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PubMed1997

[The temperature dependency of the protective properties of the St. Thomas' Hospital cardioplegic solution, the University of Wisconsin solution, and Bretschneider buffered solution].

We studied three preservation solutions such as St. Thomas' hospital cardioplegic solution No. 2 (ST), the University of Wisconsin solution (UW) and Bretschneider's solution (BR) for protective properties, especially in terms of temperature dependence during the preservation. Rat hearts were studied and divided into three groups; ST. UW and BR. In each group, six hearts were carried out perfusion, cardioplegic infusion, ischemia and reperfusion for four different conditions. Using an isolated working rat heart model, the hearts were subjected to 5 minutes Langendorff perfusion followed by 20 minutes working perfusion. During this working period, cardiac functions such as aortic and coronary flow, aortic pressure, and heart rates were measured every 5 minutes. After working perfusion, 3 minutes of cardioplegic infusion was carried out either with UW, ST, and BR at 37, 20, 4, 1 degree C. The hearts were subjected to either 35 min at 37 degrees C, 120 min at 20 degrees C, 300 min at 4 degrees C, or 450 min at 1 degree C. The hearts were immersed in the same solution during ischemia. The hearts were reperfused at 37 degrees C, initially in the Langendorff mode for 15 min. Coronary effluent was collected for the measurement of CK leakage during reperfusion. The heart were then converted to the working mode for 20 minutes. During working reperfusion period, the variables of cardiac function were again measured and expressed as a percentage of their individual preischemic control values. Under conditions of 37 degrees C ischemia, % recovery of cardiac output (%CO) in ST group is 62.8 +/- 2.8%, although the hearts preserved with UW and BR were not recovered. Under conditions of 20 degrees C ischemia, %CO in UW, ST and BR were 46.8 +/- 2.7, 82.0 +/- 3.1 and 41.4 +/- 2.6%, respectively. Under conditions of 4 degrees C ischemia, %CO in UW, ST and BR were 66.2 +/- 8.0, 68.6 +/- 2.3 and 47.2 +/- 2.9%, respectively. Under conditions of 1 degrees C ischemia, %CO in UW, ST and BR were 70.6 +/- 3.3, 56.5 +/- 1.6 and 43.0 +/- 2.5%, respectively. In conclusions, ST revealed the best protective properties for the heart preservation between 37 degrees C and 20 degrees C ischemia. The properties of ST was similar to that of UW under conditions of 4 degrees C, although UW showed most excellent protective properties under conditions of 1 degrees C ischemia. These results suggested that, protective ability of preservation solution might be changed by the temperature during preservation period.

Adenosine↗
PubMed2006

Solute dependence of mobility of solvent molecules in solvophobic solute solutions: Dielectric relaxation of nonpolar solute/alcohol mixtures.

The dielectric relaxation spectra of alcohol/nonpolar solute mixtures are measured at several temperatures (-15 degrees C < or = T < or = 25 degrees C) and for several molar fractions of solute (0 < or = X(s) < or = 0.114) in the frequency range of 200 MHz < or = nu < or = 20 GHz. The double-Debye-type function is used for fitting of the spectra of mixtures, and the mean dielectric relaxation times (tau(mean)) of alcohol molecules are determined. In the systems having strong interaction between alcohol and nonpolar solutes, tau(mean) becomes shorter with an increase in the concentration of the solutes. On the other hand, tau(mean) becomes longer in the system having weak interaction between alcohol and nonpolar solutes. These results contradict with our intuitive predictions, do not correspond to mixing enthalpy, and are not explained by the hydrodynamic theory. They are attributed to the mechanism of the coupling between long-range electrostatic interactions and concentration fluctuation caused by the addition of solutes, which is suggested by Yamaguchi et al. based on the mode-coupling theory (Yamaguchi, T.; Matsuoka, T.; Koda, S. J. Chem. Phys. 2004, 120, 7590).

