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Effect of cell-free synchronous uterine flushings and microsurgery on the development of porcine embryos in vitro.

Experiment I was designed to determine if cell-free synchronous uterine flushings contain an embryotoxic substance that is normally screened by the intact zona pellucida. Sixty 4-cell embryos were allocated to three treatment groups: 1) control embryos (n = 20) were cultured in Modified Kreb's Ringer Bicarbonate medium + 10% bovine calf serum (mKRB-BCS), 2) UF embryos (n = 20) were cultured in 80% mKRB-BCS + 20% sterile dialyzed uterine flushings (UF), 3) MicroUF embryos (n = 20) received a microsurgical incision in the zona pellucida and were cultured in 80% mKRB-BCS + 20% UF. Following 72 h in culture at 37 degrees C under a 90% N2, 5% CO2, and 5% O2 atmosphere, the number of nuclei/embryo and the incidence of protrusion of the trophoblast through the zona pellucida (PTZ) were recorded. Addition of UF had no effect on embryo development. A greater (P less than .005) proportion of MicroUF embryos exhibited PTZ as compared to UF and control embryos. Experiment II was devised to further characterize the occurrence of PTZ in Micro porcine embryos. Thirty-three 4- to 10-cell embryos and 14 morulae were distributed across two treatments: 1) control embryos (n = 16 and 6, respectively) were cultured as described in Experiment I; and 2) micro embryos were treated similarly to MicroUF embryos in Experiment I but were cultured in mKRB-BCS only. At the onset of PTZ, embryos were immediately fixed and examined. The proportion of embryos exhibiting PTZ was greater (P less than .007) for Micro versus control embryos.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗

Effect of pre-reperfusion portal venous blood flush on early liver transplant function.

Portal venous blood for rinsing out the University of Wisconsin solution (UWs) has the advantages of being a physiological fluid, removing acidotic mesenteric venous blood and perhaps resulting in more stable haemodynamic parameters during reperfusion. A group of 209 consecutive adult OLTs carried out between July 1993 and February 1995 were studied prospectively. The UWs was flushed out with 500 ml portal blood in 95 OLTs (group 1) and with 1.0 L 0.5% dextrose at 37 degrees C in 114 OLTs (group 2). The median day 1 and peak day 1-5 AST levels were significantly elevated in the 5% dextrose group: median 755 (118-11090) vs. 546 (121-6150) IU/I (P = 0.007, Wilcoxon); and median 1095 (159-11090) vs. 744 (157-7870) IU/l (p = 0.008, Wilcoxon), respectively. A median of 5 (0-27) units of blood were transfused in group 1 compared to 4 (0-54) units in group 2 (n.s.). There was no difference in peak bilirubin, lowest day 1-5 PT levels, primary nonfunction, median ITU stay, total inpatient stay and 1-month graft survival between the two groups (89% vs. 88%). Pre-reperfusion blood flush may be associated with less hepatocellular damage, without significant additional blood usage.

Adolescent↗

Comparison of intermittent injection of nondepolarizing solution with a single flush of UW solution for donor heart preservation.

Isolated canine hearts were preserved for 6 h at 5 degrees C followed by normothermic reperfusion for 2 h. The dogs were divided into two groups of nine hearts each; group 1 received a nondepolarizing preservation solution in multidose, and group 2 received a single flush of University of Wisconsin (UW) solution. Serum MB-CK and mitochondrial aspartate aminotransferase (m-AAT) concentrations and calcium overload during reperfusion were lower in group 1 than in group 2. At the end of reperfusion, myocardial ATP and total adenine nucleotide concentrations were higher and mitochondrial morphology appeared more intact in group 1 than in group 2. Left ventricular diastolic function was preserved better in group 1 than in group 2. These results suggest that in 6-h heart preservation, a nondepolarizing solution applied in multidose fashion protects the myocardium from the deleterious effects of hypothermia and cardioplegia better than a single flush of UW solution.

Adenosine↗

An underlying mechanism for improved liver preservation with a combined histidine-lactobionate-raffinose flush solution.

