BACKGROUND: The selective unilateral administration of drugs into a single lung of a rat is difficult because of the small airway diameter. Therefore, a simple method for unilateral administration into rat lung is needed. METHODS: Rats were assigned to 1 of 2 groups according to the direction of the catheter used for drug administration. Anesthetized rats were intubated, and curved epidural catheters were rotated up to a maximum of 90degrees toward the left lung (group L) or right lung (group R). Bronchial catheters were then inserted via a tracheal tube and fixed. Methylene blue (0.3 ml) was injected via the epidural catheter. Additionally, to compare survival rates, rats were assigned to one of two groups according to the drug administration route. In group T, bleomycin hydrochloride (20 mg/kg) in 0.3 ml of phosphate-buffered saline (PBS) was administrated into the lung intratracheally via a tracheal tube. In group B, the same dose of bleomycin was administrated into the lung intrabronchially via a bronchial catheter, targeting the left lung. RESULTS: Gross examination revealed that targeted administration was 100% successful. Methylene blue was observed in the right lung of all rats in the R group and in the left lung of all rats in the L group. The survival rate was higher in group B than in group T. CONCLUSIONS: The intrabronchial method offers an advantage over tracheal administration as it decreases mortality and allows the administration of a drug unilaterally into a single lung or into a localized area without the need for double-lumen tubes or more invasive procedures.
Animals ; Bleomycin ; Catheters ; Drug Administration Routes ; Imidazoles ; Lung ; Methylene Blue ; Nitro Compounds ; Rats ; Survival Rate

Methemoglobinemia is a condition in which the iron portion of hemoglobin, which binds to oxygen, is oxidized to produce methemoglobin, which increases blood concentration. There are many causes of methemoglobinemia, the most common being food, drugs, and chemicals. A 75-year-old male patient who had taken an herbicide did not notice any nonspecific symptoms. However, after 4 hours, his methemoglobin levels increased to 17.1%, while after 7 hours it increased to 26.5%, at which time intravenous administration of methylene blue 1 mg/kg (an antidote) was started. After a total of five doses of methylene blue at 1 mg/kg due to reactive methemoglobinemia for about 36 hours, the methemoglobin levels increased to 23.7%. Because no more methylene blue could be administered, 10 g of ascorbic acid (vitamin C) was administered intravenously. After 82 hours, ascorbic acid 10 g was administered six times for repeated reactive methemoglobinemia. No additional reactive methemoglobinemia was observed. The ventilator and endotracheal tube were successfully removed on day 5 after admission.
Administration, Intravenous ; Aged ; Ascorbic Acid* ; Humans ; Iron ; Male ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Oxygen ; Poisoning* ; Ventilators, Mechanical ; Vitamins*

PURPOSE: Canine rabies is a serious health problem in Morocco and about 22 human deaths are reported yearly. Following the World Health Organization (WHO) recommendations, Moroccan authorities evaluated oral rabies vaccine baits specially designed for dogs. MATERIALS AND METHODS: The study was performed in Tiflet area. The vaccine strain was SAG2, a modified live oral rabies vaccine strain. Each bait contained an aluminium/PVC capsule filled with a liquid. Two kinds of baits were used: placebo baits containing methylene blue as a topical marker and vaccine baits containing vaccine suspension. The study was performed according to recommended WHO strategies, i.e., door to door model (DDDM), hand-out and wildlife immunization model (WIM). The DDDM was performed in the rural area of Tiflet on 60 owned dogs. The hand-out strategy was tested on 15 stray dogs. The WIM was performed on 4 transects lines near Tiflet slaughterhouse and near the weekly traditional market location. RESULTS: Using the DDDM, 100% of owned dogs were attracted by the baits and 77% ate the bait. Using the hand-out model, 100% of dogs showed interest in baits and 46.7% took the baits. Using the WIM in stray dogs, up to 73% of baits disappeared and 68% of the capsules containing the SAG2 vaccine were found pierced, depending on the sites of distribution. CONCLUSION: This pilot study showed that baits have a good palatability and that oral vaccination of both owned and stray dogs is feasible with baits specifically developed for dogs and with adapted strategy of distribution.
Abattoirs ; Administration, Oral ; Animals ; Capsules ; Dogs* ; Humans ; Immunization ; Methylene Blue ; Morocco* ; Pilot Projects ; Rabies Vaccines ; Rabies* ; Vaccination* ; World Health Organization

