Oral Tube Research Articles

Food habits of medical students: A study among the students of a health university in Eastern India

Type 2 diabetes mellitus (T2DM) is the most common type of diabetes, accounting for 90% of diabetic cases. It is characterized by chronic hyperglycemia which is caused by a combination of deficiency in insulin action and secretion. Adipose tissue regulates insulin sensitivity via the circulating adipocytokines, leptin, resistin and adiponectin. Hypoadiponectinemia contributes to the development of obesity and related disorders such as diabetes, hyperlipidemia and cardiovascular diseases. The present study aimed to evaluate the beneficial effect of flavonoid 2-hydroxychalcone in T2DM through its effect on peroxisome proliferator activated receptor gamma (PPAR-γ) and adiponectin. T2DM was induced in male Wistar rats using high fat diet and low dose of streptozotocin (STZ, 35 mg/kg, i.p.). The flavonoid 2-hydroxychalcone was administered by oral tubes. Levels of PPAR-γ in sub abdominal adipose tissue, serum adiponectin, serum tumor necrosis factor-α (TNF-α) and serum insulin levels were detected by ELISA. Moreover, malondialdehyde (MDA) and reduced glutathione (GSH) in sub abdominal adipose tissue, fasting serum glucose, serum triglycerides and serum total cholesterol levels were measured by colorimetric methods. Results showed that 2-hydroxychalcone attenuated changes induced by T2DM in rats. 2-Hydroxychalcone treatment increased PPAR-γ levels in adipose tissue, reduced oxidative stress, restored adiponectin levels and decreased high glucose levels in T2DM rats. In conclusion, 2-hydroxychalcone reduced hyperglycemia in T2DM by regulating adiponectin secretion. This effect involves PPAR-γ signaling pathway.

Antioxidant effects of rice bran oil mitigate repeated haloperidol-induced tardive dyskinesia in male rats.

Tardive dyskinesia (TD) is associated with the use of antipsychotic drugs such as D2 antagonist haloperidol (HP). The chronic use of HP is involved in the causation of free radicals and/or oxidative stress. In view of the nootropic, anti-anxiety, anti-inflammatory-like effects of rice bran oil (RBO) in a variety of investigations, we assessed the protective properties of RBO on HP-induced TD and neurochemical alteration. Rats treated with HP orally at a dose of 0.2mg/kg/day for a period of 5weeks developed VCMs which increased progressively as the treatment continued for 5weeks. Co-administration of RBO by oral tubes at a dose of 0.4ml/day prevented the induction of HP-induced VCMs. Repeated administration of HP increases the turnover of dopamine metabolism in the striatum. Conversely animals treated with HP+RBO decrease the metabolism of DA than water+HP treated animals. Striatal, malondieldehyde (MDA), hydrogen peroxide (H2O2) and antioxidant enzyme superoxide dismutase (SOD), catalase (CAT) and glutathione peroxidase (GPx) were also determined. It is suggested that beneficial role of RBO in attenuation of HP-induced TD. The results therefore recommended that supplementation of RBO may be useful in the HP-induced TD. The findings have also potential implication in the treatment of schizophrenia and motor disorders.

Evaluation of modified nasal to oral endotracheal tube switch—For modified alar base cinching after maxillary orthognathic surgery

BackgroundSoft tissue changes secondary to Maxillary orthognathic surgery are many fold. The alar flare is one among them, which affects the appearance of the patient. Cinch suture has been used to prevent alar flare; but the presence of anaesthetic tube hinders cinching. So, the study was aimed to assess an efficacy of modified nasal to oral tube switch technique for modified alar cinching to prevent alar flare after orthognathic and nasal corrective surgeries. Materials and methodsPatients were randomly allocated in each group, who underwent modified alar base cinching with and without nasal to oral tube switch. Changes in alar base width, upper lip length was measured with Digital Vernier Caliper and nasolabial angle (Cotg-Sn-Ls) on lateral cephalogram at 1st, 3rd, 6th, and 12th months after surgery. The time taken and ease of tube switch were noted. The data obtained were tabulated and interpreted using a test of significance. ResultsStudy results showed no statistical significant difference in perinasal soft changes among both groups. But tube switch appears to be beneficial to prevent alar flare. ConclusionModified alar base cinching was performed effectively in patients with a modified tube switch technique. It increased positive results in comparison with non-shift. The technique of tube switch used is effective in prevention of alar flare. Because of small sample size and limited period of follow up, our study suggests multi centre, randomized studies to know the technical difficulties of tube switch for cinching and aesthetic results with varying anaesthetist and the surgeon’s experience.

