Blood level of free serotonin, catecholamines and the renin-angiotensin-aldosterone system in patients with primary hypertension]

Two subgroups of patients were selected out of those dialysed for chronic renal failure. Group A included patients without arterial hypertension before dialysis, and group B patients with arterial hypertension before dialysis. Blood endogenous digoxin-like substance (DLS) has been assayed. Its blood levels were not increased in hypertensive patients either before or after dialysis. No correlation was found between DLS and mean arterial pressure in the whole group of patients with chronic renal failure. The obtained results do not suggest that arterial blood pressure in patients with chronic renal failure is related to the presence of DLS in the blood.     

Plasma concentration of antidiuretic hormone in patients with chronic renal insufficiency on maintenance dialysis.

Radioimmunoassay of plasma arginine-vasopressin (AVP) in regularly dialyzed patients with chronic renal insufficiency revealed a parallel increase of AVP and plasma osmolality (POsm) before dialysis (4.16 +/- 0.36 pg/ml and 312.6 +/- 1.80 mOsm/1) and their parallel declin to the normal range (1.93 +/- 0.27 pg/ml and 292.0 +/- 1.27 mOsm/1) during dialysis. Plasma AVP correlated with POsm before and after dialysis (r = 0.611 and 0.453, p less than 0.01 and less than 0.05 respectively). The increase of AVP before dialysis was lower than would correspond to the rise of POsm and lower than that recorded in healthy subjects during dehydration. Statistical correlation between plasma AVP and indicators of body fluid volume changes between or during dialysis were not proved. We found statistical correlation between the mean blood pressure and AVP before dialysis (r = 0.468, p less than 0.05). These findings suggest that in chronic renal insufficiency changes of POsm remain primary regulating factor of AVP secretion. The expansion of extracellular fluid volume has probably only a modifying effect. It remains to be elucidated whether the revealed statistical relationship between the mean blood pressure and AVP before dialysis plays also a pathogenetic role in the development of hypertension in chronic renal insufficiency.     

A method for producing regional hypoglycemia in blood perfused tissue

Numerous studies have focused on the metabolic contributions of glucose and other substrates in isolated tissue preparations by examining the effects of eliminating glucose from the physiologic perfusate or bath solution. To date, however, an effective method of glucose removal from the blood supply to selected tissue in the whole animal model has not been available. We have developed a method for blood glucose removal by continuous flow dialysis. This method was used to generate isolated coronary hypoglycemia for an investigation of myocardial metabolic substrate selection during hypoperfusion in open-chest, anesthetized dogs. Arterial blood was passed through the dialysis system against an isotonic and physiologic dialysate solution prior to controlled coronary perfusion. During normal perfusion pressure (100 mmHg), with a coronary blood flow of 32 ± 4 ml/min, arterial blood glucose was reduced from 3.26 ± 0.31 to 0.54 ± 0.14 mM. When blood flow was reduced to 12 ± 3 ml/min with lower perfusion pressure (40 mmHg), dialysis reduced arterial glucose from 3.53 ± 0.36 to 0.15 ± 0.03 mM. We conclude that this is an effective method for producing regional hypoglycemia.     

Debate: Does it matter how you lower blood pressure?

Whether it matters how pressure is lowered has been debated since antihypertensive drugs proved to prevent cardiovascular events. However, in clinical trials, while the stroke benefit predicted by a given difference in blood pressure was achieved, the results for myocardial infarction were roughly half that expected. This suggested that adverse drug effects of diuretics and β-blockers might have detracted from their hypotensive effects. Trials with newer antihypertensive classes have revealed superior effects on outcomes associated with converting enzyme inhibitor use, and that α-blockers are less cardioprotective than diuretics. These studies establish that simple blood pressure reduction is an inadequate guide to therapy. The challenge now will be to determine the optimal therapy for each hypertensive patient.     

Regular short haemodialysis in end-stage renal failure.

A study was made of thrice weekly haemodialysis of 3-3 1/2 hours'' duration using a large surface area dialyser in patients with end-stage renal failure. Body water, potassium, and blood pressure control were satisfactory and comparable with the more widely used long dialysis schedules (6-9 hours thrice weekly). Patient rehabilitation was improved overall and the regimen enabled the dialysis unit to treat more patients despite a reduction in technical and nursing staff. The technique proved inadequate, however, in two patients with an intercurrent infection, and more intensive dialysis in recommended in such cases.     

