Optimum Calcium Concentration of Dialysis Fluid for Maintenance Haemodialysis

To define the minimum and maximum levels for calcium concentration of dialysis fluid a combination of acute and long-term observations was carried outIn acute experiments the external calcium balance during dialysis was dependent on the gradient between plasma ultrafilterable calcium and dialysis fluid calcium concentration. Changes in plasma calcium during dialysis did not correlate with measured external balance.In long-term studies it was found that raising the dialysis fluid calcium concentration from 5.0 to 6.0 mg./ 100 ml. both arrested biochemical and radiological changes of hyperparathyroidism, and, by causing a progressive fall in plasma phosphates, made metastatic calcification less likely. Raising the concentration to 6.5 mg./lOO ml. in an attempt to compensate for negative alimentary calcium balance caused nausea and vomiting in some patients.A concentration of 6.0±0.2 mg./100 ml. is recommended.     

Ionized calcium in exchange transfusion with THAM-buffered ACD blood

In 20 exchange transfusions with THAM-buffered ACD blood 5 ml. of 2% calcium gluconate (8 mg. elemental calcium) was injected after each 100 ml. of blood exchanged. Plasma ionized calcium decreased significantly during the procedure, although after each injection of calcium gluconate, levels returned briefly to normal. Ten minutes after the end of exchange ionized calcium had returned to pre-exchange levels and remained there until at least 30 mins. postexchange.Total calcium also increased significantly. Short periods of extreme hypercalcemia (between 7 and 8 mEq./l.) were noted after each injection of calcium gluconate.The amount of calcium gluconate was insufficient to counteract the calcium-chelating effect of citrate. If no heparinized blood is available we suggest adding heparin and calcium chloride to THAM-buffered ACD blood to avoid the repeated sudden fluctuations between low and high calcium ion activity.     

The fluorimetric determination of oxalic acid in blood and other biological materials

1. Oxalic acid is separated from interfering substances by extraction with tri-n-butyl phosphate followed by co-precipitation with calcium sulphate. The precipitated oxalic acid is then reduced to glyoxylic acid, which is coupled with resorcinol to form a coloured fluorescent complex. 2. The spectrofluorometric method described is sensitive and highly specific, the minimum detectable amount of oxalic acid being 0.9mumole under the recommended conditions. 3. The concentration of oxalic acid in blood from 15 normal adults was 200-320mug./100ml. For serum the range was 135-280mug./100ml. The urinary excretion of oxalic acid by 60 normal adults on a normal diet was 9.0-28.5mg./24hr.     

Effect of aerobic and resistance exercise training on vascular function in heart failure

Exercise training of a muscle group improves local vascular function in subjects with chronic heart failure (CHF). We studied forearm resistance vessel function in 12 patients with CHF in response to an 8-wk exercise program, which specifically excluded forearm exercise, using a crossover design. Forearm blood flow (FBF) was measured using strain-gauge plethysmography. Responses to three dose levels of intra-arterial acetylcholine were significantly augmented after exercise training when analyzed in terms of absolute flows (7.0 +/- 1.8 to 10.9 +/- 2.1 ml x 100 ml(-1) x min(-1) for the highest dose, P < 0.05 by ANOVA), forearm vascular resistance (21.5 +/- 5.0 to 15.3 +/- 3.9 ml x 100 ml forearm(-1) x min(-1), P < 0.01), or FBF ratios (P < 0.01, ANOVA). FBF ratio responses to sodium nitroprusside were also significantly increased after training (P < 0.05, ANOVA). Reactive hyperemic flow significantly increased in both upper limbs after training (27.9 +/- 2.7 to 33.5 +/- 3.1 ml x 100 ml(-1) x min(-1), infused limb; P < 0.05 by paired t-test). Exercise training improves endothelium-dependent and -independent vascular function and peak vasodilator capacity in patients with CHF. These effects on the vasculature are generalized, as they were evident in a vascular bed not directly involved in the exercise stimulus.     

