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The effectiveness of University of Wisconsin solution on prolonged myocardial protection as assessed by phosphorus 31-nuclear magnetic resonance spectroscopy and functional recovery.

The effectiveness of the University of Wisconsin solution on extended myocardial preservation was examined in this study using phosphorus 31-nuclear magnetic resonance spectroscopy. Isolated perfused rat hearts were arrested and stored in four preservation solutions: group 1, modified Krebs-Henseleit solution; group 2, modified St. Thomas' Hospital solution; group 3, oxygenated modified St. Thomas' Hospital solution containing 11 mmol/L glucose; and group 4, University of Wisconsin solution. The changes in myocardial high energy phosphate profiles and the intracellular pH values were measured during 12 hours of cold (4 degrees C) global ischemia and 90 minutes of normothermic reperfusion. Following ischemia, the hearts were assessed for hemodynamic recovery and myocardial water content. During ischemia, adenosine triphosphate depletion was observed in all groups; however, after 5 hours of ischemia, the adenosine triphosphate levels were significantly higher in group 3 compared with the other groups (adenosine triphosphate levels at 6 hours in mumol/gm dry weight: group 3, 7.6; group 4, 3.2; group 2, < 1; p < 0.025). The tissue water content at the end of ischemia was lower with the University of Wisconsin solution compared with the modified St. Thomas' Hospital solution or the oxygenated modified St. Thomas' Hospital solution (in ml/gm dry weight: group 4, 3.0; group 2, 4.4; group 3, 3.9; p < 0.05). The adenosine triphosphate repletion during reperfusion was greater with the University of Wisconsin solution compared with the modified St. Thomas' Hospital solution or the oxygenated modified St. Thomas' Hospital solution (12 mumol/gm dry weight in group 4; 8.1 in group 2; 9.0 in group 3; p < 0.05). Similar findings were obtained for the recovery of left ventricular pressure (in percent of preischemic control: group 4, 70%; group 2, 42%; group 3, 52%; p < 0.01) and coronary flow (group 4, 61%; group 2, 49%; group 3, 49%; p < 0.05). These data suggest that preservation with the University of Wisconsin solution affords improved hemodynamic recovery, enhanced adenosine triphosphate repletion, and reduced tissue edema upon reperfusion; however, oxygenated St. Thomas' Hospital solution with glucose is associated with the preservation of higher myocardial adenosine triphosphate levels during prolonged cold global ischemia. In conclusion, these data indicate that the University of Wisconsin solution might improve graft tolerance of ischemia in clinical heart transplantation.

Adenosine↗

Formulation of trichloroacetic acid peeling solution: a bibliometric analysis.

Since the beginning of this century, trichloroacetic acid solutions of various concentrations have been used for chemical exfoliation. These solutions have been prepared by using four different formulas. To prepare a 50% solution, for instance, water may be added to 50 g of trichloroacetic acid crystals until 100 ml of solution is obtained (weight-to-volume solution). Alternatively, 50 g of water may be added to 50 g of trichloroacetic acid crystals (weight-to-weight solution), or 50 g of trichloroacetic acid crystals may be solved in 100 ml of water (weight-plus-volume solution). Finally, a saturated trichloroacetic acid solution (or "100% solution") may be diluted by an equal volume of water (dilution). Depending on the method used, these so-called 50% solutions contain 40 to 71 weight-to-volume percentages of trichloroacetic acid. From a review of 120 publications on trichloroacetic acid peeling that have appeared since 1926, it was concluded that the authors of 87 of these publications (73 percent) did not report their formula for the trichloroacetic acid solution. Any one of the four methods was reported to have been used by the 33 authors who did report their formula. Eight of 10 internationally reputed pharmacopeias were found not to include the formula of a trichloroacetic acid solution. Proper evaluation of results and prevention of complications of trichloroacetic acid chemexfoliation is only feasible if both the concentration and the formula of trichloroacetic acid solution are reported by the author. Practitioners who use a trichloroacetic acid solution need to establish that the concentration of the solution they apply corresponds with that of the solution reported in the literature.

Bibliometrics↗

[Effect of vitrification state of protective solutions on recovery of red blood cells after lyophilization preservation].