Sodium nitrite is commercially used as a coloring agent, food preservative, and corrosion inhibitor. Accidental poisoning with sodium nitrite from contaminated food and water causes gastrointestinal irritation, vasodilatation, and methemoglobinemia with subsequent tissue hypoxia. We describe an outbreak case of sodium nitrite-induced methemoglobinemia following the ingestion of noodles contaminated with industrial antifreeze. The eEight patients involved initially complained that their noodles tasted 'unpleasant' and soon afterwards experienced nausea, vomiting, dizziness, and fatigue. Some of them noted cyanosis on their lips and fingers. Subsequent investigations demonstrated a high methemoglobin concentration which was corrected by the intravenous administration of methylene blue three hours after the onset of symptoms. The patients made a prompt, uncomplicated recovery and were discharged home 4 four days later. Industrial antifreeze contains sodium nitrite and calcium nitrite. Because an accidental poisoning of industrial antifreeze causes fatal methemoglobinemia, emergency physicians should promptly identify its symptoms and institute treatment with methylene blue promptly. In addition, industrial agencies must caution construction businesses against such contamination events.
Administration, Intravenous ; Anoxia ; Calcium ; Commerce ; Corrosion ; Cyanosis ; Dizziness ; Eating ; Emergencies ; Fatigue ; Fingers ; Humans ; Lip ; Methemoglobin ; Methemoglobinemia ; Methylene Blue ; Nausea ; Sodium ; Sodium Nitrite ; Vasodilation ; Vomiting

OBJECTIVETo explore the effect of arterial infusion with methylene blue during total mesorectal excision (TME) for better preservation of pelvic autonomic nerve on urination function and sexual function in male patients with rectal cancer.

METHODSA total of 68 male rectal cancer patients from Zhejiang Xiaoxing People's Hospital and 44 male rectal cancer patients from Guangdong Zhongshan Chenxinghai Hospital between June 2013 and June 2015 were prospectively enrolled. Patients were randomly divided into the trial group receiving arterial infusion with 8 ml of 1% methylene blue and the control group without artery infusion, with 56 cases in each group. All the patients underwent TME. Intra-operational lymph node removal and postoperative urination and sexual function (erection and ejaculation) were compared between two groups.

RESULTSThe baseline data of the two groups were not significantly different (all P>0.05). As compared to the control group, the trial group had shorter operation time [(3.28±0.63) hours vs. (4.01±0.94) hours, P<0.01], less blood loss[(92.5±36.4) ml vs. (174.1±61.4) ml, P<0.01], and more lymph nodes harvested per patient (15.8±7.6 vs. 11.9±4.3, P<0.01). One year after operation, classI(, II(, III(, IIII( of urination was observed in 33 cases (58.9%), 15 cases (26.8%), 6 cases (10.7%), 2 cases (3.6%) in the trial group, while 24 (42.9%), 15 (26.8%), 12 (21.4%), 5 (8.9%) in the control group, which indicated that trial group was superior to control group(P<0.05). ClassI(, II(, III( of erection was observed in 36 cases (64.3%), 18 cases (32.1%), 2 cases(3.6%) in the trial group, while 25(44.6%), 23(41.1%), 8(14.3%) in the control group, which indicated that trial group was superior to the control group (P<0.05). ClassI(, II(, III( of ejaculation was found in 36 cases (62.5%), 18 cases (32.1%), 3 cases (5.4%) in the trial group, while 24 (42.9%), 22 (39.3%), 10(17.9%) in the control group, which also indicated that trial group was superior to the control group(P<0.05).

CONCLUSIONSIn the treatment of male rectal cancer patients, TME combined with arterial infusion with methylene blue can facilitate the distinction of operation scope, which is beneficial to reduce damages to the pelvic nerve, leading to the protection of urinary function and sexual function. In addition, this procedure can result in shorter operation time, less operational blood loss and more lymph nodes harvested.

