Injection Of Hypertonic Solution Research Articles

Primary cystic echinococcosis of the peritoneum: a case report

BackgroundPeritoneal cystic echinococcosis happens usually after traumatic rupture or after surgical treatment. Primary peritoneal cystic echinococcosis is a very rare case that constitutes a diagnostic and therapeutic challenge.Case reportA 30-year-old Tunisian man was admitted for hypogastric pain since 4 months. He has a 10 cm hypogastric mass. Biological-tests were normal. A computed tomography Scan showed a cystic mass on the pelvis measuring 13 × 17 cm without echinococcosis cyst in the liver.The patient was operated and we found a cystic mass of 17 cm located on the Douglas cul-de-sac that suggest a pelvic hydatid cyst. We have performed an aspiration of the cyst confirms the diagnosis followed by injection of hypertonic solution, extarction of the germinal layer and a maximal reduction of the pericyst. The postoperative course was uneventful.ConclusionTrough our case, we try to focus on the diagnosis and therapeutic options of this rare entity that we should think of in front of a patient with isolated peritoneal cyst especially in endemic country.

Hypertonic solution-induced preconditioning reduces inflammation and mortality rate

BackgroundDysregulated inflammatory response is common cause of organ damage in critical care patients. Preconditioning/tolerance is a strategy to prevent exacerbated inflammation. The aim of this study is to analyze hypertonic saline 7.5% as a potential inducer of preconditioning that protect from a lethal dose of LPS and modulates systemic inflammatory profile in mice.MethodsMale Balb/C mice received intravenous (i.v.) injections of Hypertonic solution (NaCl 7.5%) (0.8 ml) for 3 days, on day 8th was challenged with LPS 15 mg/kg. Controls with Saline 0.9%, urea and sorbitol were performed. Microarray of mRNA expression was analyzed from HS versus saline from macrophages to identified the pathways activated by HS.ResultsHS preconditioning reduced mortality after LPS injection as well reduced the cytokines release in plasma of the animals challenged by LPS. In order to check how HS induces a preconditioning state we measured plasma cytokines after each HS infusion. Repeated HS injections induced a state of preconditioning that reprograms the inflammatory response, resulting in reduced inflammatory cytokine production. A microarray of mRNA demonstrated that Hypertonic solution increased the expression of several genes in special Mapkbp1 and Atf3.Conclusionhypertonic solution induces preconditioning/tolerance reducing mortality and inflammatory response after LPS challenge.

Spinal Injections for Functional Gastrointestinal Disorders

Purpose: Several functional GI disorders have been successfully treated by injections into posterior spinal ligamentous structures. Cases of GERD, IBS, recurrent daily vomiting and esophageal spasm have all been resolved with injections of hypertonic solutions that induce an inflammatory repair of these ligaments. This stops somatic nociception which is known to sensitize spinal cord neurons to colonic distention. Methods: Interspinous ligaments and bilateral facet joint capsules of various thoracic and/or lumbar spinal segments were injected with 1–2 ccs of a 25% dextrose and 0.5% lidocaine solution using fluoroscopic guidance. Results: Case 1 GERD Hx Pt is a 54 y.o. female with a multi-year Hx of daily epigastric pain associated with reflux. Daily esomeprazole would mostly control these symptoms except when exacerbated by spicy foods or tomato based sauces. Severe epigastric pain ensued hours after missing a dose of esomeprazole. Upper and lower endoscopy revealed only mild esophagitis and gastritis. Tx Injected from T2 through T6 and between T10 and S1. Results Complete resolution of all symptoms for over three years. Case 2 IBS Hx Pt is a 43 y.o. female with a several year Hx of constipation predominant IBS. Several days after the previous bowel movement she would develop nausea, occasional vomiting, anorexia, cramping, bloating and abdominal pain relieved by passing hard stools followed by diarrhea. Tx Injected at L5-S1, both sacroiliac joints and between T4 and T10. Results Complete resolution of all symptoms for last three years. Case 3 Recurrent daily vomiting Hx Pt is a 55 y.o. male who would have bouts of vomiting two or three times per day with little warning for years. Extensive work-up including blood chemistry, upper and lower GI endoscopy were negative. Tx Twice injected at T1-T12 and all rib joints. Results Complete resolution of his symptoms for last 11 months. Case 4 Esophageal spasm Hx Pt is a 45 y.o. female who has a multi-year history of dysphagia associated with the sensation of food sticking substernally. After an initial swallow, she would sometimes regurgitate triggering coughing spells. Complaints of substernal pressure led to a negative cardiac, pulmonary and upper GI endoscopic work-up. Tx Injected between C2 and L1 all rib joints. Results Complete resolution of all symptoms for last 10 months. Conclusion: These case studies demonstrate a safe and effective treatment for various functional GI disorders. Additionally, these cases imply that the visceral symptom generation and adverse GI motility seen in the functional GI disorders may be induced by abnormal somatic posterior spinal afferentation. This may occur via viscerosomatic convergence that occurs normally in the spinal cord.

