PURPOSE: We wanted to evaluate the clinical efficacy of an increased computed tomography attenuation coefficient (CTAC) of urine after the oral administration of iohexol in neonates who are suspected of suffering with neonatal necrotizing enterocolitis (NEC). MATERIALS AND METHODS: During a recent 1 year-period, seventeen neonates were admitted for suspected NEC, and they were divided into the suspected and definite groups based on their clinical signs and radiographic findings; we also included ten normal neonates as the control group. Diluted iohexol was administered and the CTACs of collected urine samples at 8-12 hour intervals were measured. Comparative analysis of the three groups was done and statistical significance was determined by the Scheffe test. RESULTS: Among 17 neonates, there were 13 neonates in the suspect group and 4 neonates in the definite group. The mean CTACs of urine in each group were 2711 HU (control group), 3411 HU (suspected group), and 7625 HU (definite group), respectively. There was a significant difference between the mean CTAC of the definite group and that of the control or suspected groups (Scheffe t >2.65). However, no statistically significant difference was seen between the suspected and control groups (Scheffe t=1.14). CONCLUSION: Although measurements of the CTAC of urine showed no significant diagnostic efficacy in the suspected group, the CTAC of urine, which reflects the correlated degree of bowel mucosal injury, can be a useful aid for determining the severity and progression of NEC.
Administration, Oral ; Colitis ; Enterocolitis, Necrotizing ; Humans ; Infant, Newborn* ; Iohexol ; Water*

With the development of natural products, the research activities on the solubilization methods of water-insoluble natural products have been carried out worldwide. Big molecular weight and poor solubility of most natural active ingredients lead to a very poor oral absorption and low bioavailability, which has extremely limited their development in pharmaceutical fields and clinical application. As a result, it is necessary to find out a suitable technique to improve the solubility and enhance the oral bioavailability of insoluble natural drugs. Based on the related references published in these years, this review introduced some new techniques to improve the solubility and bioavailability of natural drugs, including prodrugs, inclusion complex, solid dispersion, cocrystals, osmotic pump, liquisolid compacts, micronization, self-microemulsifying, nanosuspensions, lipsomes, polymeric micelles and so on, and summarized the theory, characteristics, application range, application examples, problems and development direction of each technique.
Administration, Oral ; Biological Availability ; Biological Products ; administration & dosage ; chemistry ; pharmacokinetics ; Chemistry, Pharmaceutical ; methods ; trends ; Solubility ; Technology, Pharmaceutical ; methods ; trends ; Water

OBJECTIVES: To evaluate the effects on the formation of benzidine-hemoglobin, and benzidine metabolite-hemoglobin adducts, caused by pretreatment with the known xenobiotic metabolism effectors, ethanol and phenobarbital, in rats administered Direct Black 38 dye. METHODS: The experimental rats were divided into three groups: a control group, an ethanol group and a phenobarbital group. Rats were pretreated with ethanol (1g/kg) or phenobarbital (80mg/kg) 24 hours prior to the oral administration of Direct Black 38 (0.5mmol/kg), with the control group being administered the same amount of distilled water. Blood samples were obtained from the vena cava of 5 rats from each group prior to, and at 30 min, 3 h, 6 h, 9 h, 12 h, 24 h, 48 h, 72 h, 96 h, and 144 h following the oral administration of Direct Black 38. Directly after sampling the blood was separated into hemoglobin and plasma, with the adducts being converted into aromatic amines by basic hydrolysis. Hydrolyzed benzidiene, monoacetylbenzidine and 4-aminobiphenyl were analyzed by reverse-phase liquid chromatography with an electrochemical detector. The quantitative amount of the metabolites was expressed by the hemoglobin binding index (HBI). RESULTS: In the ethanol group, benzidine-, monoacetylben-zidine-, and 4-aminobiphenyl-HBI were increased to a greater extent than those in the control group. These results were attributed to the ethanol inducing N-hydroxylation, which is related to the formation of the hemoglobin adduct. In the phenobarbital group, all the HBIs, with the exception of the benzidine-HBI, were increased to a greater extent than those of the control group. These results were attributed to the phenobarbital inducing N-hydroxylation related to the formation of the hemoglobin adduct. The N-acetylation ratio was only increased with the phenobarbital pretreatment due to the lower benzidine-HBI of the phenobarbital group compared to those of the control and ethanol groups. The N-acetylation ratios for all groups were higher than 1 for the duration of the experimental period. Although the azo reduction was unaffected by the ethanol, it was inhibited by the phenobarbital. The ratio of the benzidine-HBI in the phenobarbital group was lower than those of the ethanol the control groups for the entire experiment. CONCLUSION: Our results indicate that both ethanol and phenobarbital increase the formation of adducts by the induction of N-hydroxylation, but also induced N-acetylation. Phenobarbital decreased the formation of benzidine-HBI due to the decrease of the azo reduction. These results suggest that the effects of ethanol and phenobarbital need to be considered in the biochemical monitoring of Direct Black 38.
Administration, Oral ; Amines ; Animals ; Chromatography, Reverse-Phase ; Ethanol* ; Hydrolysis ; Metabolism ; Phenobarbital* ; Plasma ; Rats* ; Water

