Ink Injection Research Articles

High-resolution ultrasound of the paratenon of the Achilles calcaneal tendon: anatomical study and description of the paratendinous injection technique.

The aim of this study is to determine if ultrasound (US) allows a precise assessment of the paratenon (PT) of the Achilles calcaneal tendon (AT), and to anatomically describe the US-guided paratendinous injection technique. This study was initially conducted on eight cadaveric specimens using high-resolution ultrasound (HRUS) to examine the PT appearance, thickness, and its relationships with the AT, plantaris tendon (PLT), Kager's fat pad (KFP), sural nerve (SN), and fascia cruris (FC). US-guided paratendinous injection of China ink was performed in all specimens, followed by anatomical dissection to assess injectate distribution. Then, HRUS study of the PT was carried out bilaterally in twenty asymptomatic volunteers (40 legs). Two musculoskeletal radiologists recorded all data in consensus except PT thickness in volunteers which was recorded independently in order to calculate intra and inter-observer reliability. The PT was consistently identified with HRUS along its entire course in both cadaveric specimens (8/8) and volunteers (40/40). The mean PT thickness was 0.54mm in cadavers and 0.39mm in vivo, without any correlation with the AT thickness. Intra- and inter observer reliability were respectively excellent and good for PT thickness. All eight (100%) ex vivo China ink injections were accurate, demonstrating a circumferential distribution of the injectate between the PT and the AT, associated with an anterior spread to the KFP. HRUS allows visualization of the PT along its entire length, and assessment of its relationships to adjacent structures. US-guided paratendinous injections can accurately and safely deliver injectates in the paratendinous sheath.

Mixing properties of coronary infusion catheters assessed by in vitro experiments and computational fluid dynamics.

Continuous infusion thermodilution is an established technique for the assessment of absolute coronary blood flow and microvascular resistance due to its proven accuracy and reproducibility. However, for this technique to yield reliable measurements, direct and homogenous mixing of injected saline and blood is mandatory. This study aimed to assess and compare the mixing properties of two different microcatheters, namely the Rayflow® (with sideholes for infusion) and the Finecross® catheter (single end-hole for infusion), which are commonly used in the catheterization laboratory. The study employed three different methods to evaluate the mixing properties of the catheters. Firstly, a qualitative assessment of mixing was performed using ink injections in an in vitro bench model of a coronary artery. Secondly, in analogy to the human catheterization laboratory, mixing properties over the length of the coronary artery were assessed semi-quantitatively by temperature measurements in the bench model. Lastly, a quantitative assessment was performed by 3D computational fluid dynamics, where the standard deviation and entropy ratio of the temperature over the cross-section in the coronary artery model were calculated for both catheters. All three evaluation methods demonstrated that the Rayflow catheter's specific design leads to a more optimal, homogeneous mixture of blood and saline over both the cross-section and length of a coronary vessel, as compared with the standard end-hole catheter.

High-quality VO2 films synthesized on polymer substrates using room-temperature pulsed laser deposition and annealing

With the growing trend towards portable and adaptable devices in various fields, the demand for flexible electronics and coatings utilizing phase transition materials like VO2 as a functional layer is rising. However, depositing high-quality crystalline VO2 films directly onto polymer substrates remains challenging due to the thermosensitivity of such materials being barely compatible with usual VO2 deposition methods. In this study, we present a simple method for directly growing VO2 on Kapton substrates. VOx films were first deposited onto the Kapton substrate at room temperature using pulsed laser deposition and subsequently annealed in an oxygen atmosphere at 390 °C. The electrical and optical properties of the VO2/Kapton samples with different film thicknesses were investigated. The 200 nm-thick vanadium dioxide films exhibit the best resistivity contrast with 3.1 orders of magnitude (OOM), while the 50 nm-thick films show the best transmittance change of 54 % at 2500 nm. The switching performances are comparable or even superior to those achieved previously using more complicated synthesis processes such as film transfer, introduction of buffer layers, and ink injection. Additionally, by coupling W elemental doping and thin film strain, we successfully tuned the VO2 transition temperature to room temperature with a dopant concentration of only 1.1 at.% while maintaining a high electrical contrast (2 OOM). The impressive electrical and optical transition performance of the VO2/Kapton samples, combined with their tunable transition temperature, makes them promising candidates for flexible electronic devices and thermochromic smart coatings.