In previous experimental liver transplant studies, it was possible to extend cold ischaemic time (CIT) by using a flush/storage solution combining histidine, lactobionate and raffinose (HLR). In this study, energy metabolism, glycolytic substrate (glucose) and anaerobic end-product (lactate) were examined in rat liver over 24 h of cold storage to determine the mechanism of action of the HLR solution. In livers subjected to simple flush and storage with the HLR solution, levels of ATP and ADP were considerably higher than livers stored with modified UW throughout 24 h of storage; at 4 h of storage, ATP and ADP levels were 1.1 and 3.1 mumol/g for HLR solution versus 0.18 and 0.81 mumol/g for UW solution. Total adenylate contents (TA = ATP + ADP + AMP) also remained 1-2 mumol/g higher in HLR-treated livers than those preserved in UW; TA values ranged from 3.8 to 5.7 mumol/g. Glucose increased to 20-35 mumol/g by 10-24 h of storage (similar to the UW group). Lactate rose to almost twice that in livers stored in UW; total lactate accumulation was approximately 10.0 mumol/g. This study demonstrated that the combined HLR solution is able to prolong the maximum 'safe' CIT by increasing anaerobic metabolism and consequently preserving liver energetics. The second part of the experiment examined the effect of continuous perfusion (with/without O2) over the 1st h of cold ischaemia. Under current methods of liver flushing and excision, the 1st h of cold storage may be the critical time of metabolic 'adjustment' since most of the pH and ATP changes occur during this period.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine↗

Pancreatic flush injury in combined pancreas-liver recovery.

The function of pancreatic grafts harvested from six pancreas-liver (PL) donors was compared to that of nine pancreas-alone (PA) donors. All donors had comparable physiological parameters. Pancreas and liver were flushed in situ with 4C Collins solution and the portal vein was vented immediately. The pancreaticoduodenal grafts were reflushed and stored in Collins solution (three PA and two PL), silica gel-filtered plasma (six PA and two PL), or University of Wisconsin solution (two PL). Later they were revascularized by the iliac vessels and drained into the bladder. All pancreas recipients were insulin-dependent. Serum glucose, amylase, lipase, blood urea nitrogen (BUN), creatinine, protein, albumin, and urine amylase, bicarbonate and pH were monitored for 12 days. Data were analyzed using the Mann-Whitney U-test and Fischer's exact test. The PL grafts received a significantly higher aortic flush volume (5983 cc vs 1622 cc, P = 0.001) than those in the other group. Recipients of PL grafts had higher serum amylase (335 vs 250 IU/l) and lipase (1048 vs 424 IU/l), significantly lower levels of urine bicarbonate (11.2 vs 27.1 mEq/l, P = 0.01), pH (6.8 vs 7.3, P = 0.04), and amylase (9202 vs 19,981 IU/l, P = 0.05) than those in the PA group.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

Levonorgestrel levels in serum and uterine flushings in women bearing LNG-Cu-IUD.

Radioimmunoassay was employed to measure levonorgestrel levels in serum and uterine flushings in women using intrauterine device releasing both copper ions and levonorgestrel (LNG-Cu-IUD) after one-year insertion. In the meanwhile physical characteristics of cervical mucus have been observed in women using LNG-Cu-IUD and compared with those using Tcu-220c-IUD. The mean concentrations of levonorgestrel in serum and uterine flushings (5 ml) were 84.53 pg/ml and 266.93 pg/ml respectively. In LNG-Cu-IUD group, the cervical mucus lacking in ferny crystals had a viscosity significantly higher than that in Tcu-220c-IUD group, suggesting that the local high concentration of levonorgestrel changed the environment of the uterine cavity and the cervical mucus status.

Adult↗

Improvement of parenchymal and vascular enhancement using saline flush and power injection for multiple-detector-row abdominal CT.

The aim of this study was to determine if a saline solution flush following low dose contrast material bolus improves parenchymal and vascular enhancement during abdominal multiple detector-row computed tomography (MDCT). Forty-one patients (24 men and 17 women; mean age 49 years, age range 27-86 years) underwent abdominal MDCT (collimation 4x5 mm, 15-mm table increment, reconstruction interval 5 mm, gantry rotation period 0.8 s) with a single- as well as with a double syringe power injector. Indication for examination were benign and malignant tumors and inflammatory diseases. Patients received 100 ml nonionic contrast material (300 mgI/ml) alone or pushed with 20 ml saline solution. Mean enhancement values for both protocols were measured in the liver, the spleen, the pancreas, the renal cortex, the portal vein, the inferior vena cava and the abdominal aorta. Double syringe power-injector protocol led to significantly higher parenchymal and vascular enhancement than single syringe power-injector protocol (p<0.05). The improvement in mean enhancement of the liver was 9 +/- 9 HU, of the spleen 8 +/- 10 HU, of the pancreas 7 +/- 9 HU, and of the renal cortex 8 +/- 20 HU. The improvement in mean enhancement of the portal vein was 10 +/- 17 HU of the inferior vena cava 8 +/- 13 HU and of the abdominal aorta 10 +/- 17 HU. The use of a double syringe power injector with saline flush following contrast material bolus significantly improves parenchymal and vascular enhancement during contrast-enhanced abdominal MDCT with low iodine doses.