Chemical Phenomena↗
PubMed2001

Solute-binding protein-dependent ABC transporters are responsible for solute efflux in addition to solute uptake.

The ATP-binding cassette (ABC) transporter superfamily is one of the most widespread of all gene families and currently has in excess of 1100 members in organisms ranging from the Archaea to manQ1. The movement of the diverse solutes of ABC transporters has been accepted as being strictly unidirectional, with recent models indicating that they are irreversible. However, contrary to this paradigm, we show that three solute-binding protein-dependent (SBP) ABC transporters of amino acids, i.e. the general amino acid permease (Aap) and the branched-chain amino acid permease (Bra) of Rhizobium leguminosarum and the histidine permease (His) of Salmonella typhimurium, are bidirectional, being responsible for efflux in addition to the uptake of solutes. The net solute movement measured for an ABC transporter depends on the rates of uptake and efflux, which are independent; a plateau is reached when both are saturated. SBP ABC transporters promote active uptake because, although the Vmax values for uptake and efflux are not significantly different, there is a 103-104 higher affinity for uptake of solute compared with efflux. Therefore, the SBP ABC transporters are able to support a substantial concentration gradient and provide a net uptake of solutes into bacterial cells.

ATP-Binding Cassette Transporters↗
PubMed1982

[Comparative measurement of transmural gastric potential difference after administration of Euphyllin solution, theophylline solution, ethylenediamine dihydrochloride solution and Riopan, buffered theophylline].

Across the surface of the stomach mucosa exist large electrolytic concentration differences. While the pH value of the mucosa cells remains very constant within the range of 7.0 to 7.2, the pH value of the stomach fluctuates between 1 and 5. The differences in concentration of H-ions and other ions on both sides of the mucosa membrane result in an electrical voltage. Measurement of this voltage permits inferences to be made about the integrity of the mucosa cells. The electrical voltage and its changes can be measured and evaluated using a model developed in our Institut. Previously, there existed no studies comparing the irritation on the human stomach of solutions of Euphyllin and Theophylline. Now, using the forementioned model, we have performed such a study by examining the gastric transmural potential difference changes in nine (9) healthy subjects receiving Euphylline, Theophylline, and Ethylendiamin dihydrochloride in a cross-over design. Additionally, we have attempted to clarify if it is possible to suppress the irritation caused by Theophylline with Riopan. The investigation led to the following results: 1) The gastric irritation caused by Euphylline solution is statistically smaller than that caused by Theophylline solution. 2) The Ethylendiamin-dihydrochloride solution caused a minor irritation smaller than that of the Euphylline solution. 3) A pretreatment with Riopan reduced the irritation of the Theophylline solution.

Aluminum Hydroxide↗
PubMed2004

Sedimentation equilibrium in a solution containing an arbitrary number of solute species at arbitrary concentrations: theory and application to concentrated solutions of ribonuclease.

Simple expressions are derived describing the equilibrium concentration gradient of each species in a solution containing an arbitrary number of solute species at arbitrary concentration, as a function of the concentration of all species. Quantitative relationships between the species gradients and experimentally observable signal gradients are presented. The expressions are model-free and take into account both attractive and repulsive interactions between all species. In order to analyze data obtained from strongly nonideal solutions, a statistical thermodynamic model for repulsive solute-solute interactions is required. The relations obtained are utilized to analyze the dependence of the equilibrium gradient of ribonuclease A in phosphate-buffered saline, pH 7.4, upon total protein concentration. Experimental results are interpreted in the context of a model for weak self-association leading to the formation of significant amounts of oligomers at total protein concentrations exceeding 25 g/l.

Attention↗
PubMed2003

Celsior solution compared with University of Wisconsin solution (UW) and histidine-tryptophan-ketoglutarate solution (HTK) in the protection of human hepatocytes against ischemia-reperfusion injury.

