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The efficacy of methylcellulose was evaluated in 538 patients with a history of constipation. The patients were seen both by primary care physicians and by consultants. Patients were selected on the basis of passage of fewer than three stools per week. Frequency, consistency, and ease of passage of the stools were measured before and after one to three tablespoonsful per day of methylcellulose. The frequency of bowel movements as well as the consistency and ease of passage of the stools returned to normal with methylcellulose treatment; 61% of the patients were judged to have less constipation. The response to methylcellulose was not altered by the sex or age of the patients nor by the presence of colonic diverticular disease. This study suggests that methylcellulose is beneficial for the treatment of chronic and acute constipation.

Current pharmacological therapy for the obese patient focuses primarily on centrally acting drugs that affect food intake. At the research level, there is an awareness of the possibility of discovering peripherally acting drugs to modify metabolic processes and thereby create favourable changes in energy balance. Whilst a number of compounds have been shown to be effective as slimming agents in experimental animals, none, as yet, have proved effective in man.

Pericardial adhesions subject patients requiring cardiac reoperation to potential injuries of the heart, great vessels, and extracardiac grafts during resternotomy. We evaluated polyvinylpyrrolidone (PVP) and a methlycellulose derivative (MCD) as intraoperative irrigating solutions in the prevention of postoperative pericardial adhesions. Fifteen dogs weighing 15 to 20 kg were divided into three equal cohorts and subjected to left thoracotomy with pericardiotomy. Prior to surgical manipulation, the pericardial cavity was irrigated with either PVP, MCD, or Ringer's lactate (RL). Serosal injury stimulating intraoperative trauma was induced by gauze sponge abrasion of the epicardium and inner surface of the pericardium and by allowing desiccation of serosal surfaces for 30 min. The pericardial cavity was evaluated for adhesion formation 6 weeks postoperatively by reoperation. Two independent observers, unaware of the study solution, evaluated the extent and severity of pericardial adhesions on a 0-4 scale. All dogs in the RL control group had surgically significant adhesions and a mean adhesion score of 3.2 +/- 1.1. In contrast, no PVP- or MCD-treated dog had surgically significant adhesions. The mean adhesion scores were 0.2 +/- 0.4 for PVP and 0.5 +/- 0.7 for MCD. Our results indicate that PVP (P less than 0.004) and MCD (P less than 0.024) significantly reduce pericardial adhesion formation when compared to RL. Clinical application of PVP or MCD for the prevention of pericardial adhesions should reduce morbidity and mortality of cardiac reoperation.

The effects of N-(2-hydroxyethyl) palmitamide (PEA) a natural and antitoxic substance on the treatment of RBA rat leukemia were studied. Repeated administration of PEA prolonged substantially survival of leukemic animals in the course of the treatment with cis-diamminedichlor-platinum (cis-Pt(II) in combination with cyclophosphamide, vincristine and methotrexate respectively. The most advantageous combination used was the cis-Pt(II) with methotrexate and PEA administration even improved the treatment results. The long-termed PEA treatment depressed first of all undesirable side effects and enabled to use higher therapeutic dosage of chemotherapeutics and improved the final results.

In a double blind trial 47 anaesthetized patients were given eye protection with the paraffin-based neutral eye ointment Ph. Nord. 63 in one eye and the water-based Methyl cellulose (MC) 4% in the other. Twenty-four hours later the eyes were vital-stained with rose bengal/fluorescein. No unintended effects of the ointments were found and no injury to the eyes were seen. Compared with the paraffin-based ointment the MC ointment produced a more firm adhesion of the eyelids. A water-based 4% MC ointment is therefore as alternative to the fat-based neutral eye ointment.

