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A low-sodium solution for gastrointestinal lavage.

Golytely is a sodium sulfate-based solution used for lavage cleansing of the colon. Although most patients and physicians prefer Golytely lavage over other methods of bowel cleansing, its highly salty taste is a drawback. This report describes the development of a modified lavage solution that has a barely perceptible salty taste. This solution was developed by removing sodium sulfate, increasing the concentration of polyethylene glycol, and making minor adjustments in the concentration of other salts. Golytely, reduced sodium sulfate Golytely (Golytely-RSS), and a balanced electrolyte solution were infused into the stomachs of normal subjects. After steady-state lavage conditions were established, the rates of fluid and electrolyte absorption were measured. Average fluid absorption rate was 791 ml/h with the balanced electrolyte solution, compared with only 63 and 45 ml/h with Golytely and Golytely-RSS, respectively. Golytely-RSS was studied at 3 infusion rates, from 0.9-1.8 L/h, and the time and volume of solution required for colon cleansing was determined; the lower infusion rate (0.9 L/h) took longer but required less solution to cleanse the colon. In conclusion, Golytely-RSS has the essential feature of Golytely; i.e., lavage is associated with negligible salt and water absorption. The less-salty taste of Golytely-RSS may make it less difficult to drink and thereby enhance patient compliance; the total volume of solution required for cleansing is less when the solution is ingested at 0.9 L/h than when the ingestion rate is 1.8 L/h.

Colon↗

Quality of home use of oral rehydration solutions: results from seven HEALTHCOM sites.

This study examined the volume of oral rehydration solutions given to children during diarrhea and the length of time the solutions are administered. It also attempted to test the importance of individual and contextual factors--especially mothers' knowledge--in explaining the administration of oral rehydration solutions. Data about the treatment of an episode of child diarrhea within the last three months were collected from large samples of mothers in seven sites in Africa, Asia, and Latin America. The results showed that oral rehydration solutions were given in smaller volumes and for shorter periods of time than recommended. The majority of children received at least a glass (200-250 ml) of solution on the first day, but few received more than that. Daily administration of packet-based solutions or of sugar-salt solutions (promoted in two of the countries) during diarrhea was generally quite low, ranging from 16 to 60% of cases given an oral rehydration solution. However, in four out of six sites, at least half of the children with diarrhea for more than one day were given an oral rehydration solution for more than one day. The majority of children were given some form of other fluids (e.g. more water, special teas, or continued breastfeeding), but their value in preventing dehydration was not clear because the volume of other fluids given could not be assessed. Few of the hypothesized predictors of administration explained the variation in volume or duration of ORS/SSS administration within any specific country or across sites. The research points to the need for more information on the decision process used by mothers when treating their children's diarrhea and on outside factors influencing this process.

Adult↗

DSC study of reversible and irreversible thermal denaturation of concentrated globular protein solutions.

A calorimetric study of the thermal denaturation of bovine serum albumin, RNAase and catalase in concentrated solutions (crystals) has been carried out. The results obtained for RNAase studied within the pH range 2.5-8.5 show that for concentrated solutions there is an interval of pH where, on cooling of the solution which had undergone denaturation, its renaturation is observed. In the case of concentrated and dilute solutions of RNAase these intervals coincide. The study of RNAase under such conditions at various heating rates shows that there is a range of rates in which the process of denaturation of concentrated solutions can be considered as reversible. The dependences of Td and Hd on pH and concentration of solutions have been determined. The denaturation enthalpy of concentrated solutions like in dilute ones, has been found to be independent of the pH of solutions, and the experimentally registered change has been proved to be the result of its dependence on temperature. A new method of determination of protein denaturation enthalpy under the conditions of intensive molecule aggregation is suggested. The forms of irreversibility as appearing in the calorimetric experiment were determined by comparing reversible and irreversible denaturation under continuous and step-heating regimes. It is shown that the decrease in Tmax and the narrowing of the heat absorption peak in the case of decreasing heating rates of protein solutions, observed under certain environmental conditions, results from the irreversibility of the denaturation process.

Animals↗

Surfactant solutions and porous substrates: spreading and imbibition.

