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PubMed1985

Behavior of cultured glandular cells obtained by flushing of the uterine cavity.

In 77 of 115 cultures from uterine/tubal flushes performed in women undergoing diagnostic laparoscopy for reasons of infertility, epithelioid colonies of "tadpole-like" cells appeared. In cultured jet washings from the uterine cavities in women with ligated tubes, the same tadpole-like cells are present. These cells are also observed in vitro in laparoscopic biopsy specimens of active endometriosis nodules. Judged by the presence of cytokeratin in these cells, demonstrated by polyvalent or monoclonal antikeratin antibodies (the latter as a marker for glandular epithelia), there can be no doubt about their origin from the lining and glandular epithelium of part of the genital tract. Peritoneal washings not preceded by uterine/tubal flushing never contained the tadpole-like cells in culture. True epithelial cells were observed in the peritoneal cavity after flushing, and the proliferative capacity of these cells in vitro during the preovulatory phase was proven.

Cell Division↗
PubMed1980

Comparison of intracellular flushing and cold storage to machine perfusion for human kidney preservation.

Transplant teams have been reluctant to accept kidneys preserved with intracellular electrolyte flushing followed by simple cold storage, especially when retrieved by non-transplant surgeons or when preservation time exceeds 24 hours. This study from 1 center is a comparison of 40 primary cadaver kidney grafts preserved with Collins' C2 flushing followed by simple cold storage to 37 primary cadaver kidney grafts preserved with cryoprecipitated plasma on the MOX-100 machine. Cold storage time was 10 to 44.5 hours in the C2 group and 3.5 to 39 hours in the machine-perfused group, with a mean of 23 hours in each group. There was no significant difference between the 2 preservation methods no matter who removed the kidney with respect to 1) the incidence of acute tubular necrosis, 2) the 1-month serum creatinine nadir of surviving grafts and 3) the actuarial graft survivals up to 2 years. Among the 40 C2-preserved kidneys 17 were retrieved by community surgeons and 23 were retrieved by transplant surgeons. Human kidneys removed from beating-heart cadaver donors can be preserved satisfactorily with either Collins' 2 flushing followed by simple cold storage or pulsatile machine perfusion, even when preservation times exceed 24 hours.

Adolescent↗
PubMed1997

Successful recovery of preimplantation embryos by nonsurgical uterine flushing in the bonnet monkey.

A major limitation to progress in primate embryology is the lack of an adequate supply of preimplantation embryos. We describe a method for recovering preimplantation-embryos in bonnet monkeys (Macaca radiata ) using a nonsurgical uterine flushing technique similar to the one previously employed in rhesus monkeys. Forty cyclic females were screened for cervical cannulation, and 10% of these had an impassable cervix. Eleven females suitable for cannulation were selected, and 27 menstrual cycles were monitored over a 5-mo period. Seventy-one percent of the cycles showed estrogen peaks, which were observed between Days 9 and 14 of the cycle. Following natural mating, uterine flushings were performed on Days 5 to 8 of pregnancy (Day 0 = the day following the estrogen peak). Of the 27 recovery attempts, 9 (33.3%) resulted in the recovery of ovulation products, including those of an unfertilized oocyte and empty zona (2 cases), retarded cleavage-stage (4 to 8-cell) embryos (4 cases), morula (1 case) and blastocysts (2 cases). These results show, for the first time, that the nonsurgical uterine flushing technique can be successfully performed to recover uterine-stage preimplantation embryos from bonnet monkeys.

Journal Article↗
PubMed1984

Prolonged human kidney preservation by intracellular electrolyte flush followed by cold storage.