Celsior, a new preservation solution in thoracic organ transplantation was evaluated for efficacy in cold preservation of human hepatocytes and compared with University of Wisconsin solution (UW) and histidine-tryptophan-ketoglutarate solution (HTK, Custodiol). Human hepatocyte cultures were preserved at 4 degrees C in Celsior, UW and HTK for 2, 6, 12, 24 and 48 h with 6 h of reperfusion. Levels of lactate dehydrogenase (LDH; cell necrosis), 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide (MTT; mitochondrial function), and adenosine 5'-triphosphate (ATP; loss of intracellular energy) were measured. Cell necrosis, mitochondrial dysfunction, and loss of ATP were significantly ( P<0.001, P<0.001, P<0.002, respectively) lower in Celsior than in HTK. The amount of cell necrosis and mitochondrial dysfunction in Celsior solution (CS) and UW was equal ( P=n.s.) up to 24 h and significantly lower in UW after 48 h ( P<0.001). Additionally, the intracellular level of ATP was significantly higher after ischemia ( P<0.001) and reperfusion from long-term ischemia (24, 48 h) ( P<0.002). We can conclude that Celsior was superior to HTK and equal to UW in the protection of human hepatocytes against cold preservation injury from ischemia and reperfusion. Furthermore, Celsior was effective in long-term preservation of human hepatocytes.

Adenosine↗
PubMed1996

Effect of Saccharides on the Glass-Forming Tendency and Stability of Solutions of 2,3-Butanediol, 1,2-Propanediol, or 1,3-Butanediol in Water, Phosphate-Buffered Saline, Euro-Collins Solution, or Saint Thomas Cardioplegic Solution

The effect of sugars or reduced saccharides trehalose, sucrose, sorbitol, or mannitol on the glass-forming tendency during cooling and the stability of the wholly amorphous state during warming has been studied with 2,3-butanediol, 1,2-propanediol, or 1,3-butanediol in three different carrier solutions. The 2,3-butanediol contained 96.7% (w/w) racemic mixture of the levo and dextro isomers and 3.1% (w/w) of the meso isomer (called 2,3-butanediol 97% dl). The carrier solutions were water, a phosphate-buffered saline, and two organ preservation solutions (Euro-Collins and Saint Thomas). The latter two were chosen because they are often used for kidney and heart preservation, respectively. The concentrations of 2,3-butanediol, 1,2-propanediol, and 1,3-butanediol varied respectively from 25 to 34, 30 to 35, and 30% (w/w). The concentrations of saccharides were 4 or 5% (w/w). In the absence of saccharides, for a given 2,3-butanediol concentration, the glass-forming tendency increased in the following order: water, Saint Thomas, the phosphate buffer, Euro-Collins. Addition of 4 or 5% (w/w) saccharide resulted in a large increase in the glass-forming ability of the solution during cooling and increased the stability of the glass during warming; but replacement of 4 or 5% diol by an equivalent weight (percentage) of a saccharide decreased, though to a lesser extent, these properties.

Journal Article↗
PubMed1993

Oral contrast media in CT of the abdomen. A double-blind randomized study comparing an aqueous solution of amidotrizoate, an aqueous solution of iohexol and a viscous solution of iohexol.

In a double-blind randomized study 3 different preparations of oral contrast media for bowel opacification at CT of the abdomen have been compared. Plain aqueous solutions of amidotrizoate (9 mg I/ml) and iohexol (9 mg I/ml) were used as well as a preparation of iohexol (9 mg I/ml) to which a viscosity-increasing agent had been added. The distribution of the contrast media in the intestine, transit time and patient tolerance were evaluated. No significant differences were found regarding the distribution between the 3 preparations of contrast media, while there was a tendency for the transit time to be increased when the viscous preparation of iohexol was used. The aqueous solution of iohexol had the best taste, while the viscous preparation was markedly more difficult to drink. Aqueous solutions of iohexol and amidotrizoate were equal for bowel opacification and the addition of the viscosity-increasing agent did not improve the distribution of the contrast medium in the intestine.

