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A comparative study of the antimycotic activity of a miconazole HP-beta cyclodextrin solution and a surfactant solution.

The antimycotic activity of a new parenteral solution containing miconazole was compared to that of a marketed solution (Daktarin IV solution). This solution has been withdrawn from the belgian market probably because of the toxic effects related to the presence of polyoxyl 35 castor oil. We propose a new formulation containing 10 mg of miconazole per ml (as the marketed solution), in combination with HP-beta cyclodextrin and lactic acid. The MIC of these two solutions were determined by broth microdilution method (following the NCCLS guidelines) against 15 yeasts and 16 filamentous fungi isolates. This study showed that MIC obtained with these two solutions are not significantly different. In vitro, the cyclodextrin solution has the same antimycotic activity as the Daktarin IV solution and can be proposed as a safe and effective parenteral solution to replace the previous surfactant solution.

Antifungal Agents↗

[Comparison of peritoneal transport of solutes and water during CAPD with glucose or amino acids solutions. Preliminary report].

The aim of the study was the comparison of peritoneal transport of solutes and water during dialysis with presently used 1.1% amino acid solution in relation to 1.36% glucose solution. 20 clinically stable patients on CAPD for 50.0 +/- 27.6 months were enrolled into the study. On the basis of blood and dialysate samples taken during 4-hour CAPD, intraperitoneal dialysate volume and diffusive mass transport coefficients (KBD) for: glucose, creatinine, urea, sodium, potassium and total protein were calculated. Intraperitoneal dialysate volume was higher in the case of amino acid solution in comparison to glucose solution. The KBD values for the investigated solutes were higher when amino acid solution was used, but for glucose and sodium the KBD values were statistically significantly higher. In conclusion, the differences in transperitoneal transport of solutes and water between both solutions found in our study suggest better clinical usefulness of amino acid solution than standard glucose solution for achieving adequate ultrafiltration.

Adult↗

[Comparison of myocardial protective effects between GIK solution and St. Thomas solution by use of canine isolated heart-lung preparations].

The myocardial protection afforded by GIK solution, widely used as cardioplegic solution in this country, was compared with that provided by St. Thomas solution or oxygenated St. Thomas solution. Eighteen isolated heart-lung preparations of dogs were made and their hearts were subjected to 3 hours cold (4 degrees C) cardioplegic arrest. GIK group hearts (n = 6) received 20 ml/kg of GIK solution at the time of aortic cross-clamp perfused through the aortic root and were subsequently given 10 ml/kg of GIK solution every 30 minutes. St. Thomas group hearts (n = 6) and oxygenated St. Thomas group hearts (n = 6) were treated identically except that cardioplegic solution were St. Thomas solution or fully oxygenated one. Four hearts of GIK group showed ventricular fibrillation immediately after reperfusion that required DC countershock. Temporary A-V block was recognized in two hearts. In the other two groups, however, neither ventricular fibrillation nor A-V block was found. Heart rate, coronary flow, aortic flow and LVSW were measured before arrest and after 60 minutes of reperfusion (mean aortic pressure 70 mmHg, left atrial pressure 4 mmHg). Post reperfusion % recovery rates (post-reperfusion/before arrest) of heart rate, coronary flow, aortic flow and LVSW (mean value +/- standard deviation) were 93.4 +/- 10.32%, 104.6 +/- 24.91%, 18.8 +/- 8.54%, 32.6 +/- 6.12% respectively for GIK group, 81.4 +/- 6.50%, 125.9 +/- 15.23%, 35.4 +/- 9.91%, 56.3 +/- 12.90% for St. Thomas group and 83.1 +/- 8.40%, 121.6 +/- 16.92%, 47.0 +/- 7.89%, 69.1 +/- 9.71% for oxygenated St. Thomas group. St. Thomas and oxygenated St. Thomas groups revealed significantly (p less than 0.05, p less than 0.01 respectively) more excellent functional preservation than GIK group. Intramyocardial pH was also measured by use of glass needle pH electrode punctured into the anterior interventricular septum. Preischemic intramyocardial pH (at 37 degrees C) was 7.49 +/- 0.106 in GIK group, 7.48 +/- 0.113 in St. Thomas group and 7.43 +/- 0.114 in oxygenated St. Thomas group. During 3 hours of cardioplegic arrest, intramyocardial pH (at 4 degrees C) decreased to 6.84 +/- 0.101 in GIK group, 7.03 +/- 0.088 in St. Thomas group and 7.23 +/- 0.239 in oxygenated St. Thomas group, which was significantly higher than GIK group (p less than 0.01). Therefore oxygenated St. Thomas solution was found to maintain more favorable energy supply to ischemic myocardium. These results clearly evidenced that St. Thomas and oxygenated St. Thomas solutions would provide more effective myocardial protection during ischemic arrest than GIK solution.