To study effect of vitrification state of protective solutions on recovery of red blood cells after lyophilization, four protective solutions composed of isotonic buffers containing 7% DMSO (v/v) and 20%, 30%, 40% or 50% polyvinylpyrrolidone (PVP) (w/v) were adopted. Vitrification state of protective solutions was examined first when white ice crystal appeared in any protective solution during freezing or thawing, if the used solution was not a vitrification solution. Red blood cells were lyophilized in MINILYO45 freeze-dryer after washing, mixing with protective solutions and prefreezing. After lyophilization, the samples were quickly rehydrated by 37 degrees C rehydration solution. The results showed that in vitrification and devitrification experiments, white ice crystal appeared in solution of 20% PVP + 7% DMSO and 30% PVP + 7% DMSO during freezing and thawing; vitrification appeared in solution of 40% PVP + 7% DMSO during freezing, but devitrification appeared during thawing; vitrification appeared in solution of 50% PVP + 7% DMSO during freezing and thawing. After rehydration, the recoveries of red blood cells and hemoglobin in 40% PVP + 7% DMSO group were (81.36 +/- 14.94)% and (77.54 +/- 12.86)%, which were significantly higher than that in 20% PVP + 7% DMSO, 30% PVP + 7% DMSO and 50% PVP + 7% DMSO groups (P < 0.01). The concentration of free hemoglobin in 40% PVP + 7% DMSO group was also significantly lower than that in other three groups (P < 0.01). With increase of PVP concentration in protective solutions, vitrification state and protective effect of these solutions also increased; when concentration of PVP in protective solution was 40% though it was not a vitrification solution, the effect of lyophilization was the best; but when concentration of PVP further increased to 50%, though it was a vitrification solution, the effect decreased. It is concluded that excessive vitrification state could not benefit lyophilization of red blood cells.

Cryoprotective Agents↗

A comparative study of cardiac preservation with Celsior or University of Wisconsin solution with or without prior administration of cardioplegia.

BACKGROUND: We have previously reported the cardiac functional and metabolic benefits of administration of extracellular-type cardioplegia before preservation with University of Wisconsin solution. Celsior solution was designed to be used both as an arresting solution and a storage solution for heart transplantation. The objective of the present study is to compare cardiac function of hearts arrested and preserved with Celsior solution to hearts arrested with cardioplegia followed by preservation with UW solution. METHODS: Rabbit hearts were divided into 4 groups: in the Celsior group, hearts were arrested and preserved with Celsior solution; in the C-Celsior group, hearts were arrested by an extracellular-type cardioplegia and preserved with Celsior solution; in the UW group, hearts were arrested and stored in University of Wisconsin solution; and, in the C-UW group, hearts were arrested with extracellular-type cardioplegia and stored in University of Wisconsin solution. After 6 hours of preservation, cardiac function was measured using modified Frank-Starling curves in the isolated blood-perfused working heart. RESULTS: Cardiac function in the Celsior group was inferior to that in both the C-UW group and UW group. The C-Celsior group demonstrated inferior cardiac function compared with the Celsior group (p < 0.01), whereas no significant difference was observed between the C-UW and UW groups. CONCLUSIONS: Celsior solution did not surpass UW solution regardless of the use of cardioplegia. Further studies are required to develop optimal solution for use as both an arresting solution and a storage solution.

Adenosine↗

A new dextran 40-based solution for liver preservation.

UW solution is at present the most efficient solution for preservation of livers for transplantation. We have developed an alternative solution based on dextran instead of hydroxyethyl starch and without raffinose, allopurinol, magnesium sulfate, insulin, penicillin, or dexamethasone, which all are used in UW solution. In addition, 62.5 mM potassium in UW solution is replaced with sodium. We tested this new solution for liver preservation using the isolated perfused rabbit liver. We found that livers preserved in the UW solution for 24 or 48 hr lost 11.6 +/- 2.6% and 16.8 +/- 2.0% of the prepreservation weight, respectively, as a sign of organ shrinkage (P less than 0.001). In contrast, no change in liver weight was observed after preservation in the new dextran-based solution. Similarly, no change in total tissue water of the rat liver slices was seen after preservation in the new solution. Furthermore, livers preserved for 24 hr in the UW solution or the new solution produced the same amount of bile as unpreserved livers. However, after preservation in the UW solution for 48 hr, bile production was reduced by 65% (P less than 0.05). In contrast, livers preserved for 48 hr in the new solution showed no reduction in bile production. We conclude that our new solution significantly improves long-term liver preservation, and with this modified solution, 48-hr preservation may be safe.

