title: Visualization of diffusion of the drug solution during aluminum potassium tannic acid injection therapy: a pilot study.
abstract: Sclerotherapy with aluminum potassium tannic acid (ALTA), which was approved in Japan for the treatment of internal hemorrhoids in July 2004 (Takano et al., Int J Colorectal Dis 21:44-51, 2006), has been widely accepted because of its effectiveness and low invasiveness. More than 200,000 patients have received ALTA injection therapy. ALTA is injected directly into 4 points of an internal hemorrhoid (4-step injection) to induce sclerosis and remission of the hemorrhoids, and consequently, resolution of symptoms such as prolapse and bleeding. The precision of the 4-step injection is considered to be a crucial determinant of the success of this therapy and the risk of complications. However, sufficient evidence has not yet been obtained concerning the diffusion and distribution of the injected drug. A pilot study visualized the real-time diffusion/distribution of the drug solution following the 4-step injection, using the ICG (indocyanine green) fluorescence technique, and an infrared camera (Photodynamic EYE; PDE, Hamamatsu Photonics K.K.).
authors.affiliation: Yamamoto Clinic, 2-8-28 Hikinocho kita, Hukuyama, Hiroshima 721-0941, Japan. yamayu@bingonet.jp
authors.forename: Yutaka
authors.initials: Y
authors.lastname: Yamamoto
authors.forename: Mitsuharu
authors.initials: M
authors.lastname: Miwa
mesh_terms: D000534:Alum Compounds / Q000008:administration & dosage* / Q000493:pharmacokinetics*; D004058:Diffusion; D006484:Hemorrhoids / Q000601:surgery / Q000628:therapy*; D006801:Humans; D007208:Indocyanine Green; D007267:Injections; D057054:Molecular Imaging / Q000379:methods*; D061848:Optical Imaging / Q000295:instrumentation / Q000379:methods*; D010865:Pilot Projects; D012597:Sclerosing Solutions; D015911:Sclerotherapy / Q000379:methods*; D013634:Tannins / Q000008:administration & dosage* / Q000493:pharmacokinetics*
chemical_list: D000534:Alum Compounds; D012597:Sclerosing Solutions; D013634:Tannins; C041524:aluminum sulfate; D007208:Indocyanine Green