Contrast Media↗

Increase of proopiomelanocortin-related peptides during subjective menopausal flushes.

The present study reports the plasma levels of gonadotropins (luteinizing hormone, follicle-stimulating hormone), proopiomelanocortin-related peptides (adrenocorticotropic hormone, beta-endorphin, and beta-lipotropin), and cortisol in eight menopausal women experiencing frequent hot flushes. beta-Endorphin and beta-lipotropin levels were measured by radioimmunoassay after extraction and Sephadex G-75 column chromatography. Plasma levels of adrenocorticotropic hormone (after extraction), luteinizing hormone, follicle-stimulating hormone, and cortisol were measured by specific radioimmunoassay. All hormone levels showed a prompt and significant rise on occurrence of hot flushes (18 total recordings), remained high for 15 minutes, and decreased to basal levels 35 minutes later. The evaluation of the behavior pattern of single hormone levels revealed a more pronounced increase of proopiomelanocortin-related peptides and cortisol than of gonadotropins (p less than 0.01).

Adrenocorticotropic Hormone↗

Is alpha-adrenoceptor blockade responsible for atropine flush?

Toxic amounts of atropine usually, and therapeutic doses occasionally, dilate cutaneous blood vessels, especially those in the blush area (atropine flush). However, the mechanism of this anomalous vascular response is unknown. We, therefore, investigated this action of atropine not only in functional but also in binding studies with isolated rat aorta and brain, respectively. Endothelium-denuded rat thoracic aortic rings were contracted with norepinephrine, U46619 (9,11-dideoxy-11alpha,9alpha-epoxymethanoprostaglandin F2alpha, thromboxane A2 receptor agonist) and KCl, and the relaxation in response to atropine was recorded. The norepinephrine-, but not the U46619- or KCL-mediated contraction was relaxed by atropine. Atropine caused a rightward parallel shift of the phenylephrine concentration-contraction curve with a pA2 value of 6.57 (slope 0.58), but did not affect the concentration-contraction curve for U46619. In rat cerebral cortex homogenates, atropine displaced [3H]prazosin with Ki values of 3.33 nM and 0.19 microM, respectively. These results suggest that even though atropine has low affinity for the alpha-adrenoceptor, it possesses characteristics similar to those of a competitive ligand for the alpha-adrenoceptor. Thus, atropine, especially at high concentrations, has direct alpha-adrenoceptor blocking activity, which may account, at least in part, for atropine flush.

15-Hydroxy-11 alpha,9 alpha-(epoxymethano)prosta-5↗

Improved lung preservation using a dimethylthiourea flush.

The purpose of this study was to evaluate the ability of dimethylthiourea (DMTU), a low molecular weight hydroxyl free radical scavenger, to improve preservation of the lung for transplantation. Following preservation, 15 isolated canine left lower lobes were reperfused for 90 min with autologous blood. Five group I lobes served as controls and were not subjected to ischemia prior to reperfusion. Five group II lobes were flushed and submerged in a cold Euro-Collins solution and stored for 4 hr at 4 degrees C prior to reperfusion. Group III lobes were flushed with a 20 mM DMTU-enhanced Euro-Collins solution, stored for 4 hr, and then reperfused. The isogravimetric method was utilized to determine the capillary permeability coefficient (Kfc) for the reperfused lobes. The Kfc values were 0.10 +/- 0.01, 0.17 +/- 0.01, and 0.10 +/- 0.008 ml/min/mm Hg/100 g lung for groups I, II, and III, respectively (P less than 0.01 II vs I, III). Extravascular lung water values in the reperfused lobe were 4.44 +/- 0.45, 6.57 +/- 0.38, and 5.23 +/- 0.22 ml/g blood free dry lung weight for groups I, II, and III (P less than .05, II vs. I, III). Lung lipid peroxidation, measured as thiobarbituric acid-reactive material, was higher in group II, 146 +/- 6 nmole/g, than in either group I, 90 +/- 5 nmole/g, or group III, 91 +/- 4 nmole/g (P less than 0.01). The results indicate that the addition of DMTU improves hypothermic lung preservation by reducing lipid peroxidation and edema formation upon reperfusion.

Animals↗

Chlorpropamide-alcohol flushing, malar thermal circulation index, and baseline malar temperature.

Chlorpropamide-alcohol flushing (CPAF) has been advanced and challenged as a specific marker for familial noninsulin dependent diabetes mellitus. The previous studies assay flushing reactions employing arbitrarily defined critical threshold values of rise and rate of rise in facial temperature. Since these methods ignore the curvilinear relationship between skin temperature and cutaneous blood flow, errors of analysis obtained, Further, the role of baseline facial temperature is obfuscated. The method of malar thermal circulation index derived from the relationship between skin temperature and cutaneous blood flow provides a more accurate assay method and permits the characterization of the role of baseline facial temperature. Baseline facial temperature is less in subjects with CPAF and noninsulin dependent diabetes than in normal subjects. The lower baseline facial temperature alone may account for the reported differences in the parameters of the CPAF test.

