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Query: UMLS:C0016382 (flushing)
 6,387 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The purpose of this study was to evaluate the value of additive components and colloid included in the University of Wisconsin (UW) solution. Therefore, this solution was compared with a solution consisting of the basic components of the UW solution (potassium lactobionate, raffinose, phosphate buffer and MgSO4). We employed a method of measuring the amount of chromium-51-labeled erythrocyte trapped in the medullary vasculature 20 min after reperfusion of kidney grafts cold-stored for 24-48 h in either the basic UW (bUW) or the original UW (oUW) solution. The amount of trapping has been shown to correlate well with the degree of cold ischemic injury. Both hemodiluted (hct 20-27%) and normal (hct 41-45%) recipients were used. Long-term viability of grafts stored in either bUW or oUW was investigated in survival experiments and the flow rates during in situ flush-out were also measured, as well as weight changes during the storage period. The results showed no significant difference between the two solutions, regardless of ischemia time or whether hemodiluted or normal recipients were used. However, the flow rate and weight measurements showed that flushing was more rapid and kidney swelling less pronounced using oUW. Survival rates in long-term transplantation experiments were similar. It was concluded that the inclusion of a colloid improves the rheological properties of the UW solution and that the additives besides the basic components did not offer any advantage.
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PMID:Relevance of additive components of University of Wisconsin cold-storage solution. An experimental study in the rat. 278 5

A large hypertensive population of patients in general practice was used to assess the tolerability of nifedipine in previously untreated patients and was compared with other antihypertensive drugs in previously treated patients. A total of 3972 patients with a sitting diastolic blood pressure between 95 and 115 mmHg were treated with 20 mg nifedipine twice daily for 1 month. In non-responders the dose was increased to 40 mg twice daily for a second month; responders continued to take 20 mg twice daily. A total of 2772 patients had been previously untreated for hypertension, whereas 857 had previously been treated with beta-blockers alone or in combination and 346 had received diuretics alone or in combination. Adverse events were recorded for 28 days prior to treatment being initiated with or changed to nifedipine and for two 28-day nifedipine treatment periods. Flushing and headache, which diminished with time, occurred during nifedipine treatment. Ankle oedema did not diminish with time. Reductions were seen in occurrences of dyspnoea, impotence, lethargy and cold extremities.
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PMID:General practice data derived tolerability assessment of antihypertensive drugs. 280 16

This study was done to determine whether core-cooling could provide extended cardiopulmonary preservation and if reimplantation could be simulated and evaluated in the ex vivo autoperfused working heart-lung model. Twenty calves were divided into four groups and placed on cardiopulmonary bypass and rapidly cooled to 15 degrees C. Control heart and lungs were harvested after administration of cardioplegia through the aortic root and were subsequently resuscitated in the autoperfused working heart-lung circuit (group 1) or were orthotopically allotransplanted (group 2). Preserved heart and lungs were similarly excised but stored in a normal saline solution bath at 4 degrees C for 4 hours and then were resuscitated in the autoperfusion circuit (group 3) or were orthotopically allotransplanted (group 4). All groups received isoproterenol during explantation and reperfusion and were studied for 4 hours. Myocardial function was assessed by sonomicrometric techniques, and pulmonary preservation was evaluated by measurements of extravascular lung water, arterial oxygen tension on 100% inspired oxygen, and pulmonary vascular resistance. Cardiorespiratory function after 4-hour static preservation was similar in all four groups except that the arterial oxygen tension in group 1 was lower compared with group 3. Core-cooling on cardiopulmonary bypass without pulmonary artery flushing results in cold ischemic heart-lung preservation, comparable to other currently used modalities. In addition, reperfusion in the ex vivo autoperfusion circuit provides a simplified model to assess the adequacy of cardiopulmonary preservation techniques.
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PMID:Successful four-hour heart-lung preservation with core-cooling on cardiopulmonary bypass: a simplified model that assesses preservation. 311 45