Conceptual Design and Numerical Validation of a Carbon-Based Ink Injector.

This paper shows the design of an injector, using carbon nanotubes as inkjet material, implemented in a 3D printer. According to the available literature, few injectors are capable of depositing material. Due to the lack of information, the central part of this research is to develop a suitable device for ink injection that is capable of applying the Fused Deposition Modeling (FDM) method to print nanomaterial ink. The injector was designed using a CAD program based on an open-source desktop 3D printer, which allows it to be modified according to the needs of the injector. This prototype was manufactured in aluminum alloy 7075T6. Computational fluid dynamics (CFD) were carried out to analyze the behavior of the fluid when it passes through the injector, obtaining parameters such as pressure, velocity, and vorticity. An experimental matrix of the injector operation was carried out to achieve an adequate printing speed. The results show that the optimum speed was 250 ms, considering that a temperature of 100 °C is needed in the heated bed to dry the ink so that it does not undergo expansion.

Preoperative fluorescent clip marking vs. India ink tattooing for tumor identification during colorectal surgery.

Identifying tumor location is important in colorectal tumor resection. Preoperative endoscopic India ink marking is a widespread practice, but local injection of ink is an unstable procedure. Although it is often invisible, the ink may be sprayed into the peritoneal cavity and contaminate the surgical field. At our hospital, we introduced fluorescent clip marking (FCM) using the Zeoclip FS®, an endoscopic clip developed using near-infrared fluorescent resin. We tested the usefulness of FCM by retrospectively comparing cases in which FCM was used with cases in which conventional ink marking was used. We enrolled 305 patients with colorectal tumors who underwent colorectal surgery after preoperative marking from January 2017 to April 2022. We classified the patients into the FCM group (86 patients) and the India ink tattoo group (219 patients). Endoscopic marking was completed in the FCM group by the day before surgery, and fluorescence was evaluated during surgery with a fluorescent laparoscopic system. Patient backgrounds, marking visibility, adverse effects, and early postoperative results were retrospectively compared between groups. Marking was visually confirmed in 80 patients in the FCM group (93.02%) and in 166 patients in the India ink tattoo group (75.80%) (p = 0.0006). In the group with India ink tattoos, contamination of the surgical field was observed in seven cases (3.20%). No adverse events were observed in the FCM group. In colorectal surgery, FCM provides better visibility than the conventional India ink tattooing method and is a simple and safe marking method. Examination of fluorescence navigation for laparoscopic colorectal cancer surgery. Research Ethics Committee of the Kawaguchi Municipal Medical Center (Saitama, Japan) approval number: 2020-3. https://kawaguchi-mmc.org/wp-content/uploads/clinicalresearch-r02.pdf .

Determination of Selected Elements in Commercially Available Tattoo Inks of the Greek Market Using Atomic Absorption Spectrometry

In recent decades, tattooing has become a form of social and artistic expression. To apply a tattoo, the skin is marked by the internal injection of ink in the skin. Hence, it includes human health exposure to metals since the tattoo ink composition includes such elements. The present paper reports the determination and quantification of 8 elements (As, Cd, Co, Cr, Cu, Hg, Ni, Pb) in twenty tattoo ink colors available in the Greek market imported from the USA and China. The elemental content was carried out by atomic absorption spectrometry after microwave-assisted digestion. A comparison was carried out between the results of the present study and the maximum permitted concentrations as proposed in the ResAP and EPA guidelines, while the level of dermal exposure due to pigment application through ink injection was also estimated. All inks contained Cr, Cu, Ni, and Pb, while the content of As, Cd, and Co was below the detection limit in certain samples. Mercury was determined in three samples. Chromium, Cu, and Ni were present in the highest concentrations, while Cd and Hg contents were in general low. Most elements presented their maximum levels in the brown ink originating from USA.