In Section 1, spreading of small liquid drops over thin dry porous layers is investigated from both theoretical and experimental points of view [V.M. Starov, S.R. Kosvintsev, V.D. Sobolev, M.G. Velarde, S.A. Zhdanov, J. Colloid Interface Sci. 252 (2002) 397]. Drop motion over a porous layer is caused by an interplay of two processes: (a) the spreading of the drop over already saturated parts of the porous layer, which results in an expanding of the drop base, and (b) the imbibition of the liquid from the drop into the porous substrate, which results in a shrinkage of the drop base and an expanding of the wetted region inside the porous layer. As a result of these two competing processes, the radius of the drop goes through a maximum value over time. A system of two differential equations has been derived to describe the evolution with time of radii of both the drop base and the wetted region inside the porous layer. This system includes two parameters, one accounts for the effective lubrication coefficient of the liquid over the wetted porous substrate, and the other is a combination of permeability and effective capillary pressure inside the porous layer. Two additional experiments were used for an independent determination of these two parameters. The system of differential equations does not include any fitting parameter after these two parameters are determined. Experiments were carried out on the spreading of silicone oil drops over various dry microfiltration membranes (permeable in both normal and tangential directions). The time evolution of the radii of both the drop base and the wetted region inside the porous layer were monitored. All experimental data fell on two universal curves if appropriate scales are used with a plot of the dimensionless radii of the drop base and of the wetted region inside the porous layer on dimensionless time. The predicted theoretical relationships are two universal curves accounting quite satisfactory for the experimental data. According to theory predictions [1]: (i) the dynamic contact angle dependence on the same dimensionless time as before should be a universal function, and (ii) the dynamic contact angle should change rapidly over an initial short stage of spreading and should remain a constant value over the duration of the rest of the spreading process. The constancy of the contact angle on this stage has nothing to do with hysteresis of the contact angle: there is no hysteresis in the system under investigation. These conclusions again are in good agreement with experimental observations [V.M. Starov, S.R. Kosvintsev, V.D. Sobolev, M.G. Velarde, S.A. Zhdanov, J. Colloid Interface Sci. 252 (2002) 397]. In Section 2, experimental investigations are reviewed on the spreading of small drops of aqueous SDS solutions over dry thin porous substrates (nitrocellulose membranes) in the case of partial wetting [S. Zhdanov, V. Starov, V. Sobolev, M. Velarde, Spreading of aqueous SDS solutions over nitrocellulose membranes. J. Colloid Interface Sci. 264 (2003) 481-489]. The time evolution was monitored of the radii of both the drop base and the wetted area inside the porous substrate. The total duration of the spreading process was subdivided into three stages-the first stage: the drop base expands until the maximum value of the drop base is reached; the contact angle rapidly decreases during this stage; the second stage: the radius of the drop base remains constant and the contact angle decreases linearly with time; the third stage: the drop base shrinks and the contact angle remains constant. The wetted area inside the porous substrate expends during the whole spreading process. Appropriate scales were used with a plot of the dimensionless radii of the drop base, of the wetted area inside the porous substrate, and the dynamic contact angle on the dimensionless time. Experimental data showed [S. Zhdanov, V. Starov, V. Sobolev, M. Velarde, Spreading of aqueous SDS solutions over nitrocellulose membranes. J. Colloid Interface Sci. 264 (2003) 481-489]: the overall time of the spreading of drops of SDS solution over dry thin porous substrates decreases with the increase of surfactant concentration; the difference between advancing and hydrodynamic receding contact angles decreases with the surfactant concentration increase; the constancy of the contact angle during the third stage of spreading has nothing to do with the hysteresis of contact angle, but determined by the hydrodynamic reasons. It is shown using independent spreading experiments of the same drops on nonporous nitrocellulose substrate that the static receding contact angle is equal to zero, which supports the conclusion on the hydrodynamic nature of the hydrodynamic receding contact angle on porous substrates. In Section 3, a theory is developed to describe a spontaneous imbibition of surfactant solutions into hydrophobic capillaries, which takes into account the micelle disintegration and the concentration decreasing close to the moving meniscus as a result of adsorption, as well as the surface diffusion of surfactant molecules [N.V. Churaev, G.A. Martynov, V.M. Starov, Z.M. Zorin, Colloid Polym. Sci. 259 (1981) 747]. The theory predictions are in good agreement with the experimental investigations on the spontaneous imbibition of the nonionic aqueous surfactant solution, Syntamide-5, into hydrophobized quartz capillaries. A theory of the spontaneous capillary rise of surfactant solutions in hydrophobic capillaries is presented, which connects the experimental observations with the adsorption of surfactant molecules in front of the moving meniscus on the bare hydrophobic interface [V.J. Starov, Colloid Interface Sci. 270 (2003)]. In Section 4, capillary imbibition of aqueous surfactant solutions into dry porous substrates is investigated from both theoretical and experimental points of view in the case of partial wetting [V. Straov, S. Zhdanov, M. Velarde, J. Colloid Interface Sci. 273 (2004) 589]. Cylindrical capillaries are used as a model of porous media for theoretical treatment of the problem. It is shown that if an averaged pore size of the porous medium is below a critical value, then the permeability of the porous medium is not influenced by the presence of surfactants at any concentration: the imbibition front moves exactly in the same way as in the case of the imbibition of the pure water. The critical radius is determined by the adsorption of the surfactant molecules on the inner surface of the pores. If an averaged pore size is bigger than the critical value, then the permeability increases with surfactant concentration. These theoretical conclusions are in agreement with experimental observations. In Section 5, the spreading of surfactant solutions over hydrophobic surfaces is considered from both theoretical and experimental points of view [V.M. Starov, S.R. Kosvintsev, M.G. Velarde, J. Colloid Interface Sci. 227 (2000) 185]. Water droplets do not wet a virgin solid hydrophobic substrate. It is shown that the transfer of surfactant molecules from the water droplet onto the hydrophobic surface changes the wetting characteristics in front of the drop on the three-phase contact line. The surfactant molecules increase the solid-vapor interfacial tension and hydrophilise the initially hydrophobic solid substrate just in front of the spreading drop. This process causes water drops to spread over time. The time of evolution of the spreading of a water droplet is predicted and compared with experimental observations. The assumption that surfactant transfer from the drop surface onto the solid hydrophobic substrate controls the rate of spreading is confirmed by experimental observations. In Section 6, the process of the spontaneous spreading of a droplet of a polar liquid over solid substrate is analyzed in the case when amphiphilic molecules (or their amphiphilic fragments) of the substrate surface layer are capable of overturning, resulting in a partial hydrophilisation of the surface [V.M. Starov, V.M. Rudoy, V.I. Ivanov, Colloid J. (Russian Academy of Sciences English Transaction) 61 (3) (1999) 374]. Such a situation may take place, for example, during contact of an aqueous droplet with the surface of a polymer whose macromolecules have hydrophilic side groups capable of rotating around the backbone and during the wetting of polymers containing surface-active additives or Langmuir-Blodgett films composed of amphiphilic molecules. It was shown that droplet spreading is possible only if the lateral interaction between neighbouring amphiphilic molecules (or groups) takes place. This interaction results in the tangential transfer of "the overturning state" to some distance in front of the advancing three-phase contact line making it partially hydrophilic. The quantitative theory describing the kinetics of droplet spreading is developed with allowance for this mechanism of self-organization of the surface layer of a substrate in the contact with a droplet.

