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J I Shapiro

Publications and source records attributed to J I Shapiro.

At least 55 records · Page 3Linked to original sources
PubMed1991

Improvement in experimental cardiac preservation based on metabolic considerations.

Viability of rat hearts preserved in the standard Euro-Collins and a modified preservation medium utilizing the Euro-Collins medium as the base were assessed. The additions for the modified medium were chosen in order to attenuate the various forms of damage that may occur to an organ during cold ischemia. The viability of the hearts was assessed biochemically via 31P nuclear magnetic resonance spectroscopy and functionally during reperfusion in an isolated Langendorff preparation. It was noted that a modified medium containing magnesium, adenosine, allopurinol, glutathione, and polyethylene glycol provided superior protection of the cold ischemic myocardium as compared with the standard Euro-Collins medium in the isolated heart perfusion apparatus. Both physiologic function (dp/dt) and metabolic status (Pi/PCr ratio) were superior with the modified compared with the control medium (325 +/- 83 vs. 90 +/- 35 mmHg/sec and 0.42 +/- .09 vs. 0.68 +/- .05, respectively, both P less than 0.05). Moreover, this modified solution resulted in more rapid development of contractions, as well as improved Pi/PCr ratio (0.71 +/- .32 vs. 2.02 +/- .59, P less than 0.05) in the in vivo heterotopic transplant model. It seems likely that a combination of pharmacologic additives may be developed that synergistically attenuate damage to the preserved myocardium.

Animals↗
PubMed1991

Contractile dysfunction during metabolic acidosis: role of impaired energy metabolism.

To investigate the mechanisms by which acidosis depresses cardiac function, a Langendorff isolated perfused rat heart preparation was studied using 31P magnetic resonance spectroscopy. Isolated hearts were subjected to normal perfusion conditions or experimental manipulations simulating severe metabolic acidosis, substrate depletion, impairment of oxidative metabolism, or low perfusate calcium concentrations. All maneuvers resulted in marked reductions in oxygen consumption and the force of myocardial contraction (dP/dt). Metabolic acidosis had bioenergetic changes suggestive of impaired energy production, specifically, increases in Pi and decreases in phosphocreatine concentrations, which did not occur in hearts subjected to low perfusate calcium concentrations. In acidotic perfusions as well as substrate depletion and impairment of oxidative metabolism, the change in dP/dt correlated best with the change in the intracellular concentration of monovalent Pi (P(im)) (r = 0.70, P less than 0.01), whereas in hearts subjected to a low perfusate calcium concentration, there was no relationship between dP/dt and the change in Pim concentrations. More detailed analysis of the time course of the metabolic and physiological changes with metabolic acidosis revealed a discordance between changes in Pim and the decreases in dP/dt during the first 20 min of the induction of acidosis and the first 10 min of recovery from acidosis. These data suggest that metabolic acidosis has a major direct effect on energy metabolism in this model. Moreover, impairment of oxidative metabolism in concert with decreases in intracellular pH may be important in the contractile failure associated with prolonged metabolic acidosis.

Acidosis↗
PubMed1991

Study of brain electrolytes and organic osmolytes during correction of chronic hyponatremia. Implications for the pathogenesis of central pontine myelinolysis.

Osmotic injury induced by rapid correction of severe chronic hyponatremia has been implicated in the development of central pontine myelinolysis. Organic osmolytes known previously as "idiogenic osmoles" accumulate intracellularly to protect cells from osmotic injury. We investigated the changes of these organic osmolytes as well as electrolytes in the brain during the induction and correction of chronic hyponatremia. Using 1H-nuclear magnetic resonance spectroscopy and HPLC, we found that in rats with chronic hyponatremia (3 d, serum sodium = 109 +/- 3 meq/liter), brain concentrations of myoinositol (41%), glycerophosphorylcholine (45%), phosphocreatine/creatine (60%), glutamate (53%), glutamine (45%), and taurine (37%) were all significantly decreased compared with control values (percentage control value shown, all P less than 0.01). The contribution of measured organic osmolytes and electrolytes to the total brain osmolality change was 23 and 72%, respectively. With rapid correction by 5% NaCl infusion, significant brain dehydration and elevation of brain Na and Cl levels above the normal range occurred at 24 h. These changes were not seen with slow correction by water deprivation. Reaccumulation of most organic osmolytes except glycerophosphorylcholine is delayed during the correction of hyponatremia and is independent of the correction rate of serum sodium. It is concluded that: most of the change of brain osmolality in chronic hyponatremia can be accounted by the changes in organic osmolytes and brain electrolytes; and rapid correction of hyponatremia is associated with an overshoot of brain sodium and chloride levels along with a low organic osmolyte level. The high cerebral ion concentrations in the absence of adequate concentrations of organic osmolytes may be relevant to the development of central pontine myelinolysis.

Animals↗
PubMed1991

Nuclear magnetic resonance spectroscopy in patients with anion-gap acidosis.