Quantification of Lung Microvascular Injury with Ultrasound

Quantification of water and solute exchange rates across the lung microvascular barrier (LMB) may be an important early-warning indicator of pulmonary microvascular diseases such as acute respiratory distress syndrome. Our objective was to determine the degree to which osmotic water movement across the LMB induced by injection of hypertonic solutions of NaCl and glucose could be detected downstream from the lung with a specialized ultrasonic velocity (USV) transducer manufactured by Transonic Systems. We hypothesized that mathematical modeling of the osmotic transients (OT) would yield estimates of osmotic exchange parameters that were sensitive to microvascular injury. Two groups of six dogs were studied under baseline conditions and after injury with high dose (HD) or low dose (LD) oleic acid. Osmotic conductances (sigmaK(1), sigmaK(2)), and volumes (V(1), V(2)) of two extravascular spaces were estimated by fitting the mathematical model to the OT data. HD results (mean +/- standard error) indicated a significant decrease (by paired t test) in sigmaK(1) from 1.59 +/- 0.09 to 1.04 +/- 0.015 [ml h(-1) (mosm/l)(-1) g(-1) WLW)], an increase in sigmaK(2) from 0.20 +/- 0.08 to 0.32 +/- 0.12 [ml h(-1) (mosm/l)(-1) g(-1)], and a significant increase in V2 from 23.26 +/- 2.51 to 78.0 +/- 15.23 (ml) for NaCl injections. LD V2 estimated from NaCl increased significantly from 21.57 +/- 2.15 to 37.59 +/- 2.36 (ml), sigmaK2 increased from 0.09 +/- 0.03 to 0.17 +/- 0.04 and no significant change in sigmaK(1) was found. Baseline glucose sigmaK(1), sigmaK(2), and V1 in the LD series were 2.08 +/- 0.18, 0.64 +/- 0.19 [ml h(-1) (mosm/l)(-1) g(-1)] and 13.08 +/- 1.89 (ml), respectively, and did not change significantly with injury. We conclude that OT data measured by USV is a sensitive and informative indicator of LMB osmotic properties, and may be useful for quantification of LMB permeability changes due to acute injury. We further conclude that V(1) represents microvascular endothelial volume and V(2) is an estimate of interstitial volume.

Fos induction in rat brain neurons after stimulation of the hepatoportal Na-sensitive mechanism.

Responses of hepatic afferent nerves to intraportal bolus injection of hypertonic solutions were examined in anesthetized rats. Hepatic afferent nerve activity increased in response to an intraportal injection of 0.75 M NaCl or NaHCO3 but did not respond to a similar injection of 1.5 M mannitol, 0.75 M LiCl, or 0.15 M NaCl, implying that nerves in the hepatoportal area are sensitive to increases in Na concentrations and that this leads to stimulation of hepatic afferent nerve activity. To study central activation in response to stimulation of the hepatic Na-sensitive mechanism, c-fos induction was monitored. After electrical stimulation of hepatic afferent nerves, neurons containing Fos-like immunoreactivity (Fos-li) were found in the area postrema, nucleus of the solitary tract, paraventricular hypothalamic nucleus, and supraoptic nucleus at 90 min after stimulation. Induction of Fos-li was also studied after simultaneous infusion of 0.45 M NaCl into the portal vein and distilled water into the inferior vena cava in conscious rats so as to keep the total amount of solution introduced into the systemic circulation isotonic, thus avoiding changes in mean arterial pressure, plasma osmolality, and plasma NaCl concentrations. Fos-li-containing neurons were found in the same regions in which they were found after electrical stimulation. However, few, if any, Fos-li-containing cells were found if the rats were hepatically denervated or if they received an intraportal infusion of hypertonic LiCl or mannitol. These data provide evidence for involvement of the brain stem and forebrain structures in NaCl regulatory functions induced by stimulation of the hepatoportal Na-sensitive mechanism. However, stimulation of the hepatoportal osmosensitive mechanism does not activate these central structures.