Administration, Oral↗
PubMed1997

Prolonged hypothermic cardiac storage with histidine-tryptophan-ketoglutarate solution: comparison with glucose-insulin-potassium and University of Wisconsin solutions.

BACKGROUND: The purpose of this study was to compare the efficacy of histidine-tryptophan-ketoglutarate (HTK) solution after prolonged cold storage with that of the conventional glucose-insulin-potassium (GIK) and University of Wisconsin (UW) solutions in experimental heart preservation. GIK solution was chosen as a control to mimic current clinical regimens. Variables of cardiac function, myocardial tissue water, and adenine nucleotide pool metabolites were used to assess prolonged myocardial preservation in the isolated rat heart model. METHODS: Hearts isolated from male Wistar rats were mounted on a Langendorff apparatus to estimate baseline cardiac function. The hearts were divided into three groups (n=6 per group) according to each preservation solution used: group 1, GIK solution; group 2, UW solution; and group 3, HTK solution. The hearts were then arrested and stored in each solution for 6, 8, and 12 hr at 4 degrees C. After storage, the hearts were reperfused and recovery of cardiac function and myocardial tissue water content were evaluated. Myocardial adenylate contents just after storage in each group (n=5 hearts/group) were also measured. RESULTS: The hearts stored in HTK solution showed maintenance of cardiac function at up to 8 hr of almost 80% of prepreservative baseline function; however, recovery of cardiac function of the hearts stored in UW solution revealed an initial loss of function at 6 hr of almost 60% and a decline to 50% at 8 hr. Furthermore, recovery of cardiac function of the hearts stored in GIK solution revealed a progressive loss of function at 6 hr of storage of almost 50% and a decline to 30% at 8 hr of storage. The myocardial ATP/ADP ratios after 6 hr of storage in HTK and UW solutions were significantly higher than the ratio found in GIK solution. Although the myocardial ATP/ADP ratio after 8 hr of storage in HTK solution was maintained above 50%, the ratios in GIK and UW solutions declined to 15%. In addition, the myocardial energy charge values of the hearts stored in HTK solution were sufficiently maintained until 8 hr of storage, whereas the values in UW and GIK solutions declined to below 50% at 6 hr of storage and 20% at 8 hr of storage. Although there were no significant differences in tissue water contents after 6 and 8 hr of storage among the three groups, the water contents of the hearts after 12 hr of storage in HTK and UW solutions were significantly lower than that of the hearts stored in GIK solution. CONCLUSIONS: Our results suggest that HTK solution is much more effective than UW and GIK solutions for isolated rat heart preservation; however, successful cold storage of the heart is highly energy-dependent, and a dramatic breakdown of myocardial energy level, which causes a crucial decline in cardiac function, occurs between 8 and 12 hr of storage.

Adenosine↗
PubMed1994

Comparison of saphenous vein graft relaxation between Plasma-Lyte solution and normal saline solution.

