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At least 469 records · Page 26Linked to original sources
PubMed1998

[Superior vena cava thrombosis manifesting as vasomotor facial flushes].

BACKGROUND: The first sign in the reported case of superior vena cava thrombosis secondary to a pacemaker lead, was exceptional: facial flush. CASE REPORT: A 52-year-old woman had a pacemaker for 10 years for rhythm disorders. She developed facial flush triggered by exercise and anteflexion. The clinical examination revealed collateral thoracic circulation, suggesting thrombosis of the superior vena cava which was confirmed by the angiocavogram. DISCUSSION: Vasomotor flush is an uncommon and misleading initial sign of superior vena cava thrombosis. Induction by exercise and anteflexion is characteristic. Due to the increasing number of implanted patients, clinicians should be aware that pacemaker leads are an uncommon cause of superior vena cava thrombosis.

Collateral Circulation↗
PubMed1992

Flush aortic tie versus selective preservation of the ascending left colic artery in low anterior resection for rectal carcinoma.

The effects of two methods of colonic vascular ligation were studied in 143 consecutive patients who underwent low anterior resection with total mesorectal excision and full mobilization of the splenic flexure. Either the ascending left colic artery (ALCA) was selectively preserved (n = 52) or a flush aortic ligation was performed (n = 91). In those with a protective colostomy, the radiological leak rate was 12 per cent when the ALCA was preserved (n = 41) and 10 per cent when a flush aortic tie was performed (n = 60) (P greater than 0.95; 95 per cent confidence interval (c.i.) for difference -10 to +15 per cent). In those without a colostomy, the clinical leak rates of 9 per cent when the ALCA was preserved (n = 11) and 19 per cent when a flush aortic tie was performed (n = 31) were not significantly different (P greater than 0.10; 95 per cent c.i. for difference -12 to +32 per cent). Proportional hazards analysis showed no association between the method of vascular ligation and the risk of tumour recurrence and death. Anastomotic leak rates, tumour recurrence and survival were not related to the method of vascular ligation.

Anastomosis, Surgical↗
PubMed1994

Flushing the vessel ends: the effect on ischemic free flap survival.

During vascular anastomosis of experimental ischemic free flaps it is common to observe that stagnant blood in the vessel ends has clotted. A study was performed to investigate if flushing away the stagnant blood on division of the vessels would increase flap survival. Flushing did not influence flap survival. Clinically, clot is rarely seen, except in conditions of prolonged ischemia or damaged vessels. Current surgical practice does not involve flushing the vessel ends upon division of the vessels and this approach is affirmed by our results.

Anastomosis, Surgical↗
PubMed1993

Long-chain acyl-coenzyme A thioesters and renal hypothermic ischemic injury: effects of glycine flush.

The effects of hypothermic ischemia utilizing Euro-Collins flush on renal tissue long-chain activated fatty acid content was studied in dogs. Also, the ability of the simple amino acid glycine to complex these acyl thioesters was also investigated. Renal inner cortex was found to contain (in increasing amounts) myristoyl-, palmitoleoyl-, palmitoyl-, arachidonyl-, and oleoyl-coenzyme A throughout the 3 days of cold ischemia. Although the amounts of individual long-chain acyl-CoA compounds varied considerably, the concentrations were not found to differ significantly with increasing ischemia times. The presence of 5 mM of glycine in the flush also did not influence the amount or species of long-chain acyl-CoA esters in renal tissue during cold ischemia. Ischemic renal tissue content of most long-chain acyl-CoA compounds was reduced by about 50% when the tissue underwent in vitro reperfusion with 37 degrees C O2-saturated media. Glycine included in the flush storage solution did not alter acyl-CoA levels in tissue undergoing hypothermic ischemia and short-term in vitro reperfusion with O2-saturated buffer. In conclusion, long-chain acyl-CoA thioesters are present during hypothermic renal ischemia and the levels of most of these species are reduced during in vitro reperfusion after ischemia. The quality and production mass of these metabolites appears to be unaltered by progressive hypothermic ischemia times. Finally, the protective effects of glycine in this model of renal organ preservation injury are not associated with reductions of renal tissue long-chain activated fatty acids.

