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[Availability of TPD ophthalmic solution (mixture of Mydrin-P solution, Neosynesin Kowa solution, and Diclod solution) in regard to the corneal barrier function--clinical evaluation for vitrectomy in patients with diabetic retinopathy].

PURPOSE: We made TPD ophthalmic solution by combining Tropicamide solution(Mydrin-P: T), Phenylephrine Hydrochloride(Neosynesin Kowa solution: P) and Diclofenac Sodium(Diclod solution: D), and evaluated its efficiency in terms of corneal epithelial damage in patients with diabetic retinopathy. SUBJECTS AND METHODS: Five patients(10 eyes) who were to undergo vitrectomy were enrolled in this study. They each received T, P, and D 6 times and TPD solution in the same way. Before and after the instillation, superficial punctate keratopathy (SPK) was evaluated and corneal epithelial permeability was determined by anterior fluorophotometry. RESULTS: After the instillation of T, P, and D, corneal damage increased in all eyes. After the instillation of TPD, three eyes showed only one grade change up in AD(A: area, D: density) classification of SPK. The fluorescein uptake change between pre- and post-instillation was 457.5 +/- 468.8 (mean +/- standard deviation) ng/ml with T, P, and D and 100.5 +/- 235.6 ng/ml with TPD(p < 0.01). CONCLUSION: TPD solution decreases both corneal epithelium damage and barrier function change of corneal epithelium.

Adult↗

A comparison of some simplified lactobionate preservation solutions with standard UW solution and Eurocollins solution for pancreas preservation.

Fifty-two rat pancreas transplants were performed to investigate which components of the UW solution were essential for successful pancreas preservation. LEW rats were used and the pancreata stored at 4 degrees C for 48 hr after flushing with commercial UW solution (ViaSpan, DuPont Pharmaceuticals) or a number of simplified solutions. Following storage the pancreata were transplanted into syngeneic recipient animals with streptozotocin-induced diabetes mellitus. Graft function was assessed by regular postoperative blood sugar measurements and a glucose tolerance test on the 14th postoperative day. With commercial UW solution, 4 of 9 recipients (44%) showed satisfactory graft function, while only one of 5 pancreata preserved using Eurocollins solution demonstrated satisfactory function. With solution A, in which hydroxyethyl starch and insulin were omitted from the standard UW solution, 3 of 7 recipients (43%) showed satisfactory function. Omission of glutathione, allopurinol, and adenosine from this solution (solution B) gave satisfactory function in 4 of 8 cases (50%). Substitution of raffinose in solution B with an equimolar concentration of glucose (solution C) resulted in acceptable function in 5 of 8 cases (62%). Increasing the raffinose concentration in solution B to 100 mM/L resulted in only 2 of 8 grafts (25%) with adequate function. By contrast, reversing the Na/K concentrations in solution A resulted in 100% (7/7) satisfactory graft function. We conclude that the rat pancreas can be successfully transplanted following 48-hr cold preservation using UW solution and some simplified versions, and that a substantially simplified lactobionate-based solution with a reversed sodium/potassium ratio improved survival.

Adenosine↗

Influence of solute degradation on the accumulation of solutes migrating into solution from polymeric parenteral containers.

Solute stability in solution, in addition to solute-polymer interaction properties and the total solute available pool, impacts the interaction between a polymeric container and a parenteral product, specifically in terms of the migration of trace polymer components into the contained solution. A specific solute/polymer system has been studied with respect to properties impacting the magnitude and rate of solute migration from the polymer into solution. The solute, an alkyl ester, originates in a polyolefin composite packaging material. Solute degradation kinetics were studied as a function of solution temperature and pH. Solute-polymer interaction properties including the equilibrium binding constant and diffusion coefficient were obtained. An accumulation rate model is developed for the determination of the solution phase concentration of the liberated solute as a function of storage time and conditions. Coupling the model with the properties of the polymer-solute system studied provides a tool that accurately predicts solute accumulation behavior in a representative parenteral product configuration.

Drug Packaging↗

[Effects of cardioplegic solutions on coronary artery and myocardium--comparison of the glucose-insulin-potassium solution and the St. Thomas' Hospital cardioplegic solution].