Venospasm of saphenous vein grafts may damage endothelial cells and compromise early and late graft performance. Hence it is desirable to identify and use storage solutions that minimize vascular spasm during vein preparation. In view of this, we initiated isometric tension-recording studies in isolated canine and human saphenous vein to evaluate the acute, vasoactive effects of two storage solutions, Plasma-Lyte solution and normal saline solution. In initial experiments, canine saphenous veins were mounted in tissue baths containing physiologic salt solution and tonically constricted by 2 x 10(-6) mol/L norepinephrine. The physiologic salt solution in the bath was then replaced by Plasma-Lyte solution or normal saline solution containing the same norepinephrine concentration, and changes in contraction amplitude were recorded for 90 minutes. Storage in Plasma-Lyte solution at 37 degrees C completely relaxed norepinephrine-activated canine saphenous vein within 20 minutes, whereas veins remained partially constricted in normal saline solution. Both Plasma-Lyte solution and normal saline solution relaxed canine saphenous vein less at room temperature (25 degrees C) than at 37 degrees C, implying that warming of storage solutions in the operating room may promote graft dilation. To identify the mechanism by which Plasma-Lyte solution induced relaxation, we replaced its putative vasodilator components of gluconate and acetate with NaCl, but this alteration did not reduce relaxation induced by Plasma-Lyte solution. However, adding 1.6 mmol/L CaCl2 to Plasma-Lyte solution completely reversed the venodilation, suggesting that the low Ca2+ content of Plasma-Lyte solution confers its relaxant action. Finally, we tested the vasoactive effect of Plasma-Lyte solution on human saphenous vein obtained by discard from coronary bypass operations. Plasma-Lyte solution at 37 degrees C effectively dilated norepinephrine-activated human saphenous vein, inducing complete relaxation within 20 minutes. On this basis, we recommend the use of Plasma-Lyte solution as a venodilating storage solution during coronary bypass operations to optimize vein graft relaxation before implantation.

Acetates↗
PubMed2005

The fixed combination of fortified vancomycin and amikacin ophthalmic solution--VA solution: in vitro study of the potency and stability.

PURPOSE: We compared the in vitro potency and stability of a fixed combination of vancomycin and amikacin solution (VA solution) with amikacin or vancomycin solution. METHODS: Solutions of 2% amikacin (20 mg/mL) and of 5% vancomycin (50 mg/mL) and VA solution (each 1 mL contained 20 mg of amikacin and 50 mg of vancomycin) were prepared from parenteral antibiotics by reconstituting them with sterile injection water and refrigerated (4 degrees C) in the dark. Triplicate 5-mL portions of each solution were tested before storage and 7 and 14 days after preparation for potency of antimicrobial activity by the disk diffusion method and for stability. RESULTS: There were no significant differences in the diameter of zones of inhibition of VA solution compared with amikacin or vancomycin solution within a 2-week period. Visual inspection revealed that all solutions remained clear, colorless, and particle-free at 4 degrees C throughout the study period. For osmolarity, the VA solution was much higher than that of either amikacin or vancomycin solution at all tested times and more near the well-tolerated range of human eyes. There were no significant differences at days 0, 7, or 14 for either vancomycin, amikacin, or VA solution. For pH, the VA solution was higher than that of vancomycin solution (nearly equal to that of amikacin solution) at each time and more near the level of normal tear film. The pH did not differ significantly for either vancomycin, amikacin, or VA solution at all tested times. CONCLUSIONS: The vancomycin and amikacin ophthalmic solutions can be mixed together with the same potency and stable physical properties. It may be useful in the treatment of bacterial keratitis pending clinical trials to determine its effectiveness and safety.

Amikacin↗
PubMedDate not supplied

Palatability of a new solution compared with standard polyethylene glycol solution for gastrointestinal lavage.

The salty unpleasant taste of the standard polyethylene glycol electrolyte lavage solution constitutes a major drawback, which limits patient compliance. Recently, a new low-sodium cleansing solution was described and introduced as a major advance, allegedly providing a distinctly better taste and improving compliance. We compared the taste of both solutions, seeking a possible preference applying a double-blind randomized design. Twenty-eight healthy volunteers tasted one of the two solutions without a direct comparison. Both solutions were found to have a similar palatability and an equal salty taste. A different group of 50 volunteers compared the two solutions. Twenty-one preferred the standard solution, 25 preferred the new solution (not significant), and 4 subjects had no preference. Among the subjects basing their preference on the saltiness of the solutions, 18 estimated the standard solution to taste more salty than the new low sodium solution, while 18 volunteers found the new solution to taste more salty than the standard solution. This study does not confirm a taste preference for the new low-salt polyethylene glycol electrolyte lavage solution as compared with the standard solution for colonic cleansing. The difference in the salt concentrations of the two solutions could not regularly be distinguished by a group of healthy volunteers.