Acyl Coenzyme A↗
PubMed1994

The effects of hepatic preservation at 0 degrees C compared to 5 degrees C: influence of antiproteases and periodic flushing.

The optimal preservation temperature for liver allografts is unknown. We evaluated the effect of small differences in preservation temperature, 5 degrees C vs 0 degrees C, on outcome of prolonged preservation. Livers of Wistar rats were preserved at these temperatures in UW solution for 40 h. Function was studied during reperfusion on the isolated perfused rat liver system at 37 degrees C. To compare the effects of a small reduction in temperature with known beneficial strategies, the effects of including antiproteases and periodic flushing of the graft with UW solution during cold preservation at 5 degrees C were also studied. Aspartate transaminase (AST) and alanine transaminase release after 4 h of reperfusion were much higher in the livers stored at 5 than at 0 degrees C (P < 0.0005). Addition of antiproteases to the preservation solution or periodic flushing reduced AST release but neither treatment at 5 degrees C was as good as simple storage at 0 degrees C. Cumulative bile production after 4 h of reperfusion was significantly greater in the 0 degrees C preserved group than in liver at 5 degrees C or 5 degrees C with periodic flushing. The addition of antiproteases resulted in slightly increased bile production (not significant). Platelets and WBCs in the perfusate decreased during reperfusion. This effect was more pronounced in the 5 degrees C preserved livers than in those stored at 0 degrees C. Antiproteases in the preservation solution appeared to inhibit platelet and WBC loss. Perfusate flow was significantly higher in the 0 degrees C group. We conclude that small differences in preservation temperature even at these low temperatures are important in postreperfusion liver function.

Adenosine↗
PubMed1991

Improved renal transplant preservation using a modified intracellular flush solution (PB-2). Characterization of mechanisms by renal clearance, high performance liquid chromatography, phosphorus-31 magnetic resonance spectroscopy, and electron microscopy studies.

A number of new intracellular renal flush solutions have been found to be more efficacious than Collins-2 (C-2) solution in extending organ viability during simple cold storage. However, the mechanism of action of these solutions remains poorly understood. To delineate better underlying intracellular mechanisms, we studied a modified, simple, hypothermic, intracellular (340 mOsm/kg) flush solution (PB-2). The development of PB-2 solution is based on the ability of some of its individual components to minimize ischemic adenine nucleotide (AN) catabolism and endothelial post "reperfusion injury." Preliminary results in 10 canine autorenal transplants show a significant (P less than 0.02) improvement in renal recovery and viability (recipient posttransplant inulin clearance and survival) after 50 h of cold storage compared with 10 canine kidneys similarly preserved using conventional C-2 flush solution. High performance liquid chromotography (HPLC) studies show a significant (P less than 0.01) loss of AN using C-2, while PB-2 was associated with regeneration of AN within 45 min of reperfusion. Magnetic resonance spectroscopy using phosphorus 31 (31P-MRS) showed more high energy phosphorus metabolites (phosphomonoester and nicotinamide-adenine-dinucleotide phosphate: P less than 0.001) at 50 h cold storage using PB-2 compared with C-2. Electron micrographs (EM) revealed normal microcapillary morphology for the PB-2 group; however, moderate vascular red and white blood cell clumping was observed in the C-2 group. Characterization of the basic preservation mechanisms by HPLC, 31P-MRS, and EM studies indicates that PB-2 solution enhances renal preservation by diminution of both reperfusion injury and the loss of intracellular high energy metabolites that are necessary for viability.

Animals↗
PubMed1991

High osmolality-low pH flush solutions improve renal transplant function in rats.