Using cardiopulmonary bypass to cool the graft and flushing the lungs with cold crystalloid solution are the most popular methods for clinical cardiopulmonary preservation. Heart-lung transplantation was carried out in 11 cynomolgus monkeys. Donor cardiac preservation was achieved with cold crystalloid cardioplegic solution (10 ml per kilogram of body weight) in all animals. Lung preservation was achieved with a rollerhead pump and by cooling (12 degrees C) the donor in one group of 4 animals (deep hypothermia group) and infusing cold (4 degrees C) modified Euro-Collins solution (15 ml/kg X 4 minutes) into the main pulmonary artery of 7 donors pretreated with prostaglandin E1 (PGE1) (PGE1 group). PGE1 was given intravenously (0.5 to 4.0 micrograms/kg/min) beginning 15 minutes prior to aortic cross-clamping and was continued during administration of the pulmonary cooling solution. In the deep hypothermia group, no pharmacotherapy was used. Grafts were stored at 4 degrees C for about 6 hours. After heart-lung transplantation, arterial blood gases were measured on 40% inspired oxygen and 2 to 3 cm of positive end-expiratory pressure, and were significantly higher in the PGE1 group than the deep hypothermia group after 8 hours of reperfusion (p = 0.04). The partial pressure of arterial oxygen decreased significantly during the 8 hours of reperfusion in the deep hypothermia group (153 to 108 mm Hg; p = 0.01) and increased in the PGE1 group (189 to 218 mm Hg;p = 0.0002). Eighty-six percent of the animals in the PGE1 group survived more than 24 hours (p = 0.03). There were no survivors in the deep hypothermia group.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Donor deep hypothermia or donor pretreatment with prostaglandin E1 and single pulmonary artery flush for heart-lung graft preservation: an experimental primate study. 314 74

The isolated perfused rabbit liver model has been used to determine the essential components of the UW solution for hepatic preservation by simple cold storage. Livers were stored on ice for 48 hr after initial flushing with the solution being tested, and then reperfused at 38 degrees C in an isolated perfusion circuit; bile flow and enzyme (SGOT, SGPT, and LDH) release during a 2-hr period were recorded. All solutions tested contained phosphate (25 mM) as a buffer and magnesium sulfate (5 mM). Sodium can be substituted for potassium without adverse effects. Lactobionate, raffinose and glutathione cannot be omitted; all other components can be eliminated without altering the effectiveness of the solution in this model.
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PMID:An analysis of the components in UW solution using the isolated perfused rabbit liver. 317 57

Cooling is accepted as a practical way of lowering cell metabolism in vein grafts during coronary by-pass surgery. We have previously shown that low temperature causes endothelial cells to become detached, both in in vitro and in vein graft. In this study we have looked at the effect of cold on the concentrations of intra- and extracellular electrolytes. Human endothelial cells were grown on titanium grids for electron microscopy. The cells were incubated for 30 min at 37 degrees, 20 degrees, and 4 degrees C with cell culture medium containing human serum, and at 20 degrees and 4 degrees C with heparinized sodium acetate solution with serum, frequently used for flushing and distending vein grafts. Freeze-dried cells were then subjected to elemental X-ray microanalysis. The ambient fluid was analysed by flame photometry. At 20 degrees and 4 degrees C, intracellular concentration of sodium increased, and potassium decreased, compared with controls (37 degrees C). The changes in sodium concentrations were aggravated when cell culture medium was replaced by heparinized sodium acetate. The intracellular chloride concentration did not change when cells were stored in cold cell culture medium. The extracellular concentration of potassium increased with increasing incubation time at 4 degrees C. The connection between these findings and cell detachment is discussed.
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PMID:Effect of cooling on the intracellular concentrations of Na+, K+ and Cl- in cultured human endothelial cells. 321 59