Biophysical Phenomena↗

Solubility of drugs in aqueous solutions. Part 4. Drug solubility by the dilute approximation.

As in our previous publications in this journal [Int. J. Pharm. 258 (2003a) 193; Int. J. Pharm. 260 (2003b) 283; Int. J. Pharm. 267 (2003c) 121], this paper is concerned with the solubility of poorly soluble drugs in aqueous mixed solvents. In the previous publications, the solubilities of drugs were assumed to be low enough for the so-called infinite dilution approximation to be applicable. In contrast, in the present paper, the solubilities are considered to be finite and the dilute solution approximation is employed. As before, the fluctuation theory of solutions is used to express the derivatives of the activity coefficient of a solute in a ternary solution (dilute solute concentrations in a binary solvent) with respect to the concentrations of the solvent and cosolvent. The expressions obtained are combined with a theoretical equation for the activity coefficient of the solute. As a result, the activity coefficient of the solute was expressed through the activity coefficients of the solute at infinite dilution, solute mole fraction, some properties of the binary solvent (composition, molar volume and activity coefficients of the components) and parameters reflecting the nonidealities of binary species. The expression thus obtained was used to derive an equation for the solubility of poorly soluble drugs in aqueous binary solvents which was applied in two different ways. First, the nonideality parameters were considered as adjustable parameters, determined from experimental solubility data. Second, the obtained equation was used to correct the solubilities of drugs calculated via the infinite dilution approximation. It was shown that both procedures provide accurate correlations for the drug solubility.

Algorithms↗

Anterior chamber irrigation with an ozonated solution as prophylaxis against infectious endophthalmitis.

