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Cerebral blood volumes in young rats with and without in situ saline flushing of cerebral vasculature. Implications for in vivo studies of brain substance uptake.

In recent studies of bilirubin encephalopathy, in situ flushing of the cerebral vessels has been used to clear blood from the brain. The effectiveness of such procedures has not been adequately documented. Herein young, male Sprague-Dawley rats were given about 750 KBq of 51Cr-labelled rat erythrocytes 3 min prior to sacrifice. There were four experimental groups: control, displacer (sulfisoxazole), hyperosmolality, and hypercarbia. Half of the rats in each group had the brain vasculature flushed in situ, while the remaining rat brains were not flushed. The brains were dissected into seven regions, and the radioactivity in the tissues was compared to that of blood drawn from the rats immediately before death. Significant amounts of blood (22-42%) remained after in situ flushing. Retention was significantly higher in the hyperosmolar animals, and significantly lower in the hypercarbic animals as compared to controls. Interregional differences in blood volumes per gram wet weight were significant without, but not with flushing. Similar observations were made using 125I-IgM as a marker for the plasma compartment. In studies of brain uptake of substances with high plasma concentrations, substance remaining within the cerebral vessels may contribute significantly to the apparent brain uptake values.

Animals↗

Menopausal hot flushes, plasma calcitonin and beta-endorphin. A preliminary report.

The association between plasma calcitonin and beta-endorphin has been shown in various studies with analgesic and thermoregulatory effects. In the present study, we sought a similar association between those chemicals and physiological menopausal hot flush. Plasma calcitonin and beta-endorphin levels were measured in 5 women in physiologic menopause who suffered from frequent episodes of hot flushes. An increase in plasma calcitonin levels was noted during the hot flushes, although it was not significant. In contrast, plasma beta-endorphin levels fell significantly at onset of the hot flush, as compared to their levels 5-20 min earlier (p less than 0.005), and rose 5-15 min following the hot flush episode.

Calcitonin↗

The role of flushing dental water lines for the removal of microbial contaminants.

OBJECTIVES: This study was designed to determine the role of flushing dental water lines for the removal of heterotrophic plate count bacteria, Legionella spp., and free-living protozoa. METHODS: Forty dental offices were surveyed in the study. An initial sample and a sample taken after three minutes of flushing were obtained from the air/water syringe at each location. All samples were quantitatively analyzed for heterotrophic bacteria using three bacteriological procedures. The samples were analyzed for the presence of Legionella spp. using cultural, immunological, and molecular procedures and for the occurrence of free-living protozoa using a killed bacteria plate procedure. RESULTS: The flushing process reduced the level of heterotrophic plate count bacteria by 1.1 to 1.5 log10 CFU/ml. Compliance with recommendations for bacterial levels varied depending on the methodology employed in the analysis. The flushing process did not reduce the occurrence of Legionella spp. or free-living protozoa. CONCLUSION: The results support recent U.S. Centers for Disease Control and Prevention recommendations that the process of flushing dental water lines cannot be relied upon as a sole means of reliably improving the quality of water used in dental treatment.

Bacteriological Techniques↗

Pilot study on prevention of lung injury during surgery for type A acute aortic dissection: no evident improvements with celsior flushing through the pulmonary artery.

