• 대한기관식도과학회지
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• 제14권2호
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• pp.31-37
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• 2008

Background and Objectives: In most cases of benign neck cysts, surgical excision has been considered as treatment of choice. However, sometimes complete excision is very difficult, and recurrences has been occured due to insufficient surgery frequently. In this point of view, non-surgical treatment has been attempted with sclerosing agents such as picibanil(OK-432). In this study, we evaluated the efficacy of picibanil sclerotherapy for benign neck cysts. Materials and methods: We retrospectively reviewed 53 patients(27 males, 26 females) who had undergone sclerotherapy with picibanil for benign neck cysts such as ranula, lymphangioma, thyroglossal duct cyst and branchial cyst. Information was gathered with respected to age, sex, number of injections, side effect and outcome of treatment. All patients were treated with intralesional aspiration of cystic contents and injection of picibanil, and followed on neck ultrasonography or neck CT. Results: 53 patients received sonoguided sclerotherapy using picibanil(OK-432). 31 patients(41.3%) showed total shrinkage, near total shrinkage(more than 90% of volume) in 7 patients(9.3%), marked shrinkage(more than 70%) in 5 patients(6.6%) and partial shrinkage(less than 70%) in 17 patients. 15 patients(20%) reaveled no response and 8 patients showed recurrences with repeated sclerotherapy. The side effects of therapy were observed by symptoms such as fever, localized pain and odynophagia. However, these complications disappeared after several days in all cases. Conclusions: We recognized that picibanil(OK-432) sclerotherapy for benign neck cyst is a safe and effective procedures as a primary treatment before considering surgery.

• 대한두경부종양학회지
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• 제18권1호
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• pp.84-86
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• 2002

Plunging ranula is occured in about 10% of all ranula cases although surgery is the first choice therapy. However, frequent recurrences of the disease due to insufficient surgery have been reported, and various therapies have been designed in addition to surgery. We here report a case on whom we conducted intralesional injection of OK-432 for recurrent plunging ranula. A 36-year-old man was admitted who had a 2-months history of swelling of right submandibular area. He had been operated for right plunging ranula twice, 7 years ago. Under fluoroscopic guidance, contents of the ranula were aspirated and OK-432 solution was injected twice with 3-week interval. Examination after 6 weeks showed that the cystic ranula seen before therapy had disappeared completely and no recurrence was encountered after 18months. Therefore the intralesional injection of OK-432 is effective method for treatment of the plunging ranula.

• Maxillofacial Plastic and Reconstructive Surgery
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• 제23권3호
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• pp.281-288
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• 2001

림프관종의 치료에 있어 전통적으로 수술적요법만이 선호되어져 왔으나 최근 Ogita 등에 의해 소개된 OK-432는 안전성과 효과면에서 기존의 경화제에 비해 뚜렷이 구별되는 효과를 지니고 있는 것으로 여러 저자등에 의해 보고되고 있다. 특히 수술이 매우 어려운 부위에 존재하는 경우라든지 수술후 재발된 증례등에서 일차 혹은 이차적으로 투여하여 높은 성공률을 보였다고 하였고 더불어 OK-432 투여후 시행된 수술시에도 섬유성유착등의 어려움없이 병소를 절제할 수 있다고 하였다. 본 증례의 경우도 일차적인 OK-432 투여후 8개월째 시행된 이차적인 수술에서 큰 어려움없이 병소를 절제할 수 있었다. 이에 저자등은 좌측 혀 및 구강저와 경부의 급성 부종으로 인한 호흡부전 및 대설증의 증상을 보여 본원 소아과에서 의뢰된 생후 5개월된 환자에게 병력 및 임상검사와 방사선적 검사를 시행한 결과 림프관종으로 진단하고 일차적으로 흡입천자를 통한 감압술과 OK-432 를 통한 경화요법을 시행하였고 이차적인 연속수술을 시행하여 병소를 완전히 절제하였으며 술후 현재까지 재발소견없이 양호한 결과를 보였기에 이에 보고하고자 한다.

• 대한기관식도과학회지
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• 제4권1호
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• pp.96-100
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• 1998

Lymphangiomas are congenital malformations of the lymphatic system. Cervicofacial lymphangioma represents 75% of all lymphangiomas. Surgical excision has been the treatment of choice, however the reported results have been unsatisfactory. Various sclerosants have been tried to treat lymphangiomas, with variable results and considerable side effects. Herein we report the results of treatment using intralesional picibanil for lymphangioma. Between January 1996 and January 1998, 16 patients with lymphangiomas, 10 boys and 6 girls, were treated with intralesional picibanil injections. All cases were treated as a primary therapy. Eight lymphagiomas were located in the neck, and 2 in the cheek, 2 in the parotid, 2 in the trunk, 1 in the oropharynx, 1 in the thigh. Dose and method of intralesional injection was similar to that reported by Ogita in 1987. Complete regression was observed in 10 cases and marked regression(> 75% size decrease) in 2 cases and moderate regression(75%-25% size decrease) in 2 cases and poor regression(< 25% size decrease) in 2 cases. No serious side effect was observed except fever lasting for 2-3 days. Intralesional injection of picibanil for lymphangiomas represents a safe, easy and effective way of treatment with high success rate. Picibanil injection can be used as a primary therapy for lymphangiomas.

