Objective: To determine the diagnostic accuracy of transvaginal ultrasound and saline infusion sonography in the evaluation of postmenopausal bleeding. Setting: Philippine General Hospital Design: Cross-sectional study. Transvaginal sonography and saline infusion sonography were performed and findings correlated with histopathologic results obtained by hysteroscopy or endometrial biopsy. Results: At a 95 percent confidence interval, the sensitivity of TVS was higher than SIS (92.9 percent), the specificity of SIS was greater than TVS (50 percent vs 0). The positive predictive value and negative predictive of SIS (91.7 percent, 50 percent) were both greater than that obtained by TVS (86.7 percent, 0). Comparing these two proportions, there was no sufficient evidence to say that there exists a significant difference. Conclusion: Transvaginal sonography and saline infusion sonography are invaluable tools in the evaluation of postmenopausal bleeding.
HEMORRHAGE ; ULTRASONOGRAPHY ; SALINE SOLUTION, HYPERTONIC

The effects of subconjunctivally injected normal saline and hypertonic saline solution on the choroidal blood flow in albino rabbits were investigated. By the injection of 0.9% saline solution, no significant changes in the choroidal blood flow took place. Subconjunctival injection of 3% saline solution produced increase in the blood flow which continued for 30 minutes. The average increase was 22%. Hot dry compress by infra-red lamp for 10 minutes increased also the blood flow by 41 % which lasted for 20 minutes after cessation of hot compress.
Choroid ; Rabbits ; Saline Solution, Hypertonic* ; Sodium Chloride

A gastric intramural hematoma is very rare and commonly associated with trauma, anticoagulation therapy, coagulopathy, pancreatic disease, aneurysm and peptic ulcer disease. This is a case of gastric intramural hematoma which occurred in a patient taking aspirin after hypertonic saline-epinephrine injection for bleeding from a biopsy site. We describe a case of gastric intramural hematoma that was successfully managed with conservative therapy.
Aneurysm ; Aspirin ; Biopsy ; Epinephrine ; Hematoma* ; Hemorrhage ; Hemostasis* ; Humans ; Pancreatic Diseases ; Peptic Ulcer ; Saline Solution, Hypertonic

PURPOSE: To report a case of toxic corneal reaction induced by accidentally infused distilled water into the anterior chamber during cataract operation. METHODS: 67-year-old female patient was admitted due to corneal edema and opacity which had been developed instantly by distilled water infused into anterior chamber during cataract operation at a private eye clinic. Cataract surgery was performed after 1 week, and the patient was treated with 5% NaCl solution and artificial eyedrop. RESULTS: On the sixth month after operation, the corneal edema and opacity were decreased remarkably. CONCLUSIONS: When acute corneal edema is developed during cataract operation, the surgeon should stop the procedure and examine all intraocular solutions and irrigation fluids. The prognosis must be estimated after use of hypertonic saline solution at least 6 months.
Aged ; Anterior Chamber ; Cataract* ; Corneal Edema ; Female ; Humans ; Prognosis ; Saline Solution, Hypertonic ; Water*

BACKGROUND AND OBJECTIVES: Nasal or sinus irrigation is the traditional treatment for chronic paranasal sinusitis and is the one of the most important postoperative care for those who have undergone functional endoscopic sinus surgery (FESS). However the bases of any scientific evidence to determine efficacy of different concentrations of saline are lacking. The objective of this clinical study was to determine if nasal mucociliary clearance (NMC) in vivo was improved significantly by the use of differently concentrated buffered saline nasal irrigations. MATERIALS AND METHODS: The acute effect of NMC was measured using saccharin test in 20 volunteers without any significant sinonasal disease on four separate days, involving single administration of each of the followings: 1) atomized 0.65% saline; 2) atomized 0.9% saline; 3) atomized 3% saline; 4) atomized 7% saline. Normal subjects served as their own control using a saccharin test before any nasal irrigation was used, and then used one of four different concentrated saline solutions to irrigate their nose. Comparison of the change of NMC at different concentations was performed by using Wilcoxon signed rank test. RESULTS: When compared to each control, the buffered 3% hypertonic saline improved mucociliary transit time of saccharin (p<0.05), whereas other concentrations of buffered saline had no such effect. CONCLUSION: We concluded that this hypertonic saline should be useful as nasal irrigation solution on medical and postoperative care of chronic paranasal sinusitis.
Mucociliary Clearance* ; Nasal Lavage* ; Nose ; Postoperative Care ; Saccharin ; Saline Solution, Hypertonic* ; Sinusitis ; Volunteers

OBJECTIVETo compare the effects of 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden for treatment of intracranial hypertension in patients with severe traumatic brain injury.

METHODSWe used an alternating treatment protocol to compare the effects of hypertonic saline with that of mannitol given for episodes of increased intracranial pressure (ICP) in patients with severe brain injury. Standard guidelines for the management of severe traumatic brain injury were followed. For episodes of increased ICP, 20% mannitol (2 ml/kg, infused for over 20 min) and 15% saline (0.42 ml/kg, administered as a bolus via a central venous catheter) of similar osmotic burden were given alternately, with the choice of agent for the initial hypertensive event determined on a randomized basis. Reduction of ICP and duration of the action were recorded after each event.

RESULTSThe data were collected from 33 patients with 237 hypertensive events. The mean decrease in ICP was 8.7 mm Hg at 28.7∓9.3 min after mannitol treatment as compared with 9.3 mm Hg at 23.6∓7.1 min after treatment with hypertonic saline (P>0.05). The mean duration of the effect was 270 min for mannitol and 318 min for hypertonic saline (P>0.05).

CONCLUSIONSTreatment with 15% hypertonic saline and 20% mannitol in doses of similar osmotic burden produces similar effects in management of increased ICP in patients with severe traumatic brain injury in terms of the time of action onset, maximum ICP reduction, and duration of action.

