Injection Of 5-fluorouracil Research Articles

Cryoblebbing with 5-fluorouracil versus cryoblebbing with melanocyte keratinocyte transplant procedure or cryoblebbing alone in treatment of stable vitiligo.

Both the surgical non-cultured melanocyte-keratinocyte transplant procedure (MKTP) and intradermal injection of 5-Fluorouracil (5-FU) are effective in the treatment of vitiligo. Intrablisters injection of MKTP was done in one study with better results than MKTP application after ablative CO2 laser of the reciepient area. However, intrablister injection of 5-FU was not done before. To compare the efficacy of 5-FU, MKTP after preparation of the recipient site by cryoblebing in the treatment of stable vitiligo. Treatment efficacy was evaluated clinically, histopathologically, and immunohistochemically. This prospective, single-blinded, randomized comparative study included 20 patients with stable vitiligo in 128 areas. The recipient sites were prepared by cryoblebbing. The blisters were injected with either a suspension of MKTP in area A (MKTP group, 49 areas), 5-FU in area B (5-FU group, 48 areas) or left without injection in area C (control group, 31 areas). The assessment was performed 6months after the procedure based on the percentage of repigmentation, histopathologically and immunohistochemically for the pigmented lesions. Six months after treatment, the mean percentage change in repigmentation was 82.96% ± 31.46% in the MKTP group, 44.79% ± 39.38% in the 5-FU group, and 28.23% ± 24.00% in the control group.The median of the percent change was 100%, 37.5% and 25% in MKTP group, 5-FU group and control group, respectively, with a significant difference (P < 0.001) between the groups. After treatment, H&E-stained sections from the repigmented lesions showed the reappearance of melanocytes (MCs) and melanin pigmentation, especially in the MKTP group followed by 5-FU. Immunohistochemical staining revealed large MCs with an increased density of reactions and dendricity with positive expression of Melan A, and HMB45 especially in the MKTP and 5-FU groups. Intrablister injection with 5-FU appears to be effective for the management of stable vitiligo with less efficacy than MKTP.

Microneedle drug delivery system based on hyaluronic acid for improving therapeutic efficiency of hypertrophic scars.

Hypertrophic scar (HS) is a disease with excessive skin fibrosis and collagen disorder, which is generally caused by abnormal wound repair process after burn and trauma. Although intralesional injection of 5-fluorouracil (5-Fu) has been used in clinical treatment of HS, the patients' compliance of injection treatment is poor. In this study, a double-layer dissolution microneedle (MN) containing asiaticoside (AS) and 5-Fu was designed for the treatment of HS. Biological macromolecules materials affected the formability, drug release, and hardness of MNs. Therefore, several types of biomacromolecules, including hyaluronic acid (HA), chitosan, and sodium alginate, which could be used to prepare MNs, underwent prescription optimization experiments and the optimized MN prescriptions were obtained. In vitro characterization showed that the MN was sufficient to deliver drugs through the skin. Animal in vivo experiments showed that AS and 5-Fu can synergistically treat HS, significantly reduce the abnormal proliferation of fibroblasts and collagen fiber deposition, and down-regulated collagen I (Col I) and transforming growth factor-β1 (TGF-β1) expression. In conclusion, the micro-needle designed in this study has great prospects in the treatment of HS.

Effectiveness of stepwise progressive ultra-tension-reducing suture method in treatment of high-tension wounds on chest, back, and limbs