Effects of two cardioplegic solutions on coronary artery and myocardium were experimentally investigated in three types of preparations. In the isolated perfused guinea pig heart, infusion of Glucose-Insulin-Potassium (GIK) solution (37 degrees C) caused contraction of coronary artery, whereas the St. Thomas' Hospital cardioplegic solution (37 degrees C) produced vasodilation. At the end of 30 minutes reperfusion after continuous infusion of cardioplegic solution, the St. Thomas' Hospital cardioplegic solution produced a greater recovery of cardiac function than GIK solution. In the isolated pig coronary artery, vasoconstriction caused by high potassium content was diminished by addition of magnesium in concentration dependent manner. In the electrophysiological examination, the membrane potential of the guinea pig papillary muscle was recorded by means of conventional glass microelectrodes. Though GIK solution produced greater depolarization of resting membrane potential than the St. Thomas' Hospital cardioplegic solution, effects of the two different cardioplegic solution was not so different after reperfusion of Tyrode solution. The St. Thomas' Hospital cardioplegic solution resulted in greater recovery of contracting activity after reperfusion than GIK solution. These data suggest that GIK solution causes coronary vasoconstriction and has deleterious effects on myocardium and that the St. Thomas' Hospital cardioplegic solution has a vasodilating action and produced a greater myocardial protection than GIK solution.

Animals↗

Modeling Gibbs energies of solution for a non-polar solute in aqueous solutions of the protein stabilizers glycerol and ethylene glycol.

The Hydration Shell Chemical Equilibrium Model (HSCE) has been applied to Gibbs energies of solution data for toluene in aqueous solutions of the protein stabilizers glycerol and ethylene glycol. The HSCE model fits the experimental data to nearly experimental uncertainty. This satisfactory rendering of the data provides certainty on the physical significance of the model parameters and allows a description, from the molecular point of view, of the behaviour of a non-polar solute in aqueous solutions of protein stabilizers. The toluene-stabilizer interchange energy is positive indicating a dislike between toluene and the stabilizer molecules. This dislike is, however, much less pronounced than that between the solute and water, i.e. the non-polar solute prefers to be in contact with the stabilizer rather than with water. The cohesion between water molecules is much larger than that between stabilizer molecules and it remains to be the dominant cause of the hydrophobic behaviour of the non-polar solute. Since the solute-stabilizer interactions are energetically favoured over the solute-water ones, in the vicinity of the solute the stabilizer molecules are preferred over water ones. However, there is no specific interaction leading to a distinct chemical entity (a solute-stabilizer complex). Thus, the non-polar solute-stabilizer interaction is better described by the term 'preferential solvation of the solute by the stabilizer'.

Cryoprotective Agents↗

Effect of solute size and solute-water attractive interactions on hydration water structure around hydrophobic solutes.

Using Monte Carlo simulations, we investigated the influence of solute size and solute-water attractive interactions on hydration water structure around spherical clusters of 1, 13, 57, 135, and 305 hexagonally close-packed methanes and the single hard-sphere (HS) solute analogues of these clusters. We obtain quantitative results on the density of water molecules in contact with the HS solutes as a function of solute size for HS radii between 3.25 and 16.45 A. Analysis of these results based on scaled-particle theory yields a hydration free energy/surface area coefficient equal to 139 cal/(mol A2), independent of solute size, when this coefficient is defined with respect to the van der Waals surface of the solute. The same coefficient defined with respect to the solvent-accessible surface decreases with decreasing solute size for HS radii less than approximately 10 A. We also find that solute-water attractive interactions play an important role in the hydration of the methane clusters. Water densities in the first hydration shell of the three largest clusters are greater than bulk water density and are insensitive to the cluster size. In contrast, contact water densities for the HS analogues of these clusters decrease with solute size, falling below the bulk density of water for the two largest solutes. Thus, the large HS solutes dewet, while methane clusters of the same size do not.

Journal Article↗

Response of the canine corneal endothelium to intraocular irrigation with saline solution, balanced salt solution, and balanced salt solution with glutathione.