Patients who have lost such a large portion of their small bowel that they permanently require total parenteral nutrition for survival would greatly benefit by receiving a small-intestinal transplant. Over the past two decades, many experimental studies have delineated the specific problems surrounding small-bowel transplantation and provided strategies for their control. Control of rejection, the most difficult problem, may be achieved with a combination of cyclosporine, azathioprine, prednisone, antithymocyte globulin, and monoclonal antibodies. The threat of graft-versus-host disease originating from the allogeneic lymphatic tissues in the allograft is abolished by in vitro x-irradiation of the cold, nonperfused graft with 1000 rads. Monitoring of the intestinal allograft is possible with the combination of a function test (maltose absorption, glucose absorption, or any other function test) and repeated graft biopsy. Effective short-term preservation of small-bowel segments for up to 18 h is possible by intravascular flushing with a balanced electrolyte solution containing 3% fructose and by subsequent hypothermic storage. Clinical small-bowel transplantation is certainly not an imminent therapeutic tool. However, clinical trials in highly selected patients could be envisioned on the basis of our present understanding of small-bowel transplantation and of transplantation biology in general, and in view of the clinical successes achieved with duodenal grafts transplanted in conjunction with pancreatic grafts.
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PMID:Current status of small-bowel transplantation. 327 69

The development of biliary sludge, in the absence of anastomotic obstruction in the common bile duct, has become a very rare complication following orthotopic liver transplantation since the adoption of modern techniques of biliary reconstruction and routine biliary flushing before cold preservation. We describe the successful treatment of this serious complication in an 18-year-old woman whose biliary sludge aggregated into firm casts occupying the extrahepatic and intrahepatic bile ducts causing obstruction and cholangitis necessitating operative intervention followed by interventional radiological approaches to treat the intrahepatic bile duct strictures. Postoperative choledochofiberscopy was also used to remove the retained biliary casts. The pathogenesis of biliary sludge appeared to be multifactorial, but cold ischemic damage to the bile duct wall seemed to play an important role in this case.
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PMID:Biliary sludge-cast formation following liver transplantation. 328 14

In a prospective study, 53 consecutive patients with solitary thyroid cysts were randomized to ultrasonically guided cyst aspiration and subsequent flushing with isotonic saline (n = 30) or tetracycline hydrochloride (n = 23). The patients were followed up clinically and ultrasonically 1, 3, 6, and 12 months after treatment. If the cyst recurred, a repeated treatment was offered. Cure was defined as the absence of any residual nodule and an ultrasonic cyst volume of less than 1 mL 12 months after the last treatment. During follow-up, two patients without recurrence after saline treatment and six patients without recurrence after tetracycline treatment developed solid cold nodules. Fourteen (47%) of 30 patients in the saline group and ten (43%) of 23 patients in the tetracycline group were cured (not statistically significant). Tetracycline does not seem to offer any advantage over isotonic saline in the treatment of thyroid cysts, and some of these patients still need thyroid surgery.
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PMID:Tetracycline for sclerosis of thyroid cysts. A randomized study. 328 1

The efficacy of three flushing techniques on subsequent liver function was assessed using the in vivo isolated liver perfusion model (ILPM). Livers from brain-dead mongrel dogs were flushed with cold Euro-Collins as follows: Group I, rapid in situ flushing (10 min); Group II, regular in situ flushing (45 min); Group III, ex vivo flushing (10 min). All livers were then heterotopically transplanted into recipients, using the ILPM, by anastomosis of the portal vein, vena cava, and hepatic artery to the recipient's portal vein, iliac vein, and iliac artery. Reperfusion followed for 30 min. Laboratory samples collected at 0, 5, 15, and 30 min showed that hepatic function was not altered by ex vivo flushing and was only slightly altered by rapid in situ flushing. Regular in situ flushing proved to be damaging to livers. Histological analysis confirmed these findings. Therefore, either rapid in situ or ex vivo flushing can be safely used by the transplant specialist.
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PMID:Comparison of rapid in situ, regular in situ, and ex vivo flushing on hepatic function. 329 30


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