To investigate effectiveness of a novel suture method-stepwise progressive ultra-tension-reducing suture method in closing high-tension wounds on the chest, back, and limbs. A retrospective analysis was conducted on 25 patients with high-tension wounds on the chest, back, and limbs who were treated with stepwise progressive ultra-tension-reducing suture method between January 2022 and December 2022. Among the patients, there were 8 males and 17 females, with an average age of 30.5 years (range, 18-56 years). All wounds after scar or tumor resection were located on the chest, back, upper limbs, and lower limbs in 8, 6, 9, and 2 cases, respectively. The size of wounds ranged from 3.5 cm×2.8 cm to 40.0 cm×15.0 cm. All patients were advised to use topical silicone-based treatments postoperatively. The protrusion of the incision, the height of the protrusion, and the duration of the tension reduction effect were observed. The scar formation at the incision site at 6 months after operation was observed, the scar appearance was evaluated by Vancouver Scar Scale (VSS) score, and the scar width was measured. The patient's satisfaction and adverse reactions to incisions were also evaluated. The incisions significantly elevated, with a height of 0.3-2.5 cm, and the tension reducing effect lasted for 8.5-18.0 weeks after operation, with an average of 13.6 weeks. All incisons healed by first intention. One patient experienced transient hyperpigmentation, which resolved spontaneously. Three keloid patients showed localized redness postoperatively, and 2 experienced local recurrence, which improved significantly after treatment with triamcinolone, 5-fluorouracil injections, and laser therapy. All patients were followed up 6.0-13.5 months, with an average of 10.1 months. At 6 months after operation, all patients had linear scars, with VSS scores ranging from 1.0 to 3.5 (mean, 2.0). The width of the scars ranged from 0.5 to 3.0 mm (mean, 1.4 mm). The patients expressed satisfaction with the effectiveness. The stepwise progressive ultra-tension-reducing suture method for high-tension wounds can effectively reduce the tension at the wound edges, providing a prolonged tension-reducing effect and satisfactory effectiveness.

Use of Postoperative Radiotherapy and Multiple Adjuvant Treatments After Surgical Removal of a Giant Retroauricular Keloid ina Pediatric Patient.

The use of postoperative radiotherapy (PORT) for the treatment of keloids in the pediatric population is rare, despite being a common pathology at this age. Recurrences after surgery are very common. The absence of a standardized protocol for the management of recurrent keloids further complicates therapeutic decision-making. Here, we present a clinical case involving a recurrent giant retroauricular keloid in a pediatric patient, demonstrating a satisfactory response to a comprehensive approach involving surgery, PORT, and periodic injections of 5-fluorouracil with corticosteroid. We believe that reporting this case adds value as a potential therapeutic option in the absence of established protocols for recurrent keloids in pediatric patients.

Treatment of Alopecia Areata using Transdermal Delivery of 5-Fluorouracil by Fractional CO2 Laser versus Intralesional Injection of 5-Fluorouracil

Treatment of Alopecia Areata using Transdermal Delivery of 5-Fluorouracil by Fractional CO2 Laser versus Intralesional Injection of 5-Fluorouracil

Successful corneal endothelium preservation in the management of epithelial downgrowth with 5-fluorouracil injections and membranectomy

A 74-year-old Chinese man underwent extracapsular cataract extraction in his right eye and developed a translucent iris membrane 4 months later. He was treated with two intracameral 5-FU injections and membranectomy at 2 weeks apart. At one year following the second membranectomy, the patient maintained a clear cornea without residual or recurrent membrane, an endothelial cell density of 1072 cell/mm2, a visual acuity of 20/50 and a normal intraocular pressure. Our technique of using dispersive and cohesive viscoelastics in protecting the corneal endothelium from intracameral 5-FU, helped preserve corneal endothelial cells and maintain corneal clarity at one year after surgery.

Prediction of anti-gastric cancer effect of Panacis Quinquefolii Radix by network pharmacology and in vivo validation