A new method for detection of drug-binding proteins using a parallel-flow dialysis technique

A parallel-flow dialysis technique utilizing a Technicon dialyzer and a constant-flow system has been described for the detection of drug-binding proteins. The effect of temperature, flow-rate and drug concentration was investigated by measuring the efficiency of dialysis and detecting the binding of methyl orange to bovine serum albumin. The larger response was shown to be achieved by increasing the efficiency of dialysis or the drug concentration. The present method will enable the continuous monitoring of drug-binding proteins.     

糖尿病肾病腹膜透析血管内皮功能变化及内皮功能不全的相关因素探讨

目的：探讨分析糖尿病肾病腹膜透析患者血管内皮功能的变化。方法：将来我院行腹膜透析的糖尿病肾病患者56例作为观察组,非糖尿病肾病患者64例作为对照组,测量血压及血容量,采用血流介导的肱动脉扩张法测定血流介导的血管扩张。结果：观察组患者的收缩压、脉压、细胞外液均明显高于对照组,血管扩张则显著低于对照组（P〈0．05）;血管扩张与身高、体重、收缩压、细胞外液均呈负相关（P〈0．05）;细胞外液、有无糖尿病肾病是血管扩张的独立预测因素。结论：糖尿病肾病腹膜透析患者具有严重的内皮功能不全,其中细胞外液、有无糖尿病肾病是血管扩张的独立预测因素。     

透析培养

本讨论了有效利用透析技术从发酵液中及时转移低分子杂质混合物,从而获得高密度发酵细胞的方法,章从反应系统、工艺策略、膜相关性能、应用我、生产性放大等方面说明了利用透析技术以达到高浓度细胞发酵的有效性和可靠性。透析技术不仅克服了微孔过滤和超滤中存在的膜孔堵塞弊端,而且如果应用“营养分离”补策略,还可以防止营养物质的损失而使培养基被高效利用,在实验条件下,透析培养的潜力通过两种反应模型进行演示：内置     

Iron Metabolism in Patients Undergoing Regular Dialysis Therapy

Thirteen patients with chronic renal failure maintained on regular renal dialysis were studied. Seven proved to have iron deficiency on the basis of marrow iron studies, reticulocyte iron uptake, and saturation of the serum iron-binding capacity. They absorbed iron when given it by mouth and were able to utilize it for haemoglobin formation. Iron-deficient patients given 600 mg of ferrous sulphate daily for three months showed an increase in haemoglobin, but the failure to replace stores of iron is probably related to their relatively limited ability to absorb iron and the variable but sometimes considerable blood loss occurring with each dialysis.The loss may be occult, and prolonged iron therapy may be required. This is most safely achieved by giving iron by mouth.     

高通量血液透析对糖尿病肾病血液透析患者心脏功能及结构的影响及预后的影响因素分析

摘要 目的：探讨高通量血液透析对糖尿病肾病（DN）血液透析患者心脏功能及结构的影响,并分析预后的影响因素。方法：选取2017年5月~2018年11月期间我院收治的DN血液透析患者（n=172）,上述DN血液透析患者中普通透析治疗者60例（普通透析组）、高通量血液透析治疗者112例（高通量透析组）。普通透析组采用低通量透析治疗,高通量透析组采用高通量透析治疗,比较两组患者心脏功能及结构以及预后情况,采用单因素、多因素Logistic回归分析预后的影响因素。结果：高通量透析组治疗6个月后左心房内径（LAD）、左心室舒张末内径（LVDd）、左心室心肌重量指数（LVMI）低于治疗前和普通透析组（P<0.05）,高通量透析组治疗6个月后左心室射血分数( LVEF )高于治疗前和普通透析组（P<0.05）。高通量透析组的生存率高于普通透析组（P<0.05）。存活组年龄、上机前舒张压、上机前收缩压、血磷、全段甲状旁腺激素（iPTH）均低于死亡组（P<0.05）,存活组透析频率、白蛋白、血红蛋白均高于死亡组（P<0.05）,两组性别、血钙比较无差异（P>0.05）。多因素Logistic回归分析结果显示,上机前舒张压高、上机前收缩压高、血磷高、iPTH高、透析频率少、白蛋白低、血红蛋白低均是DN血液透析患者死亡的危险因素（P<0.05）。结论：高通量血液透析能减轻DN患者血液透析所引起的心脏功能及结构损伤,改善患者预后。影响DN血液透析患者预后的因素较多,其中上机前舒张压、上机前收缩压、血磷、iPTH越高,白蛋白、血红蛋白越低,透析频率越少,患者的死亡风险越大。     

Use of solid-phase immunoenzyme analysis for determining allergen-specific IgE antibodies