PURPOSE: To assess the validity of anterior chamber irrigation with an ozonated solution as prophylaxis against endophthalmitis. SETTING: Department of Ophthalmology, Nippon Medical School, Tokyo, Japan. METHODS: Viability of human corneal endothelium in culture was assessed by the WST-8 assay, lactate dehydrogenase (LDH) release assay, and trypan blue exclusion assay after exposure to a 4 to 40 parts per million (ppm) solution for 10 to 60 seconds. The in vivo effect was observed 1 week after irrigation of a 4 ppm solution in the rabbit anterior chamber by trypan blue exclusion assay. Bactericidal efficacy of the anterior chamber irrigation with the 4 ppm solution was examined by bacterial colony count of the aqueous humor following methicillin-resistant Staphylococcus aureus (MRSA) contaminated intraocular lens implantation in the porcine eye. RESULTS: The WST-8 assay revealed no significant reduction of viability with 10-second exposure to a 4 ppm solution. Lactate dehydrogenase release and trypan blue exclusion assays similarly demonstrated little damage after 60-second exposure to a 4 ppm solution. In the rabbit cornea 1 week after treatment, damage caused by 30-second exposure to a 4 ppm solution was not significant. The MRSA colony count documented almost complete bactericidal action with 5-second exposure to the 4 ppm solution when no ophthalmic viscosurgical device existed in the anterior chamber. CONCLUSION: Limited damage to the corneal endothelium after 10-second exposure and potent bactericidal action with 5-second exposure suggests the validity of anterior chamber irrigation with a 4 ppm ozonated solution as prophylaxis against endophthalmitis.

Animals↗

Effect of ophthalmic solution components on acrylic intraocular lenses.

PURPOSE: To investigate the effect of ophthalmic solution components on the surface of acrylic intraocular lenses (IOLs). SETTING: Department of Opthalmology, Showa University School of Medicine. METHODS: Measurement of the contact angles of ophthalmic solutions on 3 acrylic IOLs was performed. The solutions were diclofenac sodium (Diclod), bromfenac sodium (Bronuck), betamethasone phosphate (Rinderon), dibekacin sulfate (Panimycin), polysorbate 80 (Tween 20), benzalkonium chloride, chlorobutanol, methylparahydroxybenzoate, and propylparahydroxybenzoate. The IOLs were incubated at 35 degrees C for 2 weeks in undiluted ophthalmic solutions and in 1:10 dilutions of ophthalmic solution components. The IOLs were sectioned and observed by scanning electron microscopy. RESULTS: The contact angle of Diclod and Bronuck solutions was the smallest. The contact angle of Rinderon and Panimycin was similar to that of distilled water. Scanning electron microscopy examination of IOLs incubated in ophthalmic solution components showed intralenticular changes. The IOLs immersed in ophthalmic solutions did not show any change, even after extended incubation. CONCLUSION: The chemical components of ophthalmic solutions, such as surfactants and solvents, permeate acrylic IOLs, suggesting the potential for long-term adverse effects of eyedrops in pseudophakic eyes.

Acrylic Resins↗

Luminal preservation of rat small intestine with University of Wisconsin or Celsior solution.

AIMS: Luminal administration of a preservation solution that prevents mucosal injury may decrease posttransplant complications. However, luminal administration of University of Wisconsin solution (UW) is controversial. In this study, we examined the potential of Celsior as a luminal small bowel preservation solution in comparison to UW or UW enriched with glutamine. METHODS: Small bowels of six normal WagRij rats were excised and divided into six equal segments. Each segment was luminally flushed with 10 mL ice-cold UW, UW with glutamine (20 g/L) or Celsior, and stored for 0, 2.5, and 24 hours at 4 degrees C. LDH, glucose, and lactate concentrations were determined in the preservation solutions. Histologic changes were determined using the Park score. RESULTS: Lactate dehydrogenase (LDH) was increased in all solutions after 2.5- and after 24-hour preservation. However, LDH was lower in Celsior than UW and UW with glutamine. Furthermore, higher glucose and lactate levels were found after 2.5- and 24-hour preservation in UW and UW with glutamine compared to Celsior. Histologically, jejunal segments were more susceptible to preservation than ileal segments, irrespective of the preservation solution used. Mucosal injury was evident after 2.5 hours (Park Scale 0-3) and increased significantly after 24 hours (park scale 3-6). CONCLUSIONS: Based on the lower glucose, lactate, and LDH levels in small intestines stored in Celsior, this study suggests that Celsior is a better luminal preservation solution than UW. Unfortunately, histological evaluations still show severe mucosal injury, indicating that there is a need for better luminal preservation solutions or for concomittant intravascular delivery of a preservation solution.

Adenosine↗

Kidney preservation with IGL-1 solution: a preliminary report.