This study investigated the anti-gastric cancer activity and mechanism of Panacis Quinquefolii Radix(Panax quinquefolium L.), and preliminarily compared the in vivo anti-gastric cancer efficacy of American-imported(JK-AG) and domestically produced(Shandong) Panacis Quinquefolii Radix decoctions(SD-AG). Based on network pharmacology predictions, a LUC-MGC803 cell ectopic gastric cancer nude mouse model was established. Mice were administered JK-AG and SD-AG at 1 g·kg~(-1) via gavage for 21 consecutive days. The positive control group received intraperitoneal injections of 5-fluorouracil(5-FU) at 20 mg·kg~(-1) every other day. Tumor volume was measured during the experiment. At the end of the experiment, high-resolution ultrasound imaging was used to measure tumor size, and an in vivo imaging system was used to observe tumor fluorescence expression. Tumor tissues were excised, weighed, and subjected to pathological histological examination. The terminal deoxynucleotidyl transferase-mediated nick end labeling(TUNEL) assay and TUNEL+caspase-1 fluorescence double staining were used to detect tissue apoptosis and caspase-1 expression. Immunohistochemistry(IHC), Western blot(WB), and quantitative real-time PCR(RT-qPCR) techniques were used to detect the expression of predicted key proteins and genes involved in apoptosis and pyroptosis in tumor tissues. Network pharmacology predictions indicated that Panacis Quinquefolii Radix had anti-gastric cancer activity, primarily due to its ginsenoside components. Apoptosis induced by tumor necrosis factor(TNF)-α activation and caspase-1 may be key molecular mechanisms of its anti-cancer effects. In in vivo anti-tumor studies, compared to the model group, JK-AG and SD-AG did not affect the body weight or organ indices of the mice, whereas 5-FU significantly reduced body weight(P&lt;0.05) and increased lung and liver indices(P&lt;0.05). The tumor inhibition rates of JK-AG and SD-AG were 29.76% and 27.97%, respectively, which were lower than that of 5-FU. However, both JK-AG and SD-AG significantly reduced tumor tissue fluorescence intensity and three-dimensional tumor volume(P&lt;0.05 or P&lt;0.01). HE staining results showed that the drug groups had larger areas of tumor tissue necrosis. TUNEL and TUNEL+caspase-1 fluorescence staining indicated that both groups induced tumor cell apoptosis and increased caspase-1 expression. Both JK-AG and SD-AG significantly increased the expression of cleaved-caspase-8 and cleaved-caspase-3 proteins in tumor tissues detected by IHC and WB, as well as the mRNA expression of TNF-α, caspase-8, and caspase-9 detected by PCR, while reducing B-cell lymphoma 2(Bcl-2) protein expression. IHC showed that SD-AG increased the expression of TNF-α, caspase-9, cleaved-caspase-9, and tumor necrosis factor receptor 1(TNFR1) proteins more significantly than JK-AG, and also increased the Bax/Bcl-2 ratio, whereas JK-AG increased Bax mRNA expression more significantly than SD-AG. Additionally, JK-AG and SD-AG significantly increased the expression of NLRP3, caspase-1, cleaved-caspase-1, Gasdermin D(GSDMD), cleaved-GSDMD, IL-18, Gasdermin E(GSDME), and GSDME-NT proteins and the mRNA expression of caspase-1 and GSDME. JK-AG increased cleaved-caspase-1 protein expression more significantly than SD-AG in WB analysis. At the same time, JK-AG increased the expression of GSDMD mRNA, which was significantly higher than that of SD-AG group. For GSDME-NT protein expression, SD-AG increased it more significantly than JK-AG. The above studies indicate that Panacis Quinquefolii Radix has anti-gastric cancer effects, and the efficacy of American and Shandong ginsengs is comparable. Their mechanisms are related to TNF-α-mediated extrinsic apoptosis pathways and the induction of pyroptosis. The sensitivity of their action targets varies between American and Shandong ginsengs.

Assessment of endobronchial chemotherapy in patients with bronchogenic carcinoma

BackgroundMalignant airway obstruction is commonly found in patients with lung cancer and is associated with significant morbidity and mortality. Relieving malignant obstruction may improve symptoms, quality of life, and life expectancy. The aim of the present work is to determine the efficacy of endobronchial intratumoral injection of 5-Fluorouracil as a chemotherapeutic agent in palliative care for patients with inoperable nonsmall-cell lung cancer (NSCLC).Patients and methodsA total of 30 patients diagnosed as inoperable advanced-stage NSCLC were included into this randomized prospective controlled comparative study and divided into two groups (group A: 15 patients received the conventional sessions of systemic chemotherapy only and group B: 15 patients received the conventional sessions of systemic chemotherapy in addition to two to three sessions of local endobronchial intratumoral chemotherapy using 5-fluorouracil). Patient characteristics, histology, airways infiltrated with the tumor, performance status, treatment cycles, complications, and therapeutic outcomes were evaluated. Tumor response was analyzed based on bronchoscopic evaluation performed on completion of the final treatment session.ResultsThere was no significant difference in the total objective response between patients who used systemic chemotherapy alone for treatment of advanced NSCLC and those who used systemic chemotherapy in addition to sessions of local chemotherapy using 5-fluorouracil that was injected intratumorally through bronchoscopy in multiple sessions.ConclusionWe concluded that endobronchial intratumoral chemotherapy using 5-fluorouracil is not an effective promising treatment approach for palliative treatment of patients with advanced malignant endobronchial NSCLC.