We conducted a prospective randomized clinical trial of 2% hydroxypropyl methylcellulose and 1% sodium hyaluronate (Healon) in routine extracapsular cataract surgery with implantation of a posterior chamber intraocular lens. Of the 84 patients 40 received methylcellulose and 44 received sodium hyaluronate. There was no statistically significant difference in endothelial-cell loss or induced cellular polymegathism between the two groups. The intraocular pressure before and after surgery was similar in the two groups, as was the visual acuity 8 weeks after surgery. The results suggest that 2% hydroxypropyl methylcellulose is a safe and effective alternative to 1% sodium hyaluronate in routine implant surgery.

An account is presented of the early experiences with the use of visco elastic materials in keratoplasty. Materials used have been sodium hyaluronate ('Healonid') and 1 per cent and 2 per cent solutions of hydroxypropyl methylcellulose. The surgical methods and the initial results have been outlined. The freedom from any short term or intermediate complications is noteworthy.

Methylcellulose has been used since 1976 to prevent damage to the corneal endothelium during operations for implantation of intraocular lenses. Originally one drop of a 1% solution was placed on the artificial lens just before its insertion. Later the anterior chamber was completely filled with a 2% solution of methylcellulose before implantation. In this way it is possible to maintain a space between the cornea and iris even if vitreous pressure is present and to operate without risk to the corneal endothelium. This paper demonstrates the safety of the intraocular use of methylcellulose on the basis of over 400 operations. The substance is cheap, universally available, and can be easily prepared for intraocular use.

Poor compliance from patients who require the use of a bulk laxative for chronic constipation is cited as a clinical problem. Many patients are dissatisfied with the taste and/or grittiness of psyllium seed products. Citrucel, made from methylcellulose, is completely soluble in water and may result in improved compliance from improved palatability. As with any medication, nursing should take an active role in patient instruction and teaching regarding the use of laxatives. Currently indicated in the treatment of constipation associated with a number of conditions, Citrucel may also be found to have a beneficial effect on serum cholesterol levels.

This article reports a new concept in the treatment of tear film abnormalities. Solubilization of an artifical tear insert provides a continuous flow of polymer into the tear film in place of intermittent drop therapy. The physiochemical properties of succinylated collagen were studied in vitro and compared favorably with presently available tear substitutes. The use of this polymer as a solid solubilizable insert was evaluated in normal patients. It was found to be comfortable, resulted in no blurring of vision, and prolonged the tear film breakup time.

MK 458 is a potent and selective D2 receptor agonist. MK 458 consists of (+)-4-propyl-9-hydroxynaphthoxazine (PHNO) in a hydroxypropyl-methylcellulose-lactose matrix. MK 458, mean dose 8.1 mg (range 2.5 to 13.5 mg), was administered to 14 patients with advanced Parkinson's disease (PD) who were no longer satisfactorily responding to levodopa. The duration of the study was 4 weeks with a titration to maximum dose in 2 weeks. The addition of MK 458 resulted in a mean reduction in levodopa of 41% (range 0 to 81%). This degree of levodopa reduction was not seen in previous studies with other DA agonists. While the reduction in signs of PD was comparable to those on levodopa, MK 458 did not induce dyskinesias or dystonias. It is postulated that MK 458 may be able to replace levodopa as the primary treatment for PD.

The authors' study of the viscosities of various concentrations of sodium hyaluronate, chondroitin sulfate, and methylcellulose revealed that sodium hyaluronate and methylcellulose are pseudoplastic fluids in contrast to chondroitin sulfate, which is a Newtonian fluid. Pseudoplastic fluids are ideal for maintaining the anterior chamber, since they are more viscous at rest. Intermediate viscosity preparations of these three agents used as a thin endothelial coating gave excellent protection from intraocular lens abrasion. A highly viscous agent, eg, sodium hyaluronate 1%, in a thin layer produced extensive endothelial cell damage because it transmitted excessive shear force to the endothelium. A highly viscous agent, sodium hyaluronate 1% in a thick layer produced a physical barrier to compression with little endothelial damage. A low-viscosity agent, balanced salt solution provided insufficient protection against intraocular lens abrasion.