of glucocorticoid and antiglucocorticoid hormones on rat hepatic hydroxysteroid sulfotransferase-a and aryl sulfotransferase IV gene expression were investigated in vivo and in primary rat hepatocyte culture. Adult male Sprague-Dawley rats were treated for three consecutive days with 2% Tween-20 vehicle, or 100 mg/kg of dexamethasone, betamethasone, hydrocortisone, or triamcinolone acetonide. Betamethasone and triamcinolone acetonide significantly increased hepatic aryl sulfotransferase IV mRNA to levels that were approximately 252% and approximately 452% of control, respectively. Dexamethasone significantly increased hydroxysteroid sulfotransferase-a mRNA and protein to levels that were approximately 150% and approximately 316% of control, respectively. In contrast, in vivo treatment with hydroxysteroid sulfotransferase-a substrate dehydroepiandrosterone significantly decreased hydroxysteroid sulfotransferase-a mRNA levels (by approximately 55% relative to control). To determine if glucocorticoid mediated changes in sulfotransferase expression occurred as a result of direct effects on the hepatocyte, studies were performed in primary rat hepatocyte culture. Triamcinolone acetonide and betamethasone increased sulfotransferase mRNA expression in hepatocyte culture and hydrocortisone proved to be a less effective inducer. Effects of glucocorticoids on sulfotransferase gene expression were compared with glucocorticoid effects on tyrosine aminotransferase expression, a gene known to be regulated by a classical glucocorticoid receptor-mediated mechanism. Dexamethasone produced maximal increases in aryl sulfotransferase IV and tyrosine aminotransferase mRNA levels when added to culture medium at a concentration of 10(-7) M, whereas hydroxysteroid sulfotransferase-a mRNA levels continued to increase through a dexamethasone concentration of 10(-5) M. Treatment of hepatocytes with the antiglucocorticoid RU-486 (10(-5) M) inhibited dexamethasone-stimulated aryl sulfotransferase and tyrosine amino-transferase mRNA expression by approximately 48% and approximately 35%, respectively, but had less effect on hydroxysteroid sulfotransferase mRNA expression. These results suggest that glucocorticoids regulate rat hepatic aryl sulfotransferase IV and hydroxysteroid sulfotransferase-a via classical glucocorticoid receptor-mediated and non-classical mechanisms, respectively.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8894510&dopt=Abstract triamcinolone Kenalog



Kenalog
Particle size and drug interactions of injectable corticosteroids used in ophthalmic practice.

Francis BA, Chang EL, Haik BG.

Tulane University, Department of Ophthalmology, New Orleans.

PURPOSE: The aim of this study is to compare the particle sizes of commercially available corticosteroids for intralesional injection to manufacturers' specifications and to evaluate changes in size when mixed with other steroids and other commonly used solutions. METHODS: The particle sizes of dexamethasone sodium phosphate, methylprednisolone acetate, triamcinolone acetonide, and betamethasone sodium phosphate and beta-methasone acetate were measured with the Coulter counter. Each steroid was mixed with each of the others, lidocaine, and lidocaine with epinephrine, then measured immediately and after 1 hour to determine the effect on particle size. RESULTS: All steroids showed accurate manufacturer specifications. Dexamethasone showed an increase in particle size when mixed with lidocaine alone, immediately and after 1 hour. Triamcinolone showed an increase in particle size only after 1 hour after mixture with lidocaine alone. Triamcinolone, dexamethasone, and methylprednisolone particles increased in size when mixed with lidocaine and epinephrine. Dexamethasone and triamcinolone showed an additional increase in size when allowed to sit for 1 hour after mixture with lidocaine and epinephrine. Mixing steroids caused no increase in particle size. CONCLUSION: Because an increase in the number of particles greater than 20 microns in a solution also increases the likelihood of vascular occlusion, the authors urge care in the mixing of these drugs, especially with lidocaine and epinephrine. If mixture is necessary, the authors recommend that injection take place immediately subsequent.

Online source: www.ncbi.nlm.nih.gov/entrez/query.fcgi?cmd=Retrieve&db=PubMed&list_uids=8942886&dopt=Abstract triamcinolone Kenalog