An ELISA system for the detection of allergen-specific IgE antibodies to ragweed allergen has been developed. The system is highly sensitive and specific. Ragweed pollen allergen has been obtained by the dialysis of water-soluble extract through a kidney membrane. The high molecular fraction of ragweed allergen, showing the whole of the allergenic activity detected by skin tests in untreated patients, has been used for coating polystyrene assay plates. To detect IgE antibodies to ragweed allergen, the conjugate of sheep anti-IgE antibodies with horse-radish peroxidase has been used. The level of allergen-specific IgE antibodies has been determined on the basis of the data on the optical density of the samples in comparison with that of the normal sera. The correlation factor of the results obtained in the assay of specific IgE antibodies with the newly developed assay system and with the commercial kit Phadezyme RAST manufactured by Pharmacia AB (Sweden) has proved to be 0.82 at n = 39, p less than 0.01, while the variation factor in the reproduction of the assay results has proved to be 12% at n = 40.     

The importance of oxidative stress in patients with chronic renal failure whose hypertension is treated with peritoneal dialysis

Increased oxidative stress is a well-known phenomenon in dialysis patients. However, the contribution of hypertension to the oxidative stress in peritoneal dialysis patients has not yet been assessed. The present study aimed to investigate if hypertension had an additional effect on oxidative stress in peritoneal dialysis patients. A total of 50 patients treated with peritoneal dialysis were divided into two groups: The patients with mean of last three blood pressure results as 135/90 mmHg and above were considered hypertensive, the patients with lower blood pressure were considered normotensive. The control group included 25 healthy individuals. Serum malondialdehyde (MDA), advanced oxidation protein product (AOPP), myeloperoxidase (MPO), catalase (CAT) and glutathione peroxidase (GSH-Px) levels were measured in all groups. MDA level, an indicator of lipid peroxidation, was significantly higher in the hypertensive group compared to the control group, while the increase in the normotensive group was not significant. However, the difference between the hypertensive and normotensive groups was significant. The levels of AOPP, an indicator of protein oxidation level, and MPO, an indicator of neutrophil activation, were not different between the groups, while the activities of antioxidant CAT and GSH-Px decreased in both normotensive and hypertensive groups compared to the control group, and there was no significant difference between the patient groups. This study shows that both normotensive and hypertensive peritoneal dialysis patients have increased-oxidative stress and decreased antioxidant levels and hypertension might have an additional effect on oxidative stress by increasing MDA level in peritoneal dialysis patients.     

Plasma Renin Activity and Blood Pressure in 89 Patients Receiving Maintenance Haemodialysis Therapy

Blood pressure, plasma renin activity, plasma sodium concentration, plasma potassium concentration, dietary sodium intake, and duration of dialysis have been measured under standard conditions in 89 patients on maintenance haemodialysis. No significant relation was found between plasma renin activity and blood pressure. Statistically significant correlations were found between plasma renin activity and plasma sodium concentration and between plasma renin activity and dietary sodium intake.Only one patient was found to have uncontrollable hypertension associated with a markedly raised plasma renin activity. Reasons are given for not performing bilateral nephrectomy in this patient. We believe the low incidence of uncontrollable hypertension and hyperreninaemia in our patients to be due to their slow introduction to haemodialysis, thus preventing violent swings in body weight, blood pressure, and renin secretion.Although plasma renin activity did fall with duration of dialysis, all 15 patients who have been on maintenance dialysis for longer than five years have normal levels.     

Methods for intracellular recording from hippocampal brain slices under high helium pressure

A method for intracellular recording from rat hippocampal brain slices under helium pressure is described. The preparation is mounted on a horizontal mobile platform that is rolled into the pressure chamber and can be viewed at pressure. Remote manipulation of the glass microelectrodes is achieved by a high-resolution electrically driven commercially available system. The slice is superfused continuously from a closed system within the chamber. Temperature is maintained at 37 degrees C and PO2 at 0.5 atm within the pressure chamber. A pressure of 200 ATA can be obtained, although thus far recordings have been made up to only 130 ATA. The experiments demand that a number of sample recordings be made from the same slice at both ambient and high pressure, and tests have proved that, although difficult, this can be achieved. The resting membrane potential, the current-voltage relationship, and the action potential responses to short (8 ms), medium (80 ms), and long (800 ms) depolarizing current pulses have all been measured in CA1 pyramidal neurons.     