PURPOSE: The efficacy of continuous bladder irrigation with amphotericin B versus oral administration of fluconazole(Diflucan ) was compared in the treatment of patients with candiduria. . MATERIALS AND METHODS: A prospective and comparative study of candiduriawas done on 28 patients(Amphotericin B: 13, Fluconazole: 15). Continuous bladder irrigation with 50mg amphotericin B/iota sterile water infused during 24 hours for 2 days was compared to oral administration of 50-100mg/day fluconazole for a range of 7-14 days. Urine culture were obtained 3days, 7 days after continuous bladder irrigation with amphotericin B and 7 days, 14 days after oral administration of fluconazole. RESULTS: The organism was eradicated in 10 patients(76.9%) who received continuous irrigation of amphotericin B and 11 patients(73.3%) who received oral fluconazole therapy. So, There was no statistically significant difference between continuous bladder irrigation with Amphotericin B group and oral medication of fluconazole group(p>0.05). CONCLUSIONS: There was no difference in the cure rate of candiduria between continuous bladder irrigation with Amphotericin B group and oral medication of fluconazole group. So, patient's condition(Foley catheterization, possibility of ambulation and oral feeding) and convinience will be the important deciding factors to select adequate treatment method of candiduria.
Administration, Oral* ; Amphotericin B* ; Catheterization ; Catheters ; Fluconazole* ; Humans ; Prospective Studies ; Urinary Bladder* ; Walking ; Water

We evaluated the prophylactic efficacy of intravesical irrigation with distilled water immediately after transurethral resection(IUR) of superficial bladder tumor patients. Control group(n=30), with normal saline irrigation immediately after TUR(=15 min.) and continuous intravesical instillation of adriamycin 150mg with 3000ml normal saline for 2 days postoperatively. Distilled water group(n=28), with the same modality as control group, except for distilled water as the irrigation solution. The overall recurrence rates were 35.7% in distilled water group, which were more effective than 60.0% in control group. The 2 yeas tumor free rates by Kaplan-Meier method was higher in distilled water group ( 71.4% ) than control group (46.4% ), respectively with statistical significance. But, the mean time to recurrence were 13.3 months in control group and 14.1 months in distilled water group, without significant differences between two groups. These results support that the reasonable benefits of distilled water for prophylaxis of recurrence in superficial bladder tumor.
Administration, Intravesical ; Doxorubicin ; Humans ; Recurrence ; Urinary Bladder Neoplasms* ; Urinary Bladder* ; Water*

BACKGROUNDHigh fluoride exposure can result in dental fluorosis. Fluoride and iodine are coexistent in the drinking water of areas in China and may affect the prevalence of dental fluorosis and osteogenesis. The aim of this study was to investigate the relationship between serum calciotropic hormone level, and dental fluorisis in children exposed to different concentrations of fluoride and iodine in drinking water.