Animals↗

Both blood and crystalloid-based extracellular solutions are superior to intracellular solutions for lung preservation.

OBJECTIVE: Lung transplantation remains limited by donor organ ischemic time, inadequate graft preservation, and reperfusion injury. We evaluated lung preservation with use of an extracellular solution, with or without the addition of blood, as compared with preservation with the intracellular Euro-Collins solution. METHODS: With use of an isolated, whole blood perfused/ventilated rabbit lung model, we studied three groups of animals. Lungs were flushed with Euro-Collins, low-potassium dextran, or 20% blood-low-potassium dextran solution. Lungs were harvested en bloc, stored inflated at 4 degrees C for 18 hours, and then reperfused at 60 ml/min with whole blood. Continuous measurements of pulmonary artery pressure, pulmonary vascular resistance, and dynamic airway compliance were obtained. Fresh, nonrecirculated venous blood was used to determine the single-pass pulmonary venous-arterial oxygen gradient. RESULTS: Lungs preserved with Euro-Collins solution demonstrated elevated pulmonary artery pressure and pulmonary vascular resistance when compared with those preserved with low-potassium dextran and 20% blood-low-potassium dextran solutions (pulmonary artery pressure: 40.8 +/- 2.2 mm Hg vs 28.9 +/- 2.4 mm Hg and 28.3 +/- 1.5 mm Hg, respectively, p < 0.001; pulmonary vascular resistance: 46.0 +/- 3.1 x 10(3) dynes x sec x cm(-5) vs 29.0 +/- 4.2 x 10(3) dynes x sec x cm(-5) and 28.8 +/- 2.3 x 10(3) dynes x sec x cm(-5), respectively, p < 0.001). Euro-Collins solution-preserved lungs demonstrated a significant drop in compliance when compared with those preserved with low-potassium dextran and 20% blood-low-potassium dextran (-21.9% +/- 4.7% vs 1.8% +/- 3.3% and 1.4% +/- 6.2%, respectively; p = 0.002). Oxygenation was improved with low-potassium dextran and 20% blood-low-potassium dextran solutions as compared with that with Euro-Collins solution (296.3 +/- 54.6 mm Hg and 290.2 +/- 66.4 mm Hg, respectively, vs 37.2 +/- 4.6 mm Hg; p = 0.001). CONCLUSIONS: Extracellular solutions provided superior preservation of pulmonary function in this rabbit lung model of ischemia-reperfusion. However, the addition of blood does not confer any demonstrable advantage over low-potassium dextran solution alone with use of an 18-hour period of cold ischemia.

Animals↗

[Pharmaceutical and pharmacological evaluation of Burow's solution (aluminum acetate solution), hospital preparation, and development of its rapid preparation method].