Although transplanting rat kidneys is an established microsurgical technique, inulin clearance is abnormally low, due to rejection and/or warm ischemia-induced damage. In the present studies, rejection was avoided by using inbred Brown Norway rats as donors and recipients. Donor kidneys were flushed with ice-cold solutions of various composition (saline, saline + 200 or 400 mM mannitol) and pHs (5.7, 6.4, and 7.4), and the kidneys were kept cold during transplantation into unilaterally nephrectomized recipients. Renal function was assessed by clearance techniques 1 week later. In control rats, with both native kidneys intact, the ratio of inulin clearance, left kidney to right kidney, was 0.99 +/- 0.02. In rats with a native right kidney and a transplanted left kidney that had been flushed with saline, the ratio was considerably lower (0.46 +/- 0.09). Adding 200 mM mannitol to the saline flush solution increased the ratio (0.89 +/- 0.09). In comparison, adding 200 mM mannitol and 5 mM phosphate buffer at pH 7.4 resulted in a somewhat lower ratio (0.80 +/- 0.09), whereas adding 200 mM mannitol and 5 mM phosphate buffer at pH 5.7 resulted in a higher ratio, one that was indistinguishable from control (0.97 +/- 0.09). Thus, in this latter group, the inulin clearances of the transplanted kidneys were identical to those of the contralateral native kidneys.

Animals↗
PubMed1980

Flushing in rosacea: an experimental approach.

A simple method is described which causes rosacea patients to flush. This flush is experienced similarly to the flush which occurs spontaneously and its intensity can be measured and monitored quantitatively. Therefore, it can be used as a suitable experimental tool to measure and compare the inhibitory effects of some drugs, as well as the fluctuations of the blood level of certain chemical vasoactive mediators.

Adult↗
PubMed1982

Flushing in rosacea: a possible mechanism.

Flushing in rosacea has been investigated by means of (a) pharmacological inhibition of some possible chemical mediators and (b) titration of bradykinin as a possible effector directly in the blood. Clonidine-inhibited flushing was seen in all patients (mean 45%), other drugs had poorer results. Bradykinin increased in all patients at the climax of flushing (mean 60%). These findings support the hypothesis that epinephrine promotes a bradykinin release responsible for vasodilation.

Adult↗
PubMed1987

Are ultrasonic-guided follicular aspiration and flushing safe for the oocyte?

Oocyte collection was carried out in 53 patients by ultrasonically guided abdominal puncture under local or epidural anesthesia. Follicles were aspirated and flushed two to six times using a syringe with culture medium. A total of 196 oocytes was collected and 84 of those (42.9%) were found in the flushes. Mechanical damage was observed in 5.1% of the oocytes. Cleavage rates in mature oocytes (157) after 48 hr in culture were similar in the aspirate group (56.5%) and in the flush group (54.2%). Ten clinical pregnancies were obtained, corresponding to a pregnancy rate of 18.9%.

Female↗
PubMed1988

Frequency response evaluation of radial artery catheter-manometer systems: sinusoidal frequency analysis versus flush method.

It is well recognized that catheter-manometer systems significantly distort direct radial artery pressure measurements. Sinusoidal frequency analysis and the flush method of assessing the degree of distortion caused by the monitoring system were compared to determine whether these two methods agree in the estimation of natural frequency and damping coefficient. The frequency response of 30 radial artery catheter-manometer systems used for intensive-care unit patients was measured by the flush method and sinusoidal frequency analysis. The monitoring system consisted of a 20-gauge cannula, 150-cm pressure tubing, two plastic stopcocks, a continuous infusion device with fast flush valve, an American Edwards dome, a Hewlett-Packard quartz transducer, and a Hewlett-Packard blood pressure amplifier. Sinusoidal frequency analysis demonstrated second-order underdamped response for all 30 catheter-manometer systems. No secondary resonance peaks were observed up to a frequency of 200 Hz. The measured frequency response demonstrated that the average catheter-manometer system in use in our intensive care unit would cause significant distortion of the radial artery pressure, with the mean natural frequency (fn) of 14.7 +/- 3.7 Hz and the mean damping coefficient (zeta) of 0.24 +/- 0.07. Although the 30 monitoring systems had identical configurations and visible bubbles were carefully removed, a wide range of frequency responses was found (fn = 10.2 to 25.3; zeta = 0.15 to 0.44).(ABSTRACT TRUNCATED AT 250 WORDS)

Arm↗
PubMed1996

Equivalence of fast flush and square wave testing of blood pressure monitoring systems.