Clinical Impact of the Use of Ologen in Filtering Surgery Performed in Uncontrolled Glaucoma.

Introduction: To compare the efficacy and safety of trabeculectomy with a collagen matrix implant (Ologen®) versus trabeculectomy with mitomycin C (MMC) versus trabeculectomy with both Ologen® and MMC (OLO + MMC). Methods: This non-randomized study included 119 eyes of 101 patients with uncontrolled open-angle glaucoma who underwent trabeculectomy, either alone or combined with phacoemulsification. The data were initially recorded following a standard surgical protocol, using an electronic database with structured fields. The patients were divided into three groups: 44 received trabeculectomy with adjunctive MMC (MMC group), 34 received surgery with Ologen® (OLO group), and 41 received surgery with both Ologen® and MMC (OLO + MMC group). The main outcome measures were the change in intraocular pressure (IOP), change in number of medications needed, complete success rate (defined as IOP ≤ 20 mmHg and at least 20% IOP reduction without hypotensive medications), rate of complications, and rate of postoperative interventions. The follow-up period was 36 months. Results: IOPs significantly decreased (p = 0.01) in all groups across all study visits, decreasing from 19.8 ± 4.6 mmHg to 12.7 ± 4.2 mmHg in the MMC group, from 20.5 ± 4.7 mmHg to 13.9 ± 3.5 mmHg in the OLO group, and from 23.5 ± 6.1 mmHg to 13.1 ± 3.5 mmHg in the OLO + MMC group. After correcting for the baseline IOP, only the first two postoperative visits (first week and first month) showed a significantly greater IOP reduction in the OLO + MMC group. The number of hypotensive medications was significantly reduced from 3.1 ± 0.6 to 0.56 ± 1.1 in the MMC group, from 2.9 ± 0.4 to 0.83 ± 1.1 in the OLO group, and from 3.0 ± 0.6 to 0.45 ± 0.95 in OLO + MMC group, with no statistically significant differences among the groups (p = 0.57). The complete success rates were 63.6% in the MMC group, 67.6% in the OLO group, and 80.5% in the OLO +MMC group, with no statistically significant differences between the groups (p = 0.21). Suture release was significantly more frequent in the MMC group (86.1%) than in the OLO group (62.1%) and in the OLO + MMC group (45.9%; p = 0.02). Bleb needling, with (33.3%; p = 0.005) or without (66.7%; p = 0.0001) 5-fluorouracil injection (5-FU), was significantly more common in the MMC group. The highest complete success rate (61%) was observed in the OLO + MMC group. Conclusions: The use of Ologen® and mitomycin C provided similar surgical IOP reduction in glaucoma surgery compared with either MMC or Ologen® alone, but significantly reduced the need for postoperative interventions.

Keratoacanthoma

ABSTRACTKeratoacanthomas (KAs) are a type of skin tumor that rapidly grow (Bosch-Amate et al., 2022). A form of KAs was first identified in 1889 (Jeon et al., 2011). These types of lesions can be challenging to differentiate from cutaneous squamous cell skin carcinoma both through histopathology and clinically (Higgins et al., 2015; Ko et al., 2012; Mei et al., 2022). Adding to the complexity, there are no current evidence-based guidelines for treatment of KAs. Although KAs can be self-resolving, the persistence and growth of the KA is unpredictable (Bettoli et al., 2023; Ko et al., 2012). Treatment of KAs with surgical excision or Mohs are typically considered first line due to the possibility of misdiagnosis and invasion into local tissue (Ambur et al., 2022). Dependent upon the location and size of the KA, comorbidities, patient preference, and other considerations, surgical treatment may not be the most ideal treatment (Kiss et al., 2019). There are many nonsurgical options including intralesional injections of methotrexate, fluorouracil, corticosteroid, bleomycin, or interferon alpha (Kiss et al., 2019). Ionizing radiation, systemic agents, destructive therapy, topical imiquimod, and topical fluorouracil are also possibilities for treatment of KAs (Ambur et al., 2022). Even though conditions of KAs were first identified over 100 years ago, more research is needed to be able to accurately diagnose and appropriately treat KAs (Tisack et al., 2021).

