PubMed Health⌕ Search

Biomedical subjects

J Cardinal

Publications and source records attributed to J Cardinal.

At least 37 records · Page 2Linked to original sources
PubMed1995

Continuous ambulatory peritoneal dialysis for patients with severe left ventricular systolic dysfunction and end-stage renal disease.

To better define the survival and quality of life of patients with major left ventricular systolic dysfunction and end-stage renal disease treated by continuous ambulatory peritoneal dialysis (CAPD), we reviewed all cases who started CAPD between May 1984 and March 1993 who had an isotopic left ventricular ejection fraction (LVEF) < or = 35%. Seventeen patients (12 men and five women with a mean age of 51.6 +/- 14.9 years) met the inclusion criteria. Mean isotopic LVEF before initiation of CAPD was 24.8% +/- 8.2%. All patients were symptomatic from congestive heart failure. Thirteen patients were classified as New York Heart Association grade III or IV. Continuous ambulatory peritoneal dialysis was associated with a significant improvement of isotopic LVEF, of functional status, and of blood pressure control. In 10 patients with a second measurement on CAPD, LVEF increased from a mean value of 23.2% +/- 9.1% to a mean value of 30.3% +/- 8.1% (P < 0.01). This represents a 30% increase of LVEF. After 6 months on CAPD, 94% of patients were classified as New York Heart Association grade I or II. Actuarial survival rates were 94%, 80%, and 64% at 12, 18, and 24 months, respectively. The mean duration of CAPD was 24 +/- 17 months. These results suggest that current CAPD treatment is an elective modality of treatment in patients with concomitant heart and renal failure.

Adult↗
PubMed1995

Genetic mapping of the multiple endocrine neoplasia type 1 locus at 11q13.

Oncogenesis of tumours related to multiple endocrine neoplasia type 1 (MEN1) is associated with somatic deletions involving the MEN1 locus at chromosomal region 11q13, suggesting inactivation of a tumour-suppressor gene in this region. Here we describe the localization of the MEN1 gene to a 900-kb region, based on linkage analysis in affected families and deletion mapping of MEN1-associated tumours. In addition, a set of microsatellite markers mapped to the 11q11-13 region were used for linkage analysis in a large Tasmanian MEN1 pedigree, demonstrating the usefulness of these markers for presymptomatic testing in affected families.

Adult↗
PubMed1994

High dialysate flow rate continuous arteriovenous hemodialysis: a new approach for the treatment of acute renal failure and tumor lysis syndrome.

A continuous dialysis technique such as continuous arteriovenous hemodialysis (CAVHD) could be an interesting alternative to frequent intermittent hemodialysis to treat acute renal failure (ARF) secondary to tumor lysis syndrome (TLS). However, because of massive release of intracellular solutes in TLS, CAVHD clearances need to be increased to treat this syndrome. Continuous arteriovenous hemodialysis using a high dialysate flow rate at 4 L/hr was assessed in TLS and ARF associated with severe hyperphosphatemia. A 0.6-m2 hollow-fiber polyacrylonitrile dialyzer (Multiflow 60; Hospal, St-Léonard, Québec, Canada) was used. Blood urea nitrogen and serum creatinine levels decreased, respectively, from 102.5 to 27.2 mg/dL and from 3.1 to 1.8 mg/dL during the 36 hours of treatment. Serum urate concentration was normal at the beginning of treatment (4.5 mg/dL) and decreased to 2.1 mg/dL by the end of CAVHD. Serum phosphorus decreased from 16.7 to 4.4 mg/dL after the 36 hours of treatment. The calcium x phosphorus product decreased from 111.1 to 42.1 by 28 hours and remained under 50 thereafter. Serum potassium was easily controlled with the addition of 2.5 mEq/L of KCl in dialysate and replacement solutions. No rebound increases in phosphorus or potassium were noted after cessation of therapy. Continuous arteriovenous hemodialysis clearances of urea, creatinine, phosphorus, and urate were measured at 2-hour intervals for the first 24 hours and at 4-hour intervals for the remaining 12 hours. They were 53.0 +/- 2.3 mL/min, 43.7 +/- 2.2 mL/min, 40.4 +/- 1.9 mL/min, and 39.3 +/- 1.9 mL/min (n = 15), respectively.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1993

Basolateral K+, Cl-, and HCO3- conductances and cell volume regulation in rabbit PCT.