Burow's solution, or aluminum acetate solution, is effective in inhibiting various microorganisms including methicillin-resistant Staphylococcus aureus (MRSA) that are commonly observed in chronic suppurative otitis media. It takes several days to prepare Burow's solution using aluminum sulfate, and the pharmaceutical properties of the solution are not fully understood. In this study, the effect of storage (5 months) of Burow's solution prepared according to the Teine-Keijin Hospital manual on its pharmaceutical properties and antibacterial activities was examined. We also attempted to develop a rapid preparation method of aluminum acetate (or 1.7% aluminum) solution using two commercially available compounds of aluminum acetate basic (Al(2)O(CH(3)CO(2))(4), Al(OH)(CH(3)CO(2))(2)). The properties of Burow's solution, pH, osmolarity and antibacterial activity, were the same among different preparations and its storage for 5 months at 4 degrees C had no effect on these properties. The antibacterial potency of Burow's solution was dependent on aluminum concentration and its antibacterial potency against S. aureus and several MRSA strains was of the same magnitude. In a rapid preparation, aluminum acetate basic was mixed with appropriate amounts of tartaric acid and acetic acid, and the suspension was boiled for 2-2.5 hr until dissolved. The rapidly prepared aluminum acetate solution showed the same pharmaceutical properties and antibacterial activities as those of Burow's solution. The newly developed preparation method for aluminum acetate solution is expected to be convenient and feasible for hospital treatment of chronic suppurative otitis media.

Acetates↗

Effects of cardioplegia induced by a Young's solution (YNG solution) on the blood-perfused canine papillary muscle preparation.

Experiments were carried out in the blood-perfused canine papillary muscle preparation to evaluate the protective effect of a cardioplegic solution, Young's solution (YNG solution), on the myocardial function. Both in spontaneously contracting preparations and in electrically paced (2 Hz) preparations, the time to the cardiac arrest and the time to the maximum blood flow were found to be significantly shorter when the cardiac arrest was induced with cardioplegic solutions than when it was induced with the cold modified Krebs-Ringer's solution (cold cardioplegia). The maximum blood flow of the paced preparation tended to be greater with cardioplegic solutions. The time to resumption of regular contractions was significantly shorter with YNG solution as compared with cold cardioplegia. The developed tension and the blood flow at the time of resumption of the regular contractions tended to approach the control value more quickly with YNG solution, as compared with other cardioplegic solutions and cold cardioplegia. It is concluded that YNG solution represents an optimal cardioplegic solution.

Animals↗

Capillary electrophoretic studies on the migration behavior of cationic solutes and the influence of interactions of cationic solutes with sodium dodecyl sulfate on the formation of micelles and critical micelle concentration.

The migration behavior of cationic solutes and influences of the interactions of cationic solutes with sodium dodecyl sulfate (SDS) on the formation of micelles and its critical micelle concentration (CMC) were investigated by capillary electrophoresis at neutral pH. Catecholamines and structurally related compounds, including epinephrine, norepinephrine, dopamine, norephedrine, and tyramine, which involve different extents of hydrophobic, ionic and hydrogen-bonding interactions with SDS surfactant, are selected as cationic solutes. The dependence of the effective electrophoretic mobility of cationic solutes on the concentration of surfactant monomers in the premicellar region provides direct evidence of the formation of ion-pairs between cationic solutes and anionic dodecyl sulfate monomers. Three different approaches, based on the variations of either the effective electrophoretic mobility or the retention factor as a function of surfactant concentration in the premicellar and micellar regions, and the linear relationship between the retention factor and the product of a distribution coefficient and the phase ratio, were considered to determine the CMC value of SDS micelles. The suitability of the methods used for the determination of the CMC of SDS with these cationic solutes was discussed. Depending on the structures of cationic solutes and electrophoretic conditions, the CMC value of SDS determined varies in a wide concentration range. The results indicate that, in addition to hydrophobic interaction, both ionic and hydrogen-bonding interactions have pronounced effects on the formation of SDS micelles. Ionic interaction between cationic solutes and SDS surfactant stabilizes the SDS micelles, whereas hydrogen-bonding interactions weakens the solubilization of the attractive ionic interaction. The elevation of the CMC of SDS depends heavily on hydrogen-bonding interactions between cationic solutes and SDS surfactant. Thus, the CMC value of SDS is remarkably elevated with catecholamines, such as epinephrine and norepinephrine, as compared with norephedrine. In addition, the effect of methanol content in the sample solution of these cationic solutes on the CMC of SDS was also examined.