Variation in Plasma Calcium with Induced Changes in Plasma Specific Gravity,Total Protein,and Albumin

The relationship of plasma calcium levels to changes in plasma specific gravity, total protein, and albumin induced by venous stasis was investigated. Factors were derived for adjusting calcium results to offset the effects of variation in protein concentration and thus to make them of increased discriminatory value to the clinician. The validity of an existing specific gravity correction has been substantiated, but a more exact adjustment of 0·23 mg/100 ml of calcium for every 0·001 change in specific gravity is proposed. We recommend for automated laboratories that the factor based on albumin be used: 0·09 mg/100 ml of calcium should be subtracted from the total calcium value for every increase of 0·1 g in albumin above 4·6 g/100 ml, and a corresponding addition should be made for values of albumin below 4·6 g/100 ml.Using a calcium specific electrode, it has been shown that the ionized calcium concentration does not alter with prolonged venous stasis.     

Plasma atrial natriuretic peptide in conscious rats with reduced renal mass

The effect of salt intake and reduction of renal mass (RRM) on plasma immunoreactive atrial natriuretic peptide (iANP) levels in conscious rats was studied. Rats were divided into RRM and sham-operated groups, and then further subdivided into groups infused with 1 or 6 mEq of sodium per day. Plasma urea nitrogen increased in the groups with RRM. Plasma sodium, sodium balance, and heart rate did not differ between the sham and RRM groups. Rats with RRM maintained on 1 mEq of sodium per day did not have an elevation of water intake, arterial pressure, or plasma iANP. Rats with RRM maintained on 6 mEq of sodium per day had significantly (P less than 0.05) elevated water intake, arterial pressure, and plasma iANP. Arterial pressure and plasma iANP were correlated (r = 0.800) for rats with RRM on either 1 or 6 mEq of sodium per day. Increased plasma iANP in the RRM group on 6 mEq per day was not caused by either RRM or high sodium alone; it was an effect of RRM plus high salt intake. The increase in plasma iANP in the RRM group may be caused by the increase in arterial pressure, possibly due to an increase in extracellular fluid volume. ANP may not be responsible for the sustained increase in fractional sodium excretion observed in RRM.     

Biophysical and biochemical characteristics of bactrian camel semen collected by artificial vagina

Seminal characteristics were investigated in Bactrian camel in this study. Semen samples from ten mature Bactrian camel bulls were collected using a modified bovine artificial vagina. The biophysical parameters including volume, color, sperm concentration and fast forward progressive motility, percentage of live sperm and the biochemical parameters including osmolarity, pH, glucose, calcium, phosphorus, chloride, triglycerides, phospholipids, total protein, albumin and non-protein nitrogen concentrations in seminal plasma were measured. The mean time for semen collection was 5.3 +/- 0.29 min. The volume of semen varies from 1.2 to 26 (8.2 +/- 0.7 mls). The majority of semen samples (83.6%) were milky in color and consistency. The average osmolarity of semen was 316.1 +/- 1.48 mOsm/kg H(2)O. The pH of semen was slightly alkaline (7.4 +/- 0.03). The mean concentration of spermatozoa was 414.8 +/- 25.04 x 10(6)cells/ml. The fast forward progressive motility of spermatozoa was 62.4 +/- 1.57%. The percentage of live spermatozoa was 85.6 +/- 1.15. Seminal plasma concentration of glucose was 35.8 +/- 0.9 mg/dl. Non-protein nitrogen, total protein and albumin were 32.5 +/- 2.5, 2200 +/- 100 and 1100 +/- 100mg/dl, respectively. The average concentrations of phospholipids and triglycerides in seminal plasma were 36.4 +/- 2.1 and 101.6 +/- 5.5mg/dl, respectively. The concentrations of calcium, phosphorus and chloride were 8.2 +/- 0.1, 2.9 +/- 1.7 mg/dl and 97.9 +/- 2.9 mEq./l, respectively.     

Ontogeny of tracheal fluid, pulmonary surfactant, and plasma corticoids in the fetal lamb.