The relationship between changes in cellular volume, intracellular pH (pHi), basolateral membrane potential (VBL), and membrane partial basolateral conductances to K+ (tK) and Cl- (tCl) and mediated by the Na-HCO3 cotransporter (tNaHCO3) was determined in the collapsed proximal convoluted tubule (PCT) submitted to a 125-mosmol/kg hypotonic shock. The shock that produces a rapid swelling followed by partial volume regulation was accompanied by a rapid and transient VBL hyperpolarization of 10.0 +/- 1.5 mV and a second gradual hyperpolarization of 5.0 +/- 0.7 mV with respect to a control value of -44.0 +/- 4.6 mV.tK was 0.12 +/- 0.03 in control, increased transiently to 0.15 +/- 0.03, and then gradually increased to reach 0.32 +/- 0.06 at the end of hypotonic shock. In contrast, tCl was 0.03 +/- 0.01 in control, increased rapidly to a maximum of 0.16 +/- 0.01, and then decreased slowly to 0.08 +/- 0.02. During the same period, tNaHCO3 decreased rapidly from 0.41 +/- 0.04 to a minimum of 0.11 +/- 0.02 and slowly reincreased to reach 0.16 +/- 0.01.pHi increased transiently from 7.09 +/- 0.03 in control to 7.24 +/- 0.05 to come back gradually to 7.15 +/- 0.05 at the end of the hypotonic period. The membrane absolute conductance mediated by the Na-HCO3 cotransporter was found to increase only slightly in hypotonic conditions, whereas that to K+ and Cl-, GK and GCl, increased by at least factors of 8 and 17, respectively, with the increase of GCl being much faster than that of GK. In addition, the temporal variations in GCl followed closely those of the cellular water efflux. We conclude that the hypotonic swelling leads to important increases in the conductive pathways for K+ and Cl- and that the Cl- conductance pathway appears to be the rate limiting step in triggering and supporting regulatory volume decrease.

Animals↗
PubMed1992

Solute clearances with high dialysate flow rates and glucose absorption from the dialysate in continuous arteriovenous hemodialysis.

The purpose of this study was to determine the effects of high inlet dialysate flow rates (IDFR) on the clearances of urea and creatinine and to measure the absorption of glucose through the dialyzer in continuous arteriovenous hemodialysis (CAVHD). Ten anuric acute renal failure patients in the intensive care unit were studied. Increasing the IDFR from 0 to 33.3 mL/min (0 to 2 L/h) produced linear increments in the clearances of urea and creatinine, whereas further increases in the IDFR from 33.3 to 66.7 mL/min (2 to 4 L/h) produced less important, but still significant, increases in the clearances. At 66.7 mL/min, the clearances for urea and creatinine were 48.5 +/- 3.4 and 42.2 +/- 2.5 mL/min, respectively. Using a dialysate with a glucose concentration of 25.3 mmol/L (0.5 g/dL), the net transfer of glucose through the dialyzer did not change significantly, from 16.7 to 66.7 mL/min of IDFR. Increasing the inlet dialysate glucose concentration from 25.3 to 75.8, 126.3, and 214.6 mmol/L (0.5 to 1.5, 2.5, and 4.25 g/dL) at a fixed IDFR of 16.7 mL/min produced linear increments in the net glucose transferred to the patient, from 0.12 +/- 0.02 to 0.67 +/- 0.05, 1.25 +/- 0.06 and 2.30 +/- 0.14 mmol/min, respectively (21.4, 121.0, 225.7, and 414.5 mg/min). No significant changes in the ultrafiltration and plasma flow rates through the dialyzer were recorded at these different IDFR or inlet dialysate glucose concentrations. Ten patients were treated for 4 days or more with 16.7 mL/min (1 L/h) IDFR CAVHD with excellent control over kidney function parameters.(ABSTRACT TRUNCATED AT 250 WORDS)

Acute Kidney Injury↗
PubMed1992

Peritonitis in continuous ambulatory peritoneal dialysis: impact of a compulsory switch from a standard to a Y-connector system in a single North American Center.