OBJECTIVE: Postoperative respiratory failure is a frequent and serious complication in patients with type A acute aortic dissection. Experimental evidence suggests that pulmonary artery perfusion using hypothermic protective solutions helps prevent lung injury. The aim of this pilot prospective study was to evaluate the effect of pulmonary artery flushing during selective cerebral perfusion (SCP) on lung function. METHODS: Twenty patients referred for acute type A aortic dissection, who were free from preoperative respiratory dysfunction, were assigned prospectively and alternately to two treatment groups. Pulmonary flushing was performed during SCP in group P (10 patients), while conventional Kazui technique was applied in group N (10 patients). Lung perfusion consisted of single-shot hypothermic pulmonary artery flush with Celsior. Lung function was evaluated by intubation time, scoring of chest radiograms at 12 hours after CPB, and PaO2/FiO2 assessed from immediately before surgery to 72 hours after termination of cardiopulmonary bypass. RESULTS: Incidence of pre, intra and post operative determinants of lung dysfunction proved homogeneous in both groups. Lung oxygenation function showed a marked post operative decline followed by a slow improvement in both groups. Analysis of respiratory ratios did not disclose significant differences even though the flushed group had a better performance in all study patients. The incidence of prolonged ventilator support (longer than 72 hours) (30% vs 20%, p = NS) and severity of x-ray pulmonary infiltrate score were comparable (mean score 1.7 +/- 0.71 vs 1.6 +/- 0.68, p = NS). CONCLUSIONS: Pulmonary artery flushing with Celsior solution does not seem to provide an effective preservation of lung function.

Aged↗

Menopausal flushes: effect of pituitary gonadotropin desensitization by a potent luteinizing hormone- releasing factor agonist.

Recent evidence suggests that the menopausal flush is linked to the neuroendocrine events which govern pulsatile LH secretion and thermoregulation. This study was designed to determine whether abolishment of LH pulses may abate flush episodes. After pituitary gonadotropin densensitization by a LRF agonist, LH and FSH pulses were abolished, and serum gonadotropin levels were decreased. Flush episodes, however, were unaltered. These findings demonstrate that pulsatile LH release by the pituitary is not causally related to menopausal flushes, and support the contention that flush episodes are initiated by a hypothalamic mechanism(s).

Body Temperature↗

Soybean isoflavones eliminate nifedipine-induced flushing of tail skin in ovariectomized mice.

Hot flushes are one of the most frequent symptoms in menopausal women. We investigated effect of soybean isoflavones (Soyaflavone HG) on nifedipine-induced flushing in ovariectomized mice. Ovariectomy markedly aggravated nifedipine-induced increase in tail skin temperature. Soyaflavone HG (10 mg/kg, p.o., once a day for 5 days) inhibited nifedipine-induced flushing in ovariectomized mice. The inhibitory effect of Soyaflavone HG was significantly reversed by an estrogen-receptor antagonist, ICI 182,780, suggesting that Soyaflavone HG prevents nifedipine-induced flushing partially through estrogen receptors. We presented the experimental evidence suggesting that soybean isoflavones including Soyaflavone HG have the benefits for menopausal hot flushes.

Animals↗

Management of hot flushes without oestrogen.

Hot flushes are probably the most common symptom resulting in medical consultation in relation to the menopause. The association between the two is so strong that the connection is often invoked even when hot flushes occur in a regularly menstruating woman. Oestrogen significantly reduces hot flushes but is not used by all women-either because of contraindications or a reluctance to take oestrogen-based therapy. In addition, hot flushes may persist in spite of adequate oestrogen replacement, and physicians are often faced with the dilemma of finding something instead of, or in addition to, oestrogen for symptom relief. The available alternatives for the management of hot flushes are reviewed.

Journal Article↗

A review of the use of lipiodol flushing for unexplained infertility.

There has been speculation for decades regarding the role of flushing women's fallopian tubes in improving the chance of pregnancy. More recent evidence has highlighted a possible specific role for lipiodol (ethiodized oil), an oil-soluble contrast medium, in the enhancement of fertility by these means. This systematic review was designed to assess the effectiveness of tubal flushing with various contrast media in improving the chance of pregnancy. The review was performed using Cochrane guidelines, including only data from randomized controlled trials. Results confirm the effectiveness of flushing with lipiodol in improving the chance of pregnancy and live birth. Although there was limited evidence to suggest a possible benefit of oil- over water-soluble contrast media, the answer to this question remains unclear. The specific groups who appear to benefit most from lipiodol flushing are couples with unexplained infertility, but particularly couples where the woman has endometriosis in the context of normal patent fallopian tubes. As a simple, low-cost, minimally invasive intervention that carries a low risk of complications and no increased risk of multiple pregnancy, lipiodol flushing may prove an appealing alternative to established fertility treatments for many couples.