Effect of 2-hydroxychalcone on adiponectin level in type 2 diabetes induced experimentally in rats

Type 2 diabetes mellitus (T2DM) is the most common type of diabetes, accounting for 90% of diabetic cases. It is characterized by chronic hyperglycemia which is caused by a combination of deficiency in insulin action and secretion. Adipose tissue regulates insulin sensitivity via the circulating adipocytokines, leptin, resistin and adiponectin. Hypoadiponectinemia contributes to the development of obesity and related disorders such as diabetes, hyperlipidemia and cardiovascular diseases. The present study aimed to evaluate the beneficial effect of flavonoid 2-hydroxychalcone in T2DM through its effect on peroxisome proliferator activated receptor gamma (PPAR-γ) and adiponectin. T2DM was induced in male Wistar rats using high fat diet and low dose of streptozotocin (STZ, 35mg/kg, i.p.). The flavonoid 2-hydroxychalcone was administered by oral tubes. Levels of PPAR-γ in sub abdominal adipose tissue, serum adiponectin, serum tumor necrosis factor-α (TNF-α) and serum insulin levels were detected by ELISA. Moreover, malondialdehyde (MDA) and reduced glutathione (GSH) in sub abdominal adipose tissue, fasting serum glucose, serum triglycerides and serum total cholesterol levels were measured by colorimetric methods. Results showed that 2-hydroxychalcone attenuated changes induced by T2DM in rats. 2-Hydroxychalcone treatment increased PPAR-γ levels in adipose tissue, reduced oxidative stress, restored adiponectin levels and decreased high glucose levels in T2DM rats. In conclusion, 2-hydroxychalcone reduced hyperglycemia in T2DM by regulating adiponectin secretion. This effect involves PPAR-γ signaling pathway.

Use of Vacuum-Assisted Closure in the Management of Colostomy

Background: This article is the first report of the simultaneous use of vacuum-assisted closure (VAC) therapy and an oral tube applied as a life-saving treatment for colostomy dehiscence to avoid fecal contamination. Case Presentation: A 75-year-old female was admitted to our surgical unit in 2012 for knee trauma caused by an accidental fall at home. Surgery for lysis of adhesions, left colectomy, colorectal anastomosis, and protective ileostomy was performed initially for sigmoidovaginal fistula. Vacuum-assisted closure therapy (applying continuous negative abdominal pressure) was used after median wound dehiscence and a parastomal abscess that caused the necrosis of the skin and subcutaneous tissue surrounding the colostomy. Conclusion: The application of a negative pressure is a novel approach to colostomy dehiscence and complicated abdominal wound management and can lead to complete abdominal wound closure and finally to apply a standard plate for colostomy bag.

Flora Colonization and Oral Glucose Levels During the Early Postnatal Period in High-Risk Newborns

Purpose: A longitudinal study was conducted to explore flora colonization and oral glucose high-risk newborns during the first 7 days after birth. Methods: Oral secretions of hospitalized newborns were obtained for microbial cultures and glucose test at days 1-7 after birth. Results: Among the total 112 newborns, 40% were girls and 73% were premature. Mean gestational age was 34.4±3.2 weeks and weight was 2,266±697.5 grams. The most common flora included Streptococcus (28.2%), Methicillin-resistant Staphylococcus aureus (MRSA, 10.9%), Staphylococcus (6.0%) and Coagulase-Negative Staphylococcus (CNS, 4.0%). The average oral glucose level was 29.2±23.0 ㎎/dL~58.2±39.5 ㎎/dL. Newborns with higher oral glucose than serum (crude odds ratio [ORc] =1.75; 95% confidence interval [CI] =1.03-2.97), phototherapy (ORc=3.30; 95% CI=2.29-4.76) and prone position (ORc= 2.04; 95% CI=1.13-3.69) were more likely to be colonized. Having oral tubes (ORc=0.42; 95% CI=0.29-0.59), parental nutrition (ORc=0.21; 95% CI=0.13-0.32) and antibiotics (ORc=0.51; 95% CI=0.36-0.73) had protective effects. For oral glucose statistical significances existed on time effect among newborns with Streptococcus (F=9.78, p=.024), MRSA (F=7.60, p=.037) or CNS (F=11.15, p=.019) and interaction between time and colonization among newborns with all of four flora (F=2.73, p=.029) or colonization with only Staphylococcus (F=2.91, p=.034). Conclusion: High-risk newborns develop flora colonization at an early period of life. Their clinical features were associated with types and time of oral flora colonization. They need close monitoring and multifaceted intervention to improve oral environment and infection control.