Adenosine↗

Effects of preservative-free artificial tear solutions on corneal epithelial structure and function.

OBJECTIVES: To test the efficacy of a bicarbonate-containing artificial physiologic tear solution (solution PT) in providing an environment in which the damaged corneal epithelium can recover its normal barrier function and to compare this solution with other available artificial tears. Also, to investigate the effects on the corneal mucin layer and epithelial ultrastructure. METHODS: The corneal epithelial permeability of anesthetized rabbits was increased by exposure to 0.1% benzalkonium chloride. The corneas were then exposed to solution PT, with or without bicarbonate, or one of four commercially available artificial tear solutions for 1.5 hours, followed by a 5-minute exposure to 5(6)-carboxyfluorescein. Frozen sections of the corneas were examined by fluorescence microscopy. The fluorescence intensity (FI) of the epithelium was measured by image analysis. Undamaged corneas exposed to tear solutions were examined by transmission electron microscopy after fixation of the mucin layer with cetylpyridinium chloride. RESULTS: The FI of corneas damaged by benzalkonium chloride was increased threefold above those of undamaged controls. Damaged corneas treated with either of two commercial isotonic tear solutions partially recovered their barrier function, but the FI did not reach control levels. Corneas treated with hypotonic solutions containing ethylenediaminetetraacetic acid (EDTA) did not recover. In contrast, the FI of corneas treated with solution PT returned to control levels. This effect was lost in the absence of bicarbonate. Solution PT and the two isotonic solutions maintained normal corneal ultrastructure and mucin layer. Lack of bicarbonate in solution PT resulted in focal damage to superficial epithelial cells, whereas the EDTA-containing solutions destroyed the first two cell layers and reduced the mucin thickness. CONCLUSIONS: Bicarbonate-containing solution PT is superior to the other tear solutions tested in promoting recovery of the damaged corneal epithelial barrier and maintaining normal ultrastructure. The presence of bicarbonate appears to be essential to this process.

Bicarbonates↗

Vitrification properties of solutions of ethylene glycol in saline containing PVP, Ficoll, or dextran.

Vitrification solutions which are used for cells or embryos generally contain cryoprotectant, physiological saline, and one or more macromolecular solutes. The macromolecules modify the vitrification tendencies of these solutions, but there is little detailed information on the vitrification properties of ethylene glycol solutions containing the additives PVP, Ficoll, and dextran. This study therefore added ethylene glycol to 0.9% NaCl in water (saline) and used differential scanning calorimetry to determine the lowest concentration at which the solution would remain vitreous when a warming rate of 10 degrees C/min was used. In the absence of other additives 59 wt% ethylene glycol (EG) in saline formed a stable glass. When ethylene glycol was replaced by the polymers Ficoll and/or dextran on a weight for weight basis, the resulting solution vitrified less readily than an EG-saline solution even though the total solute concentration was kept constant. The total solute concentration required to form a stable vitreous solution increased as the Ficoll 70,000 and 400,000 MW or dextran 78,000 MW content increased (5, 10, and 20 wt%). Ficoll and dextran had little or no effect on the glass transition and melting points of the solutions. In the presence of PVP vitrification occurred at a total solute concentration of 59 wt% (PVP 360,000 MW) or 60 wt% (PVP 40,000 MW) for all three tested PVP concentrations (5, 10, and 20 wt%). Although this indicates that PVP and EG have comparable vitrification properties, the melting and the glass transition temperature of the solutions rose as the PVP content increased. When 1 m sucrose was added to saline and 0, 5, 10, or 20 wt% PVP 40,000 MW vitrification was achieved with 31, 26, 23, and 15% EG, respectively, indicating that the total solute concentration required for vitrification could be estimated with reasonable accuracy from the sum of the individual components. We conclude that the tested polymers differ in how they interact with ethylene glycol-based vitrification solutions.