The right or left anterior chamber of 12 dogs (ie, 24 eyes) was irrigated with 100 ml of 0.9% saline solution, balanced salt solution, or balanced salt solution with glutathione (8 eyes/solution) for 22 minutes. Changes in endothelial cell density and corneal thickness from pretreatment values were evaluated immediately after, and at 2 and 7 days after irrigation. Using specular microscopy and scanning and transmission electron microscopy, corneas were examined immediately after and at 2, 7, and 14 days after irrigation. Changes were not seen in endothelial cell density after irrigation with any of the solutions evaluated. Corneal thickness increased 4% immediately after irrigation with 0.9% saline solution and returned to normal by 1 week after irrigation; treatment with 0.9% saline solution was not associated with visible corneal edema. Ultrastructural changes attributable to differences in irrigating solution composition were not observed. The difference between the endothelium's response to limited irrigation with saline solution, balanced salt solution, and balanced salt solution with glutathione was small and irrigation with these solutions was not associated with permanent endothelial damage.

Acetates↗

Non-polar solutes in water and in aqueous solutions of protein denaturants. Modeling of solution and transfer processes.

A simple molecular model for the thermodynamic behavior of non-polar solutes in water and in aqueous solutions of protein denaturants is presented. Three contributions are considered: (i) combinatorial arising from the mixing process, (ii) interactional characterizing the molecular interactions occurring in the mixture and (iii) a contribution originating from the structural changes occurring in the first shell of water molecules around the solute. The latter is modeled assuming that water molecules in contact with the solute are involved in a chemical equilibrium between two states. The model describes well the temperature and denaturant concentration dependences of the Gibbs energies of solution and transfer for benzene, toluene and alkanes in water and aqueous solutions of urea and guanidine hydrochloride. Model parameters are physically meaningful, allowing a discussion of the molecular interactions involved. A preferential solvation of the solute by the denaturant is found. However, the non-polar solute-denaturant interaction is not specific, i.e. leading to a distinct chemical entity. Urea and guanidine hydrochloride are non-polar solubilizing agents because their interactions with the solute are less unfavorable than those between water and the solute.

Hydrogen Bonding↗

Colloid solutions for fluid resuscitation.

BACKGROUND: Colloids are widely used in the replacement of fluid volume, however doubts remain as to their benefits. Different colloids vary in their molecular weight and therefore in the length of time they remain in the circulatory system. Because of this and their other characteristics, they may differ in their safety and efficacy. OBJECTIVES: To compare the effects of different colloid solutions in patients thought to need volume replacement. SEARCH STRATEGY: The Cochrane Injuries Group specialised register, The Cochrane Controlled trials register (all years), MEDLINE (1994-98), EMBASE (1974-98) were searched. Bibliographies of trials retrieved were searched and drug companies manufacturing colloids were contacted for information. SELECTION CRITERIA: Randomised and quasi randomised trials comparing colloid solutions in critically ill and surgical patients thought to need volume replacement. The main outcomes measured were death, amount of whole blood transfused and incidence of adverse reactions. DATA COLLECTION AND ANALYSIS: Two authors independently extracted the data and assessed the quality of the trials. MAIN RESULTS: 46 trials met the inclusion criteria, with a total of 2884 participants. Many of the trials were small. In the majority of trials quality was poor or uncertain. Deaths were obtained from 27 trials. Twenty three trials recorded the amount of blood transfused, however quantitative analysis was not possible due to skewness and variable reporting. Thirteen trials recorded adverse reactions, but none occurred. For albumin or PPF versus hydroxyethyl starch (HES) 20 trials reported mortality. The pooled relative risk (RR) was 1.17 (95% CI 0.91, 1.50). For albumin or PPF versus gelatin 3 trials reported mortality. The RR was 0.99 (0.69, 1.42). For gelatin vs HES 3 trials reported mortality, RR was 0.97 (0.65, 1.44). RR was not estimable in the albumin vs dextran, gelatin vs dextran, and HES vs dextran groups. REVIEWER'S CONCLUSIONS: From this review, there is no evidence that one colloid solution is more effective or safe than any other, although the confidence intervals are wide and do not exclude clinically significant differences between colloids. Larger trials of fluid therapy are needed if clinically significant differences in mortality are to be detected or excluded.

Blood Proteins↗

Treatment of solutions with binary solutes using an admicellar enhanced CSTR: background solute effect.

This study presents an admicellar enhanced continuous-flow stirred tank reactor (CSTR). Solutions containing single and binary aliphatic alcohols are introduced into this reactor for breakthrough experiments. Two phenomena occur during experiments with binary solutes: (a) a competitive effect caused by background solutes with relatively high hydrophobicity; (b) a co-solvent effect attributable to background solutes with relatively low hydrophobicity. The competition phenomenon and the corresponding mechanism involved are well demonstrated by directly monitoring the pre-adsolubilized solutes drawn out back to the solution while adsolubilizing other solutes with higher hydrophobicity. On the other hand, adsolubilization kinetics hindered by the background solute, which acts as a co-solvent, significantly alters the slopes of breakthrough curves of the target solute treated in the reactor.