Secondary Neovascular Glaucoma in the Course of Diabetes in a Kidney Transplant Recipient: Case Report and Review of the Literature

The increase in intraocular pressure during hemodialysis challenges nephrologists and ophthalmologists. It most often affects patients with previously diagnosed glaucoma and is particularly dangerous in the setting of diabetic retinopathy. Hypoperfusion and hypoxia of the retina may occur, leading to pathologic neovascularization in the retina and the anterior chamber angle. Changes in the filtration angle block the outflow of aqueous humor and cause secondary glaucoma. A special type of glaucoma is neovascular glaucoma, developing among others in patients with diabetic retinopathy. This study describes a patient with secondary neovascular glaucoma in whom a significant increase in intraocular pressure was observed during hemodialysis, not responding to the applied topical treatment. The patient experienced severe pain, and her cornea was constantly injured by paracentesis. Ultimately, secondary glaucoma led to a significant decrease in vision in both eyes. The patient was enrolled on a transplant waiting list and transplanted with priority. The patient experienced some urologic and infectious complications, although 7 months after transplantation, her creatinine concentration was 1.2 mg/dL, and the ocular disease was stabilized. The intraocular pressure decreased, but there were still values above the norm, which required periodic injections of anti-vascular endothelial growth factor into the vitreous chamber and 5-fluorouracil injections under the conjunctiva. Patients with diabetes and secondary neovascular glaucoma on dialysis constitute an extremely difficult therapeutic problem and require the involvement of several specialists. Successful kidney transplantation, besides ameliorating general clinical conditions, may increase the chance of successful ophthalmologic treatment.

Профилактика роговичных осложнений послеоперационного адъювантного применения антиметаболитов после непроникающей глубокой склерэктомии

Original article Prevention of corneal complications after post-operative application of antimetabolites following nonpenetrating deep sclerectomy S.N. Svetozarskii, A.N. Andreev, A.V. Shvaikin, S.V. Scherbakova, I.G. Smetankin Volga District Medical Center under the Federal Medical and Biological Agency, Nizhny Novgorod, Russian Federation Privolzhsky Research Medical University under the Ministr y of Health of Russia, Nizhny Novgorod, Russian Federation Purpose. To evaluate the clinical and functional effectiveness of the developed method for prevention of corneal complications of nonpenetrating deep sclerectomy (NPDS) with postoperative adjuvant use of 5-fluorouracil in comparison with the control group. Material and methods. Retrospective comparative study in 2 groups included patients with open angle glaucoma who were initially underwent NPDS and received at least 1 subconjunctival injection of 5-fluorouracil in the postoperative period. 1st group included 101 patients (101 eyes) who underwent subconjunctival injection of 5-fluorouracil after surgery using standard technique, 2nd group included 176 patients (176 eyes) who underwent subconjunctival injection of 5-fluorouracil with prophylaxis of corneal complications. Best corrected visual acuity (BCVA), intraocular pressure (IOP), frequency of corneal complications and number of visits to the doctor during the first 4 weeks after surgery were analyzed as criteria of efficacy and safety. Results. Comparison groups did not differ in demographic characteristics and preoperative BCVA and IOP parameters. Fluorescein stained corneal epithelium defects were statistically significantly more frequently observed in 1st group (38.6%) in comparison with 2nd group (7.4%) (p&lt;0.001). Four weeks after NPDS, IOP decrease was 25.5% in 1st group and 31.5% in 2nd group (p=0.042). Mean BCVA loss was 1.9 lines in 1st group and 1.3 lines in 2nd group (p&lt;0.001). The number of follow-up visits during the first month after surgery was 0.6 less in 2nd group than in 1st group (p=0.002). Conclusion. Prevention of corneal complications simply and effectively reduces the risk of corneal epithelial defects after subconjunctival injection of 5-fluorouracil as well as markedly improves the clinical and functional results of NPDS and reduces the need for outpatient visits. Key words: antimetabolites, open-angle glaucoma, corneal erosion, toxicity, prevention of complications

Myofibroblasts reside in the middle dermis of the keloids but do not predict the response to injection therapies: a double-blinded, randomized, controlled trial.