Simplified Technique to Change the Endotracheal Tube from Nasal to Oral Cavity.

We introduce modified nasal to oral tube switch technique for modified alar cinching to prevent alar flare after orthognathic and nasal corrective surgeries. The technique is beneficial to prevent alar flare. Modified alar base cinching is effective in patients with modified tube switch technique. It increased positive results. The technique of tube switch is effective in prevention of alar flare. We suggest multi center randomized studies to know the technical difficulties of tube switch for cinching.

Profile, recommendation criteria, and outcome of gastrostomy tube insertions in a pediatric teaching hospital

Objective: To describe the profile of patients undergoing a gastrostomy, the recommendations and outcome of this insertion in a Pediatric Teaching Hospital. Method: This was a retrospective, quantitative, and descriptive study that researched the records of patients who underwent a gastrostomy between January 2010 and December 2012. Results: The diseases and conditions most frequent were chronic infantile encephalopathy (77.5%), pneumonia (67.5%), seizures (57.5%), and malnutrition (42.5%). Although most patients presented a history of dysphagia (62.5%), oral feeding was observed most frequently as the most common form of nutrition, before the gastrostomy insertion (42.5%), followed by nasoenteric tube (40%). The introduction of nutrition by gastrostomy was successful and occurred an average of 2.82 (± 1.19) days after insertion. Six months after their gastrostomy, 80% of patients continued feeding only through this access tube and only 2.5% had removed the gastrostomy; 45% of the participants had gastrostomy complications, with extravasation of gastric material (15%) and local inflammation (15%) being the most frequent. Conclusion: The profile of patients undergoing gastrostomy is mostly of individuals with neurological and respiratory diseases, without respiratory support, of the male gender, and feeding by oral cavity or nasoenteric tube for a prolonged period. The main recommendation criteria were dysphagia and neurological diseases. Regarding the outcome, the introduction of nutrition by gastrostomy was successful; most individuals remained with this long-term nutritional support and the most common complications were gastric material extravasation and local inflammations

Where did this oral tube come from

A well looking 11-month-old baby presented to accident and emergency department with a 24 hour history of vomiting. In the last vomit, a fine bore tube was expelled from his mouth. He had multiple abdominal surgeries in the past and 10 days prior to admission, his ventriculo-peritoneal shunt had been revised. Plain X-ray of chest and abdomen was undertaken as a part of shunt series. Plain X-ray of chest and abdomen demonstrated migration of the distal end of the shunt into the stomach and out through the mouth (Fig. 1). The perforation was very small and did not require any surgical correction. Neurosurgical management involved externalization of the distal end of the shunt along with 2 weeks of intravenous antibiotics prior to insertion of a new ventriculo-atrial shunt. 

Anti-nephrolithic potential of catechin in melamine-related urolithiasis via the inhibition of ROS, apoptosis, phospho-p38, and osteopontin in male Sprague-Dawley rats