The University of Wisconsin (UW) solution is the most commonly used preservation solution. However, a new preservation solution-IGL-1-contains an inversion of K and Na concentrations and substitution of polyethylene glycol for hydroxyethyl starch in the UW solution. The present study is the first clinical experience on the outcome of kidneys preserved in IGL-1 solution. From June 2003 to June 2004, 119 cadaveric kidneys were retrieved and stored in IGL-1 solutions; among the 119 organs, this study includes 37 IGL-1-preserved kidneys that were locally transplanted versus 33 kidneys stored in University of Wisconsin (UW) solution that were also locally transplanted. The groups were comparable with regard to donor and recipient characteristics. Renal function outcome was evaluated by comparing delayed graft function (DGF) rates, the evolution of serum creatinine, daily urine output, and creatinine clearance. Biopsies were performed after reperfusion to evaluate apoptosis. The incidence of DGF was 5.71% among IGL-1 kidneys and 13.79% among UW kidneys. Creatinine values were significantly lower among the IGL-1 group from 2 to 14 days postoperative and at 1 month. Daily urinary output did not show any significant differences between the two groups. IGL-1 kidneys had a superior creatinine clearance during the first 15 postoperative days compared to UW kidneys. Kidneys preserved in IGL-1 solution showed fewer apoptotic cells compared to kidneys preserved in UW solution. This preliminary report suggests a superiority of IGL-1 for the immediate outcome of transplanted kidneys.

Adenosine↗

Use of the SCOT solution in kidney transplantation: preliminary report.

SUBJECT: This article reports preliminary findings relating to the use of a new preservation solution, the Solution de Conservation des Organes et des Tissus (SCOT), in renal transplantation. This fourth-generation solution combines an extracellular-like composition with 20 kDa polyethylene-glycol, known for its cell-protection capacity and immunocamouflage properties. METHODS: We have reported preliminary data obtained in 29 transplantations (25 cadaveric donors and 4 living related donors) between December 2004 and November 2005. The SCOT solution was used for both in situ flush and static preservation. We compared primary organ nonfunction and delayed graft function rates as well as blood creatinine levels in recipients of grafts processed with SCOT solution, versus University of Wisconsin solution (paired for age with the previous group) and with EuroCollins solution (historic data). RESULTS: We observed delayed graft-function in 10% of the SCOT-processed group, 14% in the University of Wisconsin solution group, and 23% of the EuroCollins group. No case of primary organ nonfunction was reported. Creatinine levels in both SCOT and University of Wisconsin solution groups were similar. We did not observe any humoral or cellular graft rejection in the first 3 months after transplantation. In light of these preliminary results, the use of SCOT is safe for kidney preservation in the human setting. Further experience is warranted to assess the clinical consequences of its immunocamouflage properties as described in animal models.

Adenosine↗

Cardiopulmonary bypass tubes and prime solutions stimulate neutrophil adhesion molecules.

OBJECTIVE: To evaluate effects of the material of the cardiopulmonary bypass (CPB) tubes (polyvinyl chloride, PVC) and prime solutions on expression of neutrophil adhesion molecule CD11b and L-selectin. METHODS: We carried out a series of experiments using donor blood from 30 healthy adult human volunteers. In all experiments, neutrophil cell surface expressions of CD11b and L-selectin were assayed immediately and serially up to 2 hours, using immune-fluorescence techniques and flow cytometry. Study 1: Effects of PVC were compared with glass and polystyrene (n = 5). Study 2: Blood was mixed with Plasma-lyte (Pl) (prime solution), Hartman solutions, albumin or not altered (control), n = 5. Study 3: The effects of changing pH of the Pl (control, neutralised and acidic solution, n = 5) were examined. Study 4: Haemodilution (undiluted, 1:1, 1:2, and 1:3, vol/vol, prime to blood, n = 5) was carried out using Pl and the subsequent changes in expressions of the adhesion molecules were analysed. Study 5: The combined effect of PVC and Pl was assessed (n = 5). Study 6: We evaluated the effect of increasing plasma water by adding sterile water to whole blood and compared it with control (n = 5). RESULTS: Study 1: PVC, similar to glass, caused more up-regulation of CD11b and down-regulation of L-selectin than polystyrene (238 and 162% vs. 68 increase of CD11b, P < 0.001; 89 and 95% vs. 16% decrease of L-selectin, P < 0.001). Study 2: Pl and Hartman solutions caused more up-regulation of CD11b and down-regulation of L-selectin compared to albumin and control (166 and 188% vs. 26 and 44% increase of CD11b, P < 0.01; 19 and 26% vs. 10 and 6% decrease of L-selectin, P < 0.01, respectively). Study 3: Haemodilution had no effect on these molecules. Study 4: The mean of the difference between the acidic and neutral solution was 208% increase of CD11b and 30% decrease of L-selectin, P < 0.05. Study 5: The combined effect of mixing blood with Pl and exposure to PVC caused marked up-regulation of CD11b (336% increase, P < 0.01) and down-regulation of L-selectin (78% decrease, P < 0.05). Study 6: Water for injection caused marked up-regulation of CD1 1b and down-regulation of L-selectin. CONCLUSIONS: Mixing blood with acidic prime solution and/or exposing it to PVC tubes causes up-regulation of neutrophil adhesion molecule CD11b and down-regulation of L-selectin. Neutralisation of the prime solution reduces the extent of neutrophil activation, whereas haemodilution has no effect. Increasing plasma water is stimulating to the neutrophil. Modulation of prime solutions and the material of CPB tubes may reduce neutrophil activation which may reduce patient morbidity.