One hundred one continuous ambulatory peritoneal dialysis (CAPD) patients from a single North American center were analyzed in a retrospective and cross-over study for peritonitis rates using a standard system (Travenol System II) or a Y-shaped disconnect-disinfectant system (Travenol O-set). Twenty-one of 34 patients using the standard set (group I) had 53 episodes of peritonitis in 508 patient-months or one episode per 9.6 patient-months. Nine of 17 patients switching from the standard to the disconnect-disinfectant system (group II) experienced 22 episodes of peritonitis in 275 patient-months or one episode per 12.5 patient-months on the standard set, while six patients had 10 episodes of peritonitis in 275 patient-months or one episode per 27.5 patient-months on the disconnect-disinfectant system (P less than 0.04). Twenty-eight of 67 new CAPD patients starting on the disconnect-disinfectant system (group III) had 37 episodes of peritonitis in 1,086 patient-months or one episode per 29.4 patient-months (P less than 0.01 v group I). Exit-site infections (ESI) occurred in 35.3% of patients using the standard set versus 34.3% of those using the O-set. The presence of an ESI was not associated with a higher risk of peritonitis, but modified the bacteriological profile of subsequent peritonitis episodes in patients using the O-set, favoring the organisms isolated from the exit site. Decreases in peritonitis rates with the O-set were due to a reduction of peritonitis episodes secondary to most bacterial agents and not only to skin organisms. Diabetics using intraperitoneal insulin had similar peritonitis and ESI rates as nondiabetics.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1992

Involvement and source of calcium in volume regulatory decrease of collapsed proximal convoluted tubule.

We examined the role of Ca2+ in the volume regulatory decrease (VRD) of rabbit collapsed proximal tubules. Reduction of bath osmolality by 125 mosmol/kgH2O led to an initial cell swelling of 62.3 +/- 7.5% followed by a partial regulatory phase bringing cell volume to a value of 13.3 +/- 2.9% above control (n = 5). This swelling was accompanied by a transient intracellular Ca2+ ([Ca2+]i) increase from 174 +/- 33 to 306 +/- 67 nM (P < 0.05, n = 8). In the same condition, but in absence of extracellular Ca2+ ([Ca2+]e) [1 mM ethylene glycol-bis(beta-aminoethyl ether)-N,N,N',N'-tetraacetic acid (EGTA)], VRD following hypotonic shock was identical to that observed in presence of [Ca2+]e (n = 5), and [Ca2+]i increased transiently from 136 +/- 29 to 161 +/- 31 nM (P < 0.05, n = 5). Addition of 100 microM 8-(N,N-dimethylamino)octyl 3,4,5-trimethoxybenzoate hydrochloride (TMB-8), an agent known to inhibit Ca2+ release from intracellular stores, did not affect the initial cell swelling (63.4 +/- 4.2%), and VRD occurred to the same extent (25.0 +/- 7.1%, n = 4), although at a lower rate. In these conditions, [Ca2+]i, which was 113 +/- 30 nM in the isotonic solution, decreased progressively to 81 +/- 20 nM over the 5-min hypotonic period (n = 5). Mere preincubation with 100 microM TMB-8 before hypotonic shock led to a VRD identical to that observed in presence of Ca2+ and absence of TMB-8 while still blocking the Ca2+ release, with cell Ca2+ decreasing progressively from 179 +/- 32 to 87 +/- 21 nM (n = 7).(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1991

Intracellular potassium activity in mammalian proximal tubule: effect of perturbations in transepithelial sodium transport.