Cations↗

Changes in hydration, protein and proteoglycan composition of the collagen-keratocyte matrix of the bovine corneal stroma ex vivo in a bicarbonate-mixed salts solution, compared to other solutions.

Many solutions have been used to investigate the swelling properties of the mammalian corneal stroma but few of the solutions resemble the expected extracellular matrix fluid of the corneal stroma, and little information is available on whether incubation ex vivo causes significant changes in the gross composition of the stroma. From quality-selected recent post-mortem eyes of adult cattle, stroma preparations were cut from the central part of the cornea. The time-dependent changes in wet mass were assessed over 9 h at 37 degrees C, and the preparations then dried. Various solutions of known pH (6.88-8.32) and osmolality (<50-327 mosmol/kg) were used, and were assayed for protein and proteoglycan after the incubation. The rates and extent of stromal swelling were lowest in a glucose-supplemented mixed salts solution containing 35 mM bicarbonate (0.5% CO2) solution, marginally greater in a mixed salts solution containing 35 mM bicarbonate (5% CO2) or similar non-bicarbonate mixed salts solutions (including BSS), and progressively greater in phosphate-buffered saline (PBS), various phosphate buffers (10-67 mM) and saline solutions (0.025-1%), and greatest in water. The initial rates of swelling ranged from 44 to 451 mg/h and the secondary rates from 9 to 106 mg/h. In all solutions, protein and proteoglycans were detected, but these ranged from around 1 to 10% of the samples with the bicarbonate-buffered solutions, to around 30% with the use of some phosphate buffers or saline.

Animals↗

[Comparative study of the protective effects of a cold potassium cardioplegic solution verses the Collins solution in the preservation of canine hearts for 24 hours by simple immersion method].

This study was undertaken to compare the protective effects of a cold potassium cardioplegic solution (K+:23 mEq/l, Na+:25.2 mEq/l) versus the Collins solution (K+:115 mEq/l, Na+:10 mEq/l) on the preservation of isolated canine hearts for 24 hours by simple immersion. To assess the viability of the preserved hearts, recovery of left ventricular function, myocardial water content and myocardial ultrastructures were evaluated before and after preservation. Isovolumic left ventricular function was evaluated with an intra-ventricular balloon method using a preparation of an isolated, blood-perfused heart. The cardioplegic solution group (n = 9) showed significantly better recovery results of pressure developed in the left ventricular (84-76 vs. 35-37%) and dp/dt (90-52% vs. 44-39%) as compared to the Collins solution group (n = 13). Compliance of the left ventricle was well maintained in the cardioplegic solution group. The Collins solution group showed a significant increase of myocardial water content and a remarkable decrease in compliance of the left ventricle after preservation. The quantitative evaluation results of the mitochondrial injury (mitochondria score) found through electron microscopy revealed that the mitochondria of the cardioplegic solution group were less injured as compared to those of the Collins solution group. We concluded that our cold potassium cardioplegic solution offers superior protective effects on the preservation of the heart by simple immersion as compared to the Collins solution.

Animals↗

Effectivity of freshly prepared or refreshed solutions for heart preservation versus commercial EuroCollins, Bretschneider's HTK or University of Wisconsin solution.

Rat hearts were preserved for 18 hr under totally ischemic storage conditions at 0-1 degree C with the commercially supplied EuroCollins, Bretschneider's HTK, and University of Wisconsin (UW) preservation solutions compared with our new preservation solution, Euro-Flush-glutathione solution, and a "refreshed" UW solution (UWG) with 3 mmol/L reduced glutathione added before use. Recovery of the organs was measured during 30 min of parabiotic reperfusion with whole blood of a host rat of the same inbred LEW strain, following an initial warm reflush for 5 min. Functional measurements were performed using a latex balloon in the left ventricle. The metabolic recovery was determined from the myocardium freeze-clamped at the end of reperfusion. The left ventricular pressure (LVP) amplitude during pacing to a heart rate of 300/min, as well as +dp/dtmax, -dp/dtmax, isotonic stroke volume, coronary flow, ATP, and ECP values, recovered significantly better after storage in Euro-Flush-glutathione solution (LVP: 63% of controls on average) compared with when the commercially available solutions were used (EuroCollins: 20%, HTK: 42% of controls in LVP). Hearts preserved in UW solution ViaSpan did not recover during the reperfusion period, when unfiltered solution was used. Filtered ViaSpan resulted in LVP recoveries of 38% of controls, while addition of reduced glutathione immediately before use (UWG) improved the effectivity of this solution significantly (LVP 63% of controls). Similar improvements were found for all other functional and metabolic parameters. Thus, the effectivity of UW solution ViaSpan depends upon extraction of the typical particles by a filtering procedure. Effectivity can be improved by a refreshment procedure with reduced glutathione immediately before use.

