Foam sclerotherapy using polidocanol (aethoxysklerol) for preoperative portal vein embolization in 16 patients.

PURPOSE: To evaluate the clinical safety and effectiveness of foam sclerotherapy using polidocanol for preoperative portal vein embolization (PVE) before hemihepatectomy of the liver. MATERIALS AND METHODS: From March 2006 to October 2008, foam sclerotherapy using polidocanol was performed in 16 patients (male-to-female ratio of 12:4, age range 48-75 years [mean 62]) for PVE. Patients were diagnosed with Klatskin tumor (n = 13), gallbladder (GB) cancer (n = 2), or hepatocellular carcinoma (HCC) (n = 1). The foam was composed of a 1:2:1 ratio of 3% polidocanol (Aethoxysklerol; Kreussler Pharma, Wiesbaden, Germany), room air, and contrast media (Xenetix 350; Guerbet, Aulnay-Sous-Bois, France). The total amount of polidocanol used (2 to 8 mL [mean 4.6]) varied according to the volume of the target portal vein. We calculated the volume of future liver remnant (FLR) before and after PVE and evaluated complications associated with the use of polidocanol foam sclerotherapy for PVE. RESULTS: Technical success was achieved in all patients. All patients were comfortable throughout the procedure and did not experience pain during sclerotherapy. No periprocedural morbidity or mortality occurred. Patients underwent a liver dynamic computed tomography (CT) scan 2-4 weeks after PVE. FLR increased significantly after PVE using polidocanol foam from 19.3% (range 16-35%) before PVE to 27.8% (range 23-42%) after PVE (p = 0.001). All patients were operable for hemihepatectomy of the liver and achieved effective resection. CONCLUSION: Foam sclerotherapy using polidocanol is clinically safe and effective for preoperative PVE.

Toxicity of spray and fumigant products containing cassia oil to Dermatophagoides farinae and Dermatophagoides pteronyssinus (Acari: Pyroglyphidae).

The toxicity of formulations of oil of cassia, Cinnamomum cassia Blume, (20 and 50 g L(-1) sprays and 100% oil-based fumigant) to adult Dermatophagoides farinae Hughes and D. pteronyssinus Trouessart was examined using contact and vapour-phase toxicity bioassays. Results were compared with the lethal activity of three commercial acaricides: benzyl benzoate, dibutyl phthalate and diethyl-m-toluamide (deet). The contact toxicity of cassia oil to both dust mite species was comparable with that of benzyl benzoate but was higher than that of the other two acaricides. Sprays containing 20 and 50 g L(-1) cassia oil were effective against both mite species when applied to fabric, glass, paper, plastic, tin or wood substrates. Applications of the 50 g L(-1) spray to different space volumes and surface areas determined that 50-60 mg of cassia oil was needed to control dust mites in 3.4 m(3) or in 1 m(2). In tests with fumigant devices, toxicity varied according to the thickness of non-woven fabric covering the device, the exposure time, the number of fumigant devices used and the volume of the space sprayed. Fumigant toxicity to adult D. pteronyssinus was more pronounced with devices enclosed in thinner (40 microm) versus thicker (45 or 50 microm) non-woven fabric covers. A single fumigant device with a 40 microm thick non-woven fabric cover resulted in substantial control in a space of 0.05 m(3) but exhibited only moderate to weak control in spaces >or= 0.097 m(3) at 4 days after application. Two fumigant devices gave 88% mortality in a space of 1.73 m(3). Cassia oil applied as sprays or in fumigant devices appears to provide effective protection of humans from house dust mites.