Intravenous injection of hypertonic NaCl solution stimulates pulmonary C-fibers in dogs

Intravenous injection of hypertonic NaCl solution evokes reflex bradycardia and hypotension, effects thought to result from stimulation of afferent vagal endings in the lungs. To identify the afferents responsible for these effects, we recorded vagal impulses arising from endings in the lungs and lower airways of anesthetized dogs and examined the response to injection of hypertonic solutions into the pulmonary circulation. Injection of 4,800 mmol/l NaCl solution (1 ml/kg) stimulated 39 of 49 pulmonary C-fibers, their impulse frequency increasing 35-fold. Stimulation was concentration dependent, the minimum effective concentration being between 1,200 and 4,800 mmol/l. Rapidly adapting receptors were also stimulated in a concentration-dependent manner, 35 of 41 receptors being stimulated by 4,800 mmol/l NaCl solution, firing increasing fivefold. Bronchial C-fibers were not stimulated by injection into the pulmonary circulation but were by injection into the bronchial artery. Hypertonic urea solutions had qualitatively similar but smaller effects on pulmonary C-fibers and rapidly adapting receptors. The results suggest that the reflex effects of intravenous injection of hypertonic solutions result principally from stimulation of pulmonary C-fibers.

Hypertonic solutions induce hemorrhage in the anterior pituitary in mice.

Acute and intense hemorrhage in the anterior lobe of the pituitary was observed in mice treated with hypertonic solutions. The onset of hemorrhage and the spontaneous recovery phase were studied with light and electron microscopes. Ten minutes after ip injection of 9% NaCl, 8% NaHCO3, 3 M glucose or 3 M sucrose at a dose of 0.03 ml/g B. W. there was selective bleeding in the anterior lobe of the pituitary. The maximum extent of hemorrhage was reached 12 h after the injection of hypertonic solution and lasted for approximately 3 days. Ontogenetic study indicated that no pituitary hemorrhage occurred in mice younger than 2 weeks of age. Hypophyseal cleft was found to be not merely a residual lumen but an active site providing for accumulation and digestion of blood cells which flowed out of the bleeding anterior pituitary. By the end of a week, the necrotic tissue in the center of the anterior pituitary was replaced by granulation tissue consisting of fibroblasts, macrophages, capillaries and a stack of excess basal lamina.

Responses of lateral preoptic neurons and behavioral reactions to angiotensin II and hypertonic NaCl and sucrose administered into the rat cerebral ventricle

In 18 acutely prepared rats and in 3 chronically implanted rats, multiple-unit responses of lateral preoptic area (LPOA) neurons to angiotensin II (A II) and hypertonic NaCl and sucrose injected into the lateral ventricle were recorded. In addition, behavioral reactions were observed in the chronically prepared rats. Results showed that i.vt. injections of hypertonic solutions or A II affect neural activity in the LPOA, indicating that the LPOA has connections with periventricular structures that are sensitive to these substances. Experiments with chronically implanted animals demonstrated the relevance of i.vt. injections for drinking. Some of the same solutions that produced changes in LPOA MUA in the acute series (or in anesthetized chronically implanted rats) also elicited drinking. A II was a more effective dipsogen than hypertonic NaCl, and in the strongest concentration used, NaCl produced stereotyped running, reduced head movement during quiescence, and caused a progressive fall in baseline MUA. Drinking was elicited by intermediate concentrations of i.vt. NaCl. Implications for the neuropsychology of thirst are discussed.

Cataracts due to repeated osmotic insults.

The long-term effect of repeated osmotic insults were investigated and the lenticular changes due to hyperosmosis were described. The results of these experiments demonstrated that subsequent hyperosmotic insults to hamster lenses by exposure of the eye and to rabbit lenses by intracameral injection of hypertonic solution did not cause permanent lenticular damages being completely reversible and not harmful.