The addition of melamine to infant formula may cause urolithiasis in humans and animals. This study examined the effects of catechin, an antioxidant, on melamine–cyanuric acid mixture (MCM)-induced crystallization in vitro and in vivo. In an in vitro study, crystal formation induced by an MCM was evaluated in media under various pH conditions and with catechin co-treatment. In an in vivo study, rats were administered an MCM (400 mg/kg, 1:1, via oral feeding tube) for four weeks and co-treated with catechin, after which crystal formation was observed. Oxidative stress biomarkers and nephrotoxicity were measured. Apoptotic cells were examined using the TUNEL assay. Phospho-p38 and osteopontin were evaluated via immunohistochemistry and Western blotting. MCM-induced crystal formation was pH-dependent in conditioned media, and catechin reduced the overall number of crystals. In the in vivo study, catechin suppressed MCM-induced protein expression and apoptosis in rats. Catechin consistently reduced the MCM-mediated production of renal malondialdehyde (MDA) and urinary 8-isoprostane (8-IP) in MCM-treated rats. The activities of antioxidant enzymes such as superoxide dismutase (SOD) were enhanced by catechin. Catechin consistently and significantly reduced levels of renal crystals and nephrotoxicity. Our findings suggest that catechin exhibits anti-nephrolithic potential by chemically inhibiting the formation of crystals and by inhibiting reactive oxygen species, apoptosis, phospho-P38, and osteopontin signaling in rats.

Propolis restored adiponectin level in type 2 diabetes through PPARγ activation

Adipose tissue regulates insulin sensitivity via the circulating adipocytokines, leptin, resistin and adiponectin. Hypoadiponectinemia contributes to the development of obesity and related disorders such as diabetes, hyperlipidemia, and cardiovascular diseases. In this study, we investigated the effects of Brazilian propolis on adiponectin levels in type 2 diabetes mellitus (T2DM), the mechanism of signaling pathway was explored as well. T2DM was induced in male Wistar rats using high fat diet and low dose of streptozotocin (STZ, 35 mg/kg, i.p.). Propolis was administered by oral tubes. Peroxisome proliferator activated receptor gamma (PPARγ) levels in sub abdominal adipose tissue, serum levels of adiponectin, tumor necrosis factor-α (TNF-α) and insulin were detected by Enzyme Linked Immunosorbent Assay (ELISA). Malondialdehyde (MDA) and reduced glutathione (GSH) in sub abdominal adipose tissue, fasting plasma glucose, plasma triglycerides and total cholesterol levels were measured by colorimetric method. Results showed that Brazilian propolis ameliorated hypoadiponectinemia in T2DM rats and relieved high glucose-induced adiponectin decrease. The signaling pathway analysis indicated that PPARγ regulation was involved. In conclusion, Brazilian propolis could have beneficial effect in T2DM by increasing tissue PPARγ levels, restoring serum adiponectin levels, enhancing insulin sensitivity and subsequently, attenuating elevated glucose level.

Where did the oral tube originate from?

Journal of Paediatrics and Child HealthVolume 51, Issue 7 p. 740-740 Images of the Month Where did the oral tube originate from? First published: 01 July 2015 https://doi.org/10.1111/jpc.12576_2Read the full textAboutPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShare Give accessShare full text accessShare full-text accessPlease review our Terms and Conditions of Use and check box below to share full-text version of article.I have read and accept the Wiley Online Library Terms and Conditions of UseShareable LinkUse the link below to share a full-text version of this article with your friends and colleagues. Learn more.Copy URL Share a linkShare onFacebookTwitterLinkedInRedditWechat No abstract is available for this article. Volume51, Issue7July 2015Pages 740-740 RelatedInformation

Improving Use of Sterile Water for Oral Care and Tube Flushes in Pediatric Intensive Care Units

Improving Use of Sterile Water for Oral Care and Tube Flushes in Pediatric Intensive Care Units

Hepatoprotective effects of glycyrrhizin and omega-3 fatty acids on Nuclear Factor-kappa B pathway in thioacetamide-induced fibrosis in rats