Keloids form as a pathological response to skin wound healing, and their etiopathology is poorly understood. Myofibroblasts, which are cells transformed from normal fibroblasts, are believed to contribute to pathological scar formation in wounds. We carried out a double-blinded randomized controlled trial (RCT) comparing the efficacy of intralesional 5-fluorouracil (5-FU) and triamcinolone (TAC) injections in treating keloids. A total of 43 patients with 50 keloids were treated with either intralesional TAC or 5-FU injections, and their clinical response was evaluated. Biopsies were collected before, during, and after injection therapy from the active border of a keloid. To understand the role of myofibroblasts in keloids, we conducted an immunohistochemical analysis to identify myofibroblasts [α-smooth muscle actin (αSMA)] from the biopsies. We first defined the three histologically distinct regions-superficial, middle, and deep dermis-in each keloid. We then demonstrated that myofibroblasts almost exclusively exist in the middle dermis of the keloids as 80% of the cells in the middle dermis were αSMA positive. However, both the percentage of myofibroblasts as well as the area covered by them was substantially lower in the superficial and deep dermis than in the middle dermis of the keloids. Myofibroblasts do not predict the clinical response to intralesional injection therapies. There is no difference in the myofibroblast numbers in keloids or in the induced change in myofibroblasts between the responders and non-responders after treatment. This study demonstrates that myofibroblasts reside almost exclusively in the middle dermis layer of the keloids, but their numbers do not predict the clinical response to intralesional injection therapies in the RCT.

Efficacy and Safety of Carbon Dioxide Laser Ablation Combined with Manual Dermabrasion and Intralesional 5-Fluorouracil Injection in Bowen's Disease.

Bowen's disease (BD) is a precancerous in-situ squamous cell carcinoma and has a high recurrence rate with any single treatment modality, necessitating combination therapy for a successful outcome. This study aimed to the efficacy and safety of carbon dioxide (CO2) laser ablation followed by manual dermabrasion and intralesional 5-fluorouracil (IL 5-FU) injection as combination therapy for BD. This was a retrospective, observational study comprising 29 clinically and histopathologically diagnosed BD patients with no history of prior treatment. Demographic characteristics and clinical examination of the lesions and regional lymph nodes were retrieved. All patients were subjected to CO2 laser ablation followed by manual dermabrasion and IL 5-FU injection. Mean age was 61.93 ± 9.31 years with male preponderance (62.1%). Trunk (48.3%) was the most frequently involved site. Mean tumor size was 40.8 ± 16.4 mm (range: 15-86 mm). All lesions healed with a cure rate of 96.6%. Complications seen in patients included atrophic scarring with persistent post-inflammatory hyperpigmentation in three patients (10.3%), secondary infection in two cases (6.9%), and hypertrophic scar with early keloid in one patient (3.4%). Recurrence was reported in one patient (3.4%). The study was limited by retrospective study design, small sample size, and no comparison with standard therapy. Combination approach using carbon dioxide laser ablation followed by manual dermabrasion and IL 5-FU injection has been proved to be effective, efficient and safe with good functional, oncological and aesthetic outcomes in treating BD.

Effect of fractional CO2 laser combined with 5-Fluorouracil injection in the treatment of Hypertrophic Scars and Keloids..

Effect of fractional CO2 laser combined with 5-Fluorouracil injection in the treatment of Hypertrophic Scars and Keloids..

Liposomes Loaded with 5-Fluorouracil Can Improve the Efficacy in Pathological Scars.