Adenosine↗

Efficacy and tolerability of timolol maleate ophthalmic gel-forming solution versus timolol ophthalmic solution in adults with open-angle glaucoma or ocular hypertension: a six-month, double-masked, multicenter study.

BACKGROUND: Timolol has been formulated in a highly purified gellan gum to improve its duration of action. The efficacy of this formulation in short-term studies using once-daily dosing has been reported. OBJECTIVE: The purpose of this study was to evaluate the efficacy and tolerability of 0.5% timolol maleate ophthalmic gel-forming solution (timolol GS) given once daily versus 0.5% timolol solution given twice daily in a long-term trial. METHODS: This was a multicenter, double-masked, 6-month trial. After a washout of ocular hypotensive medication, 286 patients with open-angle glaucoma or ocular hypertension were randomly assigned in a 2:1 ratio to receive 0.5% timolol GS in both eyes once daily or 0.5% timolol solution in both eyes twice daily. All patients received a morning (9 AM) and evening (9 PM) dose. For patients in the timolol GS group, the evening dose consisted of a vehicle only, whereas for patients in the timolol solution group, both doses consisted of active drug. Intraocular pressure (IOP) was measured at trough (before morning instillation) and peak (2 hours after instillation) at follow-up examinations at weeks 2, 4, 8, 12, and 24. Adverse events were monitored using patient reports. RESULTS: Of the 286 patients randomized, 191 received timolol GS and 95 received timolol solution. Ninety-three percent of patients (265/286) completed the study. At the end of the treatment interval (week 24), the mean decrease in IOP at trough ranged from 5.6 to 5.9 mm Hg in the timolol GS group and from 6.3 to 6.6 mm Hg in the timolol solution group. Similar efficacy was observed at 11 AM (peak). At week 24, the difference in mean IOP between treatments was -0.61 mm Hg (95% CI -1.44 to 0.22) at trough and -0.79 mm Hg (95% CI -1.77 to 0.20) at peak, indicating no significant difference between the 2 timolol formulations. The number of reports of blurred vision and tearing was significantly higher in the timolol GS group than in the timolol solution group (P = 0.04), whereas burning/stinging was reported more frequently in the timolol solution group than in the timolol GS group (P = 0.04). At week 12, the decrease in mean heart rate at trough (hour 0) was significantly less for patients in the timolol GS group than for those in the timolol solution group (-1.1 vs -4.2 bpm; P = 0.024). At week 24 (hour 0), the decrease in mean heart rate was less for patients treated with timolol GS by 2.5 bpm (P = 0.051). The heart rate data at peak (hour 2) was similar to that observed at trough at week 12 (-2.7 vs -5.7 bpm; P = 0.006) and week 24 (-3.1 vs -4.7 bpm; P = 0.063). The mean change in blood pressure was not significantly different between treatments. There were no clinically significant differences between the groups in visual acuity, biomicroscopy and ophthalmoscopy results, or visual fields. CONCLUSIONS: Timolol 0.5% GS administered once daily was shown to be as effective in lowering IOP as the equivalent concentration of timolol 0.5% solution administered twice daily in patients with ocular hypertension or open-angle glaucoma.

Adult↗

In vitro effects of different medium molecular hydroxyethyl starch solutions and lactated Ringer's solution on coagulation using SONOCLOT.