No kidney transplant center responding to a kidney preservation questionnaire would accept a kidney flushed with an intracellular electrolyte solution and cold-stored for over 40 hours. This study from one center is a comparison of 50 primary cadaver kidney grafts preserved with an intracellular electrolyte flush followed by cold storage for 40 to 61 hours to 82 primary cadaver kidney grafts preserved by the same method for 9 to 24 hours. Kidneys cold-stored for over 40 hours had a significantly increased requirement for dialysis in the 1st week following transplantation (82% versus 34%) and a significantly increased 1-month serum creatinine nadir (2.3 mg/dL versus 1.7 mg/dL). Actuarial graft survivals and serum creatinine levels at 1, 2, and 3 years after grafting were not significantly different. Cadaver donor methylprednisolone (30 to 60 mg/kg) two to nine hours prior to kidney removal significantly reduced the requirement for 1st-week hemodialysis in the kidneys cold-stored for over 40 hours (60% versus 91%). Kidneys preserved by flushing with cold intracellular electrolyte solution can be successfully transplanted after over 40 hours of simple cold storage when the warm ischemia time is very short.

Cadaver↗
PubMed2002

A volumetric biochemical niacin flush-based index that noninvasively detects fatty acid deficiency in schizophrenia.

(1) It is possible to investigate aspects of phospholipid-related signal transduction in humans noninvasively using the niacin skin flush test. (2) Patients with schizophrenia have previously been reported to show a reduced flushing response. (3) The aim of this study was to devise a comprehensive index of cutaneous response to the niacin test, incorporating aqueous methyl nicotinate concentration and time, and to test this index in schizophrenia. (4) A discrete approximation to a continuous volumetric index, which we have named the volumetric niacin response (VNR), was devised. Its value was measured in 27 patients with DSM-IV schizophrenia and 26 age- and sex-matched normal controls. (5) The mean value of the VNR in the patients with schizophrenia (16.26) was significantly smaller than that of 26.77 in the normal controls (P<.0004). (6) With a threshold value for the VNR of 21, the test differentiated well between schizophrenia and normal controls (P=.002) with a sensitivity of 78% and a specificity of 65%. (7) The present results confirm that the flushing response is reduced in schizophrenia, and show that calculation of the VNR is an effective means of allowing the total response in different patients or patient groups to be readily compared.

Adult↗
PubMed2004

[Secreted cytokines in the uterine lumina are predictive of subsequent implantation. Presence of IL18 in the uterine flushing].

The materno-foetal relationship is not simply maternal tolerance of a foreign tissue, but a series of intricate mutual cytokine interactions governing selective immune regulation and also control of the adhesion and vascularisation processes during this dialogue. There is strong evidence that locally secreted cytokines, such as interleukine 18 (IL18) control the implantation process and can cause implantation failure in case of absence or overactivation. Uterine flushing fluids may be analysed to determine the level of several cytokines. At the time of egg retrieval, the flushing procedure does not adversely affect pregnancy rates. We report a strong positive correlation between the presence of IL18 in the uterine flushing and bad implantation rates. The presence of IL18 in the lumina is the traduction of an overactivation of endometrial IL18 that should be diagnosed and treated. Moreover, endometrial biopsy could define which type of cytokinic dysregulation is implicated in repeated implantation failure and define which type of treatment need to be introduced.

Embryo Implantation↗
PubMed1999

Does PGE1 attenuate potassium-induced vasoconstriction in initial pulmonary artery flush on lung preservation?

The standard clinical protocol for lung transplantation employs cold single pulmonary artery flush with Euro-Collins solution or the University of Wisconsin solution. Prostaglandin E1 (PGE1) is usually given by direct injection into the pulmonary artery to reduce pulmonary vasoconstriction caused by these intracellular, high-potassium solutions, however, the efficacy of PGE1 on lung preservation remains controversial. In this study we demonstrated that vasodilator effects of PGE1 were markedly reduced under a high-potassium condition, and that potassium-induced pulmonary vasoconstriction were inhibited by calcium channel blocker nifedipine. There are three therapeutic options in the cold single pulmonary artery flush for optimal lung transplantation, including the use of a higher dose of PGE1, use of the calcium channel blocker instead of PGE1, or the use of the extracellular, low-potassium solution such as low-potassium dextran solution for initial pulmonary artery flush before the lung harvest.

Alprostadil↗
PubMed2000

'Hot flush', an unpleasant symptom accompanying antiandrogen therapy of prostatic cancer and its treatment by cyproterone acetate.

