Humans ; Hydrogen Sulfide ; poisoning ; Male ; Methylene Blue ; therapeutic use ; Poisoning ; therapy ; Young Adult

OBJECTIVETo study the effect of methylene blue combined with aprotinin on intraperitoneal adhesion.

METHODSFrom May 2000 to February 2004, there were 83 patients receiving total or partial colectomy and temporary ileostomy or colostomy, and second anastomosis was performed within 8-12 weeks after the first operation. These patients were divided into four groups and followed by intraperitoneal administration of saline,methylene blue,aprotinin,combined methylene blue and aprotinin respectively during the second operation, then adhesion formation was quantitatively graded.

RESULTSThe adhesion rate was 15% in combination group, 83% in saline group, 40% in methylene blue group, and 45% in aprotinin group, respectively. The adhesion rate was significantly lower in combination group(P< 0.05).

CONCLUSIONSMethylene blue and aprotinin can decrease the incidence of intraperitoneal adhesion significantly. The combination of these two drugs has significant effectiveness in the treatment of intraperitoneal adhesion.

Aprotinin ; therapeutic use ; Drug Therapy, Combination ; Female ; Humans ; Methylene Blue ; therapeutic use ; Peritoneal Diseases ; pathology ; prevention & control ; Postoperative Complications ; prevention & control ; Tissue Adhesions ; prevention & control

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

Methemoglobin (MetHb) is an oxidation product of hemoglobin in which the sixth coordination position of ferric iron is bound to a water molecule or to a hydroxyl group. The most common cause of acquired MetHb-emia is accidental poisoning which usually is the result of ingestion of water containing nitrates or food containing nitrite, and sometimes the inhalation or ingestion of butyl or amyl nitrite used as an aphrodisiac. We herein report a case of MetHb-emia after ingestion of an aphrodisiac, later identified as dapsone by gas chromatograph/mass selective detector (GC/MSD). A 24-year old male was admitted due to cyanosis after ingestion of a drug purchased as an aphrodisiac. On arterial blood gas analysis, pH was 7.32, PaCO2 26.8 mmHg, PaO2 75.6 mmHg, and bicarbonate 13.9 mmol/L. Initial pulse oxymetry was 89%. With 3 liter of nasal oxygen supplement, oxygen saturation was increased to 90-92%, but cyanosis did not disappear. Despite continuous supplement of oxygen, cyanosis was not improved. On the fifth hospital day, MetHb was 24.9%. Methylene blue was administered (2 mg/kg intravenously) and the patient rapidly improved. We proved the composition of aphrodisiac as dapsone by the method of GC/MSD.
Administration, Oral ; Adult ; Antidotes/therapeutic use ; Aphrodisiacs/adverse effects* ; Case Report ; Cyanosis/drug therapy ; Cyanosis/chemically induced ; Cyanosis/blood ; Dapsone/adverse effects* ; Human ; Male ; Methemoglobinemia/drug therapy ; Methemoglobinemia/chemically induced* ; Methylene Blue/therapeutic use

