Concentration is more important than dose when using intralesional Pingyangmycin injection for treatment of vascular malformations

Vascular anomalies represent a wide spectrum of pathology with different clinico-pathological characteristics. Approximately 60% of them occur in the head and neck region. A variety of therapeutic modalities have been reported to manage vascular anomalies over the years, including surgical resection,

PREPARATION AND DRUG RELEASE CHARACTERISTICS OF PINGYANGMYCIN GELATIN MICROSPHERES FOR EMBOLIZATION THERAPY

Objective: To prepare Pingyangmycin gelatin microspheres (PYM-GMS) for carotid artery embolization therapy and to study the release characteristics in vivo and in vitro. Methods: PYM-GMS was prepared by optical double-phase emulsified condensation polymerization. Through UV-spectrophotometer drug content and encapsulation rate were measured. The characteristics of drug release in vitro which could simulate the actual state in vivo were tested by HPLC. Three ways of vein drop, artery perfusion and artery embolization were contrasted. Under the supervision of X-ray, PYM-GMS were perfused into the external carotid artery of rabbits by superselective artery embolization. Blood samples were tested at different time and analyzed statistically. Results: The roundness of PYM-GMS was 1.02?.005. The mean diameter was 85.6 mm, 78% of them ranging from 50-200 mm, which fitted the use of embolization. PYM content and encapsulation rate were 6.8% and 91.3% respectively. 70% of the drug was released in 3 h in the simulated environment in vivo and total drug was released after more than 6 h. After artery embolization with small dosage of PYM-GMS, the local drug concentration was 8 times higher than the blood drug concentration and the high level of local drug concentration was kept for more than 120 min. Conclusion: External carotid artery embolization with PYM-GMS, which significantly reduced the circulating drug level and employment dosage, could prolong the duration higher drug concentration and suit the purpose of targeted tumor therapy.

Intralesional pingyangmycin injection sclerotherapy for oral ranulas

Objective: To investigate the efficiency of pingyangmycin (PYM) intralesional injection for the treatment of ranulas in clinical practice. Methods: PYM concentrations were 2.0 mg/ml (8 mg PYM powder + 1 ml normal saline + 2 ml 2% lidocaine + 1 ml dexamethasone). The mixed PYM solution was intralesional injected into ranulas after drawing out isometric cyst fluid in 3 patients. Results: The ranulas of 3 patients showed total disappearance after the sclerotherapy, and no recurrence was found after 6 months to 3 years’ follow-up. Compared to surgical therapy, the PYM sclerotherapy was advocated by clinicians for its advantages of less injury, no scar, less suffering, etc. Conclusions: PYM is an effective sclerosing agent for ranulas. Intracystic injection of PYM may be an optimal method for the treatment of ranulas.

Transarterial Embolization Using Pingyangmycin-Lipiodol Emulsion (PLE) for Treatment of Focal Nodular Hyperplasia of the Liver and 1-Year Follow-Up: A Case Report and Literature Review

Focal nodular hyperplasia (FNH) is a common benign hepatic tumor which is often treated non-operatively until it appears apparent symptoms such as pain and upper abdominal distension. We report here a case of trans-catheter arterial embolization (TAE) using pingyangmycin-lipiodol emulsion (PLE) for blocking a fatal bleeding originated from percutaneous biopsy as well as for FNH treatment. After embolization by means of the mixture of PLE and particles of gelfoam, the bleeding was stopped and the FNH was apparently shrinked 1 year later. TAE using PLE may be considered as a safe and effective method for the treatment of FNH.

The erapeutic effect of triamcinolone acetonide with pingyangmycin on lymphatic malformations in oral and maxillofacial regions

Objective To investigate therapeutic effect of tri- amcinolone acetonide and pingyangmycin on lymphatic malformations in oral and maxillofacial regions. Methods 29 patients with lymphatic malformations in oral and maxillofacial regions were divided into two groups to re-

Pingyangmycin Pretreatment Influences the Biological Behavior of Ocular Venous Malformation and Relates with Galectin-3 Expression

Background：Galectin-3 （Gal-3） plays a role in the mechanisms underlying ocular venous malformation.We conducted this study to investigate the effect of pingyangmycin pretreatment on the Gal-3 expressions and biological behavior of ocular venous malformation.Methods：Tissue samples were collected from 136 patients with ocular venous malformation.Patients were randomly divided into pingyangmycin （n =69） and nonpingyangmycin group （n 67）.Patients in the pingyangmycin group received a local injection of 0.02% pingyangmycin once every 2 days for 2 weeks （7 doses） before removal surgery,whereas patients in the nonpingyangmycin group underwent removal surgery without local injection.The protein and messenger RNA （mRNA） expression of Gal-3 were detected by using immunohistochemistry and in situ hybridization.Results：Gal-3 protein was expressed in 35 （52%） of 67 samples in the nonpingyangmycin group and in 19 （28%） of 69 samples in the pingyangmycin group （P 〈 0.05）.Gal-3 mRNA expression was detected in 39 （58%） of 67 samples in the nonpingyangmycin group and 22 （32%） of 69 samples in the pingyangmycin group （P 〈 0.05）.The higher Gal-3 expressions were detected in samples with deeper invasiveness than those with superficial invasiveness before （χ^2=12.720 and 13.369,respectively,both P 〈 0.05） and after pingyangmycin treatment （χ^2=8.429 and 4.590,respectively,both P 〈 0.05）.It was more frequently detected in mesh-like lesions with unclear boundary than round lesions with clear boundary before （χ^2= =30.291 and 41.466,respectively,both P 〈 0.05） and after pingyangmycin treatment （χ^2= =14.619 and 15.130,respectively,both P 〈 0.05）.Pingyangmycin treatment led to a significant difference in Gal-3 expressions at both protein and mRNA levels （χ^2==8.664 and 9.524,respectively,both P 〈 0.05）.Conclusions：Gal-3 expression may be involved in the development and invasiveness of ocular venous malformation,and pingyangmycin can inhibit Gal-3 expression,indicating a role of pingyangmycin treatment before the removal of ocular venous malformation.

Superselective uterine arterial embolization with pingyangmycin-lipiodol emulsion for management of symptomatic uterine leiomyoma

Background Uterine arterial embolization (UAE) is a safe and effective therapy for symptomatic uterine leiomyoma. This study was to assess the effectiveness and the feasibility of pingyangmycin-lipiodol emulsion (PLE) for the management of symptomatic uterine leiomyoma. Methods One hundred consecutive patients (aged 21-53 years,with 38 in average) with symptomatic uterine leiomyoma underwent superselective UAE with PLE. Clinical symptoms of the patients (including menorrhagia,bulk-related symptoms,and postprocedure-related abdominal pain) and the changes in uterine volume and tumor size after the embolization were analyzed. The patients were followed up for 8-21 months (mean,15 months). Results Ninety-nine patients (99%,99/100) were interviewed in their first menses circle after embolization,showing improvements in their abnormal bleeding and bulk-related symptoms to some extent. Imagiological results during follow-up showed a mean of 48% reduction in uterine volume at 6 months and a mean of 75% reduction in tumor size at 9 months. Eighty-three percent of the patients reported complete resolution of postprocedure pain within 7 days. Conclusions PLE is effective in the management of uterine leiomyoma,having superiority in alleviating postprocedure-related pain.