Contrast Media↗

Circulating tachykinins (substance P, neurokinin A, neuropeptide K) and the carcinoid flush.

Antisera of defined regional specificity have been used to measure the concentration of substance P-like immunoreactivity (SP-LI) and neurokinin A-like immunoreactivity (NKA-LI) during a meal-induced flush in 10 patients with metastatic carcinoid tumours. Although all patients flushed, NKA-LI levels in five patients and SP-LI in six patients were not elevated relative to healthy subjects (NKA-LI, less than 3 pg/ml; SP-LI, less than 10 pg/ml) both in the fasted state and after food. In the patients with elevated basal plasma tachykinin levels, increases in NKA-LI and SP-LI after food were erratic and did not correspond to a defined digestive phase or the occurrence of the flush. Chromatographic analysis of plasma demonstrated the presence of neuropeptide K and neurokinin A, and the detection of COOH-terminal fragments of substance P is consistent with the higher levels of circulating SP-LI measured with a COOH-terminally directed antiserum compared with an NH2-terminally directed antiserum. Subcutaneous injection of the somatostatin analogue SMS 201-995 (50 micrograms) alleviated symptoms of flush in two of three patients but only partially suppressed NKA-LI and SP-LI concentrations. It is concluded that circulating tachykinins cannot be solely responsible for the meal-induced carcinoid flush.

Adult↗

The presence of the fifth component of complement (C5) in rabbit uterine flushings in relation to reproductive state.

The fifth component of complement (C5) has been detected in rabbit uterine flushings. The C5 activity was evaluated using a hemolytic assay which requires the use of a C5-depleted reagent (C5D) prepared by affinity chromatography of normal human serum. In the absence of C5D, there was no hemolysis of antibody-sensitized erythrocytes by rabbit uterine flushings, whereas the presence of the C5D reagent resulted in substantial hemolysis. The amount of hemolysis was correlated with the reproductive state of the rabbits, with higher amounts of hemolysis (expressed per mg uterine flushing protein) evident in estrous rabbits. In addition, the amounts of immunoglobulin G (IgG), albumin, and total protein were also determined in the uterine flushings. The amounts of total protein and IgG were increased in day-6 pregnant animals compared to estrus while the amount of albumin per ml uterine flushing was not significantly changed.

Albumins↗

Hot flushes and other menopausal symptoms in relation to soy product intake in Japanese women.

OBJECTIVE: To examine the relationships between dietary intake of soy products and hot flushes and other menopausal symptoms. METHODS: Subjects were 284 women aged 40-59 years who attended a health check-up program provided by a general hospital in Gifu, Japan. They completed a health questionnaire including the Kupperman test of menopausal distress. Diet was assessed by a semiquantitative food frequency questionnaire. RESULTS: Fermented soy product intake but not total soy product intake was significantly negatively correlated with hot flush severity (r = -0.16, p = 0.01) after controlling for age and menopausal status. Neither total soy product intake nor fermented soy product intake was significantly correlated with menopausal index score. Estimated isoflavone intake from total and fermented soy products was significantly lower by 15% (p = 0.02) and 19% (p = 0.01), respectively, in women with hot flushes, compared to those without hot flushes after controlling for covariates. CONCLUSION: The data support a hypothesis that intake of fermented soy products alleviates the severity of hot flushes.

Adult↗

Gas-flushed packaging contributes to calcium lactate crystals in Cheddar cheese.