Kinetics↗

Intraocular irrigating solutions. A randomized clinical trial of balanced salt solution plus and dextrose bicarbonate lactated Ringer's solution.

BACKGROUND: Two intraocular irrigating solutions which differ principally by the presence of oxidized glutathione were compared in this randomized, masked, prospective study to discern differences in preservation of endothelial cell size. METHODS: Sixty-four patients undergoing extracapsular cataract extractions were randomized between two irrigating solution groups, Balanced Salt Solution (BSS) Plus (n = 30) and dextrose bicarbonate lactated Ringer's solution (n = 34). Preoperative and postoperative endothelial specular photomicrographs were analyzed for cell size and hexagonality, and the two groups were compared using repeated measures analysis of variance. RESULTS: Fifty-eight subjects (91%) completed the 2-month study. Change in cell size for the BSS Plus group (n = 28) (mean +/- standard error, 29.4 +/- 12.3 microns2) was not significantly different from the dextrose bicarbonate lactated Ringer's solution group (n = 30) (27.5 +/- 12.9 microns2) (P = 0.92). Groups did not differ significantly in percent hexagonality (P = 0.57) or in the variability of cell size (P = 0.61). CONCLUSION: The presence of glutathione in BSS Plus and other minor electrolyte differences between the solutions is not more advantageous with regard to endothelial cell size than dextrose bicarbonate lactated Ringer's solution for standard extracapsular cataract surgery. Cost per 500-microliters bottle of BSS plus is $62 compared with $9.80 for dextrose bicarbonate lactated Ringer's solution.

Aged↗

Effect of irrigation solutions for arthroscopic surgery on intraarticular tissue: comparison in human meniscus-derived primary cell culture between lactate Ringer's solution and saline solution.

In order to determine whether there is a difference in effect on cell morphology and function between two common arthroscopic irrigation solutions, primary cultures of cells derived from the surgically excised human menisci were incubated for 3 or 6 h in lactated Ringer's solution, isotonic sodium chloride solution, or serum-free cell culture medium (negative-control condition). Cell integrity was blindly evaluated by three independent examiners scoring photomicrographs of the cell cultures on a battery of five-point scales for abnormality of cell shape, irregularity of cell membrane, change of cell size and cell density. Cell cultures were also quantitatively assayed by semi-quantitative reverse-transcription-polymerase-chain-reaction for mRNA of alpha1 (I) procollagen, alpha1 (II) procollagen, aggrecan and heat-shock protein 70 to assess functional consequences of exposure to the solutions. There was a statistically significant difference in cell integrity scores between either lactated Ringer's solution or serum-free cell-culture medium and isotonic sodium chloride solution with greater damage to cells displayed. Scores for lactated Ringer's solution did not differ from those for serum-free cell-culture medium. There were no significant differences in mRNA expression level among the treatment conditions. It was concluded that the lactated Ringer's solution better maintained human meniscus cell integrity than the isotonic saline.

Adolescent↗

Analysis of three variables in sampling solutions used to assay bacteria of hands: type of solution, use of antiseptic neutralizers, and solution temperature.

Tests were performed using the sterile bag technique to determine the effects of type of sampling solution, use of antiseptic neutralizers, and solution temperature on the detection and quantitation of bacteria on hands. Using paired hand cultures, three sampling solutions were compared: quarter-strength Ringer solution, a phosphate buffer containing Triton X-100, and the same buffer containing antiseptic neutralizers. The phosphate buffer containing Triton X-100 was significantly better than quarter-strength Ringer solution in mean bacterial yield; the neutralizer-containing sampling solution was slightly better than Triton X-100-containing solution, although differences were not significant at the P = 0.05 level. Temperature (6 or 23 degrees C) of the sampling solution showed no consistent effect on bacterial yield from hands tested with the fluid containing neutralizers.

Adult↗

Effects of EP4 solution and LPD solution vs Euro-Collins solution on Na(+)/K(+)-ATPase activity in rat alveolar type II cells and human alveolar epithelial cell line A549 cells.