Calorimetry, Differential Scanning↗

Evaluation of a new preoperative ophthalmic solution.

BACKGROUND: Maximum mydriasis and corneal clarity during intraocular surgery are important to ensure operational safety. However, repeated instillation of mydriatic and anti-inflammatory ophthalmic solutions during surgery may affect compliance and may damage the corneal epithelium. We developed an ophthalmic solution containing tropicamide, phenylephrine hydrochloride and diclofenac sodium, and compared the properties and effect on corneal epithelial barrier function and on mydriasis of the solution and of its individual components. METHODS: We developed the ophthalmic solution by mixing 10 mL of 0.5% tropicamide/0.5% phenylephrine, 10 mL of 5% phenylephrine and 10 mL of 0.1% diclofenac (TPD). We determined the stability of the chemicals in solution using high-performance liquid chromatography immediately, 1 week and 1 month after mixing. Corneal epithelial barrier function was assessed before and after instillation of the solutions in 26 eyes of 17 patients (5 with proliferative diabetic retinopathy or diabetic maculopathy, 8 with cataract and 4 with no eye disease). The fluorescent intensity was measured 10 times at the central cornea 30 minutes after instillation of 3 mL of 0.5% fluorescein solution and the average value calculated. Finally, the pupil diameter of 50 eyes of 38 patients undergoing cataract surgery was measured before and immediately after the operation. RESULTS: No remarkable changes in the pH or pharmacologic activity of the TPD solution were observed at any time after mixing. In the patients with diabetic retinopathy or cataract, the increase in mean fluorescent intensity was significantly greater with the individual solutions than with the TPD solution (p < 0.01); there was no significant difference in mean fluorescent intensity in the subjects with no eye disease. No statistically significant difference in pupil diameter was observed between the eyes that received the TPD solution and those that received the individual solutions. INTERPRETATION: TPD ophthalmic solution is simple to prepare and use. The TPD solution had a similar effect on mydriasis as the three individual solutions but was less destructive to the corneal epithelium.

Adult↗

Evaluation of a new preservative solution for cardiac graft during hypothermia.

BACKGROUND: Reports conflict on the beneficial effects of several cardioplegic solutions such as University of Wisconsin and St. Thomas' Hospital solutions. Therefore our objective was to assess the efficacy of several cardioplegic solutions for cardiac preservation by comparing University of Wisconsin modified solution (UW-1 and UW-1 + calcium = UW-2), St. Thomas' Hospital solution N degrees 1 (STH-1), Celsior solution, and a solution from our laboratory, Lyon preservation solution (LYPS). METHODS: We randomized male rats (n = 70) to 7 groups: LYPS, Celsior, STH-1, UW-1, UW-2, normal saline solution, and control. All hearts, except control hearts were preserved by cold storage (8 hours, 4 degrees C) in the various solutions. We used isolated non-working-heart preparations (left ventricular function evaluation, n = 5/group) or biopsy specimens (energetic store evaluation, n = 5/group) to assess quality of heart preservation. RESULTS: Hearts stored with the saline solution had a mean left ventricular developed pressure (LVDP) of 3.6 +/- 1.3 mm Hg. In contrast, LYPS and Celsior hearts had mean LVDP close to that of the control hearts (97 +/- 2.6, 92.1 +/- 2.2, and 122 +/- 1.9 mm Hg, respectively), whereas STH-1, UW-1, and UW-2 hearts presented an intermediate functional response (48 +/- 4, 39.9 +/- 4.1, and 69 +/- 1.8 mm Hg, respectively). The STH-1 and saline hearts showed increased release of creatine kinase (541.9 +/- 168 and 1,080.8 +/- 126.2 UI/liter, respectively). The energetic charge (EC = [(0.5 ADP + ATP)/ATP + ADP + AMP]) in Celsior, UW-2, and saline was significantly lower (p < 0.001) than in the other groups. CONCLUSION: The composition of the preservation solutions had a notable effect on myocardial viability. Our results indicated that LYPS and Celsior solutions had comparable efficacy for left ventricular function. However these solutions may offer better preservation than do UW-1, UW-2, or STH-1 solutions.