Nuclear Factor kappa B (NF-κB) is a key transcriptional regulator that plays important roles in the pathogenesis of hepatic inflammation and fibrosis in chronic liver diseases. NF-κB activation leads to production of pro-inflammatory and fibrogenic cytokines. Glycyrrhizin (GL) is reported to suppress liver fibrosis and cirrhosis. Omega-3 fatty acids (ω-3) play an anti-inflammatory role and they are reported to decrease hepatic injury in Thioacetamide (TAA) fibrotic model. We investigated the effects of GL and ω-3 on liver inflammation and fibrosis in rats and clarified the effects of these natural compounds on NF-κB level. 50 male Wistar rats randomized to 5 groups: Control group and 4 groups received TAA 200 mg/kg i.p. twice weekly for 8 weeks: TAA group, GL group (received GL 25 mg/kg daily by oral tube), ω-3 group (received ω-3150 mg/kg daily by oral tube), (GL+ω-3) group (received similar combined doses of both natural compounds). GL and ω-3 alone or in combination protected the liver from TAA hepatotoxic effects as they significantly decreased serum AST activity and serum total bilirubin level, they also significantly increased serum albumin and total protein levels. The hepatoprotective effects of GL and ω-3 were confirmed by the histopathological analysis as they significantly reduced the necroinflammatory scores and the extent of fibrosis. GL and ω-3 significantly decreased liver malondialdehyde level (P < 0.005), liver NF-ƙB level (P < 0.005) and its tissue expression as detected by immunohistochemistry. In conclusion, glycyrrhizin and omega-3 fatty acids alone or in combination have potent anti-inflammatory, anti-oxidant and anti-fibrotic effects.

Rice bran oil prevents neuroleptic-induced extrapyramidal symptoms in rats: Possible antioxidant mechanisms

Tardive dyskinesia (TD) is one of the serious side effects of long-term antipsychotic treatment. Chronic treatment with neuroleptic leads to the development of abnormal oral movements called vacuous chewing movements (VCMs). The oxidative stress hypothesis of TD is one of the possible pathophysiologic models for TD. Preclinical and clinical studies of this hypothesis indicate that neurotoxic free radical production is likely to be a consequence of antipsychotic medication and is related to occurrence of TD. Oxidative stress is implicated in the pathophysiology of TD. Rats chronically treated with haloperidol orally at a dose of 0.2 mg/kg/day for a period of 5 weeks developed VCMs, which increased in a time-dependent manner as the treatment continued for 5 weeks. Motor coordination impairment started after the 1st week and was maximally impaired after 3 weeks and gradually returned to the 1st week value. Motor activity in an open field or home cage (activity box) not altered. Administration of rice bran oil (antioxidant) by oral tubes at a dose of 0.4 mL/day prevented the induction of haloperidol-elicited VCMs as well impairment of motor coordination. The results are discussed in the context of a protective role of antioxidant of rice bran oil in the prevention of haloperidol-induced extrapyramidal symptoms.

Converting a nasoendotracheal tube to orotracheal, following fibreoptic intubation under general anaesthesia in a paediatric patient with complete cleft palate.

Sir, Cleft lip and palate are commonly associated with retrognathia, micrognathia and glossoptosis,[1] and can be part of syndromes such as Pierre Robin syndrome, Treacher-Collin's syndrome or Goldenhar syndrome. The anaesthesiologists frequently face difficulty with airway maintenance, mask ventilation, laryngoscopy, and endotracheal intubation.[2] Many of these infants may require fibreoptic intubation when they come for surgery.[3] We are reporting a case of Pierre Robin syndrome posted for palatoplasty. The patient, 9-month-old male infant, was delivered normally and had a history of snoring and nasal regurgitation while feeding. On examination, mandible was markedly receding along with a complete cleft palate involving both soft and hard palates. After keeping the child nil per oral for 6 h, general anaesthesia was induced with 8% sevoflurane in oxygen using a Jackson Rees circuit. Following induction a nasopharyngeal airway was introduced through one nostril with an endotracheal tube connector attached to the proximal end. Anaesthesia was maintained with 4% sevoflurane in oxygen with Jackson Rees circuit connected to the airway. Electrocardiogram, non-invasive blood pressure, SpO2 and end-tidal CO2 (EtCO2) were monitored. A 4.0 mm internal diameter oral Ring-Adair-Elwyn (RAE) tube was loaded on to the paediatric bronchoscope and the child was intubated nasally through the opposite nostril. As the surgeons insisted on an oral tube, the nasal tube was pushed in till the proximal end was at the nostril [Figure 1]. Then the mouth was opened and the most proximal part of the endotracheal tube visible through the cleft was caught with a paediatric Magill's forceps and pulled into the oral cavity [Figure 2]. At the same time, the part of the tube in the pharynx was stabilised by pushing it posteriorly to the pharyngeal wall with the index finger of the left hand to prevent accidental extubation. Once the proximal end of tube was brought out through the oral cavity, endotracheal tube connector was attached and position confirmed with EtCO2 and auscultation. The tube was then fixed in the midline and surgery commenced after giving fentanyl 2 μg/kg and atracurium 0.5 mg/kg intravenously. Maintenance of anaesthesia was with O2 :N2O (1:2) with sevoflurane (1.5–2%). The child was extubated at end of surgery uneventfully after reversing the neuromuscular blockade and when fully awake.Figure 1: Nasal endotracheal tube being pushed in till the proximal end is at the nostrilFigure 2: Proximal end of endotracheal tube being pulled out through the oral cavityThough infants can be intubated orally with fibreoptic bronchoscope, technical ease is more with the nasal route. Fibreoptic intubation succeeds less frequently by oral route because of the greater angle between oral cavity and the laryngeal inlet and also since keeping the bronchoscope in the midline is more difficult with oral route.[4] Though a nasotracheal tube can be changed to orotracheal using a guide wire, in the presence of a complete cleft palate, the technique described by us can be safely and easily accomplished.