UNLABELLED: Hydroxyethyl starch (HES) solutions are widely used to replace intravascular volume. HES solutions differ from each other with regard to molecular weight and mode of hydroxyl substitution (degree of hydroxylation, C2:C6 hydroxyethyl ratio, concentration), factors which may have varying effects on coagulation. We studied, in vitro, three different HES preparations (molecular weight/degree of hydroxylation/concentration/C2:C6 ratio of substitution 70.000/0. 5/6%/3.2; Pharmacia & Upjohn Co., Erlangen, Germany; 130.000/0. 4/6%/11.2 and 200.000/0.5/6%/4.6; Fresenius Co., Bad Homburg, Germany) and, for comparison, lactated Ringer's solution (RL) at 33% and 66% dilution with whole blood. The influence of hemodilution was measured by using routine laboratory variables and SONOCLOT (Sonoclot II Coagulation and Platelet Function Analyzer, Sienco Co.) analysis, using a viscoelastic test, on the cellular as well as on the plasmatic hemostatic system. For statistical analysis of quantitative data, we used nonparametric analysis of variance and adequate post hoc tests. Qualitative data were analyzed by using the nonparametric Kruskal-Wallis test. A P value below 0.05 was considered significant. In contrast to the control group with RL, the liquid phase of coagulation (activated clotting time) was slightly affected by the 33% diluted HES solutions. HES 70.000, 130. 000, and 200.000 interfered significantly with the early stage of coagulation as expressed by the clot rate (gel/fibrin formation). Clot maturation and speed of maturation (time to peak) were strongly affected by HES 70.000 at all grades of dilution. HES 130.000 showed a faster clot formation process compared with the other HES solutions. HES 130.000 diluted 33% showed a better clot retraction as compared with the other HES solutions. In conclusion, in vitro hemodilution comparing different medium molecular weight HES solutions reveals that HES 130.000 seems preferable regarding some aspects of clot formation and retraction. RL affected clot formation only minimally, except for the early activation of clotting, which was measured by a shortened activated clotting time. IMPLICATIONS: We investigated the effect of different hydroxyethyl starch (HES) solutions (70.000, 130.000, 200.000) on coagulation. Regarding clot formation and retraction, HES 130.000 had some advantages over the other tested HES solutions. Lactated Ringer's solution affected coagulation only minimally, except for the early stage of clot formation.

Blood Coagulation↗

Ringer-Lactate solution versus isotonic saline solution on mucociliary function after nasal septal surgery.

Irrigation with isotonic saline is one of the most frequently used solutions after nasal surgery. However, the effect of saline solutions on mucociliary clearance is not well known. In a previous study, it was found that isotonic saline solution had a negative effect on ciliary beat frequency but Ringer-Locke solution had no effect in vitro. In this study we compared the effects of Ringer-Lactate solution and isotonic saline solution on mucociliary transport time before, and after, nasal septal surgery in patients with nasal septal deviation. We found that patients who used Ringer-Lactate solution as irrigation after surgery had a significantly better mucociliary transport time than the patients using isotonic saline solution (p < 0.05). In conclusion, it is better to use Ringer-Lactate solution instead of 0.9 per cent saline solution for nasal irrigation.

Adolescent↗

Comparison of UW solution and St. Thomas' solution in the rat: importance of potassium concentration.

BACKGROUND: University of Wisconsin solution (UW) is in limited clinical use for heart transplantation, but there are doubts about its efficacy and concerns about the effect of its high K+ concentration on endothelium. St. Thomas' solution with or without aspartate is widely used and is of proven efficacy. METHODS: Using a modified (starch-free) variant of UW (MUW) we studied: (1) recovery of function with UW compared with aspartate-containing St. Thomas' solution; (2) effect of elevation of K+ in St. Thomas' solution to the level in UW; and (3) effect of reduction of K+ in UW and addition of Ca2+ or aspartate. Isolated rat hearts underwent 7 hours of arrest at 1 degrees C using MUW with or without 20 mmol/L aspartate or using aspartate-containing St. Thomas' solution. RESULTS: Functional recovery with MUW (51.8% +/- 2.5%) was superior to that with aspartate-containing St. Thomas' solution (37.1% +/- 4.3%; p < 0.01). Addition of aspartate to MUW had no effect. During 6 hours of arrest, lowering the K+ in MUW from 125 mmol/L to 20 mmol/L reduced functional recovery from 59.9% +/- 4.2% to 42.3% +/- 4.3% (p < 0.01). The addition of 1 mmol/L Ca2+ had no effect. Elevation of K+ in St. Thomas' solution produced more rapid arrest but no improvement in recovery. CONCLUSIONS: The protective effect of starch-free UW is greater (+13%) than that of aspartate-enriched St. Thomas' solution. Reduction of K+ in UW to lessen possible deleterious effects would decrease its protective effect by about 30% to a level comparable with that of St. Thomas' solution.