Animals↗

Comparison of oral sodium phosphate to polyethylene glycol-based solution for bowel preparation for colonoscopy in children.

Thirty-four patients, aged 3 to 17 years, were randomized to receive oral sodium phosphate solution or a polyethylene glycol-based solution in preparation for elective colonoscopy. Nineteen patients received two doses of oral sodium phosphate solution (45 mL/1.7 m2/ dose) and 15 received polyethylene glycol-based solution (4 L/1.7 m2). Compliance with oral sodium phosphate solution was judged as easy or tolerable in 15 of 19 patients, but only in 5 of 15 who were given polyethylene glycol-based solution. The quality of colon cleansing was rated by an endoscopist who was blinded to the colon preparation method used. The bowel preparation was excellent or good (only liquid remaining in the colonic lumen) in 18 of 19 patients who received oral sodium phosphate solution and in 6 of 15 who received polyethylene glycol-based solution. The incidence of vomiting was similar in both groups, but abdominal pain occurred more frequently in the polyethylene glycol-based solution group. Hyperphosphatemia developed in patients who received oral sodium phosphate solution (serum phosphorus = 2.3 +/- 0.7 mmol/L (7.2 +/- 2.2 mg/dL; mean +/- SD), but only in 1 of 15 patients in the polyethylene glycol-based solution group. Patients did not exhibit symptoms of hyperphosphatemia and serum calcium concentrations were similar in both groups. In summary, oral sodium phosphate solution is better tolerated than polyethylene glycol-based solution for bowel preparation in children. However, hyperphosphatemia occurred frequently in patients who received oral sodium phosphate solution. Further studies are needed to determine the optimal dose for safety and efficacy for the use of these solutions in children.

Adolescent↗

Evaluation of the efficacy of oral rehydration solutions using human whole gut perfusion.

Whole gut perfusion in humans was used to compare the effect on intestinal water and electrolyte transport of the World Health Organisation oral rehydration solution (solution II, composition in mmol/l: glucose 111, sodium 90, bicarbonate 30, potassium 20; 308 mOsm/kg); a hypertonic commercial oral rehydration solution (solution III, glucose 188, sodium 50, bicarbonate 20, potassium 20 mmol/l; 335 mOsm/kg); and three experimental bicarbonate free, hypotonic oral rehydration solutions: solution IV (glucose 111, sodium 60, potassium 20 mmol/l; 260 mOsm/kg), solution V (glucose 80, sodium 60, potassium 20 mmol/l; 219 mOsm/kg), and solution VI (glucose 80, sodium 30, potassium 20 mmol/l; 177 mOsm/kg). Perfusion of the intestine with a standard cleansing solution (solution I, sodium 125, potassium 10, bicarbonate 20, sulphate 40, mannitol 80 mmol/l; 275 mOsm/kg) confirmed published data on minimal water and sodium absorption. Experimental solution VI produced maximum water absorption (mean (SE) +1660.0 (29.8) ml/h) significantly greater than solution II (+1195.3 (79.5) ml/h), III (+534.7 (140.3) ml/h), IV (+1498.0 (42.7) ml/h), and V (+1327.7 (24.4) ml/h; p less than 0.05). Sodium absorption was significantly greater with solution II (+97.4 (7.9) mmol/h) compared to VI (+43.3 (7.8) mmol/h; p less than 0.01) but not compared to IV (+67.2 (13.0) mmol/h). A hypotonic oral rehydration solution such as solution VI may provide optimal replacement treatment for patients with acute diarrhoea.

Adult↗

Supplemented dialysis: amino acid-based solutions in peritoneal dialysis.