The Effect of Low Dose of Lead Acetate on the Fallopian Tubes and the Role of Garlic Extract—A Histomorphic Study on Mouse

This study aimed to investigate the effect of lead acetate on the fallopian tube of adult mice and the possible effect of garlic extract in a Laboratory Based Randomized Control Trial. In this study, 30 female BALBc mice were selected and randomly divided into three groups. Ten animals were placed in each group. Group A being the control received only the laboratory diet. Group B was given lead acetate at a dose of 30 mg/kg/day. Group C was given lead acetate at 30 mg/kg/day and garlic extract at 500 mg/kg/day. All treatments were given through oral gavage tube for 60 days. The mice were sacrificed and dissected at the end of 60 days. The fallopian tubes were carefully dissected out and fixed in 10% formalin for routine histological examination. The histological findings in experimental group B showed increase in epithelial height, whereas no such findings were observed in group A and there was slight increase in height in group C. The lead acetate affected the epithelial height in lead acetate treated group which improved when cotreated with garlic extract.

Aralia elata Prevents Neuronal Death by Downregulating Tonicity Response Element Binding Protein in Diabetic Retinopathy

Background/Aims: The present study addresses the role of tonicity response element binding protein (TonEBP) in retinal ganglion cell (RGC) death in diabetic retinopathy and the impact of Aralia elata extract on the TonEBP/RGC interaction. Methods: Diabetes was induced in C57BL/6 mice by intraperitoneal injection of streptozotocin (STZ). Control mice received phosphate-buffered saline. After five injections of STZ or saline buffer, A. elata extract was administered by daily oral tube feeding for 7 weeks. All mice were killed at 2 months after the last injection of STZ or saline and the extent of cell death together with the protein expression levels of TonEBP, aldose reductase (AR) and nuclear factor-kappa B (NF-κB) were examined. Results: Terminal deoxynucleotidyl transferase-mediated dUTP nick end labeling (TUNEL)-positive signals were colocalized with TonEBP-immunoreactive RGCs. The apoptotic cell death of RGCs and the expression levels of TonEBP, AR and NF-κB were significantly increased in the retinas of diabetic mice compared with controls at 2 months after the induction of diabetes. However, these changes were effectively blocked by the administration of A. elata extract. Conclusions: These results indicate that A. elata prevents diabetes-induced RGC apoptosis and downregulates TonEBP expression. Therefore, A. elata extract may have therapeutic potential to prevent diabetes-induced retinal neurodegeneration in diabetic retinopathy.

Tu1113 Dexlansoprazole Modified-Release Orally-Disintegrating Tablet -The Bioavailability of Alternate Dosing Options