Exploring the Effectiveness of Visualization Techniques for NACA Symmetric Airfoils at Extremely Low Reynolds Numbers

This article aims to highlight the importance of utilizing flow visualization techniques in the preliminary analysis of streamlined and bluff bodies, especially the potential use of visualization with ink in a water channel as a tool for a preliminary approach during fluid mechanics analysis. According to this, the study compares the results obtained using a classical flow visualization technique, ink injection in water, with those obtained through the employment of a laser-based measurement and visualization technique, called PIV, in a low-speed wind tunnel. The article briefly presents both techniques and highlights the importance of flow visualization in the analysis of aerodynamic bodies. This study focuses on flow over NACA airfoils at extremely low Reynolds numbers, which is of great interest for application in extraterrestrial atmospheres, such as on Mars. After obtaining images of the flow streamlines over the NACA 0018 airfoil, the results of both techniques were compared. The results indicated that there was good agreement between the visualization with the water channel and the PIV results, suggesting that the results obtained in the water channel represented a scientifically valid approximation and an essential complement to computational models that require experimental validation.

Slot-Die Coated Copper Indium Disulfide as Hole-Transport Material for Perovskite Solar Cells

Perovskite photovoltaics have the potential to significantly lower the cost of producing solar energy. However, this depends on the ability of the perovskite thin film and other layers in the solar cell to be deposited using large-scale techniques such as slot-die coating without sacrificing efficiency. In perovskite solar cells (PSCs), Spiro-OMeTAD, a small molecule-based organic semiconductor, is commonly used as the benchmark hole transport material (HTL). Despite its effective performance, the multi-step synthesis of Spiro-OMeTAD is complex and expensive, making large-scale printing difficult. Copper indium disulfide (CIS) was chosen in this study as an alternative inorganic HTL for perovskite solar cells due to its ease of fabrication, cost-effectiveness, and improvements to the economic feasibility of cell production. In this study, all layers of perovskite solar cell were printed and compared to a spin-coating-based device. Various parameters affecting the layer quality and thickness were then analyzed, including substrate temperature, print head temperature, printing speed, meniscus height, shim thickness, and ink injection flow rate. The small print area achieved spin-coating quality, which bodes well for large-scale printing. The printed cell efficiencies were comparable to the reference cell, having a 9.9% and 11.36% efficiency, respectively.

India Ink Tattooing of Ureteroenteric Anastomoses

While upper tract access through the insensate conduit following urinary diversion takes less time and incurs fewer costs than percutaneous kidney access does for the treatment of ureter and kidney pathology, endoscopic ureteroenteric anastomoses (UEA) identification can be difficult. We injected India Ink into the bowel mucosa near the UEA during ileal conduit diversion (IC) to determine the safety and feasibility of ink tattooing. Patients undergoing IC were prospectively randomized to receive ink or normal saline (NS) injections. The injections were placed 1 cm from UEA in a triangular configuration, and loopogram exams and looposcopy were performed to identify reflux (UR), UEA, the tattooing site and strictures in 10 and 11 patients randomized with respect to ink and NS injections, respectively. Ink patients were older (72 vs. 61 years old, p = 0.04) and had a higher Charlson Comorbidity Index (5 vs. 2, p = 0.01). Looposcopy was performed in three ink and four NS patients. Visualization of UEA was achieved in 100% of the ink and 75% of the NS patients (p = 0.26). The ink ureteroenteric anastomotic stricture (UEAS) rate was higher (N = 3 vs. N = 1) and six patients vs. one patients underwent surgery, respectively, for UEAS (p = 0.31). The study was halted early due to safety concerns. Our pilot study demonstrates that ink can be well visualized following injection near UEA during IC. However, the ink cohort had more UEAS than previously cited in the literature and our prior institutional UEAS rate of 6%. While this study sample is small, the higher incidence of UEAS after ink injection led us to question the utility and safety of ink injection following IC.