Intracellular potassium activity (alpha Ki) was measured in control conditions in mid-cortical rabbit proximal convoluted tubule using two methods: (i) by determination of the K+ equilibrium potential (EK) using Ba(2+)-induced variations in the basolateral membrane potential (VBL) during transepithelial current injections and (ii) with double-barrel K-selective microelectrodes. Using the first method, the mean VBL was -48.5 +/- 3.2 mV (n = 16) and the mean EK was -78.4 +/- 4.1 mV corresponding to alpha Ki of 68.7 mM. With K-selective microelectrodes, VBL was -36.6 +/- 1.1 mV (n = 19), EK was -64.0 +/- 1.1 mV and alpha Ki averaged 40.6 +/- 1.7 mM. While these last EK and VBL values are significantly lower than the corresponding values obtained with the first method (P less than 0.001 and P less than 0.01, respectively), the electrochemical driving force for K transport across the basolateral membrane (microK = VBL-EK) is not significantly different for both techniques (30.1 +/- 3.3 mV for the first technique and 27.6 +/- 1.8 mV for ion-selective electrodes). This suggests an adequate functioning of the selective barrel but an underestimation of VBL by the reference barrel of the double-barrel microelectrode. Such double-barrel microelectrodes were used to measure temporal changes in alpha Ki and microK in different experimental conditions where Na reabsorption rate (JNa) was reduced. alpha Ki was shown to increase by 12.2 +/- 2.7 (n = 5) and 14.1 +/- 4.4 mM (n = 5), respectively, when JNa was reduced by omitting in the luminal perfusate: (i) 5.5 mM glucose and 6 mM alanine and (ii) glucose, alanine, other Na-cotransported solutes and 110 mM Na. In terms of the electrochemical driving force for K exit across the basolateral membrane, microK, a decrease of 5.4 +/- 2.0 mV (P less than 0.05, n = 5) was measured when glucose and alanine were omitted in the luminal perfusate while microK remained unchanged when JNa was more severely reduced (mean change = -1.7 +/- 2.1 mV, NS, n = 5). In the latter case, this means that the electrochemical driving force for K efflux across the basolateral membrane has not changed while both the active influx through the Na-K pump and the passive efflux in steady state are certainly reduced. If the main pathway for K transport is through the basolateral K conductance, this implies that this conductance must have decreased in the same proportion as that of the reduction in the Na-K pump activity.

Alanine↗
PubMed1991

Basolateral ionic permeabilities of macula densa cells.

It has recently been shown that membrane ionic transport pathways of macula densa cells can be measured using conventional microelectrodes. To determine if conductances could be identified at the basolateral membrane of macula densa cells, cortical thick ascending limbs (CTAL) with attached glomeruli were continuously perfused with a 25 mM NaCl bicarbonate-free Ringer solution. Individual basolateral Na+, Cl-, NaCl, and K+ concentrations were altered by isosmotic replacement with N-methyl-D-glucamine and/or cyclamate. Reduction in basolateral [Na+] from 150 to 25 mM hyperpolarized basolateral membrane potential (Vbl) by 9.9 +/- 1.3 mV (n = 10; all data are corrected for changes in liquid junction potential at bath electrode). A decrease in bath [Cl-] from 150 to 25 mM depolarized Vbl by 20 +/- 2.4 mV (n = 13), whereas decreases in bath [NaCl] from 150 to 25 mM depolarized Vbl by 29 +/- 6.8 mV (n = 5). In the presence of 150 mM NaCl bathing solution, a stepwise increase in [K+] from 5 to 15 mM (by replacement of 10 mM NaCl with 10 mM KCl) depolarized Vbl by 3.3 +/- 1.1 mV (n = 8). After correction for individual transepithelial diffusion potentials, Cl conductance averaged 59 +/- 19% of the total basolateral conductance, whereas K+ (23 +/- 8%) and Na+ (17 +/- 10%) contributed significantly less to the overall basolateral conductance. These results indicate that membrane potential of macula densa cells may be very sensitive to alterations in intracellular Cl- activity and suggest that apical transport of NaCl through a furosemide-sensitive Na(+)-K(+)-2Cl- transporter may affect membrane potential in macula densa cells via a change in intracellular Cl- activity.

Action Potentials↗
PubMed1990

Membrane crosstalk in the mammalian proximal tubule during alterations in transepithelial sodium transport.