Adult↗

Mechanisms of myocardial protection by adenosine-supplemented cardioplegic solution: myofilament and metabolic responses.

OBJECTIVE: Adenosine supplementation of cardioplegic solutions in cardiac operations improves postarrest myocardial recovery after cardioplegic arrest and reperfusion; however, the mechanism of the action of adenosine remains unknown. We tested the hypotheses that adenosine-supplemented cardioplegic solution improves myofibrillar protein cooperative interaction and increases myocardial anaerobic glycolysis. METHODS: The hearts of male Sprague-Dawley rats were randomized to undergo 120 minutes of cardioplegic arrest with 1 of 3 cardioplegic solutions: (1) St Thomas' Hospital No. 2 cardioplegic solution (St Thomas group), (2) St Thomas' Hospital No. 2 cardioplegic solution plus adenosine (100 micromol/L) (adenosine group), and (3) St Thomas' Hospital No. 2 cardioplegic solution plus adenosine (100 micromol/L) plus the nonspecific adenosine receptor antagonist 8-p -sulfophenyltheophylline (50 micromol/L) (sulfophenyltheophylline group). A fourth group of hearts underwent no cardioplegic arrest. RESULTS: Systolic and diastolic functional recovery was improved in the adenosine group compared with that in the other two groups, independent of coronary flow. Adenosine supplementation of cardioplegic solution prevented the decrease in myofibrillar protein cooperative interaction seen after cardioplegic arrest and reperfusion (St Thomas and sulfophenyltheophylline groups). Adenosine-supplemented cardioplegic solution also caused significantly increased anaerobic glycolysis during cardioplegic arrest. These responses were blocked in the sulfophenyltheophylline group. CONCLUSIONS: The changes in myocardial glycolytic activity and myofilament cooperativity coincided with functional recovery in the three cardioplegia groups and may represent mechanisms underlying protection with adenosine-supplemented cardioplegic solution.

Actin Cytoskeleton↗

Age-related effects of St Thomas' Hospital cardioplegic solution on isolated cardiomyocyte cell volume.

OBJECTIVES: We tested the hypothesis that neonatal cells are more sensitive to cardioplegia-induced cell swelling than more mature cells and spontaneous swelling in the absence of ischemia can be prevented by cardioplegia with a physiologic KCl product. METHODS: Cell volumes of isolated ventricular myocytes from neonatal (3-5 days), intermediate (10-13 days), and adult (>6 weeks) rabbits were measured by digital video microscopy. After equilibration in 37 degrees C physiologic solution, cells were suprafused with 37 degrees C or 9 degrees C St Thomas' Hospital solution (standard or low Cl(-)) or 9 degrees C physiologic solution followed by reperfusion with 37 degrees C physiologic solution. RESULTS: Neonatal cells swelled 16.2% +/- 1.8% (P <.01) in 37 degrees C St Thomas' Hospital solution and recovered during reperfusion, whereas more mature cells maintained constant volume. In contrast, 9 degrees C St Thomas' Hospital solution caused significant age-dependent swelling (neonatal, 16.8% +/- 1.5%; intermediate, 8.6% +/- 2.1%; adult, 5.6% +/- 1.1%). In contrast to more mature cells, neonatal cells remained significantly edematous throughout reperfusion (8.1% +/- 1.5%). Swelling was not due to hypothermia because 9 degrees C physiologic solution did not affect volume. Lowering the KCl product of St Thomas' Hospital solution by partially replacing Cl(-) with an impermeant anion prevented cellular edema in all groups. CONCLUSION: In the absence of ischemia, neonatal cells were more sensitive to cardioplegia-induced cellular edema than more mature cells, and edema observed in all groups was avoided by decreasing the KCl product of St Thomas' Hospital solution to the physiologic range. Differences in cell volume regulation may explain the sensitivity of neonatal hearts to hyperkalemic cardioplegic arrest and suggest novel approaches to improving myocardial protection.