Introduction: The proton pump inhibitor dexlansoprazole (DEX) is a modified release (MR) formulation consisting of 2 types of granules within a single capsule. DEX delayed-release capsules are approved for use in adults for treatment of heartburn associated with symptomatic nonerosive gastroesophageal reflux disease, healing of erosive esophagitis (EE), and maintenance of healed EE and relief of heartburn. Because some patients are unable or unwilling to swallow capsules, a DEX MR orally-disintegrating (OD) tablet has been developed. DEX MR OD contains 2 types of granules that release drug in a pH-dependent manner in order to extend DEX plasma concentrations. Objective: To assess the bioavailability (BA) of DEX MR OD 30 mg tablet swallowed intact with water or mixed with water and administered via nasogastric (NG) tube or oral syringe compared to administration of DEX MR OD 30 mg on the tongue, allowed to disintegrate, and swallowed without water. Methods: This was a phase 1, randomized, single-dose, 4-period crossover study. Qualified healthy subjects 18-55 years old received a single oral dose of 30 mg DEX MR OD as an intact tablet administered on the tongue, swallowed intact, or mixed with water and administered via oral syringe or NG tube. Each study period was followed by a 5-day washout. Blood samples for determination of plasma pharmacokinetics were collected for 24 hours post-dose in each period. Analyses of variance models were performed, and bioequivalence (BE) between an administration option and DEX MR OD administered on the tongue without water was declared if 90% confidence intervals (CIs) of central value ratios between 2 regimens for maximum plasma concentration (Cmax) and area under the curve (AUC) mean ratios were contained within the BE limits of 0.80-1.25. Safety was assessed via physical examination (PE), clinical laboratory evaluation, vital sign assessment, electrocardiograms (ECG), and adverse event reports (AE). Results: Seventy-seven subjects (mean age 38±9.8 years) were enrolled. The 90% CIs for the BA of DEX MR OD 30 mg administered via oral syringe or NG tube, or swallowed intact, relative to that from administration of DEX MR OD on the tongue without water, for Cmax and AUCs were within the BE range of 0.80-1.25 (TABLE). All 4 regimens were well tolerated. AEs were mild in intensity and were considered not related to study drug. Percentages of subjects experiencing AEs were comparable across the 4 regimens. There were no clinically important findings noted in the PE, safety clinical laboratory, vital sign, or ECG reports. Conclusions: DEX MR OD 30 mg administered as an aqueous mixture via an oral syringe or an NG tube, or as an intact tablet swallowed with water was each BE to the administration of the DEX MR OD 30 mg on the tongue without water. Single oral doses of DEX MR OD tablets were well tolerated in this study. Table. BE Assessment of Administration Routes for DEX MR OD Tablets

Airtightness of lung parenchyma without a closing suture after atypical resection using the Nd:YAG Laser LIMAX(R) 120

Lung metastases can be non-anatomically resected with a Nd:YAG Laser. It is recommended that the resected lung surface be sealed by slowly resorbable sutures. However, the lung tissue may be restricted by the sutures once it is re-ventilated. Thus, it was analysed whether the lung parenchyma is airtight after laser resection without suturing the defect. The pulmonary artery of unimpaired paracardial lung lobes of freshly slaughtered pigs (mean weight 46 g) was cannulated and rinsed out via a hypotonic saline-heparin solution (5000 IE) until the perfusate was clear of body fluid. The lobular bronchus was connected to an airtight ventilation tube (Fa. VYGON 520 3.5 oral tube) and ventilated pressure-controlled (PEEP + 5 cm H₂O, P₁ = 20 cm H₂O, frequency = 10/min) via a respirator. All lobes were perfused with Ringer solution at 42°C at normothermia and normotonia. In group 1 (n = 8), an atypical peripheral parenchymal resection (average resected surface: 2 × 2 cm(2)) and in group 2 (n = 8), a deep atypical parenchymal resection (average resected surface: 4 × 4 cm(2)) were performed with the Nd:YAG Laser LIMAX 120 (output power at 100 watts). After post-resection ventilation of 15 min, the resection surface was tested for airtightness and burst pressure. All group 1 lobes tested airtight under pressure-controlled ventilation. The mean burst pressure was 34.4 mbar (SD ± 3.2 mbar). Six lobes of group 2 were also completely airtight. The remaining two lobes, however, revealed a serious parenchymal leak (score 3). This was caused by the cross-opening of a segmental bronchus, although the surrounding lung parenchyma was also airtight. The mean burst pressure of these lobes was 31.7 mbar (SD ± 4.08 mbar). There was no significant difference between the two groups (P = 0.12). Peripheral lung defects after Nd:YAG Laser resection might not be sutured, since the laser-induced vaporization of the lung parenchyma seems to be initially airtight. These experimental data warrant confirmation in a controlled clinical study.