BACKGROUND: Intact alveolar epithelial Na(+)/K(+)- adenosinetriphosphatase (ATPase) function is important in preventing alveolar fluid accumulation after lung transplantation. We examined whether the type of preservation solution used influences Na(+)/K(+)-ATPase activity in alveolar epithelial cells. METHODS: Rat alveolar type II cells were preserved with EP4, low-potassium dextran (LPD), or Euro-Collins solution at 7 degrees C for 5 and 20 hours. To assess cell toxicity, we measured cell viability and lactate dehydrogenase release. Na(+)/K(+)-ATPase activity was measured as ouabain-sensitive ATPase hydrolysis. We also examined the effect of terbutaline (10(-3) mol/liter) and dibutyryl cyclic adenosine monophosphate (dbcAMP) (10(-3) mol/liter) on Na(+)/K(+)-ATPase activity in A549 cells preserved for 5 hours. RESULTS: All solutions caused significant damage of rat alveolar type II cells at 20 hours. However, Na(+)/K(+)-ATPase activity was preserved at normal levels with EP4 and LPD over 20 hours. Terbutaline and dbcAMP significantly increased Na(+)/K(+)-ATPase activity in A549 cells preserved with EP4 and LPD solutions for 5 hours. However, we observed no activation in the cells preserved with Euro-Collins solution. We found no significant difference in intracellular cAMP levels after terbutaline challenge among the types of preservation solution. CONCLUSIONS: We conclude that extracellular-type solutions such as EP4 and LPD may be preferable for maintaining not only the basal activity but also the ability to activate Na(+)/K(+)-ATPase in response to beta-adrenergic agonists, in alveolar epithelial cells.

Animals↗

Coagulation effects of in vitro serial haemodilution with a balanced electrolyte hetastarch solution compared with a saline-based hetastarch solution and lactated Ringer's solution.

The hydroxyethyl starches are a group of compounds that has been associated with impairment of coagulation when large volumes are administered. The thrombelastograph is commonly used to assess point-of-care whole blood coagulation. Little is known about the dose-response relationships of haemodilution, and it is reasonable to assume that a linear association exists. This may not be the case with altered electrolyte compositions of the fluids used for haemodilution. We have therefore conducted an in vitro study of haemodilution of human whole blood using lactated Ringer's solution and two high molecular weight hetastarches, one in a balanced salt solution, the other in a 0.9% saline solution. The thrombelastograph, commonly used for the assessment of the coagulation effects of synthetic colloids, was used as the coagulation assessment device. Serial haemodilution with hetastarch in a balanced salt solution demonstrated a biphasic response (of r-times and k-times, as well as alpha angles), with haemodilution in the 20-40% range causing enhanced coagulation, and higher degrees of dilution causing a decrease in overall coagulation performance. A similar picture was observed with lactated Ringer's solution, but only significantly so in alpha angles. Hetastarch in saline did not display this initial increased coagulability at mild to moderate dilutions. This biphasic response of lactated Ringer's solution and hetastarch in a balanced salt solution reflects the complex interaction of fluids and the coagulation system, and that these effects cannot be attributed to simple haemodilution. On the other hand, there was a linear decrease in maximum amplitude with haemodilution. Maximum amplitude was particularly affected by both starches, which is an expected finding in view of the known interaction between the hydroxyethyl starches and von Willebrand's factor.

Blood Coagulation↗

[The temperature dependency of the protective properties of the St. Thomas' Hospital cardioplegic solution, the University of Wisconsin solution, and Bretschneider buffered solution].