• 대한기관식도과학회지
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• 제13권1호
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• pp.33-38
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• 2007

Background and Objectives: A plunging ranula represents a mucus escape reaction occuring because of the disruption of the sublingual salivary gland. It is commonly a condition of young adults, although the reported age range is 6-43 years. There is said to be a slightly female preponderance of about 1.9:1(F:M). Surgical incision has been considered the definite treatment, but sometimes complete excision is very difficult. Non-surgical treatment of these lesions has been attempted, but the results have not been satisfactory. In this study, we present our experiences with picibanil (OK-432) sclerotherapy for a plunging ranula. Materials and Methods: We retrospectively reviewed 41 patients who have undergone sclerotherapy with picibanil for plunging ranula. Information was collected on age, sex, a number of injection, post-sclerotherapy side effect and outcome of treatment. Results: 17 patients (41.5%) showed a complete response, and 20 patients (48.7%) showed inter-mediate response. No response was seen in 4 patients (9.8%). As a side effect of intracystic OK-432 injection therapy, fever (26.8%) and pain(39.0%) were observed. However, fever and pain disappeared after several days in all cases. Conclusion: The results are showing that OK-432 injection is an effective and safe treatment for plunging ranula.

• Clinical and Experimental Pediatrics
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• 제55권5호
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• pp.177-180
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• 2012

OK-432 (picibanil) is an inactivated preparation of $Streptococcus$ pyogenes that causes pleurodesis by inducing a strong inflammatory response. Intrapleural instillation of OK-432 has recently been used to successfully treat neonatal and fetal chylothorax. Here we report a trial of intrapleural instillation of OK-432 in two preterm infants who were born with hydrops fetalis and massive bilateral pleural effusion. Both cases showed persistent pleural effusion, refractory to conservative treatment, up to postnatal days 26 and 46, respectively. An average of 80 to 140 mL of pleural fluid was drained daily. In case 1, the infant was treated with OK-432 during the fetal period at gestation 28 weeks and 4 days of gestation, but showed recurrence of pleural effusion and progressed into hydrops. Within two to three days after OK-432 injection, the amount of pleural fluid drainage was dramatically decreased and there was no reaccumulation. We did not observe any side effects related to OK-432 injection. We suggest that OK-432 should be considered as a therapeutic option in infants who have persistent pleural effusion for more than four weeks, with the expectation of the early removal of the chest tube and a good outcome.

• Advances in pediatric surgery
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• 제8권2호
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• pp.95-100
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• 2002

Lymphangiomas or cystic hygromas are quite commonly seen in children. During a 22-year period, from January 1980 to December 2001, 117 patients with lymphangioma were treated and followed in the Department of Pediatric Surgery at Hanyang University Hospital. The male-to-female ratio was 1.9:1(77:40) with a male preponderance. As for the age incidence at time of diagnosis, 10(8.5 %) patients were noted under 1 month of age, 37(31.6%) were between 1 month and 1 year of age, 12(10.3%) between 1 and 2 years of age, so 59(50.4%) were under 2 years of age. Sixty one (52.1%) lymphangioma-cases were located in the neck, including one case at the nape. Axilla was the second in frequency and the rest were scattered at various sites. The intrascrotal lymphangioma is very rare but we have experienced one case of primary intrascrotal lymphangioma. Eighteen (15.4%) cases were located in the intraabdominal area, 10 in the mesentery, 2 in the greater omentum and 6 in the retroperitoneum. The chief complaints of intraabdominal lymphangioma were abdominal pain, intestinal obstruction, inguinal hernia, palpable mass, and/or abdominal distension. Among 77 histologically proven cases, 14 cases were cavernous lymphangiomas and the rest were cystic lymphangiomas. Bleeding in the lymphangioma was noted in 20(17.1%) cases of all. As for the treatment, a complete excision was performed in 77(65.8%) patients and $AgNO_3$ sclerotherapy after incomplete excision was performed in 23(19.7%). Picibanil (OK-432) sclerotherapy was performed in 17(14.5%) patients. Recurrence rate was 7.7 % and mortality occurred in one case who had a large neck lymphangioma extending into the mediastinum.