Pathological scars, such as hypertrophic scars and keloids, are characterized by the proliferation of fibroblasts and the deposition of collagen that often cause pruritus, pain, and disfigurement. Due to their high incidence and deformity, pathological scars have resulted in severe physical and psychological trauma for patients. Intralesional injection of 5-fluorouracil (5-Fu) is a recommended option for treating pathological scars. However, the efficacy of 5-Fu injection was limited and unstable due to limited drug penetration and short retention time. Liposomes are promising carriers that have advantages, such as high biocompatibility, controlled release property, and enhanced clinical efficacy. Here, we constructed a transdermal 5-Fu-loaded liposome (5-Fu-Lip) to provide a more effective and safer modality to scar treatment. Compared to 5-Fu, 5-Fu-Lip showed superior ability in inhibiting primary keloid fibroblasts proliferation, migration, and collagen deposition, and also significantly inhibited human umbilical vein endothelial cells (HUVECs) proliferation and microvessel construction. In vivo experiments demonstrated that 5-Fu-Lip can significantly reduce the severity of hypertrophic scars in a rabbit ear wounding model. 5-Fu-Lip provides a promising strategy to improve drug efficacy, which has great potential in the treatment of pathological scars.

Treatment of Thyroid Eye Disease-Associated Ophthalmopathy and Myopathy With Intraorbital Injection of 5-Fluorouracil and Triamcinolone Acetonide.

The authors report a technique of local application of anti-metabolite and corticosteroid mixture in the orbit for treatment of thyroid orbitopathy with moderate-severe inflammation and muscle involvement. Patients of one orbital surgeon seen between March 2019 and May 2020 with active thyroid eye disease and restrictive strabismus were considered for local treatment of the myopathic component of the disease. A mixture of 1 ml 5-FU 50 mg/ml, 0.25 ml triamcinolone 40 mg/ml, and 1 ml lidocaine 2% is injected through the skin using a 25-gauge, 1.5-inch needle into the orbit adjacent to the affected extraocular muscle. Six patients were treated in the outpatient setting and 3 patients have been treated with this intervention intraoperatively at the time of orbital decompression. One was treated with the mixture reconstituted with hyaluronic acid (Healon GV) to address postoperative medial rectus fibrosis to the medial wall, this mixture was applied topically in the operative field and not injected. All patients had subjective improvement in the eye movement limitation and 2 patients had a change in motility on exam that was temporally correlated to injections. One patient did not disclose high-dose aspirin intake before injection and experienced a retrobulbar hemorrhage immediately following injection which was successfully treated. No complications were noted as a result of the medication itself. The combination of 5-fluorouracil and triamcinolone acetonide for orbital treatment may be a useful adjunct in treating patients with ongoing inflammatory activity, both in the office and in the operating room. The novel combination may optimize ophthalmic outcomes, modifying disease course in some patients.

Anise (Pimpinella anisum L.) attenuates azoxymethane-induced colorectal cancer by antioxidant, anti-inflammatory, and anti-apoptotic pathways in rats.

Herbal medicine is one of the most common fields explored for combating colon cancers, and Pimpinella anisum L. seeds (PAS) have been utilized widely as medicinal agents because of their increased essential oil (trans-anethole) contents. In this essence, our study investigates the toxic effect and chemoprotective potentials of PAS against azoxymethane (AOM)-induced colon cancer in rats. The toxicity trial for PAS conducted by clustering fifteen rats into three groups (five rats each): A, normal control had 10% Tween 20; B, ingested with 2g/kg PAS; and C, supplemented with 4g/kg PAS. The in vivo cancer trial was performed by using 30 rats (Sprague-Dawley) that were randomly adapted in five steel cages (six rats each): group A, normal controls received two subcutaneous injections of normal saline 0.09% and ingested orally 10% Tween 20; groups B-E, rats received two injections of 15mg/kg of azoxymethane (AOM) subcutaneously in 2weeks and treated orally with 10% Tween 20 (group B) or intraperitoneal injection of 5-fluorouracil (35mg/kg) (group C), or orally given 200mg/kg PAS (group D) and 400mg/kg PAS (group E) for 8weeks. After the scarification of rats, the colon tissues were dissected for gross and histopathological evaluations. The acute toxicity trial showed the absence of any toxic signs in rats even after 14days of ingesting 4g/kg of PAS. The chemoprotective experiment revealed significant inhibitory potentials (65.93%) of PAS (400mg/kg) against aberrant crypto foci incidence that could be correlated with its positive modulation of the immunohistochemically proteins represented by a significant up-regulation of the Bax protein and a decrease of the Bcl-2 protein expressions in colon tissues. Furthermore, PAS-treated rats had notably lower oxidative stress in colon tissues evidenced by decreased MDA levels and increased antiradical defense enzymes (SOD, CAT, and GPx). The outcomes suggest 400mg/kg PAS as a viable additive for the development of potential pharmaceuticals against colorectal cancer.