We studied three preservation solutions such as St. Thomas' hospital cardioplegic solution No. 2 (ST), the University of Wisconsin solution (UW) and Bretschneider's solution (BR) for protective properties, especially in terms of temperature dependence during the preservation. Rat hearts were studied and divided into three groups; ST. UW and BR. In each group, six hearts were carried out perfusion, cardioplegic infusion, ischemia and reperfusion for four different conditions. Using an isolated working rat heart model, the hearts were subjected to 5 minutes Langendorff perfusion followed by 20 minutes working perfusion. During this working period, cardiac functions such as aortic and coronary flow, aortic pressure, and heart rates were measured every 5 minutes. After working perfusion, 3 minutes of cardioplegic infusion was carried out either with UW, ST, and BR at 37, 20, 4, 1 degree C. The hearts were subjected to either 35 min at 37 degrees C, 120 min at 20 degrees C, 300 min at 4 degrees C, or 450 min at 1 degree C. The hearts were immersed in the same solution during ischemia. The hearts were reperfused at 37 degrees C, initially in the Langendorff mode for 15 min. Coronary effluent was collected for the measurement of CK leakage during reperfusion. The heart were then converted to the working mode for 20 minutes. During working reperfusion period, the variables of cardiac function were again measured and expressed as a percentage of their individual preischemic control values. Under conditions of 37 degrees C ischemia, % recovery of cardiac output (%CO) in ST group is 62.8 +/- 2.8%, although the hearts preserved with UW and BR were not recovered. Under conditions of 20 degrees C ischemia, %CO in UW, ST and BR were 46.8 +/- 2.7, 82.0 +/- 3.1 and 41.4 +/- 2.6%, respectively. Under conditions of 4 degrees C ischemia, %CO in UW, ST and BR were 66.2 +/- 8.0, 68.6 +/- 2.3 and 47.2 +/- 2.9%, respectively. Under conditions of 1 degrees C ischemia, %CO in UW, ST and BR were 70.6 +/- 3.3, 56.5 +/- 1.6 and 43.0 +/- 2.5%, respectively. In conclusions, ST revealed the best protective properties for the heart preservation between 37 degrees C and 20 degrees C ischemia. The properties of ST was similar to that of UW under conditions of 4 degrees C, although UW showed most excellent protective properties under conditions of 1 degrees C ischemia. These results suggested that, protective ability of preservation solution might be changed by the temperature during preservation period.

Adenosine↗

Solute-binding protein-dependent ABC transporters are responsible for solute efflux in addition to solute uptake.

The ATP-binding cassette (ABC) transporter superfamily is one of the most widespread of all gene families and currently has in excess of 1100 members in organisms ranging from the Archaea to manQ1. The movement of the diverse solutes of ABC transporters has been accepted as being strictly unidirectional, with recent models indicating that they are irreversible. However, contrary to this paradigm, we show that three solute-binding protein-dependent (SBP) ABC transporters of amino acids, i.e. the general amino acid permease (Aap) and the branched-chain amino acid permease (Bra) of Rhizobium leguminosarum and the histidine permease (His) of Salmonella typhimurium, are bidirectional, being responsible for efflux in addition to the uptake of solutes. The net solute movement measured for an ABC transporter depends on the rates of uptake and efflux, which are independent; a plateau is reached when both are saturated. SBP ABC transporters promote active uptake because, although the Vmax values for uptake and efflux are not significantly different, there is a 103-104 higher affinity for uptake of solute compared with efflux. Therefore, the SBP ABC transporters are able to support a substantial concentration gradient and provide a net uptake of solutes into bacterial cells.

ATP-Binding Cassette Transporters↗

[Comparative measurement of transmural gastric potential difference after administration of Euphyllin solution, theophylline solution, ethylenediamine dihydrochloride solution and Riopan, buffered theophylline].

Across the surface of the stomach mucosa exist large electrolytic concentration differences. While the pH value of the mucosa cells remains very constant within the range of 7.0 to 7.2, the pH value of the stomach fluctuates between 1 and 5. The differences in concentration of H-ions and other ions on both sides of the mucosa membrane result in an electrical voltage. Measurement of this voltage permits inferences to be made about the integrity of the mucosa cells. The electrical voltage and its changes can be measured and evaluated using a model developed in our Institut. Previously, there existed no studies comparing the irritation on the human stomach of solutions of Euphyllin and Theophylline. Now, using the forementioned model, we have performed such a study by examining the gastric transmural potential difference changes in nine (9) healthy subjects receiving Euphylline, Theophylline, and Ethylendiamin dihydrochloride in a cross-over design. Additionally, we have attempted to clarify if it is possible to suppress the irritation caused by Theophylline with Riopan. The investigation led to the following results: 1) The gastric irritation caused by Euphylline solution is statistically smaller than that caused by Theophylline solution. 2) The Ethylendiamin-dihydrochloride solution caused a minor irritation smaller than that of the Euphylline solution. 3) A pretreatment with Riopan reduced the irritation of the Theophylline solution.

Aluminum Hydroxide↗