Digestive System Surgical Procedures ; Humans ; Infusions, Intra-Arterial ; Lymph Node Excision ; Male ; Methylene Blue ; administration & dosage ; Postoperative Period ; Rectal Neoplasms ; surgery ; Rectum ; surgery ; Urination

The aim of this review is to introduce about the issue of benzocaine and methemoglobinemia. Through blocking the pain during dental treatment, fear and anxiety of patients will be reduced. Thus, anesthetic agent containing benzocaine is commonly used while controlling the pain of patients during treatment. However, on May 28, 2018, the Ministry of Food and Drug Safety reported a medication safety report about restricting the use of benzocaine-containing agents in infants under 24 months and children. Also, they recommended a cautious use to adolescents and adults to prevent methemoglobinemia (MHb). This report was published due to an advice from Food and Drug Administration (FDA) on May 23, 2018. When using agents containing benzocaine, dentists must consider the probability of MHb and prepare for early diagnosis and appropriate action. Since 1930s, methylene blue is known to cure MHb patients. Therefore, the proper use of methylene blue for emergencies and diagnosis methods for early diagnosis of MHb should be familiar to dentists planning for the use of topical anesthetic agents. Dentists should be trained for emergency situation of MHb caused by the use of benzocaine.
Adolescent ; Adult ; Anesthetics ; Anxiety ; Benzocaine ; Child ; Dentists ; Diagnosis ; Early Diagnosis ; Emergencies ; Humans ; Infant ; Methemoglobinemia ; Methylene Blue ; United States Food and Drug Administration

OBJECTIVETo evaluate the clinical efficacy of intradermal injection of methylene blue for treatment of moderate to severe acute thoracic herpes zoster and prevention of postherpetica neuralgia in elderly patients.

METHODSSixty-four elderly patients with herpes zoster were randomized to receive a 10-day course of intradermal injection of methylene blue and lidocaine plus oral valaciclovir (group A, 32 cases) and intradermal injection of lidocaine plus oral valaciclovir (group B).Herpes evaluation index, pain rating index, incidence of postherpetic neuralgia, and comprehensive therapeutic effect were compared between the two groups at 11, 30 and 60 days after the treatment.

RESULTSThe baseline characteristics were comparable between the two groups (all P>0.05). Compared with that in group B, the time for no new blister formation, blister incrustation and decrustation, and pain relief was significantly shortened in group A (P<0.05) with also obviously lower pain intensity after the treatment. The incidence of postherpetic neuralgia was significantly lower in group A than in group B at 30 days (P<0.05), but not at 60 and 90 days after the treatment. The total clinical response rate was 93.8% in group A, much higher than that in group B (62.5%, P<0.05).

CONCLUSIONIntradermal injection of methylene blue can effectively shorten the disease course, reduce the pain intensity and prevent the development of postherpetic neuralgia in elderly patients with herpes zoster.

Acyclovir ; administration & dosage ; analogs & derivatives ; therapeutic use ; Aged ; Herpes Zoster ; complications ; Humans ; Incidence ; Injections, Intradermal ; Lidocaine ; administration & dosage ; therapeutic use ; Methylene Blue ; administration & dosage ; therapeutic use ; Neuralgia, Postherpetic ; therapy ; Pain Measurement ; Valine ; administration & dosage ; analogs & derivatives ; therapeutic use

Preoperative localization is necessary prior to video assisted thoracoscopic surgery for the detection of small or deeply located lung nodules. We compared the localization ability of a mixture of lipiodol and methylene blue (MLM) (0.6 mL, 1:5) to methylene blue (0.5 mL) in rabbit lungs. CT-guided percutaneous injections were performed in 21 subjects with MLM and methylene blue. We measured the extent of staining on freshly excised lung and evaluated the subjective localization ability with 4 point scales at 6 and 24 hr after injections. For MLM, radio-opacity was evaluated on the fluoroscopy. We considered score 2 (acceptable) or 3 (excellent) as appropriate for localization. The staining extent of MLM was significantly smaller than methylene blue (0.6 vs 1.0 cm, P<0.001). MLM showed superior staining ability over methylene blue (2.8 vs 2.2, P=0.010). Excellent staining was achieved in 17 subjects (81%) with MLM and 8 (38%) with methylene blue (P=0.011). An acceptable or excellent radio-opacity of MLM was found in 13 subjects (62%). An appropriate localization rate of MLM was 100% with the use of the directly visible ability and radio-opacity of MLM. MLM provides a superior pulmonary localization ability over methylene blue.
Animals ; Ethiodized Oil/*administration & dosage ; Fluoroscopy ; Injections, Subcutaneous ; Lung/*radiography/surgery ; Methylene Blue/*administration & dosage ; Preoperative Care ; Rabbits ; Solitary Pulmonary Nodule/*surgery ; Staining and Labeling/methods ; Thoracic Surgery, Video-Assisted/*methods ; Thoracoscopy/methods ; Tomography, X-Ray Computed