Gas-flushed packaging is commonly used for cheese shreds and cubes to prevent aggregation and loss of individual identity. Appearance of a white haze on cubed cheese is unappealing to consumers, who may refrain from buying, resulting in lost revenue to manufacturers. The objective of this study was to determine whether gas flushing of Cheddar cheese contributes to the occurrence of calcium lactate crystals (CLC). Cheddar cheese was manufactured using standard methods, with addition of starter culture, annatto, and chymosin. Two different cheese milk compositions were used: standard (lactose:protein = 1.47, protein:fat = 0.90, lactose = 4.8%) and ultrafiltered (UF; lactose:protein = 1.23, protein:fat = 0.84, lactose = 4.8%), with or without adjunct Lactobacillus curvatus. Curds were milled when whey reached 0.45% titratable acidity, and pressed for 16 h. After aging at 7.2 degrees C for 6 mo, cheeses were cubed (1 x 1 x 4 cm) and either vacuum-packaged or gas-flushed with carbon dioxide, nitrogen, or a 50:50 mixture of carbon dioxide and nitrogen, then aged for an additional 3 mo. Heavy crystals were observed on surfaces of all cubed cheeses that were gas-flushed, but not on cheeses that were vacuum-packaged. Cheeses without Lb. curvatus exhibited L(+)-CLC on surfaces, whereas cheeses with Lb. curvatus exhibited racemic mixtures of L(+)/D(-)-CLC throughout the cheese matrices. The results show that gas flushing (regardless of gas composition), milk composition, and presence of nonstarter lactic acid bacteria, can contribute to the development of CLC on cheese surfaces. These findings stress the importance of packaging to cheese quality.

Animals↗

Prereperfusion flushing of ischemic territory: a therapeutic study in which histological and behavioral assessments were used to measure ischemia-reperfusion injury in rats with stroke.

OBJECT: In ischemic stroke, the ischemic crisis activates a cascade of traumatic events that are potentiated by reperfusion and eventually lead to neuronal degeneration. The primary aim of this study was to investigate a procedure that could minimize this damage by interfering with the interactions between reestablished blood flow and ischemically damaged tissue, as well as by improving regional microcirculation. METHODS: Using a novel hollow filament, the authors flushed the ischemic territory with heparinized saline before vascular reperfusion after occlusion of the middle cerebral artery (MCA). The results demonstrate a statistically significant (p < 0.001) reduction in infarct volume (75%; from 45.3 +/- 3.6% to 11.4 +/- 1.7%, determined with Nissl staining) in rats in which a 2-hour MCA occlusion was followed by a 48-hour reperfusion. Infarction and neuronal degeneration were confirmed using silver staining, which revealed a significantly larger infarct (36.3%, p < 0.05) than that detected with Nissl staining. The long-term neuroprotection of the prereperfusion flushing was also evaluated. This was determined by a series of motor behavior tasks (foot placing, parallel bar traversing, rope and ladder climbing) performed up to 28 days after reperfusion. Motor deficits were found to be significantly ameliorated in animals that underwent the flushing procedure (p < 0.001). In addition, neurological outcome was also improved significantly (p < 0.001) in the same animals. CONCLUSIONS: These results indicate that interaction between reperfusion and the metabolically and biochemically compromised tissue could be interrupted by the prereperfusion flushing procedure, which could lead to a reduction in brain injury from stroke. Mechanical reopening of the cerebral occlusion with local flushing and isolated reperfusion of the regionally injured brain might offer new treatment options for patients with stroke.

Animals↗

[A clinical study of estramustine phosphate sodium for the treatment of hot flushes in men with prostate cancer].

PURPOSE: To assess the effectiveness and tolerability of estramustine sodium phosphate in men with hot flushes during combined androgen blockade (CAB) therapy for prostate cancer. PATIENTS AND METHODS: Seven men with moderate to severe hot flushes were received estramustine sodium phosphate. Treatment response was assessed by hot flush score. RESULTS: A significant reduction in the hot flush score was seen with all patients. No thromboembolic complications occurred in any patients. CONCLUSIONS: Estramustine sodium phosphate appears to be a promising, well-tolerated and useful therapy for men with hot flushes during CAB treatment for prostate cancer.