Peritoneal dialysis is associated with several metabolic and nutritional abnormalities, some of which are related to the use of glucose-based solutions. Furthermore, the catabolic effects of uremia per se, protein and amino acid losses into the dialysate, peritonitis and poor appetite contribute to amino acid abnormalities, negative nitrogen balance and a high prevalence of malnutrition in peritoneal dialysis patients. To overcome these problems the use of amino acid instead of glucose as an osmotic agent has been proposed. Short-term studies have shown that amino acid-based solutions in peritoneal dialysis may supplement in excess the daily losses of amino acids during dialysis with glucose-based solutions. The amino acid solutions produce similar ultrafiltration and solute transport as the standard glucose solutions although the period of effective ultrafiltration is rather short. However, it should be noted that some studies have reported that the transport of small and large solutes may increase in patients using amino acid solutions. During the early 1980s several investigators have developed and tested different amino acid solutions for peritoneal dialysis. The initial clinical experience from Toronto with amino acid solutions containing large amounts of non-essential amino acids and inadequate amount of buffer were in general discouraging. The patients, who were not always malnourished and tended to have a low energy intake, developed increased BUN levels, acidosis, no improvement in nutritional status or amino acid abnormalities and, in some cases, anorexia. In 1985 a new 1% amino acid solution, containing an increased buffer amount and amino acids (mainly essential) in proportions which take the amino acid abnormalities in uremic patients into account, became available. The use of this solution resulted in some improvement in amino acid pattern and nutritional parameters, but acidosis and increased BUN levels remained problems. The experiences from these and previous studies showed that: (1) the improvement of the composition of amino acid solutions was beneficial; (2) a further increase of the buffer amount was needed; (3) patients included should have signs of protein malnutrition combined with low dietary protein intake to benefit from intraperitoneal amino acid supply, and (4) energy intake should be sufficient to prevent amino acids to end up as energy source. For this purpose a new improved 1.1% amino acid solution has been developed containing a further increase of some essential amino acids and an increased amount of lactate (40 mmol/l). This solution has been tested in malnourished patients eating 0.8 g protein/kg/day and 25-30 kcal/kg/day.(ABSTRACT TRUNCATED AT 400 WORDS)

Absorption↗

[Successful 48-72 h cold storage of dog kidneys with HX-1 solution].

HX-1 solution was used in this study to determine its effects on long term kidney preservation. 20 female and male mongrel dogs were randomly divided into control (HC-WCU solution) and experimental (HX-1 solution) groups. Kidneys were flushed with HC-WCU or HX-1 solution and stored at 0.4 degree C for 48 or 72 h. After being preserved, the kidney was implanted in the right groin of the animal and anastomosed to the iliac vessles. This procedure was immediately followed by a contralateral nephrectomy. The experimental findings were: 1. The maximum serum creatinine levels were 642.60 +/- 158.60 mumol/L and 686.20 +/- 154.04 mumol/L respectively in HC-WCU solution subgroups for 48 or 72 h cold storage. But the maximum serum creatinine levels were 448.32 +/- 36.90 mumol/L and 524.60 +/- 109.38 mumol/L respectively in HX-1 solution subgroups. 2. 80% of the kidneys were viable after 48 h storage in HC-WCU kidney solution, but 100% viable when stored in HX-1 solution: 40% of the kidneys were viable after 72 h storage in HC-WCU solution, but 60% viable when stored in HX-1 solution. 3. Histologically the kidney of dogs that died of renal failure was damaged worse in HC-WCU solution group than that in HX-1 solution group. These results suggest that HX-1 solution is superior to HC-WCU solution for preserving kidneys and HX-1 solution may store up the kidney of dogs to 48-72 h.

Animals↗

Effects of bicarbonate/lactate solution on peritoneal advanced glycosylation end-product accumulation.