BACKGROUND: The accurate recording of intraarterial pressure depends upon an appropriate dynamic response of the monitoring system. Generation of a square wave (SW) at the catheter tip is the engineering and in vitro laboratory gold standard. Fast flush (FF) testing is the clinical test of choice. Results from these two test methods have been assumed equal but have not been empirically confirmed. METHODS: We studied three different 5.1 cm catheter sizes (16 G, 18 G, 20 G Becton Dickinson, Sandy, UT) attached to three different lengths of arterial pressure tubing (36 in, 91.4 cm; 72 in, 182.9 cm; 108 in, 274.3 cm). An arterial recording system was assembled in the standard fashion by attaching a catheter to arterial pressure tubing, which was attached to a transducer (TXX-R, Ohmeda, formerly Viggo-Spectramed, Oxnard, CA) whose signal was recorded by a strip chart recorder (Gould 2400, Rolling Meadows, IL). The system was attached to a pressurized saline flush. The catheter tip was inserted into one port of a pressure generator. With the other port of the pressure generator open to atmosphere, FF tests were performed by activating the flush device of the transducer. Subsequent step response signals from the FF tests were then recorded from which natural frequency (fn) and damping coefficient (zeta) were calculated. Next, square waves were generated by closing the port that was open to atmosphere and attaching a signal generator to a pressure generator. Square waves so generated were recorded as described above and natural frequency and damping coefficients calculated. These procedures were repeated after 0.05 cc of air was introduced in the transducer and repeated again in a system containing a damping device (R.O.S.E., Resonant OverShoot Eliminator, Viggo-Spectramed, Oxnard, CA). RESULTS: There was no significant difference between fn and zeta as calculated from the step response generated from the FF test versus fn and zeta as calculated from the square wave (SW) test in systems without air. However, in systems containing air, fn by FF testing was always less than fn by SW testing for all catheter sizes and extension tubing lengths (p < 0.05). Damping was also always greater by FF testing than by SW testing in systems with air for all catheter sizes and extension tubing lengths (p < 0.05). The R.O.S.E device created marked qualitative differences, although exact fn and zeta could not be quantified. CONCLUSIONS: For the characterization of dynamic response of invasive blood pressure monitoring systems, the FF test and SW test yield identical results. However, under certain conditions-air, R.O.S.E device-dynamic response as measured by FF testing was not equivalent to dynamic response as measured by the gold standard-the SW test. Specifically, small amounts of air in fluid-filled invasive blood pressure monitoring systems cause a slightly worse dynamic response as measured by FF testing versus the laboratory gold standard-the SW test.

Blood Pressure Monitors↗
PubMed1981

Maintenance of rat liver viability enhanced by cold flushing with oxygenated perfluorochemicals.

The possible benefit of oxygenation during initial cold flushing was investigated as means of improving the quality of live preservation in rats. In five group of animals (total 61 experiments), the lives were flushed with different perfusates. Non-oxygenated groups included controls, Collins' solution alone and Collins' solution containing perfluorotributylamine (FC-43). In the oxygenated groups, Collins' solution alone and collins' solution containing FC-43 were oxygenated by bubbling. The hepatic ATP level and histopathological changes were used to assess the quality of liver preservation. Oxygenation during the initial cooling process proved to be effective in maintaining energy metabolism and preventing the characteristic microscopic changes of ischemic damage. Oxygenated Collins' solution containing FC-43 showed a much longer lasting effect compared with oxygenated Collins' solution alone. Without FC-43. Under light microscopy, in integrity of the liver appeared to be well preserved up to eight hours with the former solution. It is concluded that enhanced oxygenation with FC-43 in the initial cold flushing period can improve the quality of liver preservation.