Innate Immune Response of Galleria mellonella (Lepidoptera: Pyralidae) Larvae to Lemongrass Essential Oil and Citral

Abstract The innate immune response in insects relies on cellular responses. In most lepidopteran species, challenging the immune system causes an increase in hemocyte numbers and promotes encapsulation and melanization of invading objects, such as parasitoid eggs or artificial objects (e.g., nylon implants). We studied the effects of carbon particles (Sumi ink) on the immune response of Galleria mellonella L. (Lepidoptera: Pyralidae) last-instar larvae. Ink injections increased total hemocyte counts in a dose-dependent manner, with the 40 and 80% concentrations being most effective in eliciting hemocyte response. Hemocyte numbers increased significantly at 4 and 6 h after ink injection. Lemongrass essential oil (0.18, 0.36, and 0.72 µg/larva) and citral (0.12, 0.24, and 0.48 µg/larva) reversed the mobilization of hemocytes by the ink. Melanization of nylon larvae implants started as early as 15 min after implant insertion and reached maximum observed levels within 1 h. The degree of melanization also was higher in larvae challenged with ink 1 h prior to implant removal, which suggests initialization of the immune response. Citral injections inhibited implant melanization both in unchallenged and ink-challenged larvae. In the former case, citral concentrations needed for effective inhibition were less (0.3 µg/larva) than in ink-challenged larvae (1.2 and 2.4 µg/larva).

A study on etiology of incontinence in double knockout mouse model

Stress urinary incontinence is of concern in both pediatric and adult population. Double mutant GLI family zinc finger Gli2+/-; Gli3Δ699/+ murine model of stress incontinence has been recently developed as a reliable model which does not require surgical manipulation to create incontinence and is shown to survive to adulthood. The aim of this study was to establish the etiology of incontinence in the double mutant Gli2+/-; Gli3Δ699/+ mice. We used 13 cluster of differentiation 1 (CD-1) mice (7-9 weeks) for demonstration of histology of the bladder and urethra. There were 3 Wild Gli2+/- females, 2 Wild Gli2+/- males, 4 Gli2+/-;Gli3Δ699/+ females and 4 Gli2+/-;Gli3Δ699/+ males. The Wild Gli2+/- mice served as the control group and Gli2+/-;Gli3Δ699/+ mice served as the test group. Additionally, eight 16.5 days mice (2 each of Wild Gli2+/- females, Wild Gli2+/- males, double knockout (DKO) Gli2+/-;Gli3Δ699/+ females and Gli2+/-;Gli3Δ699/+ males) were used to assess the histology of the spinal cord. The gross appearance of bladder and urethra was studied using ink injection assays. Immunohistochemistry was done for smooth muscle actin and cytokeratin. Gross and histologic appearance confirmed the previously reported widening of bladder outlet and hypoplasia of smooth muscles in female urethra and also established them in the male urethra of Gli2+/-;Gli3Δ699/+ mice compared to Gli2+/- mice. The double knockout mice were smaller than the Gli2 mice (5.2 vs 6.1cm, p=0.002). Immunohistochemistry demonstrated epithelial hyperplasia and smooth muscle hypoplasia. Additionally, there was prostatic hypoplasia in the Gli2+/-;Gli3Δ699/+ male mice. The spinal cord length for body size appeared comparable between the Gli2+/- and Gli2+/-;Gli3Δ699/+ mice but histological evaluation revealed abnormal development of the caudal end of the vertebral body with premature termination of the spinal cord (Figure). The histological changes in the bladder neck and urethra were consistent to those previously reported. While previous report described the findings in female mice only, we confirmed that these findings are also present in males as well as prostatic hypoplasia, a possible additional factor leading to stress incontinence. The most important finding in the present study however, was the detection of premature termination of spinal cord in the DKO Gli2+/-; Gli3Δ699/+ mice which has not been reported previously and is likely a major contributor to incontinence in this model. The incontinence in male as well as female Gli2+/-; Gli3Δ699/+ mice is due to both myogenic and neurogenic involvement. These double knockout mice are a valuable model of stress incontinence related to neurogenic bladder due to low outlet resistance.

In vivo visualisation of tattoo particles using multiphoton tomography and fluorescence lifetime imaging.

