Joints injection into

Hydroxyapatite particles can be used for radiation synovectomy by exploiting the strong binding of rhenium diphosphonate complexes to the surface of hydroxyapatite (vide supra). The same 186Re-HEDP preparations as for bone palliative therapy are used. When injected into joints, these particles (mean diameter 25 pm, maximum diameter 45 pm) remain within the joint to the extent of at least 95% for several days in arthritic rabbits and rats [156], More recently, microspheres have been labeled with 188Re for this purpose [156a,b],... 

HIsmelt A direct iron smelting process in which noncoking coal, fine iron ore, and fluxes and gases, are injected into a molten iron bath the carbon monoxide produced is used to prereduce the ore in a fluidized bed. Under development by CRA, Australia, since the early 1980s, joined by Midrex Corporation in 1988. Their joint venture company, Hismelt Corporation, commissioned a pilot plant at Kwinana, near Perth, Australia, in 1993. 

KBW [Koppers Babcock Wilcox] A coal gasification process developed jointly by the Koppers Company and Babcock Wilcox, intended to supply the synthetic fuels industry. The product is a mixture of carbon monoxide and hydrogen. Dry, powdered coal, oxygen, and steam are injected into the reactor. The reaction temperature is sufficiently high that the ash is molten it runs down the reactor walls, is tapped out as a molten slag, and is quenched in water before disposal. In 1984, seven commercial synfuels projects planned to use this process but it is not known whether any was commercialized. 

The ability of MSCs to induce tissue regeneration without an immune response was investigated in a goat model of meniscal injury. Donor MSCs were injected into the damaged meniscus in the knee joint on days 7, 14 and 21 (10 million MSCs per injection). Ex vivo examinations showed that MSCs suppressed T-cell alloreactivity selectively, maintaining some types of T-cell responses [656698]. 

A second aCGRP-deficient mouse was produced by Hoff et al. (1998) in order to study the role of calcitonin. CGRP mice are born normally, are fertile and live a normal life span. These mice were tested in a model of chronic arthritis, where a mixture of kaolin/carrageenan was injected into the knee joint and in comparison to wild type mice failed to develop secondary hyperalgesia (Zhang et al., 2001). 

Probably the second most common and probably the most expensive form of chronic pain in industrialised societies behind headache. It can be acute or chronic and has many causes. It is sometimes treated with epidural injections or injections into joints. 

Curiously, osmium tetroxide s reputation for chronic toxicity is not supported in the toxicology literature [32], In fact, an aqueous solution of osmium tetroxide is used to treat refractory rheumatoid arthritis in humans by direct injection into the knee joint [33,34]. 

DNA injection directly into mouse diaphragm has also resulted in luciferase expression and there appeared to be no damage to the diaphragm due to the DNA injections (Davis and Jasmin, 1993). In a related study, /3-galactosidasc ( /3-gal)-encoding pDNA injected into the articular space of rabbit knee joints resulted in /3-gal expression in the joints (Yovandich etal., 1995). In the same study, chloramphenicol acetyltransferase (CAT) encoding pDNA injected into rat knee joints also led to reporter gene expression, with peak expression 48 hours after injection and with no detectable activity 15 days later. 

Glucocorticoids can also be injected directly into the arthritic joint, a technique that can be invaluable in the management of acute exacerbations. There is, of course, considerable controversy about whether intra-articular glucocorticoids will produce harmful catabolic effects in joints that are already weakened by arthritic changes. At the very least, the number of injections into an arthritic joint should be limited, and a common rule of thumb is to not exceed more than four injections in one joint within one year.77... 

Viscosupplementation is a clinical procedure that is being used increasingly in the treatment of osteoarthritis. This technique uses a substance known as hyaluronan to restore the lubricating properties of synovial fluid in osteoarthritic joints.6,41 Hyaluronan is a polysaccharide that can be injected into an arthritic joint to help restore the normal viscosity of the synovial fluid.6 This treatment helps reduce joint stresses, thus limiting the progression of articular destruction seen in osteoarthritis.106 Viscosupplementation has therefore been shown to reduce pain and improve function in osteoarthritis.1,95... 

Neutrophils exposed to urate crystals ingest them and produce a glycoprotein, which may be the causative agent of acute gouty arthritis. Injected into joints, this substance produces a profound arthritis that is histologically indistinguishable from that caused by direct injection of urate crystals. Colchicine appears to prevent the elaboration by leukocytes of this glycoprotein. 

In later TEM studies by Ghadially et al. (48), a lower concentration of cisplatin (30 (xM) was incubated in HeLa and human lymphoblastoid (RPMI 6410) cells for periods that ranged from 1 hour to 4 days. No intracellular platinum was detected in either cell line. However, similar incubations with platinum(II)-uracil resulted in development of lysosome-like bodies in the cytosol, which are referred to as platinosomes, that contain electron dense species identified by X-ray analysis as platinum (48). In a related study, similar concentrations of cisplatin were injected into rabbit knee joints and incubated for several days. Again, no platinum was detected in the intracellular or extracellular compartments of the synovial cells, whereas platinum was observed to accumulate only in the platinosomes after platinum-uracil incubation (49). This set of studies highlights the effect of incubation concentrations of the drug on the cellular distribution results, as well as, drawing attention to the uptake of some platinum(II) complexes in cytoplasmic organelles. 

Topical applications (creams, intranasal, inhalations, enemas) are used in attempts, often successful, to obtain local, whilst avoiding systemic, effects suspensions of solutions are also injected into joints, soft tissues and subconjunctivally. All these can, with heavy dose, be sufficiently absorbed to suppress the hypothalamus and cause other unwanted effects. Individual preparations are mentioned in the text where appropriate. 

Fosfomycin has relatively low toxicity. Its penetration into tissues, including bones and joints, and into the cerebrospinal fluid is good. When given orally (2-3 g/day), it can produce gastrointestinal distress when injected intramuscularly, it can cause local pain. Fosfomycin is recommended in daily doses of 4-16 g intravenously for the treatment of severe infections resistant to other commonly used antibiotics. Fosfomycin diffuses moderately well into bone tissue (2). 

Osmic acid is injected into joints for chemical synovectomy and is associated with local pain, effusions, and fever skin necrosis is less frequent (1). Nerve damage and abnormal urinary findings (hematuria, proteinuria, and leukocyturia) can occur (SEDA-12, 94). A potentially dangerous drug, it certainly should not be given to young patients. 

Initial pain at the site of the bite may be followed with a metallic sensation in the mouth. Victims may become weak, and experience nausea, diarrhea, diaphoresis, and chills. Edema may begin around the bite area or may be delayed. Observation of the site for edema is a clue as to whether or not a dry bite has occurred that is, that no venom was injected into the site. Envenomation is most serious if venom is injected directly into joints, muscles, or veins. Hemorrhagic blisters and tissue destruction are possible. Neurotoxicity from rattlesnakes (but generally not from cottonmouths or copperheads) may be manifested as fasciculations, which are fine continuous contractions. In some cases, systemic neurotoxicity may involve respiratory failure. In the most serious cases, massive envenomation may lead to serious bleeding, hypotension, shock, multiple organ failure, and a high incidence of mortality. 

Complications associated with i.m. administration include nerve injury, muscle contracture, and abscess formation. Less common problems include intramuscular hemorrhage, cellulitis, skin pigmentation, tissue necrosis, muscle atrophy, gangrene, and cyst or scar formation. In addition, injury may occur from broken needles and inadvertent injection into a joint or vein. ... 

---