Drugs that lack the ability to cross the blood-brain barrier (BBB) need to be placed directly into the central nervous system. Our laboratory studies the involvement of the glutamatergic system in the aggressiveness of glioma, and some ligands of glutamate receptors cannot permeate the BBB. Here, glioma-implanted rats were treated by a technique that delivers ligands directly into the cerebrospinal fluid by puncture into the cisterna cerebellomedullaris. Rats were anesthetized and fixed in a rodent stereotactic device. The head was gently tilted downwards at an angle that allowed exposure of the cisterna. Injection into the cisterna was done freehand using a gingival needle coupled to a microsyringe. The efficiency of intracisternal injection was demonstrated using a methylene blue solution. This type of injection is adaptable for any rodent model using small volumes of a variety of other drugs, and is an interesting method for neuroscience studies.
Anesthesia ; Animals ; Central Nervous System Agents ; administration & dosage ; Cerebrospinal Fluid ; Cisterna Magna ; Contrast Media ; Excitatory Amino Acid Agents ; administration & dosage ; Glioma ; drug therapy ; Methylene Blue ; Models, Animal ; Rats, Wistar

PURPOSE: Methemoglobinemia has been observed during a diarrheal illness among those who were not exposed to oxidizing agents in neonates and young infants. We performed the study to determine predisposing factors in this entity. METHODS: The medical records of 24 patients were reviewed, who were admitted for diarrhea with methemoglobinemia to Ewha Womans University MokDong Hospital, from February 1994 to November 2000. The concentration of methemoglobin was measured by CO-oximeter(ABL520(R) , Radiometer, Sweden). RESULTS: All the patients were before 2 months of age, had poor weight gain and dehydration associated with diarrhea. One patient was a breast feeding infant, 20 were bottle feeding, and 3 were mixed feeding. The seasonal variation in the incidence of the disease was indistinct but more cases were found during the winter months. We observed cyanotic skin discoloration in 21 patients, vomiting in 13, lethargy in 13, fever in 9, decreased urine output in 8, tachypnea in 4, and irritability in 2. The mean concentration of methemoglobin was 19.8+/-14.6%(range 3.8-65.0%) on admisssion. The severity of methemoglobinemia was significantly correlated with blood WBC (r=0.506, P=0.012), arterial blood pH(r=-0.600, P=0.002), total CO2 concentration(r=-0.456, P=0.025) and base excess(r=-0.429, P=0.036). The underlying diseases were milk allergy(8 patients), sepsis (2), urinary tract infection(1), salmonellosis(1), viral meningitis(1) and unknown(11). The majority of patients were treated conservatively and 9 patients(37.5%) were treated with intravenous administration of methylene blue. CONCLUSION: This study suggested that diarrhea, acidosis, infection and dehydration may be certain predisposing roles for developing methemoglobinemia in neonates and young infants. We should consider checking methemoglobin concentration in patients with diarrhea and cyanosis.
Acidosis ; Administration, Intravenous ; Bottle Feeding ; Breast Feeding ; Causality ; Cyanosis ; Dehydration ; Diarrhea ; Female ; Fever ; Humans ; Incidence ; Infant ; Infant, Newborn ; Lethargy ; Medical Records ; Methemoglobin ; Methemoglobinemia* ; Methylene Blue ; Milk ; Oxidants ; Seasons ; Sepsis ; Skin ; Tachypnea ; Urinary Tract ; Vomiting ; Weight Gain