With increased popularity of decorative tattoos, awareness of tattoo-based dermatological complications has been raised. Health issues include a broad spectrum dominated by allergies and infections. To examine the etiopathology and prognose the outcome of an appropriate therapy, a non-invasive intravital diagnostic approach is indicated. The present pilot study introduces multiphoton tomography equipped with fluorescence lifetime imaging as a diagnostic technique to examine the morphological and metabolic status of tattooed human skin at patient's bedside. The distributing course of tattoo particles can be visualised over time. By providing optical biopsies, inflammation-based alterations in freshly tattooed skin and tattoo complications can be analysed. The study concludes that multiphoton tomography combined with fluorescence lifetime imaging is a suitable technique for in vivo visualisation of tattoo pigments as well as for the assessment of quantitative and qualitative skin changes after injection of tattoo ink into human skin.

Tatouage scléral : une mode émergente dangereuse

Tattooing of the glove is an old practice used 2000 years ago on the cornea to improve the appearance of unsightly corneal scars. Since 2007, tattoo artists have been performing scleral tattoos, also called "eyeball tattoos," despite the risks involved and the disapproval of health authorities and the medical community. We report the case of a 30-year-old man with bilateral black ink scleral tattoos who came to our ophthalmologic emergency service with episcleral nodules, which had appeared at the ink injection sites. The clinical course stabilized with topical anti-inflammatory treatment. Similar cases have been reported in the literature, in one of which the patient underwent surgical excision of a similar lesion. Histological analysis showed a lympho-histiocytic reaction without any signs of malignancy. To date, 20 cases of scleral tattoos have been reported in the international literature, often with severe complications. We see, on the one hand, complications related to perforating trauma, and on the other hand, acute and chronic complications inherent to the products used. Scleral tattooing is gaining popularity around the world despite significant risk exposure, including traumatic, inflammatory, immune, infectious and probably long-term neoplastic consequences. Ophthalmologists must be aware of this practice and its consequences in order to make the most appropriate therapeutic decisions.

Fabrication of Type-Variable Electronic Paper Using Electrophoretic Particle Loading with Multiple Bottom Electrode Structure.

This study suggested the design of type-variable electronic paper with multiple bottom electrode structures and experimentally investigated the process mechanism of the electrophoretic particle loading method (EPLM) as an electronic ink injection method. The type-variable electronic paper was achieved by constructing the multi-electrode structure that had a structure of four electrodes that can independently apply voltage to one cell. By injecting electronic ink that mixes two types of particles with opposite charges into an electrically neutral color (blue) fluid, we realized electronic paper with a single color, and we then measured the optical characteristics of the panel. We used the EPLM to prevent charged particles that have lost their charge from being injected into the e-paper by using an electric field. In order to confirm the color expression and transmittance control effect using the multi-electrode structure, we conducted reflectance measurement and transmittance measurement experiments. Our experiments confirmed that the expression of more than five colors was possible and that the transmittance was controllable to a minimum of 13.50% and a maximum of 71.18%. This study provides an attractive method to create e-paper as a new form outside the framework of existing e-paper technology.

Inadvertent globe penetration due to self-attempted eyeball tattooing

Eyeball tattooing or scleral tattooing is a new form of body modification. A 27-year-old Indian male presented with defective vision in the left eye a day after self-attempted eyeball tattooing. The inadvertent penetration and ink injection led to the staining of the cornea, suspension of ink in the aqueous. The lens showed capsular staining and subsequent progression to the cataract. The posterior segment showed staining of vitreous with the red dye, retinal thickening at the macula. The optical coherence tomography showed inner retinal hyperreflectivity with retinal thickening. As these “Do it yourself” maneuvers are becoming trends influenced by social media, we report a case of self-attempted eyeball tattooing and its complications.

Fascial Organisation and Lymphatic Systems Around the Pelvic Floor: A Literature Review.

This review summarises the anatomy and lymphatic systems around the pelvic floor. We investigated the lymphovascular network in the anorectal region, focusing on the hiatal ligament, which comprises smooth muscle fibres derived from the longitudinal muscle and connecting the anal canal and coccyx, and the endopelvic fascia, which seems to comprise collagen and elastic fibres. During rectal surgery, endopelvic fascia is recognized as a sheet of fascia covering the levator ani muscle. Endopelvic fascia is extensively attached to the smooth muscle fibres diverging from the longitudinal muscle of the rectum. Analysis of the lymphovascular network using submucosal India ink injection and indocyanine green fluorescence imaging suggests a functional lymphatic flow between rectal muscle fibres and hiatal ligament and endopelvic fascia. Precise analysis of the lymphatic systems of fascial organization around the pelvic floor may be useful in formulating therapeutic strategies for low rectal cancer.