Aging↗

Effects of adding sodium and fluoride ions to glass ionomer on its interactions with sodium fluoride solution.

This investigates the effects of the addition of Na and F ions to a glass ionomer cement in which those ions are not inherently present on its interactions with dilute (0.2%) NaF solution. Both the effect of the solution on the cement's surface morphology and the effect of the cement on the solution in terms of take up of Na+ and F- and of change in pH are to be investigated. These results are to be compared to previous results obtained with glasses which contained both, one, or neither of the ions as components of their glasses. NaF (1.3% by weight in the mixed cement) was added to the powder components of a glass ionomer based on LG30 glass (which contains Al, Si, Ca, P, and O only). Discs of cement were set in moulds at 37 degrees C for 1 h then stored in water at 37 degrees C for 3 days. Each test disc was then immersed in 10 ml 0.2% NaF solution whereas controls remained immersed in water (N = 3 for test and control). Test and control disc surfaces were assessed both qualitatively by electron microscopy and quantitatively by linear profilometry (Ra values). Potentiometry was used to measure solution pH and Na and F concentrations using a pH electrode and suitable ion selective electrodes both before and after cement immersion. The surface of test specimens was subject considerable disruption with the polysalt cement matrix being removed and residual glass particles being disclosed. The controls showed no such disruption. This effect was reflected in a significant difference of Ra. Such an effect was not shown by test and control surfaces of LG30 but a similar effect was to that shown by LG26 (which contains F as a glass component). Solution pH changed by 1 unit which was much more than the change shown by LG30 or LG26 but is similar to that of AH2 and MP4 cements which both contain Na. The Na and F uptake was much lower than for LG30 whereas that of LG26 was higher than LG30. The Na:F ratio was 0.29:1 compared to 1.26:1 for LG30 (LG26 = 1.01:1, AH2 = 1.02:1, MP4 = 1.04:1). Fluoride addition to a F-free glass ionomer renders it vulnerable to surface disruption by NaF solution showing that fluoride complexes produced in glass dissolution are not necessarily involved in this process. Sodium addition to a Na-free glass ionomer confirms the role of this cement in enhancing pH change in NaF solution. The level of uptake of F- from a NaF solution in much lower than that for the F-free glass ionomer which shows there is no direct relationship between F- uptake and surface disruption. The ratio of Na:F uptake is below 0.3:1, but the pH change is similar to cements where the ratio is close to unity which indicates that F-/OH- interchange is not a significant mechanism even when anion/cation uptake is not balanced.

Anions↗

Carbopol/pluronic phase change solutions for ophthalmic drug delivery.

The major purpose of this study is to develop and characterize a series of carbopol- and pluronic-based solutions as the in situ gelling vehicles for ophthalmic drug delivery. The rheological properties, in vitro release as well as in vivo pharmacological response of various polymer solutions, including carbopol, pluronic and carbopol/pluronic solution, were evaluated. It was found that the optimum concentration of carbopol solution for the in situ gel forming delivery systems was 0.3% (w/w), and that for pluronic solution was 14% (w/w). The mixture of 0.3% carbopol and 14% pluronic solutions showed a significant enhancement in gel strength in the physiological condition; this gel mixture was also found to be free flowing at pH 4.0 and 25 degrees C. The rheological behaviors of carbopol/pluronic solution were not affected by the incorporation of pilocarpine hydrochloride. Both the in vitro release and in vivo pharmacological studies indicated that the carbopol/pluronic solution had the better ability to retain drug than the carbopol or pluronic solutions alone. The results demonstrated that the carbopol/pluronic mixture can be used as an in situ gelling vehicle to enhance the ocular bioavailability.

Acrylic Resins↗

Warmed versus room temperature saline solution for ocular irrigation: a randomized clinical trial.