The present paper examines the effects of reduced transepithelial Na transport (JNa) on membrane electrophysiological parameters in proximal convoluted tubules and the possible role of cytosolic calcium concentration ([Ca]i) in the regulation of basolateral membrane K conductance (GK). When JNa was reduced by elimination of glucose and alanine and replacement of 100 mM sodium with N-methyl-D-glucamine from the luminal perfusate, basolateral membrane potential (VBL) hyperpolarized transiently by 12.6 mV and the ratio of apical to basolateral membrane resistance (RA/RBL) doubled. The apparent transference number for K at the basolateral membrane (GK/Gcell) decreased from 0.13 to 0.08 in the first 4 min following reductions in JNa. The elimination of Na-alanine and Na-glucose cotransport was responsible for the initial hyperpolarization and increase in RA/RBL, whereas the resultant decrease in the cellular concentrations of glucose and alanine, together with the reductions in GK, could elicit the secondary VBL depolarization. Measurement of [Ca]i with the fluorescent probe fura-2 during reductions in JNa revealed that [Ca]i increased by an average of 12%, a value very similar to the average reduction in cellular volume (13%) measured using morphometric techniques. The observation that [Ca]i increased while GK was decreasing is inconsistent with the effect of [Ca]i on putative basolateral Ca-activated K channel. We believe that [Ca]i changes passively (at least in the first few minutes) in response to a decrease in cell volume occurring as a consequence of reductions in JNa and that some as yet unidentified volume-sensitive mechanism is responsible for the regulation of GK.

Animals↗
PubMed1990

Direct evidence for apical Na+:2Cl-:K+ cotransport in macula densa cells.

Previous studies by our laboratory indicate that increases in apical NaCl concentration ([NaCl]) depolarize macula densa (MD) cells, although the mechanism for apical NaCl transport was not identified. To determine the pathway for MD apical NaCl transport, we utilized microdissected cortical thick ascending limbs (CTAL) with attached glomeruli and conventional microelectrode techniques. Addition of 50 microM furosemide in the presence of 150 mM NaCl produced a variable hyperpolarization of basolateral membrane voltage (delta Vbl, -14 +/- 8.2 mV, NS P = 0.15, n = 6) and completely blocked the expected repolarization on reducing luminal [NaCl] from 150 to 25 mM. Addition of furosemide in the presence of 25 mM NaCl depolarized Vbl by 22 +/- 6.8 mV (P less than 0.05, n = 6) indicating that the direction of the NaCl transport can be reversed in low luminal [NaCl]. In other studies, luminal concentration of Na or Cl was increased from 25 to 150 mM. Increased [Na] produced a 6.9 +/- 1.2 mV (n = 9) depolarization, whereas Cl addition depolarized Vbl by 8.2 +/- 1.7 mV (n = 5), suggesting that both ions are involved in the NaCl-induced MD depolarization. Removal of K from the luminal perfusate elicited a hyperpolarization of -14 +/- 2.9 mV (n = 9). These results are all consistent with the existence of an apical Na+:2Cl-:K+ transporter that would result in NaCl reabsorption in the presence of 150 mM luminal NaCl but would produce NaCl secretion at low luminal NaCl concentrations.

Animals↗
PubMed1989

Direct measurement of basolateral membrane potentials from cells of the macula densa.

At the present time, little is known concerning the electrophysiology of the cells of the macula densa and whether or not these cells are electrically responsive to alterations in luminal fluid composition. To investigate this issue, cortical thick ascending limbs (CTAL) containing macula densa and attached glomeruli were dissected from rabbit kidney and the CTAL perfused in vitro. Basolateral membrane potential (Vbl) was measured with microelectrodes in macula densa cells and, for comparison, in cells of the CTAL. Macula densa Vbl averaged -56.5 +/- 7.6 mV (n = 4) at a (n = 22) at 20 mM NaCl, -35.6 +/- 3.9 mV (n = 16) at 45 mM NaCl, and -25.5 +/- 2.6 mV (n = 32) at 150 mm NaCl. Thus macula densa Vbl depolarized markedly (31 mV) when luminal perfusate [NaCl] was increased from low to high values. In contrast, Vbl measured in CTAL cells averaged -62 +/- 6.1 mV (n = 6) in 45 mM NaCl and did not change significantly as perfusate NaCl was increased to 150 mM. In the presence of 150 mM NaCl, luminal application of furosemide (50 microM) produced a small (3.5 +/- 1.1 mV, n = 16) but statistically significant (P less than 0.02) hyperpolarization in macula densa cells, whereas CTAL cell Vbl hyperpolarized markedly (20 +/- 5.7 mV, n = 6) with addition of furosemide. Finally, neither macula densa cells nor the CTAL cells changed Vbl when 45 mM NaCl solution was made hypotonic by removing mannitol.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1988