From 1995 to 1997 the authors have assessed 31 patients with histologically verified advanced carcinoma of the prostate (CaP) and the ensuing symptom of 'hot flush'. Patients underwent transurethral resection of the prostate (TURP), bilateral orchiectomy (OE) and combined androgen blockade (CAB) by the administration of non-steroid antiadrogens. The authors present the mechanism of the genesis of the 'hot flush' symptom as well as its subjective manifestations, methods of laboratory monitoring as well as their experience with the treatment of this symptom. 50 mg tablets cyproterone acetate administered twice daily or Androcur depot 300 mg i.m. inj. once in 14 days were the main factors in the treatment of 'hot flushes' which reduced subjective difficulties in 80.6% of the patients studied.

Aged↗
PubMed1998

The fast flush test--is the clinical comparison equivalent to its in vitro simulation?

OBJECTIVE: An in vitro simulation of the fast flush (FL) test has previously been used to prove that the FL test-measures the dynamic response of entire the blood pressure monitoring system. This simulation has also been used to confirm that the FL test is equivalent to the "gold standard" test for determining dynamic response, namely the square wave (SW) test. The conditions of the in vitro simulation can be reproduced in vivo during cardiopulmonary bypass (CPB) and circulatory arrest. Therefore the present objective was to verify that the previous conclusions about the validity of the FL test, obtained from an in vitro model, are equally valid when applied to in vivo clinical conditions. A secondary objective was to determine whether the patient's arterial tree has any affect on the dynamic characteristics of fluid-filled manometers. METHODS: Fourteen patients were studied during surgery that required CPB. We measured the dynamic response of the fluid filled arterial manometer during pulsatile conditions prior to the initiation of CPB, and then repeated the measurements during non-pulsatile CPB. In four of the fourteen patients we measured the dynamic response during circulatory arrest. A manometer, consisting of a fluid-filled tubing component, measured the patient's arterial blood pressure as well as the damped sinusoidal wave form created by the fast flush tests. The fluid-filled tubing was connected to a transducer (Utah Medical Products, Inc., Midvale, UT). The arterial pressures and the results of flush testing were recorded and displayed by a monitor (Marquette 7010, Marquette Electronics Inc., Milwaukee, WI). In an additional three patients we measured the dynamic response of the manometer in vitro and then in vivo. RESULTS: The dynamic response of the arterial pressure measuring system was the same during normal pulsatile flow, CPB and circulatory arrest. In addition, the dynamic response of the fluid-filled manometer was the same in vivo as in vitro. CONCLUSIONS: The clinical conditions during CPB and particularly during circulatory arrest duplicate the in vitro FL test simulation model. These results confirm the validity of the FL test in vivo as well as proving that the dynamic characteristics of a fluid-filled manometer are independent of the patient's vasculature.

Blood Pressure↗
PubMed2003

A direct experimental test of founder-flush effects on the evolutionary potential for assortative mating.

Founder-flush speciation models propose that population bottlenecks can enhance evolutionary potential for reproductive isolation. To test this prediction, we subjected bottlenecked (three-pair founder-flush) and nonbottlenecked populations of the housefly to 18 generations of selection for assortative mating. After the selection regime, we analysed videotaped courtship bouts in these lines to identify correlated responses to the selection protocol. The realized heritabilities for assortative mating for both the bottlenecked and nonbottlenecked treatments were very low, but still significant. The founder-flush populations had thus responded to selection as well as the nonbottlenecked populations, although not significantly greater (i.e. total increases in assortative mating were 9.6 and 8.6%, respectively). Multivariate analyses on the courtship repertoires found that, although both bottlenecked and nonbottlenecked treatments attained similar levels of assortative mating, the treatments exhibited different evolutionary solutions in their correlated responses. Specifically, the bottlenecked lines demonstrated a significantly more diverse set of evolutionary trajectories (i.e. significant shifts along the second principal component for courtship). This suggests that the bottlenecked lines had greater potential for the evolution of novel phenotypes as predicted by founder-induced speciation models. Our results, however, cannot distinguish whether the more variable evolutionary responses resulted from increased heritabilities in courtship components, reduced potential to follow the convergent evolutionary trajectories noted for the nonbottlenecked lines, or some combination of both general processes in determining the resultant multivariate phenotype.