Proton nuclear magnetic resonance spectroscopy was performed on blood or urine from five patients with an anion-gap metabolic acidosis. In all of these cases, this methodology allowed the rapid and specific diagnosis of the nature of the metabolic acidosis. In several of these patients, spectroscopic evidence for intoxication with toxic alcohols was obtained. On the basis of these preliminary data, proton nuclear magnetic resonance spectroscopy may be a useful technique in the evaluation of patients with anion-gap acidosis.

Acid-Base Equilibrium↗
PubMed1990

Evaluation of the double-quantum filter for the measurement of intracellular sodium concentration.

Evaluation of the double-quantum filter for sodium was performed on several sample series of bovine serum albumin in water. Both single-quantum (1Q) and double-quantum (2Q) measurements were obtained. The quality of the 2Q filter was found to be quite sensitive to pulse width setting. Ordinary 1Q measurements of sodium in albumin-containing solutions show 100% visibility. At high ionic strengths, the 2Q albumin results confirm earlier conclusions demonstrating the tendency for the albumin molecule to unfold under a variety of influences. At physiological sodium concentrations, the magnitude of the 2Q/1Q ratio is controlled not only by the concentration of albumin, but also by the solution pH. Non-zero, double-quantum signals were observed in physiological samples consisting of essentially intracellular material (packed red blood cells) as well as in extracellular material (plasma and urine). Measurements in human urine showed no 2Q signal. However, high-concentration NaCl solutions did produce real, measurable 2Q signals. Therefore, the 2Q filter does not measure intracellular sodium exclusively. Although packed red blood cells gave the highest 2Q/1Q ratio (8.5 x 10(-3), plasma gave a very considerable 2Q/1Q ratio (2.3 x 10(-3). Because of its relatively high extracellular concentration, extracellular sodium may give a greater absolute 2Q signal than intracellular sodium in unmodified tissue samples. Based on these data, we conclude that a 2Q filter will not provide a useful measurement of intracellular sodium in in vivo tissue samples.

Erythrocytes↗
PubMed1990

Hemodynamic and hepatic pH responses to sodium bicarbonate and Carbicarb during systemic acidosis.

Rats subjected to ammonium chloride-induced metabolic acidosis were given alkalinization therapy with either sodium bicarbonate or Carbicarb. Ammonium chloride-induced severe metabolic acidosis had minimal effect on mean arterial blood pressure and cardiac output. This acidosis resulted in a small but statistically significant fall in intracellular liver pH (pHi) as measured with 31P magnetic resonance spectroscopy (7.01 +/- 0.05 vs 7.08 +/- 0.04, p less than 0.05). Sodium bicarbonate treatment resulted in systemic alkalinization and increases in arterial pCO2 as well as transient but extreme decreases in cardiac output and mean arterial pressure. Alkalinization with sodium bicarbonate also resulted in a transient but significant decrease in intracellular liver pH (7.02 +/- 0.06 at 5 min vs 7.09 +/- 0.06 at baseline, p less than 0.05). Carbicarb therapy resulted in systemic alkalinization without major changes in arterial pCO2, cardiac output, or mean arterial blood pressure. Moreover, Carbicarb effected a sustained intracellular alkalinization of the liver (phi = 7.12 +/- 0.07 at 5 min, p less than 0.05, pHi = 7.19 +/- 0.07 at 10 min, p less than 0.01, pHi = 7.16 +/- 0.06 at 15 min, p less than 0.01, vs baseline pHi = 7.05 +/- 0.06). These data suggest that Carbicarb may be a more effective buffer than sodium bicarbonate during conditions where ventilation is limited and hemodynamic instability is present.

Acidosis↗
PubMed1990

Functional and metabolic responses of isolated hearts to acidosis: effects of sodium bicarbonate and Carbicarb.

To investigate the mechanisms by which acidosis depresses cardiac function, a Langendorff isolated, perfused rat heart preparation was studied using 31P-magnetic resonance spectroscopy. Isolated hearts were subjected to normal perfusion conditions or moderate or severe metabolic acidosis. Acidosis resulted in dose-dependent decreases in O2 consumption (VO2), rate of developed ventricular pressure (dP/dt), intracellular pH (pHi), and the tissue concentration of creatine phosphate (PCr) after 30 min. Acidosis did not affect ATP concentration but resulted in significant increases in the concentrations of total and monovalent inorganic phosphate (Pi and Pim). When metabolic determinants of the change in dP/dt with acidosis were examined, changes in pHi, extracellular pH, and tissue concentrations of Pi and Pim all correlated significantly with the change in dP/dt. In a second set of experiments using the severe acidosis model, normal saline, 1 M sodium bicarbonate, and the experimental buffer Carbicarb (1 ml/kg body wt) were infused in a crossover manner at 20-min intervals. None had significant effects on tissue concentrations of ATP, PCr, Pi, or PCr/Pi. Administration of bicarbonate resulted in an increase in VO2 without significant effects on pHi or dP/dt. In contrast, Carbicarb effected little change in VO2 but resulted in sustained increases in pHi and decreases in Pim and marked increases in dP/dt. These data suggest that the decrease in cardiac function that occurs during acidosis may be related to the metabolic consequences of reductions in pHi and that a buffer that causes intracellular alkalinization may cause functional improvement in this model.