Determination of cardiac output and of transcapillary fluid exchange by continuous recording of blood density.

We have tested the application of the continuous measurement of the density of the arterial blood for the calculation of the cardiac output and for the determination of the transcapillary fluid exchange. The density of arterial blood was continuously recorded in anesthetized dogs with a mechanical oscillator device (DMA 602 MW built by A. Paar KG, Graz). The time resolution of this device is less than 1 sec, the accuracy is 10(-6) g/ml. Simultaneously the arterial blood temperature was recorded with a thermistor probe. The intravenous injection of isotonic solutions yields temperature and density transients which are of a similar shape and proportional to the injected volume in amplitude. There is a good agreement between the cardiac output calculated from thermodilution transients and from density dilution transients. The injection of hypertonic solutions, e.g. 5% NaCl, 20% mannit or 14.4% urea, into a vein yields arterial density dilution transients which show marked differences and very characteristic features. They can be explained by the assumption of osmotic fluid shifts in the microcirculation of the lung. During the transient of a bolus of hypertonic NaCl or mannit, a transcapillary influx of about 0.170 X 10(-3) ml/sec per mosmols/l and per g wet tissue weight is generated. The effect of hypertonic urea is less by a factor of about 1/2, which is in agreement with the fact that urea diffuses rapidly into the erythrocytes. We conclude that the method of density dilution allows to record and quantify cardiac output and osmotic fluid shifts through the microcirculation of the lung of intact dogs.

Osmotic extraction of hypotonic fluid from the lungs.

After injections of sucrose, NaCl, and urea solutions, the flow of tissue fluid from the lungs amounted to 0.182, 0.216, and 0.152 x 10(-3) ml/s per mosmol/kg of concentration difference between plasma and tissues in each gram of wet tissue weight. The extracted fluid contained less than 20% of the Na(+), K(+) and urea concentrations of the plasma. It was concluded that this fluid was distinctly hypotonic in comparision with the fluids of the plasma and tissue compartments both before and after the injection of hypertonic solutions. The presence of low solute concentrations in the extracted fluid is attributed to the passage of this fluid across cellular membranes, which are relatively impermeable to small hydrophilic solutes. Movement of fluid out of the junctions appears to be less than that through the endothelial cells. It is suggested that the injected solutes rapidly leak into the junctions and consequently induce relatively little movement of water or tissue solutes out of the junctions. Concentrations of tritiated water and [(14)C]antipyrine in the extracted fluid are essentially the same as base-line plasma concentrations when the animals have been primed with these tracers. It is therefore likely that these tracers can readily traverse cellular membranes. Red cell transit through the lungs is impaired by hypertonic solutions of sucrose and NaCl with transient increases in pulmonary arterial hemoglobin concentrations of as much as 35% of base-line values.

The Effects of Exposure to Increasing Salt Loads on the Plasma Osmolarity and the Nasal Gland of Gallus domesticus

SUMMARY The effects of salt loading by replacement of drinking water with 0·6% NaCl, supplemented with daily injections of hypertonic solutions of salt, were examined over a 7-week period in 10 adult hens. With the onset of salt injections, egg laying ceased, the combs and wattles became pale and the birds looked dejected. Fluid intake increased to approximately twice that of control birds, but until the last week of the experiment, when the largest daily doses of salt were injected, no increase in plasma osmolarity was detected. When compared with the control group, no increase in the weight of the nasal gland was apparent and there was no histological evidence of increased activity of the gland. It was concluded that the nasal gland of Gallus domesticus has no osmoregulatory junction.

Mechanism of the increase in venous outflow from skeletal muscles during intraarterial injection of hypertonic solutions

Mechanism of the increase in venous outflow from skeletal muscles during intraarterial injection of hypertonic solutions

Lateral hypothalamic mediation of spinal reflex facilitation during salt arousal of drinking

Abstract Monosynaptic reflex discharges were evoked in the fifth lumbar ventral root of rat by synergistic stimulation of cut nerves to both heads of the gastrocnemius muscles. Small volumes of intracarotid injections of hypertonic solutions (NaCl, KCl, CaCl 2 , mannitol and sorbitol) produced a graded facilitation (increased amplitude of the monosynaptic component) of reflex discharges which persisted for 23 min. The facilitation did not occur in spinalized, decerebrate, adrenalectomized animals or in animals in which bilateral lateral hypothalamic lesions produced a temporary aphagia and relatively permanent adipsia. Results of intracarotid injections of hypertonic solutions and electrical stimulation of the lateral hypothalamus are also discussed.