Animals↗
PubMedDate not supplied

Auriculotemporal (Frey) syndrome in late childhood: an unusual variant presenting as gustatory flushing mimicking food allergy.

Auriculotemporal or Frey syndrome is characterized mainly by recurrent episodes of facial gustatory flushing and/or sweating, limited to the cutaneous distribution of the auriculotemporal nerve. Although relatively common in adults following injury to the auriculotemporal nerve or parotid disease, the condition has rarely been reported in children. Moreover, in childhood, auriculotemporal syndrome has been described mainly in infancy and early childhood as a sequel of perinatal birth trauma resulting from assisted forceps delivery. We report a 13-year-old girl with a 2-month history of recurrent, painless, preauricular gustatory flushing without sweating, initially suspected to be a food allergy. Detailed inquiry revealed a history of a bicycle accident with mandibular condyle fracture 7 years prior to the onset of symptoms. Our patient demonstrates an unusual presentation of auriculotemporal syndrome in late childhood as gustatory flushing mimicking food allergy. Awareness of this variant is essential for prompt recognition, thus avoiding unnecessary laboratory tests, especially as this condition usually resolves spontaneously.

Adolescent↗
PubMed2002

Hepatic dysfunction in development of menopausal hot flushes?

Obese menopausal women tend to suffer more frequently and more severely from hot flushes, though they have higher residual estrogen levels due to the conversion of adrenal androgens in fat tissue. Phytoestrogens, while not exhibiting clinically relevant estrogenic effects on peripheral reproductive tissues, seem to alleviate hot flushes in doses attainable with dietary supplementation. This paper aims to address these controversies. A synergistic action of obesity and estrogens may cause hepatic dysfunction involving inflammatory Kupffer cell activation and generation of pyrogenic signals that reach the thermoregulatory centers via the vagal route. Sudden withdrawal of this perpetual pyrogenic impetus at the onset of menopause results in a thermoregulatory imbalance. The occasional downward sliding of the thermoregulatory setpoint serves to trigger the hot flush event. Repercussions of this theory involve a possible resolution for the paradox of why estrogen-sensitive cancers manifest more frequently at the age when endogenous estrogen levels decline.

Female↗
PubMed1986

Improved lung preservation using Euro-Collins solution for flush-perfusion.

Satisfactory extended preservation of the lung has been difficult to obtain. This study investigated the influence of different total volumes and flow rates during flush-perfusion of the lung, and their effect on pulmonary artery pressure, flow distribution, regional lung temperature and functional performance of the lungs following transplantation after 24 hours. Fifteen mongrel dogs served as donors of the heart and lung block. Cold modified Euro-Collins solution was used as flush perfusate. Pulmonary artery and perfusion-line pressures were measured. The regional lung temperature was measured at one minute intervals with 5 myocardial temperature probes. Flow distribution was determined with micro-aggregated albumin labelled with Technetium 99. The heart-lung block was harvested, the right lung removed, and samples taken for gamma-counting. The left lung was stored in cold Euro-Collins solution and then transplanted. The inspired oxygen fraction (FiO2) was set at 0.4 and was kept constant throughout the procedure and the entire postoperative course. There were 3 groups of 5 animals each. In group A, the flush perfusate was administered at a total volume of 20 cc/kg over a period of 6 minutes. In group B the same volume of perfusate was administered at a pulmonary artery pressure (PAP) of 18 to 20 mmHg, resulting in a considerably shorter perfusion time (1.3 minutes). In group C 60 cc/kg of perfusate were given at the same flow rate as in group B, also resulting in PAP of 18 to 20 mmHg, but the perfusion time was increased to 4 minutes. Thus, groups B and C investigated the effect of increased pressure and volume of perfusate, respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Composition of uterine flushings from Large White and prolific Chinese Meishan gilts.