Adenosine Triphosphate↗
PubMedDate not supplied

Chlorpropamide-alcohol flushing in non insulin-dependent diabetes: prevalence of small and large vessel disease and or risk factors for angiopathy.

One hundred and eight non insulin-dependent diabetics were tested for alcohol flushing after chlorpropamide administration (CPAF test). The overall prevalence of patients who flushed at the first challenge was 32%. However, nearly half of them still flushed after alcohol administration, when placebo was given instead of chlorpropamide, so that the prevalence of 'true' flushers was only 17%. Even though the distribution of retinal lesions was similar in 'true' flushers and in non flushers, severe loss of visual acuity was confined to the non flushers and aspecific flushers. The frequency of pathological ECG findings and of peripheral pulse reduction or abolition was significantly higher in the non flushers and aspecific flushers. Blood pressure, serum lipids and hemostatic parameters were similar in the two groups, and therefore do not explain the differences in prevalence of lesions. This study confirms the previous findings of a lower prevalence of large vessel lesions in flushers; however, the prevalence of 'true' CPAF phenomenon in our out-patient population appears to be much lower than previously reported.

Adult↗
PubMed2000

Cooling of the brain through oxygen flushing of the nasal cavities in intubated rats: an alternative model for treatment of brain injury.

Local cooling of the brain by respiration has been found in several animal species with a rete mirabile in the carotid artery/cavernous sinus complex. The present experiment was made to investigate whether a similar cooling could be found in the rat, which does not have a rete. Eleven rats were anesthetized and intubated. Three thermoprobes were inserted into the brain (two probes) and rectum, and the temperatures measured continuously. The nasal cavities were flushed with oxygen (250-1000 ml/min) during 15-min periods, interrupted by 15-min control periods. The mean brain temperature decreased by 0.43 +/- 0.03 degree C (n = 86, P < 0.005) with individual values up to 1.11 degrees C during the flushing periods. The decrease was oxygen-flow dependent, but not correlated to the rectal temperature. It is concluded that even an animal species without a rete mirabile is able to decrease the brain temperature through nasal cooling. The cooling was probably connected to the blood flow. If the results can be extrapolated to man (no rete mirabile), brain temperature can be decreased by nasal flushing with air or oxygen in intubated patients with hyperthermia. We also suggest that this simple treatment will reduce the infarct volume after head injury, trauma, or brain ischemia.

Animals↗
PubMed1999

Serologic evidence of heparin sensitization in cancer patients receiving heparin flushes of venous access devices.

Cancer patients with venous access devices (VADs) often receive daily flushes of heparin. Even this relatively small heparin exposure has been reported to induce immune-mediated thrombocytopenia. To estimate how frequently this occurs we tested for heparin-related antibodies in 49 patients receiving daily heparin flushes of their VADs. Although one-third of the patients showed evidence of heparin sensitization on at least one occasion during their surveillance, their antibody titers were generally low and typical of those found in other cohorts of patients who become sensitized to heparin but do not develop secondary thrombocytopenia. However, one patient developed a positive serotonin release assay indicative of a more significant sensitization, but without thrombocytopenia. Therefore, our observations suggest that heparin-induced thrombocytopenia (HIT) related to heparin flushes of VADs is uncommon but still an important diagnosis to entertain.

Adolescent↗
PubMed2004

Removal of arsenic in tailings by soil flushing and the remediation process monitoring.

In order to investigate the optimum conditions for the application of soil flushing of arsenic, a batch test was carried out using EDTA at various concentration and pH levels. Based on the optimum condition derived from the batch test, a column test was conducted to examine the feasibility of the soil-flushing technology under field-equivalent conditions. In this column test, a low flushing solution flow rate showed a significantly higher As removal efficiency (71.6%) than a high flow rate (56.3%). TCLP (toxicity characteristic leaching procedure) and a seed germination test were carried out to monitor the toxicity both during and after the treatment. The finally treated tailings were shown to be significantly remediated, having a reduced toxicity by both the TCLP and seed germination tests.

Agriculture↗