Effects of hypertonic solutions on bile formation

Modifications of flow and composition of bile have been studied in the guinea pig with ligated ureters after injection of hypertonic solutions of two nonmetabolizable substances, mannitol and xylose (1.66 m), into the jugular vein. A distinct and persistent decrease in biliary flow always occurs. Analysis of this anticholeresis showed a parallel decrease in the flow of water and electrolytes, while the flow of bilirubin and bile acids is not modified. There are, then, two different types of mechanisms in the formation of bile: the osmotic mechanisms which control the quantity of water and electrolytes; and the active secretory mechanisms, independent of the first, for specific substances such as bilirubin and bile salts. Ultrafiltration does not occur in quantitative formation of bile, but the bile/blood osmotic gradient plays an important role.

Lysosomes and vacuolation of the liver cell.

VACUOLATION of the liver cell can be produced by a variety of experimental procedures such as intravenous or intraperitoneal injection of hypertonic solutions1, or anoxia2. The vacuoles do not contain any material detectable by ordinary histological methods and hence have been referred to as ‘watery vacuolation’. Aterman suggests that the vacuoles he studied, produced by injection of hypertonic solutions, result from uptake by the liver cell of substances from the blood. Hanzon3 and Reese4, examining anoxic vacuolation, thought they were derived from bile canaliculi. In this communication we describe vacuoles in the liver cell developing from lysosomes.

Changes in the blood pressure and their mechanism of development after injection of hypertonic solutions into the blood stream

Following quick intravenous injection of hypertonic glucose and sodium chloride solution, the arterial blood pressure in dogs increases in 2 waves with a depressor wave in-between. It then drops and subsequently rises to its initial level.

Central Localization of the Osmotic Control Center

Intracarotid injections of hypertonic solutions cause marked antidiureses in lightly chloralosed dogs. Intrafemoral injections of identical solutions of hypertonic saline and urea were done with resulting slight diureses, reflex flexing of the leg and increased urine osmolarity. Femoral artery injections of hypertonic sodium sulfate are followed by antidiureses which are explained, at least partially, by active reabsorption of the sulfate ion in the proximal renal tubules. The absence of evidence of antidiuretic activity following intrafemoral artery injections and the marked antidiuretic effect demonstrated following intracarotid injections lends support to the theory of central localization of the osmotic control center.

Osmotic regulation of body fluids.

Intracarotid injections of hypertonic solutions were made in animals, using light chloralose anesthesia to rule out the possibility of conditioning an antidiuretic response. These experiments, raising carotid osmolarity by approximately 50% for a 10-second period, confirmed previous observations that an antidiuresis follows an increase in carotid osmolarity. When carotid osmolarity is increased by less than 2% over a 40-minute period an antidiuresis also results. Little difference was observed in the relative effectiveness of hypertonic urea, sodium chloride or sodium sulfate, all of which were calculated to raise osmolarity by approximately equal amounts. Bioassay techniques showed greatly increased amounts of antidiuretic substance in urine after intracarotid injections of hypertonic solutions. Controls given isotonic saline injections showed only minimal antidiuretic activity.

Effect of Hypertonic Solutions on Cerebrospinal Fluid Pressure with Special Reference to Secondary Rise and Toxicity.

The effect of hypertonic solution on the spinal fluid pressure is of vital importance from a clinical standpoint, since Weed and McKibben1 show that the cerebrospinal fluid volume could be reduced by intravenous injection of hypertonic solution. Cushing and Foley2 and Foley and Putnam3 applied this observation to clinical cases of increased intracranial pressure and it was immediately recognized of importance in the treating of head injuries. However, Browder4 among others pointed out from clinical observations: first, the toxicity of NaCl solution, and second, the occasional deaths that occur after a short period of clinical improvement after intravenous administration of hypertonic solution in cases of head injuries with symptoms of increased intracranial pressure.Our experiments were carried out on a series of 10 dogs and one man. We used various concentrations of NaCl and of glucose. The results were uniform. First, it was demonstrated that hypertonic saline has a definitely toxic effect, which in con...