MP53-09 INDIA INK TATTOOING OF URETEROENTERIC ANASTOMOSES

You have accessJournal of UrologyTrauma/Reconstruction/Diversion: Ureter (including Pyeloplasty) and Bladder Reconstruction (including fistula), Augmentation, Substitution, Diversion II (MP53)1 Sep 2021MP53-09 INDIA INK TATTOOING OF URETEROENTERIC ANASTOMOSES Mei Tuong, and Tracey Krupski Mei TuongMei Tuong More articles by this author , and Tracey KrupskiTracey Krupski More articles by this author View All Author Informationhttps://doi.org/10.1097/JU.0000000000002083.09AboutPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissionsReprints ShareFacebookLinked InTwitterEmail Abstract INTRODUCTION AND OBJECTIVE: Upper tract access is necessary to treat diseases in the ureter or kidney after urinary diversion. Access through the insensate conduit is more cost-effective versus percutaneous kidney access. However, endoscopic ureteroenteric anastomoses (UEA) identification can be difficult. We injected India Ink (ink) into bowel mucosa near UEA during ileal conduit diversion (IC) to determine the safety and feasibility of ink tattooing and ability to facilitate retrograde upper tract access. METHODS: After IRB approval, patients undergoing IC were prospectively randomized to receive ink or normal saline (NS) injections, a control group to assess safety of ink. Injections were placed 1 cm from UEA in a triangular configuration with a 19-gauge needle. Follow-up minimized cost and radiation exposure to assess patency and location of UEA. 1-month loopogram assessed for ureteral reflux (UR). If there was any absent UR, looposcopy was performed to assess for occult UEA stricture (UEAS). Ability to visualize UEA and/or ink tattooing was recorded at time of looposcopy. RESULTS: 42 renal units (21 patients) undergoing IC were randomized to ink (20 renal units) or NS (22 renal units). Overall median age was 65 (IQR 60, 73) years with ink patients being older (72 vs 61 years old, p=0.04). Ink patients also had a higher Charlson Comorbidity Index (5 vs 2, p=0.01). Loopogram and looposcopy protocol data are shown in Figure 1. 20 renal units had no UR on loopogram (12/16 ink vs 8/20 NS). Of patients who returned for looposcopy, 14 non-UR renal units were assessed (6/12 ink vs 8/8 NS). Visualization of UEA was achieved in 6 (100%) and 4 (50%) in ink versus NS patients, respectively (p=0.26). Follow up of the cohort revealed a higher than expected UEAS rate in the ink group (N=3, 30%) compared to NS (N=1, 9%). The ink vs NS cohorts underwent 6 vs 1 surgeries respectively for UEAS (p=0.28). 2 ink and 1 NS patients were managed with either endoscopic dilation, percutaneous nephrostomy tube, or ureteral stent. 1 ink patient required open reimplantation of UEA. CONCLUSIONS: Our pilot study demonstrates ink is well-visualized following injection near UEA during IC. However, the ink cohort had more UEAS than our prior rates of UEAS (6%) and in the literature. While this study sample is small, the higher development of UEAS after ink leads to question the utility and safety of ink injection following IC. Source of Funding: none © 2021 by American Urological Association Education and Research, Inc.FiguresReferencesRelatedDetails Volume 206Issue Supplement 3September 2021Page: e942-e942 Advertisement Copyright & Permissions© 2021 by American Urological Association Education and Research, Inc.MetricsAuthor Information Mei Tuong More articles by this author Tracey Krupski More articles by this author Expand All Advertisement Loading ...

Assessment of cytotoxicity and sensitization potential of intradermally injected tattoo inks in reconstructed human skin.