We examined fetal plasma corticoids and flow rate, electrolyte composition, and surfactant content of tracheal fluid in chronic experiments with eight fetal lambs. From 120 to 148 days of gestation the rate of fluid production was 4.5 ml/kg per h, and there was no change in mean fluid sodium (147.8 meq/1), chloride (153.1 meq/1), calcium (2.2 mg/100 ml), and pH (6.23). Tracheal fluid potassium increased from 4.3 meq/1 at 120-130 days to 8.9 meq/1 at term, while plasma sodium, chloride, calcium, pH, and potassium were constant at 146.1 meq/1, 110.0 meq/1, 12.1 mg/100 ml, 7.39, and 4.0 meq/1, respectively. Plasma corticoids were less than 1.5 mug/100 ml total (0.3 mug/100 ml free) until 130 days, when they increased rapidly to 10.5 total (3.2 free) at 148 days. Surfactant was first detected in tracheal fluid between 124 and 133 days and its secretion increased rapidly after 135 days to a value of 125 mug/kg per h at 148 days. A sudden increase in fetal plasma corticoids does not seem to be the stimulus for appearance of surfactant in the lamb, although these hormones may induce the rapid accumulation of surfactant prior to delivery.     

Fluid ingestion during exercise increases skin blood flow independent of increases in blood volume.

The purpose of this experiment was to determine whether fluid ingestion attenuates the hyperthermia and cardiovascular drift that occurs during exercise dehydration due to increases in blood volume. In addition, forearm blood flow, which is indicative of skin blood flow, was measured to determine whether the attenuation of hyperthermia and cardiovascular drift during exercise with fluid ingestion is due to higher skin blood flow. On three different occasions, seven trained cyclists [mean age, body weight, and maximum oxygen uptake: 23 +/- 3 yr, 73.9 +/- 10.5 kg, and 4.75 +/- 0.34 (SD) l/min, respectively] cycled at a power output equal to 62-67% maximum oxygen uptake for 2 h in a warm environment (33 degrees C, 50% relative humidity, wind speed 2.5 m/s). During exercise, they randomly received no fluid (NF) or a volume of a carbohydrate-electrolyte fluid replacement solution (FR) sufficient to replace 80 +/- 2% of sweat loss or were intravenously infused with 5.3 ml/kg of a blood volume expander (BVX; 6% dextran in saline). The infusion of 398 +/- 23 ml of BVX maintained blood volume at levels similar to that when 2,404 +/- 103 ml of fluid were ingested during FR and greater than that when no fluid was ingested during the 2nd h of exercise (P less than 0.05). However, BVX and NF resulted in similar esophageal and rectal temperatures, forearm blood flow, and elevations in serum osmolality and sodium concentration during 2 h of exercise.(ABSTRACT TRUNCATED AT 250 WORDS)     

Hypophosphataemia in Septicaemia: Higher Incidence in Gram-negative Than in Gram-positive Infections

Phosphataemia has been investigated in 54 patients with Gram-negative septicaemias; either absolute (serum phosphate <2 mg./100 ml.) or relative (P./B.U.N. 0·04) hypophosphataemia was found in 69% of all determinations. In 37 patients with Gram-positive septicaemias hypophosphataemia was present in only 24%, many of whom had additional Gram-negative bacteriuria and possible Gram-negative septicaemia suppressed by antibiotics. The mechanism of this phenomenon is not known. This new sign of Gram-negative septicaemia has some diagnostic importance.     

The chloride phosphate ratio as the screening test for primary hyperparathyroidism

Serum chloride and phosphate concentrations were measured in 79 hypercalcemic patients. The chloride values were higher (mean 106.7 mEq/l) and phosphate lower (mean 2.08 mg/100 ml) in the 53 hyperparathyroid patients, where as the chloride concentrations were lower (mean 99.3 mEq/l) and phosphate higher (mean 4.07 mg/100 ml) in the 26 patients with hypercalcemia from other causes. The chloride phosphate ratio ranged from 19 to 32 in the subjects with hypercalcemia from other causes with 90 per cent of values less than 30. In patients with primary hyperparathyroidism we found 96 per cent of the values more than 34. From our experience with chloride phosphate ratio it seems to us that this ratio is a very useful and simple preliminary test for distinguishing patients with primary hyperparathyroidism from patients with hypercalcemia from other causes, with normal renal functions.     

Sexual maturity in rabbits defined by the physical and chemical characteristics of the semen

Semen was collected weekly from New Zealand white rabbits from the 1st positive mounting test to 43 weeks of age by means of an artificial vagina. The mean values of the results obtained in the 1st and 20th collection weeks were respectively: volume (ml) 0.61 +/- 0.30 and 0.70 +/- 0.19; pH 7.22 +/- 0.50 and 7.19 +/- 0.15; concentration (sperm/mm3 X 10(3)) 750 +/- 207 and 381 +/- 90; fructose (mg/100 ml) 117 +/- 58 and 203 +/- 121; citric acid (mg/100 ml) 256 +/- 90 and 200 +/- 97; sodium ions (mEq/l) 133 +/- 31 and 163 +/- 46; potassium ions (mEq/l) 40 +/- 21 and 29 +/- 14. On the basis of these results, New Zealand white rabbits reach sexual maturity by 6 months of age.     