BACKGROUND: Endogenous nitric oxide (NO) induces the peripheral vasodilation via the activation of guanylate cyclase in patients with septic shock. The purpose of this study was to assess the acute effects of methylene blue (MB), which is an inhibitor of guanylate cyclase, on the hemodynamics and on the production of pro-inflammatory cytokines and nitric oxide (NO) in patients with refractory septic shock. METHODS: Twenty consecutive patients with refractory septic shock, which was defined as shock refractory to a dopamine infusion of more than 20 microgram/kg/min with the appropriate use of antibiotics and adequate volume replacement, received MB infusion of 1 mg/kg intravenously. The hemodynamic and respiratory variables were measured at baseline, 30, 60 and 120 min after an infusion of MB (1 mg/kg). The blood levels of NO, IL-1, IL-10 and TNF-alpha were measured at baseline, 30 and 120 min after MB infusion. RESULTS: The administration of MB induced an increase in the systemic vascular resistance (SVR) that resulted in an increase of the mean arterial pressure (MAP) in patients with refractory septic shock, and this was without a decrease in cardiac output. The administered MB induced an increase in pulmonary vascular resistance (PVR) that resulted in an increase of pulmonary arterial pressure (PAP), without any deterioration of gas exchange. However, the increases in SVR and PVR were not associated with the alteration of endogenous production of NO, IL-1, IL-10 and TNF-alpha. CONCLUSION: MB transiently elevated the MAP by increasing the SVR without altering the endogenous productions of NO, IL-1, IL-10 and TNF-alpha during the study period in patients with refractory septic shock.
Anti-Infective Agents, Urinary/administration & dosage/*therapeutic use ; Blood Pressure/*drug effects/physiology ; Comparative Study ; Cytokines/*blood ; Enzyme-Linked Immunosorbent Assay ; Female ; Humans ; Infusions, Intravenous ; Male ; Methylene Blue/administration & dosage/*therapeutic use ; Middle Aged ; Pulmonary Circulation/drug effects/physiology ; Research Support, Non-U.S. Gov't ; Retrospective Studies ; Shock, Septic/blood/*drug therapy/physiopathology ; Treatment Outcome ; Vascular Resistance/*drug effects/physiology

Acute generalized exanthematous pustulosis is a rare severe pustular cutaneous adverse reaction characterized by a rapid clinical course with typical histological findings. It is accompanied by fever and acute eruption of non-follicular pustules overlying erythrodermic skin. The causative agents are most frequently antibacterial drugs. We present a patient with acute generalized exanthematous pustulosis caused by methylene blue and indigotin dyes.
Acute Generalized Exanthematous Pustulosis/*chemically induced/drug therapy/pathology ; Administration, Oral ; Adrenal Cortex Hormones/therapeutic use ; Aged ; Biopsy ; Coloring Agents/administration & dosage/*adverse effects ; Humans ; Indoles/administration & dosage/*adverse effects ; Intradermal Tests ; Male ; Methylene Blue/administration & dosage/*adverse effects ; Skin/*drug effects/pathology ; Treatment Outcome

OBJECTIVETo evaluate the effects of methylene blue (MB) on refractory hemorrhagic shock.

METHODSTotally 24 rabbits subjected to prolonged hemorrhagic shock and resuscitation were randomly divided into hemorrhagic shock group (12 rabbits) and MB group (12 rabbits; MB was administered immediately after resuscitation was performed). The plasma levels of tumor necrosis factor alpha (TNFalpha) , interleukin (IL)-6, IL-8, nitric oxide (NO), lactic acid (LA) , and mean arterial pressure (MAP) were detected before shock, immediately after resuscitation, and 0.5, 2, and 4 hours after resuscitation. The 12-hour survival rates were observed.

RESULTSThe plasma levels of TNFalpha, IL-6, IL-8, NO and LA after shock were significantly higher than before shock (P <0.01), and maintained at high levels. Compared with the shock group, higher MAP and lower plasma levels of TNFalpha, IL-6, IL-8, NO, and LA were observed in the MB group after resuscitation (P<0.01). The 12-hour survival rates were not significantly different between shock group and MB group.

CONCLUSIONAlthough MB can not improve the prognosis of refractory hemorrhagic shock, it can increase and maintain the MAP and thus play a beneficial role in the treatment of hemorrhagic shock.

Animals ; Blood Pressure ; drug effects ; Disease Models, Animal ; Female ; Interleukin-6 ; blood ; Interleukin-8 ; blood ; Lactic Acid ; blood ; Male ; Methylene Blue ; therapeutic use ; Nitric Oxide ; blood ; Rabbits ; Random Allocation ; Shock, Hemorrhagic ; blood ; drug therapy ; mortality ; Survival Rate ; Tumor Necrosis Factor-alpha ; blood