Advanced glycosylation end-products (AGEs) are associated with diabetic complications and peritoneal damage after long-term peritoneal dialysis (PD) with high glucose dialysis solutions. Glucose degradation products (GDPs) derived during heat sterilization of high glucose dialysis solutions are thought to accelerate AGE formation. A new technique of separating glucose from electrolytes has yielded markedly lower GDP levels and permitted the use of dialysis solutions containing the physiologic buffer bicarbonate. Formation of AGEs in vitro with this new solution is significantly lower compared with formation of AGEs with conventional solutions. The purpose of the present study was to investigate the effect of long-term intraperitoneal use of new, neutral dialysis solution (B/L) containing bicarbonate (25 mmol/L) and lactate (15 mmol/L) on peritoneal AGE accumulation and permeability. Normal male Sprague-Dawley rats were used. Twice daily for 12 weeks, 30 mL of new solution (B/L) or conventional solution [Lac (lactate 40 mmol/L)] was injected into the peritoneal cavity of the test rats. As a control, rats that were not injected were kept for 12 weeks in the same manner as the test rats. After 12 weeks, a 2-hour peritoneal equilibration test (PET) was performed in the test rats. After the PET, the parietal peritoneum and liver were obtained for evaluation of peritoneal morphology and for immunohistochemistry for AGE. Intensity of AGE staining was semi-quantitatively graded from 0 to 3. The omentum was also obtained and immediately frozen for analysis of pentosidine content by high-performance liquid chromatography. Compared with findings in the control group, hematoxylin and eosin staining of the parietal peritoneum and liver samples revealed partial denudation of mesothelial cells in the Lac group; denudation was not remarkable in the B/L group. The B/L solution showed significantly less AGE staining in the peritoneal cavity compared to conventional solution. However, B/L solution failed to lower pentosidine levels. Intraperitoneal volume and the ratio of dialysate glucose at 2 hours to dialysate glucose at instillation (D2/D0 glucose) were significantly lower and the ratio of dialysate urea to plasma urea at 2 hours (D2/P2 urea) was significantly higher in the Lac and B/L groups than in the control group. Intraperitoneal volume was significantly higher in the B/L group than in the Lac group; D2/D glucose and D2P2 urea did not differ between the two groups. In conclusion, peritoneal ultrafiltration decreased after long-term PD. The B/L solution showed a small but statistically significant protective effect against decreasing ultrafiltration as compared with Lac solution. The B/L solution attenuated peritoneal AGE accumulation compared with conventional solution, but did not affect peritoneal pentosidine levels. These findings indicate that biochemical kinetics of various AGE peptides are not unique, but multivalent.

Animals↗

Composition of cardioplegic solutions used in nine medical centers.

Eleven institutions that participated in the Coronary Artery Surgery Study (CASS) were surveyed to obtain information about the types of cardioplegic solutions used at these institutions. A short-answer questionnaire designed to obtain specific information about the composition and method of preparation of cardioplegic solutions was sent to each institution. Institutions that did not reply within four weeks were sent a second questionnaire. Nine institutions returned completed questionnaires. Four institutions used several different cardioplegic solutions, resulting in a total of 14 evaluable solutions. Six hospitals used a chemical-based cardioplegic solution, one used a blood-based solution, and two used a combination of blood and chemicals as a cardioplegic-solution base. Chloride and potassium were found in all 14 solutions, although the amounts varied widely. Dextrose was included in eight of the nine chemical-based solutions, and bicarbonate and sodium were each used in seven of the nine solutions. Centers using chemical-based cardioplegic solutions compounded them daily or froze them with a one-week expiration date; blood-based solutions had to be prepared daily. Although interinstitutional differences in dosage were evident, the cardioplegic solutions used in the institutions participating in the CASS had many similar components. Data on the composition of these solutions can be used as a guideline for developing a cardioplegic solution.

Academic Medical Centers↗

Effects of a phosphate buffered extracellular (Ep4) solution in preservation and reperfusion injury in the canine liver.

The Ep4 solution, a phosphate buffered extracellular-type solution, is effective in canine lung transplantation following a 96-hour hypothermic (4 degrees C) preservation. In this experiment, we used this solution for liver preservation followed by transplantation. We compared the Ep4 solution with the lactated Ringer's (LR) and the Collins' M (CM) solution (a phosphate buffered intracellular-type solution) in two studies, 1) 48-hour liver preservation, and 2) orthotopic liver transplantation after 5-hour preservation. In the preservation study, purine nucleoside phosphorylase (PNP) levels as a marker of endothelial damage, and alanine aminotransferase (ALT) levels were significantly lower in the livers immersed into the Ep4 solution than in those immersed into other solutions at 36 and 48 hours after preservation. Microscopically, the endothelial injury occurred 24 hours after preservation in the CM solution, and 36 hours after preservation in the LR and Ep4 solutions. In the transplantation study, serum PNP and ALT levels in the livers immersed in Ep4 solution showed a lower tendency compared with those in other solutions at the time of reperfusion, but the histological differences among three groups were not apparent. The present study suggests that the liver can be stored better for a longer time using Ep4 solution than using LR and CM solutions.