This study examined differences in selected components of uterine secretions from Large White and prolific Chinese Meishan gilts during the oestrous cycle or early pregnancy. Total recoverable protein, uteroferrin (measured as acid phosphatase activity), acyl aminopeptidase, calcium, sodium, potassium, immunoglobulins A and G, glucose, fructose, oestradiol-17 beta, and prostaglandins F2 alpha (PGF2 alpha) and E2 (PGE2) in uterine flushings were measured. During the oestrous cycle, breed effects were detected only for total protein (P = 0.07), which tended to be higher for Large White gilts. However, for pregnant gilts, total recoverable glucose (P less than 0.05), fructose (P less than 0.05) sodium (P less than 0.05), immunoglobulin A (P less than 0.01), PGF (P less than 0.01), PGE (P less than 0.01), and acyl aminopeptidase (P less than 0.05) were greater in uterine flushings from Meishan gilts. Only uteroferrin was higher (P = 0.06) in uterine flushings from Large White gilts. Concentrations of prolactin were higher (P less than 0.05) in plasma from cyclic or pregnant Meishan gilts, but concentrations of total oestrogens and progesterone were not affected by pregnancy status or breed. These results suggest that Meishan conceptuses, individually or collectively, are more stimulatory to endometrial secretion and/or transport of the components of histotroph into the uterine lumen, or that the endometrium of Meishan gilts is more sensitive to conceptus signals responsible for the accumulation of histotroph in the uterine lumen.

Acid Phosphatase↗
PubMed2002

Chlorhexidine vaginal flushings versus systemic ampicillin in the prevention of vertical transmission of neonatal group B streptococcus, at term.

OBJECTIVE: To investigate the efficacy of intrapartum vaginal flushings with chlorhexidine compared with ampicillin in preventing group B streptococcus transmission to neonates. METHODS: This was a randomized controlled study, including singleton pregnancies delivering vaginally. Rupture of membranes, when present, must not have occurred more than 6 h previously. Women with any gestational complication, with a newborn previously affected by group B streptococcus sepsis or whose cervical dilatation was greater than 5 cm were excluded. A total of 244 group B streptococcus-colonized mothers at term (screened at 36-38 weeks) were randomized to receive either 140 ml chlorhexidine 0.2% by vaginal flushings every 6 h or ampicillin 2 g intravenously every 6 h until delivery. Neonatal swabs were taken at birth, at three different sites (nose, ear and gastric juice). RESULTS: A total of 108 women were treated with ampicillin and 109 with chlorhexidine. Their ages and gestational weeks at delivery were similar in the two groups. Nulliparous women were equally distributed between the two groups (ampicillin, 87%; chlorhexidine, 89%). Clinical data such as birth weight (ampicillin, 3,365 +/- 390 g; chlorhexidine, 3,440 +/- 452 g), Apgar scores at 1 min (ampicillin, 8.4 +/- 0.9; chlorhexidine, 8.2 +/- 1.4) and at 5 min (ampicillin, 9.7 +/- 0.6; chlorhexidine, 9.6 +/- 1.1) were similar for the two groups, as was the rate of neonatal group B streptococcus colonization (chlorhexidine, 15.6%; ampicillin, 12%). Escherichia coli, on the other hand, was significantly more prevalent in the ampicillin (7.4%) than in the chlorhexidine group (1.8%, p < 0.05). Six neonates were transferred to the neonatal intensive care unit, including two cases of early-onset sepsis (one in each group). CONCLUSIONS: In this carefully screened target population, intrapartum vaginal flushings with chlorhexidine in colonized mothers display the same efficacy as ampicillin in preventing vertical transmission of group B streptococcus. Moreover, the rate of neonatal E. coli colonization was reduced by chlorhexidine.

Administration, Intravaginal↗
PubMed2002

Influence of alcohol cosurfactants on surfactant-enhanced flushing of diesel-contaminated soil.