BackgroundThe number of people within the European population having at least one tattoo has increased notably, and with it the number of tattoo‐associated clinical complications. Despite this, safety information and testing regarding tattoo inks remain limited.ObjectiveTo assess cytotoxicity and sensitization potential of 16 tattoo inks after intradermal injection into reconstructed human skin (RHS).MethodsCommercially available tattoo inks were injected intradermally into RHS (reconstructed epidermis on a fibroblast‐populated collagen hydrogel) using a permanent makeup device. RHS biopsies, tissue sections, and culture medium were assessed for cytotoxicity (thiazolyl blue tetrazolium bromide assay [MTT assay]), detrimental histological changes (haematoxylin and eosin staining), and the presence of inflammatory and sensitization cytokines (interleukin [IL]‐1α, IL‐8, IL‐18; enzyme‐linked immunosorbent assay).ResultsVarying degrees of reduced metabolic activity and histopathological cytotoxic effects were observed in RHS after ink injection. Five inks showed significantly reduced metabolic activity and enhanced sensitization potential compared with negative controls.DiscussionUsing the RHS model system, four tattoo inks were identified as highly cytotoxic and classified as potential sensitizers, suggesting that allergic contact dermatitis could emerge in individuals carrying these inks. These results indicate that an RHS‐based assessment of cytotoxicity and sensitization potential by intradermal tattoo ink injection is a useful analytical tool to determine ink‐induced deleterious effects.

Pre-Operative Localization of Axillary Lymph Nodes with Tattoo Ink: A Preliminary Report

Background: Pre-operative localization options in the axilla are limited. This study aimed to explore the utility of pre-operative localization of axillary lymph nodes using tattoo ink with multidisciplinary correlations.Methods: In this prospective, Institutional Review Board (IRB)-approved study, 19 lymph nodes in 17 patients underwent pre-operative localization with ultrasound-guided injection of Spot tattoo ink. The success rate of intraoperative identification of the tattooed node as well as the frequency in which the tattooed node was also a sentinel node were recorded. Radiologic, surgical and pathologic images were collected. Results: Tattoo ink localization was successful in 16/17 (94.1%) of patients. Tattoo ink did not hinder pathologic evaluation in any cases but was taken up by additional adjacent nodes in 1/17 successful localizations (5.9%). Successful sentinel lymph node biopsy (SLNB) occurred in 13 patients in whom 14 lymph nodes underwent pre-operative tattoo ink localization. Nine of the 14 (64.2%) tattooed lymph nodes were also a sentinel node.Conclusion: In this study, pre-operative localization of axillary lymph nodes with tattoo ink was highly successful In patients undergoing SLNB, a significant number of the tattooed nodes were not sentinel nodes (35.8%), suggesting the importance of targeted lymph node excision in addition to SLNB.

Widespread anorectal lymphovascular networks and tissue drainage: analyses from submucosal India ink injection and indocyanine green fluorescence imaging.

AimAbdominoperineal resection is associated with poor prognosis in patients with advanced lower rectal cancer. This study aimed to analyse the functional lymphovascular network and tissue drainage in the anorectal region.MethodsIn this descriptive study, we performed microanatomical evaluations and intra‐operative imaging analysis in a cadaver and patients with rectal cancer. Specimens with India ink injection were collected from a cadaver and from six patients who underwent abdominoperineal resection. Intra‐operative indocyanine green fluorescence imaging was performed on four patients who underwent surgery for lower rectal cancer. India ink was injected into the submucosa at the dentate line of specimens. Tissue sections were examined by immunohistochemistry for D2‐40 and CD31. Intra‐operative indocyanine green was injected into the submucosa at the dentate line. Lymph flow was traced using a near‐infrared camera system.ResultsFascia branching from the rectal longitudinal muscle layer extended to the posterior hiatal ligament and lateral endopelvic fascia connective tissue lamina on the surface of the levator ani muscle. The fascia contained veins labelled with ink in their lumina and initial lymphatics. Intra‐operative indocyanine green fluorescence imaging revealed extensive lymph flow from the muscle layer of the anal canal to the hiatal ligament and endopelvic fascia along the longitudinal muscle layer fibres.ConclusionsThe anorectal region contained widespread venous and lymphatic networks in proportion to its specific connective tissue framework around the longitudinal‐muscle‐layer‐extending muscle bundles, which provides extensive networks for tissue fluid and cells.