Intra-articular distribution of admistrated hematoporphirine in rheumatoid arthritis and selective synovialdesis using an argon-dye laser

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(1) Intra-articular distribution of administrated hematoporphirine (HPD) was examined on 14th day after adjuvant injention to cause the adjuvant arthritis of a rat, when the maximum inflamation was found. Existence of HPD in the synovium was demonstrated by fluorescence of 680 micrometer evoked after irradiation of 2 or 3 W of argon-dye laser light. Distribution of HPD in the adjuvant arthritic synovium was found maximun 24-48 hours after HPD administration. HPD distribution in the adjuvant arthritis was found more than 10 times comparing with the normal control.(2) The human synovial tissue was obtained during arthroscopis synoventomy, and was cultured. Admistration of HPD into the culture medium, and irradiation of argon-dye laser successfully impeded or suppressed the tissue growth.(3) A patient with rheumatoid arthritis was admistrated with HPD 2 miligram/kg intravenously, and irradiated by argon-dye laser arthroscopically 48 hours after the HPD injection. Good results were obtaine … More d for 6 months, however, recurrence of the hydroarthrosis took place.(4) HPD was distributed over not only the joint synovium but whole of the body, therefore, careful protection of the skin from sun burn should be employed. This patient was secured from sun light for a week, and massive vitamine C was administrated. However, the patient still suffered from severe sun burn. The way how to protect from sun burn required furhter investigation. It was considered that intra-articular injection of HPD was superior to intravenous administration, because of more absorption into the synovial tissue and less distribution over the skin.(5) A patient with bilateral synovitis was treated with just arthroscopic synovectomy for one side, and arthroscopic synovectomy augumented with HPD injection and argon-dye laser irradiation for the other. The latter obviosly obtained better results. HPD was considered activated by agron-dye laser light and destroyed cells, however, details of the process needed further investigation. Degeneration of the synovial tissue was demonstrated after this treatment. Less