STUDY OBJECTIVE: To test the hypothesis that ocular irrigation with warm saline solution is more comfortable than irrigation with room temperature saline solution in normal volunteers. METHODS: The study was a randomized, single-blind crossover trial, in which each subject received 30 mL warmed and 30 mL room temperature saline solution in opposite eyes. The solutions (warmed versus room temperature) and the order of irrigation (right eye versus left) were separately randomized. Physicians were blinded to solution temperature. Subjects rated the discomfort of irrigation on separate visual analog scales (VAS). The study had 80% power to detect at least a 12-mm difference in VAS readings. RESULTS: Thirty-five volunteers were enrolled in the study. There was no gender effect or order effect for the 2 solutions. The mean VAS score for warmed saline solution was 15 mm+/-15 mm (SD). The mean VAS score for room temperature saline was 34 mm+/-24 mm (SD), (95% confidence interval for difference of 19 mm [10 mm to 28 mm], P <.0001, Wilcoxon signed rank test). CONCLUSION: Warmed saline solution was both clinically and statistically more comfortable than room temperature saline solution as an ocular irrigant among normal volunteers.

Adult↗

Theoretical and experimental studies on freezing point depression and vapor pressure deficit as methods to measure osmotic pressure of aqueous polyethylene glycol and bovine serum albumin solutions.

For survival in adverse environments where there is drought, high salt concentration or low temperature, some plants seem to be able to synthesize biochemical compounds, including proteins, in response to changes in water activity or osmotic pressure. Measurement of the water activity or osmotic pressure of simple aqueous solutions has been based on freezing point depression or vapor pressure deficit. Measurement of the osmotic pressure of plants under water stress has been mainly based on vapor pressure deficit. However, differences have been noted for osmotic pressure values of aqueous polyethylene glycol (PEG) solutions measured by freezing point depression and vapor pressure deficit. For this paper, the physicochemical basis of freezing point depression and vapor pressure deficit were first examined theoretically and then, the osmotic pressure of aqueous ethylene glycol and of PEG solutions were measured by both freezing point depression and vapor pressure deficit in comparison with other aqueous solutions such as NaCl, KCl, CaCl(2), glucose, sucrose, raffinose, and bovine serum albumin (BSA) solutions. The results showed that: (1) freezing point depression and vapor pressure deficit share theoretically the same physicochemical basis; (2) theoretically, they are proportional to the molal concentration of the aqueous solutions to be measured; (3) in practice, the osmotic pressure levels of aqueous NaCl, KCl, CaCl(2), glucose, sucrose, and raffinose solutions increase in proportion to their molal concentrations and there is little inconsistency between those measured by freezing point depression and vapor pressure deficit; (4) the osmotic pressure levels of aqueous ethylene glycol and PEG solutions measured by freezing point depression differed from the values measured by vapor pressure deficit; (5) the osmotic pressure of aqueous BSA solution measured by freezing point depression differed slightly from that measured by vapor pressure deficit.

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Preferential interactions in aqueous solutions of urea and KCl.

A quantitative characterization of the thermodynamic effects due to interactions of salt ions and urea in aqueous solution is needed for rigorous analyses of the effects of changing urea concentration on biopolymer processes in solutions that also contain salt. Therefore, we investigate preferential interactions in aqueous solutions containing KCl and urea by using vapor pressure osmometry (VPO) to measure osmolality as a function of the molality of urea (component 3) over the range 0.09<or=m(3)<or=1.65 m at two fixed molalities of KCl (component 2) (m(2)=0.212 and 0.427 m). With this experimental input and corresponding VPO measurements on solutions that contain only urea or KCl, we evaluate approximately the chemical potential derivative micro(23)=( partial differential micro(KCl)/ partial differential m(urea))(T,P,m(KCl))=( partial differential micro(urea)/ partial differential m(KCl))(T,P,m(urea))= micro(32) and hence the preferential interaction coefficients Gammamicro(3) and Gammamicro(1),micro(3). These results show that for water-KCl-urea solutions neither of these coefficients is determined primarily by contributions from thermodynamic nonideality to micro(23). In aqueous solutions containing a biopolymer and a small solute, the contribution of ideal mixing entropy to micro(23) is negligible in comparison with the experimental uncertainty, whereas in KCl-urea solutions the contribution due to ideal mixing entropy accounts for at least half of the magnitude of micro(23). For comparison, we analyze literature data for NaCl-urea interactions and find again that nonideality makes a smaller contribution to micro(23) than does ideal mixing entropy. In contrast, for aqueous solutions of urea and the protein bovine serum albumin, the experimentally determined contribution of nonideality to micro(23) exceeds the contribution of ideal mixing by a factor of approximately 2 x 10(2).

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