Single-channel analysis of a K channel at basolateral membrane of rabbit proximal convoluted tubule.

The basolateral membrane of the rabbit proximal convoluted tubule (PCT) is known to be largely permeable to K ions. The patch-clamp technique was used to investigate the molecular basis of this K permeability. At room temperature and with a high-K solution (127 mM) in both the bathing medium and the patch pipette, current jumps associated with an inward-rectifying channel could be detected in every active cell-attached experiment. When the K concentration in the pipette was changed from 200 to 5 mM KCl (NaCl replacement), the single-channel conductance for inward currents changed from 54 to 10 pS. The observed shift in the zero current potential measured as a function of the patch pipette K concentration could be fitted using the Goldman-Hodgkin-Katz equation with a permeability ratio PNa/PK = 0.06. The channel was found to be moderately voltage dependent (e-fold per 56 mV depolarization). For instance, the open-channel probability (Po) increased from 0.06 to 0.16 following a membrane depolarization from -50 to +50 mV. A time interval distribution analysis showed for the open state a dominant single time constant of 14 and 10 ms at 50 and -50 mV, respectively. Two time constants equal to 1 (flickering) and 26 ms at +50 mV and to 0.6 and 300 ms at -50 mV were obtained for the closed-state interval distribution. Based on this analysis, it was concluded that the decrease of Po at negative potentials was due more to the appearance of prolonged silent periods than from a change in the channel mean open time.

Algorithms↗
PubMed1988

Southeast Asian folklore about pregnancy and parturition.

Southeast Asian refugees immigrating to the United States bring many traditional beliefs about pregnancy and childbearing to their new home. Harmony with nature, dualistic concepts of disease, and pathogenetic metaphor are important ingredients of indigenous health practices. Pregnant and postpartum women must be protected against "wind," lost of "heat," and poisons. Because these notions and the behaviors used to carry them out may seem bizarre to unsuspecting Western-trained health care personnel, it is important for Westerners to understand the basis for these beliefs.

Asia, Southeastern↗
PubMed1986

Characterization of the apical membrane ionic permeability of the rabbit proximal convoluted tubule.

Basolateral membrane potential (psi BL), transepithelial potential (psi T), and the ratio of apical to basolateral membrane resistance (RA/RBL) were measured in rabbit proximal convoluted tubules (PCT) perfused in vitro. Analysis of RA/RBL changes using several luminal perfusates indicates that the cotransport of Na with glucose and alanine would represent 19% of the apical conductance in normal conditions; the cotransport of Na with acetate, citrate, sulfate, and phosphate would represent 7%, whereas Na, K, and Cl diffusion would represent 10, 4, and 0% of this apical conductance, respectively. On the other hand, psi BL values can also be analyzed using the equivalent circuit of the epithelium to obtain the apical membrane equivalent electromotive force (EA) in the presence of each perfusate. These values, as well as the preceding values obtained from RA/RBL measurements, indicate that in the absence of cotransported solutes the transference number for Na diffusion is several times larger than for K diffusion. Among the conductance pathways studied, the transference number sequence would be as follows: Na cotransport with alanine and glucose greater than Na cotransport with anions greater than Na diffusion greater than K diffusion greater than Cl diffusion. This study also suggests the presence of another important but unidentified apical ionic permeation pathway, since the total of the transference numbers obtained from RA/RBL analysis represents only 40% of the total apical membrane conductance and the absolute values of EA are difficult to account for using only the tested apical membrane permeation pathways.

Acetates↗