A Multi-sample Microdialysis Apparatus for Proteins and Nucleic Acids

Abstract

A multiposition microdialysis system suitable for simultaneous microsample applications (between 10 μL and 500 μL), has been developed. Each sample, contained in a specially designed microfuge dialysis tube (mDT), is dialysed independently from the other samples. Each mDT has its own membrane, and this feature allows the use of different membranes and dialysis times for different samples.

The microdialysis apparatus is kept at constant temperature by an external thermostat, avoiding the use of a cold box. The dialysis release time for small ions, a parameter used for quantitation of microdialysis efficiency, decreases from 22.9 min (for a 200 μL sample) to 7 min (for a 50 μL sample). The sample is efficiently recovered by centrifugation. Quantitative recoveries (90%) of different proteins and DNA were achieved after microdialysis by mDT.     

Effect of chronic uremia on the cardiovascular alpha 1 receptor

Adrenergic dysfunction in uremia has been well described. Several lines of evidence suggest disorders of blood pressure regulation and myocardial response may occur secondary to adrenergic dysfunction; attenuated pressor response to norepinephrine (NE) in uremia; attenuated chronotropic responses during dialysis induced hypotension. Since the adrenergic receptors are the effector component of the adrenergic nervous system, we have employed the partially nephrectomized uremic rat, to examine the effect of chronic uremia (4-6 weeks) on the binding properties of alpha 1 receptors in rat mesenteric artery and myocardial tissue. The results indicate that moderate levels of uremia alter the binding properties of both the alpha 1 vascular and myocardial receptor.     

Favorable course of pregnancy in a patient two years after kidney transplantation]

A 30-year old female underwent kidney transplantation after unsuccessful 3-year dialysis for renal cortex necrosis. Immunosuppression was achieved with cyclosporin followed by azathioprine with prednisone. The patient conceived after 22 months with kidney transplantation. Mild decrease in arterial blood pressure and marked increased in glomerular filtration rate were seen during the first three months of pregnancy. Arterial blood pressure increased but insignificantly at the end of pregnancy. That time, gradual decrease in creatinine clearance was observed. An increase in serum bilirubin and alkaline phosphatase was noted. Pregnancy was terminated by cesarean section on the 38th week. Newborn was female, full-termed, viable, with body weight of 3,300 g. All examined parameters were normalized after delivery. Described case indicates that transplanted kidney functioning during pregnancy is similar to that in healthy women.     

Dialysis cultures

Dialysis techniques are discussed as a means for effective removal of low-molecular-mass components from fermentation broth to reach high cell density. Reactor systems and process strategies, the relevant properties of membranes and examples for high-density fermentation with dialysis, and problems related to scale-up are addressed. The dialysis technique has turned out to be very efficient and reliable for obtaining high cell densities. As in dialysis processes the membranes are not perfused, membrane clogging is not a problem as it is for micro- and ultrafiltration. By applying a “nutrient-split” feeding strategy, the loss of nutrients can be avoided and the medium is used very efficiently. The potential of dialysis cultures is demonstrated on the laboratory scale in a membrane dialysis reactor with an integrated membrane and in reactor systems with an external dialysis loop. In dialysis cultures with different microorganisms (Staphylococci, Escherichia coli, extremophilic microorganisms, Lactobacilli) the cell densities achieved were up to 30 times higher than those of other fermentation methods. The technique enables high cell densities to be attained without time-consuming medium optimization. For animal cell cultures the concept of a fixed bed coupled with dialysis proved to be very effective. Received: 24 March 1998 / Received revision: 18 June 1998 / Accepted: 19 June 1998     

树脂灌血液灌流在顽固性高血压患者血液透析中的应用

目的：探讨树脂灌血液灌流对血液透析顽固性高血压患者血压及肾素-血管紧张素．醛固酮系统的影响。方法：选择我院82例,均分为I组和II组各41例,I组患者采用金宝8LR聚酰胺膜透析器进行常规透析,II组患者在常规透析的基础上串联树脂血液灌流,检测两组患者治疗前和治疗后3个月血清肌酐、尿素氮变化情况,和患者体内肾素活性、血管紧张素II和醛固酮变化情况,并对血压变化值进行比较。结果：两组患者治疗后3个月血肌酐、血尿素氮均明显较治疗前降低,I组患者治疗后3个月收缩压和舒张压较治疗前均无明显变化,II组治疗后3个月收缩压和舒张压均较治疗前明显降低,I组治疗后3个月肾素、血管紧张素II和醛固酮较治疗前无明显差异,II组治疗后3个月肾素、血管紧张素II和醛固酮较治疗前均明显降低。结论：血液透析联合树脂吸附灌在保证有效清除患者体内代谢物质的同时角色较好的控制患者血压。