Relation between Plasma Lignocaine Levels and Induced Haemodynamic Changes

Intravenous lignocaine (1 mg./kg. body weight) was found to produce insignificant haemodynamic changes, and in particular no reduction in myocardial contractility. A rate of 2 mg./minute infused intravenously is suggested for therapeutic purposes.In anaesthetized dogs an infusion of 13·5 mg./minute caused moderate haemodynamic depression and a maximum plasma level of 7 μg./ml. Massive injections of 200 and 400 mg. of lignocaine produced a maximum plasma level of 13·8 and 27·8 μg./ml., respectively, and in the latter failure of myocardial contraction in the presence of a normal E.C.G. ensued (“pump failure”). Lignocaine appears to alter the uptake of calcium by myocardial sarcoplasmic reticulum, and this may explain the negative inotropic effect of large doses.     

Metabolic Studies,Aldosterone Secretion Rate,and Plasma Renin after Carbenoxolone Sodium

A formal metabolic study of carbenoxolone sodium (Biogastrone) 300 mg./day has been performed for 17 days on a woman with gastric ulcer who in a previous 21-day trial, on a 52-mEq sodium diet, showed weight gain, retention, and rise in plasma sodium and chloride concentrations, as well as hypokalaemia without change in potassium balance. In the present trial sodium intake was restricted to 26 mEq/day; while plasma electrolyte changes of lesser degree still occurred, there was no retention of water, sodium, or chloride. Aldosterone secretion in the control period was 202 μg./24 hours, and fell to 74 μg./24 hours after carbenoxolone, but plasma renin was unchanged.These results suggest that the mineralocorticoid effects of carbenoxolone (and presumably of liquorice and its other derivatives) are due to an intrinsic aldosterone-like action, and that, with sodium deprivation, aldosterone secretion is suppressed by a mechanism which is not renin-mediated—possibly hypokalaemia.     

Laboratory testing of a lethal ovitrap for Aedes aegypti

Laboratory tests were conducted to determine the feasibility of making the mosquito ovitrap lethal to Aedes aegypti (L.) when they attempt to oviposit in the trap. Heavy-weight velour paper strips (2.54 x 11 cm) were used as an alternative to the wooden paddle normally provided as a substrate for mosquito oviposition. The paper strips were pretreated with insecticide solutions and allowed to dry before being used in oviposition cups of 473 ml capacity, filled with water initially to within 2.5 cm of the brim. Insecticides chosen for their quick knock-down efficacy were bendiocarb 76% WP (1.06 mg a.i./strip) and four pyrethroids: permethrin 25% WP (0.16 mg a.i./strip), deltamethin 4.75% SC (0.87 mg a.i./strip), cypermethrin 40% WP (2.81 mg a.i./strip), and cyfluthrin 20% WP (0.57 mg a.i./ strip). For experimental evaluation, two oviposition cups (one with an insecticide-treated strip and one with an untreated strip) were placed in cages (cubic 30 cm) with gravid female Ae. aegypti mosquitoes (aged 6-8 days) from a susceptible laboratory strain. Mortality-rates of female mosquitoes were 45% for bendiocarb, 47% for permethrin, 98% for deltamethrin, 100% for cypermethrin, and 100% for cyfluthrin. Young instar larvae added to the treated cups died within 2h. After water evaporation from the cups for 38 days, fresh mosquito females had access to previously submerged portions of the velour paper paddle, and mortality rates of 59% or more occurred. Cups that had water (360 ml) dripped into them, to simulate rain, produced female mosquito mortality rates of > 50% and all larvae died within 3 h of being added. These tests demonstrate that the ovitrap can be made lethal to both adults and larvae by insecticidal treatment of the ovistrip. Field efficacy trials are underway in Brazil to access the impact of this simple, low-cost, environmentally benign approach on populations of the dengue vector Ae. aegypti.     