Body Temperature↗

Detection of trisomy 18 and Y-derived sequences in fetal nucleated cells obtained by transcervical flushing.

A procedure which combines the collection of fetal cells by transcervical flushing and in situ hybridisation techniques on nuclei in interphase was used to detect trisomy 18 in a fetus at 12 weeks of gestation. Using a primed in situ labelling method, we could also detect Y-specific sequences in a small percentage of transcervically flushed cells obtained at 8-12 weeks from pregnant women with male fetuses. This approach seems to be suitable for prenatal diagnosis of major chromosomal abnormalities and other selected inherited disorders very early in gestation.

Adult↗

Flush exposure and injection immunization of rainbow trout to selected DNP conjugates.

Rainbow trout (Salmo gairdneri) were immunized by flush exposure or intraperitoneal injection with single doses of the following dinitrophenyl (DNP) conjugates: DNP-keyhole limpet hemocyanin (KLH), DNP-Ficoll, DNP-O-antigen (from the fish pathogen, Yersinia ruckeri), DNP-sheep red blood cells, or DNP-duck red blood cells. The immune response was demonstrated by the passive hemolytic plaque assay to show splenic antibody-producing cells (APC) 14 days after antigen administration. High numbers of splenic APC specific for the hapten were found when the conjugates DNP-KLH, DNP-Ficoll, and DNP-O-antigen were given by injection and when DNP-O-antigen was given by flush exposure. The heterologous red blood cells were relatively nonimmunogenic. When the immune response to the hapten and carrier could be measured--e.g., after immunization with the DNP-O-antigen--the numbers of APC were consistently higher for the hapten.

Animals↗

Hypothesis: pathogenesis of postmenopausal hot flush.

The pathogenesis of postmenopausal hot flush is still poorly understood. A hypothesis is presented where the perimenopausal decline in circulating estrogen levels may increase central norepinephrine and LH-RH secretion and produce a downward setting of the central thermostat resulting in a hot flush.

Body Temperature Regulation↗

Ethamsylate in the treatment of climacteric flushing.

Ethamsylate, a non-hormonal agent acting at the capillary level, was compared with a placebo in a double-blind trial of 12 wk duration in 20 post-menopausal patients with hot flushes. Both ethamsylate and placebo patients showed fluctuations in the frequency of flushes during the trial, but there was a significant downward trend in the ethamsylate group. Capillary strength was measured but was not found to be low or to alter during the trial except in 1 patient in the placebo group. No side-effects attributable to trial medication were reported. Other symptoms recorded during the trial were probably climacteric and occurred more frequently during placebo treatment than during treatment with ethamsylate.

Adult↗

Effect of guanfacine, an alpha-adrenergic agonist, on menopausal flushing.

The effect of guanfacine (0.5 mg/day), an alpha-adrenergic agonist, on menopausal flushing, was studied in a double-blind, placebo-controlled crossover study in 11 patients. Both guanfacine and placebo significantly decreased the total number of flushes from baseline values. There was, however, no significant difference between placebo and guanfacine. Larger doses of guanfacine may be required to exert a therapeutic effect similar to that reported in the literature with the alpha-adrenergic agents, clonidine and alpha-methyldopa.

Climacteric↗

Respiratory changes during a menopausal hot flush.

The effect of a menopausal hot flush on respiratory parameters was studied in one subject on nine separate occasions. The flushes were associated with a significant increase in the production of carbon dioxide and lesser but still significant changes in oxygen consumption, tidal volume and minute volume. The changes in respiratory frequency and respiratory quotient were not significant. Significant changes in carbon dioxide production and oxygen consumption were still evident well into the climacteric.

Basal Metabolism↗

Computer-controlled flushing for long-term cannulation in freely moving rats.

An in vivo long-term perfusion system is presented, which is based on automated, computer-controlled high-frequency heparin (10 U/mL) flushing of the cannula inserted into the tail artery of freely moving rats. The short flushing intervals as achieved with this system guarantee stable conditions throughout an experiment of several days, and reduce blood clotting and the infiltration of fibroblasts. In addition, a specially developed software enables the periodical application of test substances into the blood stream under time-controlled conditions over long periods. The system can be used continuously to follow up blood parameters in single animals without significant elicitation of stress-sensitive plasma catecholamines for up to 12 days.

Animals↗