Local inflammatory reaction and microcirculation disturbance are the early manifestations of acute pancreatitis (AP). Studies have shown that early and reasonable fluid resuscitation of patients with AP can reduce related complications and prevent the deterioration to severe acute pancreatitis (SAP). Traditional isotonic crystalloid (such as Ringer solution) is considered to be a safe and reliable resuscitation solution, but too much and too fast infusion in the early stage of shock will increase the risk of complications such as tissue edema and abdominal compartment syndrome (ACS). Many scholars have found that hypertonic saline resuscitation solution has the advantages of reducing tissue and organ edema, rapidly restoring hemodynamics, inhibiting oxidative stress and inflammatory signal transduction, thereby improving the prognosis of AP patients and reducing the incidence of SAP and mortality. This article summarizes the mechanisms of hypertonic saline in the resuscitation treatment of AP patients in recent years, in order to provide reference for the clinical application and research of AP patients.
Humans ; Pancreatitis ; Acute Disease ; Resuscitation ; Inflammation ; Crystalloid Solutions ; Saline Solution, Hypertonic

BACKGROUND AND OBJECTIVES: Osmolarity is known to affect ciliary beat frequency (CBF) ; however, little is known about the effects of saline spray or irrigation on ciliary activity in human nasal epithelium. The aim of this study was to assess whether CBF is affected by hypertonic, isotonic or hypotonic saline solution in vitro and whether histologic changes are associated with the alteration of ciliary movement. MATERIALS AND METHODS: Normal turbinate mucosa was exposed to five different concentrations including 0.06%, 0.12%, 0.9%, 3.0%, and 7.0% of phosphate-buffered saline solutions. CBF was measured up to 60 minutes after exposure to each concentration of saline solution and histologic changes were examined by transmission electron microscopy. RESULTS: Isotonic and hypotonic saline solutions produced no ciliary slowing ; however, ciliostasis was observed within a few minutes in 3.0% or 7.0% saline solution. Immediately after complete ciliostasis in the hypertonic solutions, the solutions were replaced with 0.12% or 0.9% saline solution in order to observe the reversibility of CBF. Only 0.12% hypotonic saline induced the recovery of ciliary movement. The ultrastructural changes demonstrated that the ciliary slowing might be attributed to epithelial damage by fluid transport toward the surrounding medium. CONCLUSION: Our results suggest that isotonic and hypotonic saline solutions may be more appropriate for nasal irrigation than hypertonic saline solutions.
Humans* ; Hypertonic Solutions ; Microscopy, Electron, Transmission ; Mucous Membrane ; Nasal Lavage ; Nasal Mucosa* ; Osmolar Concentration ; Saline Solution, Hypertonic ; Sodium Chloride* ; Turbinates

Cyclophosphamide is commonly used in the treatment of malignant diseases. Symptomatic severe hyponatremia induced by low-dose cyclophosphamide is very uncommon worldwide. Recently we experienced a case of a 56-year-old woman with breast cancer who developed severe hyponatremia with generalized seizure after the first cycle of adjuvant chemotherapy with doxorubicin and cyclophosphamide. Her laboratory test showed a serum sodium of 116 mmol/L. Her hyponatremia was initially treated with hypertonic saline solution and furosemide. She completely recovered without neurological deficits after slow correction of the serum sodium concentration over two days. Clinicians must always keep in mind that life-threatening acute hyponatremia can be induced by intravenous cyclophosphamide during chemotherapy, even if the dosage is low.
Breast ; Breast Neoplasms ; Chemotherapy, Adjuvant ; Cyclophosphamide ; Doxorubicin ; Female ; Furosemide ; Humans ; Hyponatremia ; Middle Aged ; Saline Solution, Hypertonic ; Seizures ; Sodium

BACKGROUND: Mycobacterial identification in active pulmonary tuberculosis (APTB) is confirmative, even though successful rates using self-expectorated sputum are limited. Sputum specimens collected by hypertonic saline nebulization showed higher bacteriologic diagnostic sensitivities over those of self-expectoration, mostly studied in smear-negative or sputum-scarce patients. The efficacy of induced sputum was rarely assessed in real clinical settings. METHODS: A prospective randomized case-control study was performed in one hospital. The subjects highly suspicious of APTB were asked to provide 3 pairs of sputum specimens in 3 consecutive days. The first pairs of the specimens were obtained either by self-expectoration (ES) from the next day of the visit or sputum induction with 7% saline nebulization in clinic (SI), and the other specimens were collected in the same way. The samples were tested in microscopy, culture, and polymerase chain reaction (PCR). The outcomes of the bacteriological diagnosis were compared. RESULTS: Seventy six patients were assigned to either ES (38 subjects, median age of 51, 65.8% male) or SI (38 subjects, median age of 55, 52.6% male). APTB was clinically confirmed in 51 patients (70.8%), 27 in ES and 24 in SI. Among the APTB, more adequate specimens were collected from SI (41/65, 63.1%) than ES (34/80, 42.5%) (p=0.01). Bacteriological confirmation was achieved in 14 (58.3%) patients in SI, and 13 (48.1%) in ES (p=0.46). In the same-day bacteriological diagnosis with microscopy and PCR, there were positive results for 9 patients (37.5%) in SI and 7 patients (25.9%) in ES (p=0.37). CONCLUSION: Sputum induction improves sputum specimen adequacy. It may be useful for the same-day bacteriological diagnosis with microscopic examination and PCR.
Case-Control Studies ; Diagnosis ; Humans ; Microscopy ; Polymerase Chain Reaction ; Prospective Studies ; Saline Solution, Hypertonic ; Sputum* ; Tuberculosis, Pulmonary*