Adult↗
PubMed1991

A comparison of a new solution combining histidine and lactobionate with UW solution and eurocollins for rat liver preservation.

Forty-six rat liver transplants were performed to investigate the effectiveness of a simplified lactobionate solution containing histidine as a buffer (histidine-lactobionate solution) and to compare it with University of Wisconsin solution. This new solution is isoosmotic (320 mOsm/L) and has a higher sodium content and a lower potassium content (Na: 90 mEq/L, K: 45 mEq/L) than standard UW solution. Buffering capacity is increased by adding histidine (90 mM/L) together with KH2PO4 (20 mM/L) and is greater than that of Eurocollins solution or UW solution. Adenosine, insulin, hydroxyethyl starch, and dexamethasone that are included in UW solution are not included in the new solution. The 1-week survival rate of rats transplanted with livers preserved in this solutions at 4 degrees C was 85% (11/13) following 24-hr preservation and 33% (2/6) after 30-hr preservation. By contrast, UW solution gave only a 29% (5/17) survival rate after 24-hr preservation and 0% (0/6) survival after 30-hr preservation, demonstrating that this simplified UW solution with histidine is superior to UW solution in rat liver preservation. No rats (0/4) receiving livers preserved for 24 hr in Eurocollins solution survived. These findings show that the inclusion of histidine as a buffer dramatically improves the effectiveness of lactobionate-based preservation solutions and justify application in a large-animal model and subsequently in clinical liver transplantation.

Adenosine↗
PubMed1994

Effects of solution osmolality on absorption of select fluid replacement solutions in human duodenojejunum.

These experiments examined relationships between initial osmolality and carbohydrate (CHO) composition of an infused solution and osmolality and water and CHO absorption in a test segment. A triple-lumen tube with a 10-cm mixing segment and a 40-cm test segment was passed into the duodenojejunum. The infusion port was approximately 10 cm beyond the pyloric sphincter. Perfusion solutions were hypotonic (186 mosmol/kg; solution A), isotonic (283 mosmol/kg; solution B), and hypertonic (403 mosmol/kg; solution C). All solutions contained 18 meq Na+ and 3 meq K+. In the mixing segment, osmolality increased 83 mosmol/kg and decreased 90 mosmol/kg for solutions A and C, respectively. Corresponding changes in the test segment were an increase of 60 mosmol/kg and a decrease of 34 mosmol/kg. The osmolality of solution B did not change. In the test segment, mean osmolality and water and total solute fluxes were not significantly different among solutions, but solution C produced 27% greater fluid absorption than did solution A. When net fluid movement from mixing and test segments was determined, solution A produced 17% greater fluid absorption than did solution C. The mean increases in plasma and urine volumes over the 80-min test period were not significantly different. In the test segment, water flux correlated with CHO and Na+ fluxes but not with osmolality. In conclusion, 1) significant differences in solution osmolality were eliminated within the proximal duodenum and 2) perfusing 6% CHO solutions with osmolalities ranging from 186 to 403 mosmol/kg did not produce significant differences in fluid homeostasis (plasma volume) at the end of an 80-min test period.

Body Water↗
PubMed2000

Donor heart preservation with a novel hyperpolarizing solution: superior protection compared with University of Wisconsin solution.