Animals↗

Low-potassium UW solution for lung preservation. Comparison with regular UW, LPD, and Euro-Collins solutions.

University of Wisconsin solution has been used successfully in clinical kidney and liver preservation. The object of this study was to determine if low-potassium UW (LPUW) solution could be applied to pulmonary preservation. Rabbit lungs were stored after hypothermic pulmonary artery (PA) flush with four different solutions (group 1: low-potassium dextran (LPD) solution, group 2: high-potassium UW (HPUW) solution, group 3: LPUW solution, group 4: modified Euro-Collins (E-C) solution). The lungs were preserved at 10 degrees C for 30 hr and evaluated in an ex vivo ventilation/perfusion apparatus using fresh pooled venous rabbit blood. Mean PA flush pressures (MFP) during harvesting were significantly lower in groups 1 and 3 (8.1 +/- 1.0 mmHg and 7.3 +/- 0.6 mmHg, respectively; mean +/- SEM) than in groups 2 and 4 (15.5 +/- 1.7 mmHg and 12.3 +/- 0.9 mmHg, respectively). Lungs in groups 1 and 3 showed significantly higher PaO2 (103.5 +/- 8.0 mmHg and 89.3 +/- 7.2 mmHg) than groups 2 and 4 (48.3 +/- 7.7 mmHg, 66.7 +/- 4.7 mmHg). Groups 1 and 3 showed significantly lower wet/dry weight (W/D) ratios after reperfusion (6.21 +/- 0.15 and 6.39 +/- 0.23) than groups 2 and 4 (7.70 +/- 0.57 and 7.13 +/- 0.21, respectively). There were no significant differences in MFP, PaO2, PaCO2, mean pulmonary artery pressure, or W/D ratio between groups 1 and 3. These results suggest that LPUW solution may be as beneficial as LPD solution for pulmonary arterial flush and lung preservation.

Adenosine↗

Detrimental effects of temperature on the efficacy of the University of Wisconsin solution when used for cardioplegia at moderate hypothermia. Comparison with the St. Thomas Hospital solution at 4 degrees C and 20 degrees C.

BACKGROUND: We have previously reported the superior protective properties of the University of Wisconsin (UW) solution compared with the St. Thomas solution (ST) in the rat heart subjected to the deep hypothermia (4 degrees C), thus demonstrating its possible use in cardiac transplantation. We thought it was important to evaluate the potential of the UW solution as a cardioplegic solution under the moderately hypothermic (20 degrees C) conditions of routine intraoperative myocardial protection. METHODS AND RESULTS: Isolated rat hearts were subjected to 60 minutes of ischemia at 4 degrees C or 30 (or 60) minutes of ischemia at 20 degrees C with UW, ST, and ST plus 100 mM K (ST + 100) solutions. Coronary flow, mechanical function, endothelial function, and ultrastructure were observed. Mean time (seconds) to infuse 10 ml of cardioplegic solution under constant pressure, a measure of coronary vascular resistance at 4 degrees C and 20 degrees C, respectively, for each solution were ST, 69.2 +/- 6.9 and 64.7 +/- 3.8; UW, 142.2 +/- 8.8 and 187.2 +/- 10.0 (p < 0.01); and ST + 100, 78.2 +/- 8.0 and 176 +/- 8.1 (p < 0.001). Mean recovery values of cardiac output (expressed as percentage of its preischemic value) after 60 minutes of ischemia at 4 degrees C were ST, 95.5 +/- 2.1%; UW, 93.0 +/- 2.4%; and ST + 100, 96.5 +/- 1.5%. After 30 minutes of ischemia at 20 degrees C, values were ST, 88.0 +/- 1.3%; UW, 72.2 +/- 3.6% (p < 0.005 versus ST); and ST + 100, 53.3 +/- 1.8% (p < 0.001 versus ST). CONCLUSIONS: The efficacies of UW and severely hyperkalemic cardioplegic solutions are affected by the degree of hypothermia under which they are used. Under moderate hypothermia (20 degrees C), severe hyperkalemia induces a marked increase in coronary vascular resistance that is associated with impaired myocardial protection. These studies discourage the use of UW for routine intraoperative cardioplegic arrest where the degree of hypothermia cannot be readily controlled. The ST solution does not share this constraint.