The effects of medium-chain alcohols on the surfactant-enhanced diesel removal from contaminated sandy soil were investigated. The mixture of Tween 80, which has a double bond in its hydrophobic structure, and hexanol showed the best performance of diesel removal among the combinations of surfactants (Tween 20, Tween 60, and Tween 80) and alcohols (n-butanol, n-pentanol, and n-hexanol) used in this study. The efficiency of diesel flushing increased as the alkyl-chain length of the alcohol and the alcohol fraction in the flushing solution increased. Meanwhile, the removal rate was reduced when the surfactant concentration was too high most likely due to the surfactant aggregation or emulsion formation. A pulsed pumping of flushing solution was not beneficial for improving the removal rate under the experimental conditions described in this study.

Alcohols↗
PubMed2005

A randomized, controlled trial of a new vascular catheter flush solution (minocycline-EDTA) in temporary hemodialysis access.

BACKGROUND AND OBJECTIVE: We previously demonstrated that minocycline-EDTA was efficacious at preventing catheter-related bloodstream infections (BSIs) in three patients with recurrent infections. This study compared heparin with minocycline-EDTA as flush solutions used among dialysis patients with central venous catheters, a high-risk group for catheter-related BSI. METHODS: Patients were enrolled within 72 hours of catheter insertion and randomized to receive heparin or minocycline-EDTA as a flush after each dialysis session. Each syringe containing flush solution was wrapped in orange plastic to conceal the type of solution it contained. Patients were observed for evidence of infection and catheter thrombosis. After catheters were removed, cultures were performed to determine whether microbial colonization had occurred. RESULTS: During a 14-month period, 60 patients were enrolled (30 in each group). The two groups had similar demographics and underlying diseases. Catheter survival at 90 days was 83% for the minocycline-EDTA group versus 66% for the heparin group (P = .07). Significant catheter colonization, a surrogate measure of catheter-related infection, was significantly more frequent in the heparin group (9 of 14 vs 1 of 11; P = .005). There was only one catheter-related bacteremia and it occurred in the heparin group. CONCLUSIONS: When compared with heparin, minocycline-EDTA had a better 90-day catheter survival (P = .07) and a decreased rate of catheter colonization. This pilot study warrants a larger prospective, randomized trial.

Anti-Bacterial Agents↗
PubMed2006

Use of vancomycin-containing lock or flush solutions for prevention of bloodstream infection associated with central venous access devices: a meta-analysis of prospective, randomized trials.

BACKGROUND: Prolonged exposure to central venous access devices carries significant risk of device-associated bloodstream infection (BSI), which is associated with morbidity, added health care costs, and attributable mortality. We aimed to determine the efficacy of vancomycin-heparin lock or flush solution in preventing BSI in patients being treated with long-term central venous intravascular devices (IVDs). METHODS: We collected data from January 1966 to January 2006 from multiple computerized databases and compiled reference lists of identified articles. We identified prospective, randomized controlled trials comparing a vancomycin-heparin lock or flush solution with heparin alone for prevention of BSI associated with long-term central venous IVDs. Using a standardized form, we abstracted data regarding study quality, patient characteristics, and incidence of BSI. RESULTS: Seven randomized, controlled trials involving a total of 463 patients being treated with IVDs met the inclusion criteria; 5 studies were conducted among patients with cancer, 1 among a critically ill neonatal population, and 1 among patients with cancer or who required parenteral nutrition. We could not detect publication bias. The summary risk ratio with a vancomycin heparin-lock solution for IVD-associated BSI was 0.49 (95% confidence interval [CI], 0.26-0.95; P = .03). Results of the test for heterogeneity were statistically significant; however, when a single study was removed from the analysis, heterogeneity was no longer present. Use of vancomycin as a true lock solution--instilling it for a defined period, rather than simply flushing it directly through the device--conferred a much greater benefit, with a risk ratio of 0.34 (95% CI, 0.12-0.98; P = .04). The 2 studies that performed prospective surveillance cultures to identify colonization or infection by vancomycin-resistant organisms did not find an increased risk. CONCLUSIONS: Use of a vancomycin lock solution in high-risk patient populations being treated with long-term central IVDs reduces the risk of BSI. The use of an anti-infective lock solution warrants consideration for patients who require central access but who are at high risk of BSI, such as patients with malignancy or low-birthweight neonates.

Adult↗