OBJECTIVES: A donor heart preservation solution was designed to use hyperpolarized arrest with the adenosine triphosphate-sensitive potassium-channel opener pinacidil. This solution contained concentrations of potassium, sodium, calcium, magnesium, lactobionate, and the buffer histidine specifically chosen to minimize intracellular calcium accumulation associated with prolonged ischemia. METHODS: Twenty-four rabbit hearts were randomly assigned to receive 1 of 3 preservation solutions in a crystalloid-perfused Langendorff model: (1) prototype solution containing a 0.5 mmol/L concentration of pinacidil, (2) prototype solution without pinacidil as control, and (3) University of Wisconsin solution. Thirty minutes of initial perfusion preceded baseline data acquisition. Data comprised left ventricle pressure-volume curves generated by inflating an intraventricular latex balloon. After cardioplegic administration, hearts underwent 4 hours of hypothermic storage, followed by 60 minutes of reperfusion and postischemic data acquisition. RESULTS: Postischemic developed pressure was better preserved by pinacidil solution (92.4% +/- 4.5%) than by the control (74.9% +/- 3.4%, P =.01) and University of Wisconsin solutions (66.7% +/- 5.1%, P =.001). Diastolic negative dP/dT was better preserved by pinacidil solution (104.4% +/- 10.2%) than by the control (80.2% +/- 4.2%, P =.034) and University of Wisconsin solutions (71.7% +/- 7.0%, P =.015). Diastolic compliance, expressed as baseline/postischemic diastolic slope ratios, was more poorly preserved by University of Wisconsin solution (0.67 +/- 0.07) than by the pinacidil (0.88 +/- 0.05, P =.041) and control solutions (0.87 +/- 0.05, P =.021). Postischemic coronary flow was higher in hearts exposed to pinacidil solution (77.8% +/- 3.0%) than in those exposed to the control (66.8% +/- 2.4%) and University of Wisconsin solutions (70.9% +/- 4.0%, P =.07). CONCLUSIONS: The superiority of the pinacidil solution in this experiment demonstrated that hyperpolarized arrest with potassium-channel openers improves donor heart preservation when administered in a novel histidine-buffered lactobionate-enriched vehicle.

Adenosine↗
PubMed1992

Collins' solution for cold storage of the heart for transplantation must be reversed with cardioplegic solution before reperfusion. A functional and metabolic study in the rat heart.

The following hypotheses were tested using an isolated perfused working rat heart model: (1) Collins' solution for cold storage of the heart is harmful for the heart during reperfusion; (2) a "reverse" of the intracellular-type Collins' solution with an extracellular-type cardioplegic solution before reperfusion is able to prevent this disadvantage of Collins' solution. The following two major groups (I and II) and five subgroups (-a to -e) in each group were prepared. In group I (reversed group); the hearts were initially stored in Collins' solution but were reversed by a 1-minute flush with cardioplegic solution followed by storage in cardioplegic solution for the last 1 to 180 minutes of the total 3-hour storage, that is, groups I-a (reversed for 1 minute), I-b (10 minutes), I-c (30 minutes), I-d (90 minutes), and I-e (180 minutes). In group II (nonreversed control group); the hearts were stored in Collins' solution throughout 3 hours and were also divided into five subgroups of groups II-a, II-b, II-c, II-d, and II-e in which only a 1-minute flush with Collins' solution was performed at the point corresponding to group I. The coronary flow in any of group II showed a marked decrease during the early reperfusion period. In group I, however, the coronary flow increased significantly in proportion to the duration of the reversing phase. The recovery of the aortic flow and the cardiac output in group I showed a bell-shaped pattern in relation to the duration of the reversing phase, reaching their peak values when reversed for 30 minutes (group I-c). The prolonged reverse (180 minutes) resulted in a deterioration of functional recovery associated with a poorer preservation of high-energy phosphates and a larger enzyme leakage. These results suggest that the beneficial effects of intracellular-type Collins' solution for cold storage of the heart were further improved by reversing Collins' solution with the extracellular-type cardioplegic solution for the last 30 minutes of the 3-hour cold storage because the disadvantageous vasoconstriction due to Collins' solution during reperfusion was successfully prevented by the replacement of intravascular and extravascular Collins' solution with cardioplegic solution before the reperfusion.

Animals↗
PubMed1994

Is a low-osmolarity ORS solution more efficacious than standard WHO ORS solution?