Adenosine↗

Comparison of hypertonic saline-dextran solution and lactated Ringer's solution for resuscitating severely dehydrated calves with diarrhea.

OBJECTIVE: To determine effectiveness of rapid i.v. administration of hypertonic saline-dextran (HSD) solution combined with oral administration of isotonic electrolyte solution for resuscitating severely dehydrated calves and to compare the resuscitative response with that of a conventional treatment of lactated Ringer's solution (LRS) i.v. and orally administered isotonic electrolyte solution. DESIGN: Prospective study. ANIMALS: 15 male dairy calves 3 to 10 days old. PROCEDURE: Baseline data were obtained. Osmotic diarrhea and severe dehydration were induced for 48 hours. Calves were then allocated to 3 treatment groups. The control group (group C) did not receive fluids, a second group (group H) received hypertonic saline (7.2% NaCl) solution with 6% dextran 70 and isotonic electrolyte solution, and a third group (group L) received LRS and isotonic electrolyte solution. Physical examinations were performed every 8 hours. RESULTS: Calves developed diarrhea, lethargy, severe dehydration (mean, 14% of body weight), azotemia, hyperkalemia, and mild acidemia. Group-C calves remained lethargic and severely dehydrated during the 24-hour treatment phase. Calves treated with HSD and LRS were effectively resuscitated; however, response for most variables was more rapid and sustained for the HSD-treated group. Cardiac output was greater in LRS- than HSD-treated calves 1, 2, and 8 hours after initiation of treatment because of continued i.v. administration of fluids. CLINICAL IMPLICATIONS: A combination of HSD and isotonic electrolyte solution was a rapid and effective method for resuscitation of severely dehydrated calves. It was similar in effectiveness to conventional treatment in which LRS and isotonic electrolyte solution were used for resuscitating calves with severe dehydration.

Administration, Oral↗

[Comparison of a sulfate-free polyethylene glycol (PEG) solution with a standard solution for colonoscopy preparation].

In order to ameliorate the unpleasant salty taste of a standard PEG-electrolyte lavage solution and thus improving acceptance of colonoscopy cleansing, a new sulfate-free, low sodium PEG-solution has been developed as long as 10 years ago. Comparative studies regarding acceptance showed conflicting results. This study was intended to compare the standard solution L (Cololyt) with the sulfate-free solution S (Colo-Sol) on a prospective basis in a collective of average gastroenterology outpatients. The 144 patients who underwent colonoscopy ingested 1 liter of solutions L and S each on the evening before and another liter of the preferred solution (preference) in the morning of the day of examination. Moreover the taste of both solutions was rated (grading scale 0-10). Tolerance and efficacy were registered as well. Preference and thus acceptance presented very well-balanced. Solution L was preferred as frequent (by 50.7% of patients) as solution S (49.3%) which was originally claimed to be better tasting. The respective preferred solutions were rated equal with mean +/- SD values of 6.6 +/- 2.2 for L and 7.0 +/- 1.9 for S. Efficacy and tolerance did not differ from a clinical point of view.

Administration, Oral↗