Alanine Transaminase↗

Inhibitory effect of jejunal high caloric nutrient load on human biliopancreatic secretion. The role of atropine, naloxone and composition of nutrient solutions.

Our previous studies shown that a high caloric load in the jejunum decreases biliopancreatic output. However, the factors responsible for this inhibition have not yet been fully assessed. In this study, we have compared the effect of a high caloric load of either proteins or carbohydrates on stimulated pancreatic output and investigated the mechanism of this inhibition. The small intestine of 6 healthy volunteers was intubated 10 cm below the angle of Treitz, for 3 consecutive days, to infuse test solutions. After a 90 min period of stimulation, using a protein solution (0.6 kcal/min; solution A), one of the following 2 solutions was infused on for 90 min each day, in random order. In each instance, either a protein plus carbohydrate solution (3.5 kcal/min; solution B), or a protein solution (3.5 kcal/min; solution C) was administered. On the 3rd day, first solution A then solution B were infused with either IV atropine (17 mug/kg/h) in 3 subjects, or naloxone (40 mug/kg/hl) in 3 subjects. PEG 4000 was also added to solutions B and C and (14)C-PEG to solution A, as nonabsorbable markers. Intraluminal content was aspirated 25 cm below the infusion point and 50 cm distally to prevent unabsorbed nutrients from reaching the ileum. Solution B and C caused similar decreases in lipase, chymotrypsin and bile salt outputs. Neither atropine nor naloxone inhibited the jejunal-brake induced by solution B. However, naloxone, but not atropine, decreased the carbohydrate absorption rate of solution B. In conclusion, a high caloric load of proteins or carbohydrates infused into the human jejunum decreased the bilio-pancreatic output induced by a low caloric load of proteins. This mechanism is neither cholinergic nor opioid dependent. This effect, in relation to a jejunal brake, might explain functional pancreatic insufficiency after surgical procedures such as gastro-jejunostomy.

Journal Article↗

Evaluation of post-treatment solutions for clinical use with the calcium phosphate precipitation method.

OBJECTIVE: We have proposed a calcium phosphate precipitation (CPP) method that occludes dentine tubules with apatitic minerals for the treatment of dentine hypersensitivity. The current CPP method uses 1 mol/l NaOH as the post-treatment solution. However, its high pH is not desirable for clinical use. The aim of this study was to evaluate several solutions, especially buffer solutions, as post-treatment solutions for the CPP method. METHODS: The CPP solution was mixed with several post-treatment solutions at various mixing ratios in test tubes. The precipitates were collected, and freeze-dried in a vacuum. Their weights were measured to evaluate the feasibility of buffer solution for the post-treatment solutions. Among the solutions, we selected one buffer solution and have done further evaluation using human dentine disks. The degree of occlusion of dentine tubules was evaluated by scanning electron microscopic observation and measurement of dentine permeability. Also, the composition of the precipitate was analyzed using energy-dispersive X-ray microanalysis and powder X-ray diffraction. RESULTS: Among the solutions, 1 mol/l NaHCO3 gave sufficient amounts of precipitate at a relatively mild pH, and thus was considered to be a good candidate for a post-treatment solution. Scanning electron microscopic observation showed that dentine tubules were occluded with the precipitate to a depth of approximately 10 microns from the surface when the CPP treatment was done twice, and dentine permeability was reduced to 98.8%. The precipitate was dicalcium phosphate dihydrate (DCPD; CaHPO4-2H2O) when the post-treatment solution was free of NaF. In contrast, the precipitate was an apatitic mineral with CaF2 as a by-product when the post-treatment solution contained NaF. CONCLUSIONS: We concluded that 1 mol/l NaHCO3 containing 0.3 mol/l NaF would be suitable as the post-treatment solution for the CPP method as it has a relatively mild pH and occludes dentinal tubules well.

Adult↗