The clinical efficacy of a diluted oral rehydration salts (ORS) solution was compared in a pilot study with that of intravenous (i.v.) therapy and of standard World Health Organization (WHO)/United Nations Childrens Fund (UNICEF) ORS solution in children with acute diarrhea. Sixty-one boys aged 3 to 24 months, admitted to hospital with acute diarrhea and signs of dehydration, were randomly assigned to groups receiving standard ORS solution, diluted ORS solution, or i.v. therapy. In children treated with standard ORS solution and small amounts of plain water, the total fluid intake was 25-39% greater, the stool output was 58-77% greater (p < 0.01), and the duration of diarrhea was 30-55% greater than in the other treatment groups. Intake of plain water, taken separately or added to the ORS solution, was greater in children given diluted ORS solution (73 +/- 23 ml/kg) than in those given standard ORS solution (21 +/- 32 ml/kg) (p < 0.001). The mean serum sodium concentration increased by 2.2 mEq/L in children given standard ORS solution, whereas it decreased by 2.9 mEq/L in those given diluted ORS solution. This study shows that some children develop worsening diarrhea and increasing serum sodium concentrations when treated with standard ORS solution and given only small amounts of plain water. This is probably caused by the slight hypertonicity of standard ORS solution combined with transient partial glucose malabsorption. This can be avoided if water, breast milk, or another low-solute drink is given liberally during maintenance therapy with ORS solution, as recommended by the WHO.

Acute Disease↗
PubMed1999

Peritoneal fluid kinetics: comparison between polyglucose solution and albumin solution.

Polyglucose (PG) solution has been shown to be capable of inducing peritoneal ultrafiltration despite its hypo-osmolality. However, the mechanism of osmosis by PG is not clear. In this study, we compared the fluid kinetics of albumin (ALB) solution (thought to be an ideal solution that should induce ultrafiltration through colloid osmosis) and PG solution. A 4-hour dwell study with frequent sampling was conducted in Sprague-Dawley rats (six rats in each group). The study used 25 mL of dialysate buffer, 10% ALB dialysis solution, 15% ALB dialysis solution, 20% ALB dialysis solution, or 7.5% PG solution, with 131I albumin as an intraperitoneal volume marker. All solutions were prepared by adding ALB or PG to a base dialysis solution (without osmotic agent). The initial osmolality values of the five solutions were 250 mOsm/kg, 284 mOsm/kg, 300 mOsm/kg, 320 mOsm/kg, and 280 mOsm/kg, and the dialysate drainage volumes at 4 hours were 17.0 +/- 0.8 mL, 22.4 +/- 0.8 mL, 25.4 +/- 0.6 mL, 27.3 +/- 0.9 mL, and 26.3 +/- 0.6 mL (buffer, 10% ALB, 15% ALB, 20% ALB, and 7.5% PG groups, respectively). The higher initial osmolality in the ALB groups was partially due to the sodium content in the ALB powder. The intraperitoneal volume was decreasing in the 10% ALB group, rather stable in the 15% ALB group, but slowly increasing in the 20% ALB group. In the PG group, intraperitoneal volume decreased initially and then started to increase after 2 hours. This pattern was closely related to the increase in the dialysate osmolality (to higher than plasma level). At 4 hours, the dialysate osmolality was significantly higher (and higher than plasma level) in the PG group as compared to all the ALB groups. No differences in peritoneal fluid absorption rate were observed among the four treatment groups. In the 15% ALB and 20% ALB groups, the transcapillary ultrafiltration rate (Qu) was lower in the later part of the dwell than in the initial part of the dwell; in the PG group, the opposite pattern was observed. Our results suggest that the osmosis of albumin dialysis solution is different from the osmosis of polyglucose solution. Polyglucose solution induces net ultrafiltration only when the dialysate osmolality increase to higher than plasma level, suggesting that degradation of polyglucose may be important for effective ultrafiltration.

Albumins↗