Effect of heat stress on muscle blood flow during dynamic handgrip exercise

During exercise in a hot environment, blood flow in the exercising muscles may be reduced in favour of the cutaneous circulation. The aim of our study was to examine whether an acute heat exposure (65-70 degrees C) in sauna conditions reduces the blood flow in forearm muscles during handgrip exercise in comparison to tests at thermoneutrality (25 degrees C). Nine healthy men performed dynamic handgrip exercise of the right hand by rhythmically squeezing a water-filled rubber tube at 13% (light), and at 34% (moderate) of maximal voluntary contraction. The left arm served as a control. The muscle blood flow was estimated as the difference in plethysmographic blood flow between the exercising and the control forearm. Skin blood flow was estimated by laser Doppler flowmetry in both forearms. Oesophageal temperature averaged 36.92 (SEM 0.08) degrees C at thermoneutrality, and 37.74 (SEM 0.07) degrees C (P less than 0.01) at the end of the heat stress. The corresponding values for heart rate were 58 (SEM 2) and 99 (SEM 5) beats.min-1 (P less than 0.01), respectively. At 25 degrees C, handgrip exercise increased blood flow in the exercising forearm above the control forearm by 6.0 (SEM 0.8) ml.100 ml-1.min-1 during light exercise, and by 17.9 (SEM 2.5) ml.100 ml-1.min-1 during moderate exercise. In the heat, the increases were significantly higher: 12.5 (SEM 2.2) ml.100 ml-1.min-1 at the light exercise level (P less than 0.01), and 32.2 (SEM 5.9) ml.100 ml-1.min-1 (P less than 0.05) at the moderate exercise level.(ABSTRACT TRUNCATED AT 250 WORDS)     

Resorption versus secretion in the rat epididymis

Micropuncture samples were taken from the rete testis, caput epididymidis and cauda epididymidis of anaesthetized adult rats and assayed for total protein, sodium and potassium concentrations. Intraluminal sperm concentrations were determined and used to calculate the amount of fluid resorbed from the efferent duct and epididymal lumen. It was demonstrated that large amounts of protein (30.2 mg/ml cauda volume) and sodium (241.8 mequiv./l) and smaller amounts of potassium (19.4 mequiv./l) are resorbed from the rat epididymal lumen between the caput and corpus epididymidis. This occurs despite increases in intraluminal concentrations of protein (from 22 to 28 mg/ml) and potassium (from 16 to 50 mequiv./l). Resorption is an important aspect of epididymal control of the intraluminal environment.     

To serve you better

Fasting blood lipids were analyzed shortly before revascularization surgery in an attempt to find a possible correlation between the fate of the aortocoronary saphenous vein graft and lipoproteinemia. The patency of the bypass was evaluated by arteriography at two weeks and at one year following operation. Patients with closed grafts at two weeks had an original mean serum triglyceride concentration of 287 mg./100 ml. Patients with grafts which were widely patent after one year had an original triglyceridemia of 224 mg./100 ml. The severely stenosed group had an intermediate average preoperative value of 224 mg./100 ml. The same conclusion was reached with a group of patients with good vessel(s) distal to the graft(s). Cholesterolemia was about the same in all groups. These results suggest the hypothesis that hypertriglyceridemia plays a significant role in the reduction and/or occlusion of the lumen of the vein graft.     

Plasma Propranolol Levels in the Quantitative Assessment of β-adrenergic Blockade in Man

Plasma propranolol levels associated with reductions in endogenous and exogenous cardiac β-stimulation were determined in normal people. The levels associated with a given degree of blockade of exercise-induced tachycardia were about three times greater after intravenous administration than after oral administration. This shows that an active metabolite of propranolol is formed only after the drug is taken by mouth. The greatest reduction in the tachycardia of strenuous exercise was associated with plasma levels of 40 ng./ml. with oral administration and 100 ng./ml. with intravenously administered propranolol.The effect on isoprenaline-induced tachycardia following intravenously administered propranolol showed that the dose ratio for isoprenaline was about 30 with plasma levels of 100 ng./ml. and 10 with levels of 10-20 ng./ml. These plasma levels give 100% and 20-30% blockade of exercise-induced tachycardia. These findings suggest that some of the therapeutic effects of propranolol may be unrelated to β-adrenergic blockade.