METHODSA pilot study was conducted in three villages located in the Kaifeng and Tongxu counties of Henan Province, China in 2006. Children aged 8 to 12 years, born and raised in the three villages were recruited. The fluoride levels in the samples of urine from these children were detected by fluoride ion selective electrode. Calcitonin and osteocalcin levels in the serum, and serum calcium were measured by radioimmunassay and flame atomic absorption spectrometry, respectively.

RESULTSFluoride levels in urine were significantly lower in children from control area (CA) as compared with those from the high fluoride & iodine areas (HFIA) and the high fluoride area (HFA) (P < 0.05 respectively), and no statistically significant difference was found between the children from HFIA and HFA. Additionally, calcitonin levels in the serum were significantly lower in children from CA and HFA as compared with that from HFIA (P < 0.05 respectively), and osteocalcin levels in the serum was lower in children from CA than those from HFIA (P < 0.05). No statistically significant difference in serum osteocalcin concentrations was found between children from HFA and HFIA.

CONCLUSIONThis study provides an evidence that iodine exposure may modify the serum calciotropic hormone levels related to fluorine exposure.

Calcitonin ; blood ; Child ; Female ; Fluorides ; administration & dosage ; Fluorosis, Dental ; epidemiology ; Humans ; Iodine ; administration & dosage ; Male ; Osteocalcin ; blood ; Pilot Projects ; Prevalence ; Water Supply ; analysis

Hyponatremia has been recognized as an important postoperative metabolic complication after central nervous system (CNS) operations in children. If not appropriately treated, the postoperative hyponatremia can cause several types of CNS and circulatory disorders such as cerebral edema, increased intracranial pressure. The postoperative hyponatremia after CNS surgery has been considered as one of the underlying causes of the syndrome of inappropriate secretion of antidiuretic hormone (SIADH). In some cases, however, the cerebral salt wasting (CSW) syndrome has been detected. CSW syndrome is far less well-known than SIADH and also different from SIADH in diagnosis and treatment. It causes an increase in urine output and urine sodium after a trauma of CNS and dehydration symptoms. The appropriate treatment of CSW syndrome is opposite the usual treatment of hyponatremia caused by SIADH. The latter is treated with fluid restriction because of the increased level of free water and its dilutional effect causing hyponatremia, whereas the former is treated with fluid and sodium resuscitation because of the unusual loss of high urinary sodium. Early diagnosis and treatment of CSW syndrome after CNS surgery are, therefore, essential. We made a diagnosis of CSW syndrome in two craniosynostosis children manifesting postoperative hyponatremia and supplied them an appropriate amount of water and sodium via intravenous route. The hyponatremia or natricuresis of the children improved and neurologic and circulatory sequelae could be prevented.
Child, Preschool ; Craniosynostoses/*surgery ; Humans ; *Hyponatremia/diagnosis/physiopathology/therapy/urine ; Infant ; Male ; *Postoperative Complications ; *Sodium/administration & dosage/urine ; Syndrome ; Water/administration & dosage

BACKGROUNDLeft ventricular hypertrophy (LVH) is an independent predictor of morbidity and mortality in chronic hemodialysis (CHD) patients. It remains unclear whether efforts to correct fluid overload in young CHD can reverse LVH. This prospective single-center cohort study evaluated left ventricular masses index (LVMI) evolution in fluid overloaded young CHD patients with or without water-sodium control.

METHODSA total of 106 young patients aged between 22 and 44 years on CHD were enrolled in this prospective, control study. Patients were divided into three groups according to the percentage of interdialytic weight gain (PIDWG (%) = 100% × (predialysis weight-dry weight)/dry weight) at baseline. Thirty-six patients with PIDWG more than 5% received health education to restrict water-sodium intake strictly (Group I). Other 36 patients with comparable fluid status levels (the PIDWG more than 5%) did not receive health education to restrict water-sodium intake strictly (Group II) and those with PIDWG less than 5% (Group III, n = 34) were served as controls. Echocardiographic studies were performed to evaluate LVMI at baseline and then after 1, 3 and 6 months. The total follow-up time was 6 months.