Assessment of ellagic acid action in 5-fluorouracil induced intestinal mucositis

The intestinal mucositis define as inflammation and ulceration in the gastrointestinal tract wall and in some case in the oral cavity these cause by treatment with antineoplastic drug like 5-fluorouracil and Irinotecan and other types of chemotherapeutics drugs , 5-Fluorouracil-induced intestinal mucositis (IM) is consider as one of the more common tumor issue .it cause series of undesirables symptoms like severe diarrhea ,abdominal pain , stomach uncomfortable and other. The aim of this current study to see how ellagic acid act to Attenuates 5-FU-Induced Intestinal Mucositis and Diarrhea in Mice . we induced the intestinal mucositis by injected the mice intraperitoneally in 5-fluorouracil about 50mg per kg daily for four days respectively and then assessment the IM by measurement the level of some antioxidant enzymes like SOD , and level of some pro-inflammatory cytokines (IL-6) and lipid peroxidation biomarker (MDA) and we note the difference in the histopathological scoring after administration the ellagic acid to the mice in two different dose (10mg and 5mg per kg) daily for ten days respectively and before the fluorouracil injection in one hour .pretreatment with ellagic acid specialized dose of 10mg per kg significant improvement in the level of antioxidant enzymes ,pro inflammatory cytokines ,lipid peroxidation biomarker and histopathologicaL score compared with 5-FU group, moreover the potential action of ellagic acid was further supported by histopathological examination. all these data suggest that the ellagic acid effective in protective from 5-FU-induced intestinal mucositis.

The rate of cardiac complications in patients receiving a 24-hour dose of 5-Fluorouracil

Background. Cardiotoxicity caused by fluoropyrimidines is an uncommon but potentially fatal complication. Its frequency has been 1.6 to 19% in previous studies. But there are no accurate statistics in Iran. The aim of this study was to determine the rate of cardiac complications of 5-fluorouracil (5-FU) infusion. Methods. This prospective study was conducted in patients with gastrointestinal cancers who underwent chemotherapy with regimens containing 24-hour infusion of 5-FU at Rohani Hospital of Babol. Patients with a history of radiation therapy to the chest or epigastrium or suffering from COVID-19 disease in the last 6 weeks were excluded from the study. Each patient was examined in 2 cycles of chemotherapy. In case of complications, cardiac examinations including examination, electrocardiogram, echocardiography and if necessary, coronary angiography were done. Data analysis was done with SPSS 26 software using descriptive indices and Fisher exact test (significance≤0.05). Results. In sixty one patients, 122 courses of chemotherapy were evaluated. Underlying cancer was colorectal cancer in 32 patients, stomach cancer in people. Eight patients (13.11%) had cardiac complication, in eleven chemotherapy cycles, included 7 cases of chest pain and one case of each of complications of myocardial infarction, pulmonary edema and pericarditis. Four out of 8 patients suffered from complications only in the first round, one only in the second round and three patients in both rounds of chemotherapy (P=0.004).The incidence rate of complications in patients without a history of heart disease was 8.7% and in patients with a history of heart disease 26.7%(P=0.073), in non-smokers 10% and in smokers 30%(P=0.084). It was 10.6% in non-diabetic patients and 21.4% in diabetic patients (P=0.294). Conclusion. Cardiac complications are common in 24-hour injection of 5-fluorouracil. A patient who has a heart complication once, might have a higher probability of having a complication in the next cycles. Practical Implications. Due to the high prevalence of cardiac complications of 24-hour floururacil infusion, especially in patients with a history of heart disease, careful cardiac monitoring during hospitalization is recommended.