Aged↗

Injection of air bubbles during flushing of angiocatheters: an in vitro trial of conventional hardware and techniques.

BACKGROUND AND PURPOSE: Injected air bubbles are a well-accepted cause of stroke during cerebral angiography. We used an in vitro model to determine the frequency of occurrence of air emboli during catheter flushing using conventional hardware and techniques. METHODS: Two experimental models were used in this study. The first incorporated an in-line bubble trap. Ten members of our angiography section flushed this system in their usual fashion and then with two modifications of the hardware. The trap was inspected after each trial of seven injections and any visible bubble was measured with calipers. The second model used a peristaltic pump along with a transcranial Doppler device to look at the relative number of bubble events with modifications of the flush solution or technique. RESULTS: The closed-flush set in common usage in our department caused an increase in the number of visible bubbles in the trap as compared with an open basin. Degassing the solution and delaying injection decreased the number of bubble events noted in model 2. CONCLUSION: Bubble emboli are commonplace during flushing of angiography catheters when using conventional techniques and equipment.

Aged↗

[Water-quality of Westbrabantse dental units and the effect of flushing].

Dutch literature is not very clear about whether or not the effluent water/spray of handpieces of dental units meets the Dutch standards of potable water (< 200 CFU/ml and no pathogens). To improve the quality of dental unit water, flushing or purging the waterlines is recommended. In this study the quality of the effluent water/spray of 9 dental units was measured at the beginning of the day before and after 2 minutes flushing (sample size 25 ml) and the end of the day before and after 20 seconds flushing (sample size 5 ml). All units easily met the potable water standards after 2 minutes flushing, but after 20 seconds the effect was less impressive. The overall larger number of bacteria found after 20 seconds flushing can be explained as a matter of chance, whether or not a by turbulence loosened part of the biofilm has entered the small sample taken.

Biofilms↗

[Contrastive study of two methods("programmed temperature vaporization with back flushing" and "head space") for light hydrocarbon analysis].

Light hydrocarbon analytical method of "PTV with Back Flushing" presented here is characterized as follows: a) with "PTV" inlets temperature programmed; b) with gas line system of "Back Flushing"; c) with direct injection of oil samples. After oil sample injection, "Back Flushing" is on when light hydrocarbon components enter into analytical chromatographic column. At the same time, the temperature of inlet increases. The high temperature and "Back Flushing" blow the heavy components in the oil samples out of the analytical system. Besides, the analytical method of "Head Space" was established. Both "PTV with Back Flushing" and "Head Space" have the advantages of long column life and short analysis time. The resolution for lighter components < C9 meets the criterion of ASTM D5134-98, with the good repeatability. Ten oil samples from 6 oil areas were analysed by using the two methods. The relative deviations between the two analytical results represented by 19 geochemistry parameters were about +/- (1%-25%). The reasons for the deviation are discussed. It is pointed out that in geochemistry study it is not acceptable to combine the data obtained from two analytical methods. The analytical results obtained by injecting crude oil directly into injector are more reliable. The results obtained in "Head Space" analytical method should be calibrated when used in geochemistry study.

English Abstract↗

Flow velocities and shear stresses during flushing operations in sewer collectors.

Many relevant problems of drainage systems such as first flush pollution, flow capacity reduction and consequent risks of surcharges are worsened by sediment accumulation in sewer collectors. For the solution of these problems several sediment cleansing methods and techniques, e.g. mechanical methods, traps and flushing devices, have been developed and applied in the last decades. In particular, simulation studies and experimental campaigns have shown the effectiveness of flushing methods as preventive cleansing strategy in sewer collectors. In this paper the results of a numerical investigation for determining flushing waves characteristics both in terms of duration and flow rate are presented. The collector section lengths where flow velocities and average shear stresses determined by flushing waves exceed minimum threshold values are evaluated using a dimensionless approach. The results, related to the operative ranges of the practical applications, are exposed by means of graphs and regressive equations.

Geologic Sediments↗