RESULTSThere was no significant difference in clinical data (such as age, gender, aetiology of renal failure and nutritional state, etc.) among the three groups at baseline. At baseline, the prevalence of LVH in Group I, II and III was 75.0%, 72.2% and 55.9%, respectively. LVMI was directly correlated with PIDWG (r = 0.779, P < 0.01). After 6 months, the PIDWG in Group I decreased in mean by (3.77 ± 1.09)%, and LVMI decreased in mean by (27.59 ± 12.15) g/m(2). The prevalence of LVH decreased in mean by 25.0%, and the blood pressure decreased in mean by (14.69 ± 11.50) mmHg/ (7.14 ± 7.51) mmHg. The medication category and total medication frequency of hypotensive drugs significantly decreased in Group I at 6 months. However the urine volume and the levels of serum creatinine and serum albumin in Group I were not significantly different compared to the baseline. The level of LVMI in Group II was significantly increased after 6 months compared with the baseline. After 6 months, the level of LVMI in Group III were not significantly different compared with the baseline.

CONCLUSIONSA high prevalence of LVH was present in young CHD patients, and was associated with fluid overload. Reduction fuild overload with water-sodium control can reverse LVH in young CHD patients.

Adult ; Blood Pressure ; Cardiovascular Diseases ; epidemiology ; Cohort Studies ; Female ; Humans ; Hypertrophy, Left Ventricular ; epidemiology ; Male ; Prospective Studies ; Renal Dialysis ; Sodium, Dietary ; administration & dosage ; Water ; administration & dosage ; Young Adult

Rheological properties of poloxamer 407 (brand named Pluronic F127) were examined by changing shear rate, temperature and the recovery properties of apparent viscosity after heating for several times. The results indicated that poloxamer 407 aqueous solution showed a Newtonian behavior at a low concentration while it might be a pseudoplastic fluid when the concentration reached a certain point. The thixotropy and the sol-gel transition temperature decreased with increasing the concentration (it could be an in situ gel at body temperature when the concentration of poloxamer 407 up to 15.25%). The results that obtained from the theological data would be useful in the application of poloxamer 407 such as in situ gel preparation.
Dose-Response Relationship, Drug ; Drug Compounding ; Drug Delivery Systems ; Excipients ; administration & dosage ; chemistry ; Poloxamer ; administration & dosage ; chemistry ; Rheology ; Shear Strength ; Solutions ; Temperature ; Viscosity ; Water

PURPOSE: To report a case of anterior chamber irrigation with distilled water during cataract operation. METHODS: During the cataract operation of 56 year-old male patient, corneal edema and anterior chamber hazziness were noted after anterior chamber irrigation with distilled water for a minute. Distilled water was replaced rapidly balanced salt solution (BSS) as irrigation solution and operation was completed. At postoperative one day, corneal edema and anterior chamber exudative membrane were formed. After topical 5% NaCl, 1% prednisolone treatment, corneal edema and exudative membrane disappeared at postoperative sixth week. BCVA was 0.6. At postoperative ninth week, the patient complained of decreased visual acuity. On fundus exmination and flourescein angiography, cystoid macular edema (CME) was detected. RESULTS: After prednisolone oral administration and diclofenac eyedrop instillation, CME improved. At postoperative 24th month, BCVA was 0.8 and CME disappeared. CONCLUSIONS: From our experience of a case of anterior chamber irrigation with distilled water during cataract operation, if balanced salt solution replaces hypotonic solution rapidly as irrigation solution, corneal and other complications are managed properly, long term visual acuity appears good.
Administration, Oral ; Angiography ; Anterior Chamber* ; Cataract* ; Corneal Edema ; Diclofenac ; Humans ; Macular Edema ; Male ; Membranes ; Middle Aged ; Prednisolone ; Visual Acuity ; Water*