Acidosis↗
PubMed1990

Attenuation of hypermetabolism in the remnant kidney by dietary phosphate restriction in the rat.

In vivo energy metabolism in remnant and normal kidney nephrons and the effect of dietary phosphate restriction on energy metabolism were studied. Tissue concentrations of ATP did not differ between remnant and normal kidneys; however, the tissue concentration of inorganic phosphate (Pi) was higher in remnant kidneys (1.17 +/- 0.10 vs. 0.82 +/- 0.09 mumol/g, P less than 0.05) as assessed by 31P-nuclear magnetic resonance (NMR). Intracellular pH was also higher in remnant kidneys (7.48 +/- 0.04 vs. 7.20 +/- 0.05, P less than 0.01), as was oxygen consumption (QO2) when normalized for rate of net tubular sodium reabsorption (Tna; 0.032 +/- 0.005 vs. 0.018 +/- 0.002 mumol.min-1.g-1, P less than 0.01). Compared with glycine supplemented controls, dietary phosphate restriction induced by the phosphate binder diaminodihydroacetoacetate, a maneuver which independently of protein restriction has been shown to ameliorate the progression of chronic renal failure, resulted in no major change in tissue levels of ATP, intracellular pH, or TNa+ but decreased Pi (0.62 +/- 0.07 vs. 1.40 +/- 0.11 mumol/g, P less than 0.01) and QO2 (4.0 +/- 0.4 vs. 7.7 +/- 1.0 mumol.min-1.g-1, P less than 0.01) in remnant kidneys. For the amount of sodium reabsorption performed, remnant kidneys are hypermetabolic, and this hypermetabolism is attenuated by dietary phosphate restriction. These data suggest that hypermetabolism may be involved in the tubulointerstitial mechanisms operant in the progression of chronic renal failure that occurs in the rat remnant kidney, and that attenuation of this abnormality may be the mechanism by which dietary phosphate restriction ameliorates this process.

Animals↗
PubMed1990

Effects of hypernatremia on organic brain osmoles.

We studied the effects of varying degrees and durations of hypernatremia on the brain concentrations of organic compounds believed to be important, so-called "idiogenic" osmoles in rats by means of conventional biochemical assays, nuclear magnetic resonance spectroscopy, and high-performance liquid chromatography. There were no changes in the concentrations of these osmoles (specifically myoinositol, sorbitol, betaine, glycerophosphorylcholine [GPC], phosphocreatine, glutamine, glutamate, and taurine) in rats with acute (2 h) hypernatremia (serum Na 194 +/- 5 meq/liter). With severe (serum Na 180 +/- 4 meq/liter) chronic (7 d) hypernatremia, the concentrations of each of these osmoles except sorbitol increased significantly: myoinositol (65%), betaine (54%), GPC (132%), phosphocreatine (73%), glutamine (143%), glutamate (84%), taurine (78%), and urea (191%). Together, these changes account for 35% of the change in total brain osmolality. With moderate (serum Na 159 +/- 3 meq/liter) hypernatremia, more modest but significant increases in the concentrations of each of these osmoles except betaine and sorbitol were noted. When rats with severe chronic hypernatremia were allowed to drink water freely, their serum sodium as well as the brain concentrations of all of these organic osmoles except myoinositol returned to normal within 2 d. It is concluded that: idiogenic osmoles play an important role in osmoregulation in the brain of rats subjected to hypernatremia; the development of these substances occur more slowly than changes in serum sodium; and the decrease in concentration of myoinositol occurs significantly more slowly than the decrease in serum sodium which occurs when animals are allowed free access to water. These observations may be relevant to the clinical management of patients with hypernatremia.

Acute Disease↗
PubMed1990

The effect of calcium channel blockers on the cyclosporine dose requirement in renal transplant recipients.

Thirteen patients found to be hypertensive following renal transplantation were treated with either a calcium channel blocker or other antihypertensive therapy for control of blood pressure. Immunosuppression was either with cyclosporine and prednisone alone or with cyclosporine, azathioprine, and prednisone. Patients had weekly or biweekly cyclosporine whole-blood levels measured by radioimmunoassay drawn approximately 12 h after their last dose. Patients treated with cyclosporine and prednisone alone had their cyclosporine dosage adjusted to maintain their cyclosporine level between 400 and 900 ng/mL between 1 and 6 months following transplantation. Patients treated with cyclosporine, azathioprine, and prednisone had their cyclosporine level adjusted to be between 100 and 400 ng/mL during this same time period. Cyclosporine levels were significantly higher in verapamil-treated patients and significantly lower in nifedipine-treated patients as compared to controls. The dose of cyclosporine administered was significantly lower in the verapamil-treated patients and higher in the nifedipine-treated patients than controls. Normalizing the whole-blood cyclosporine level for the dose of cyclosporine, and verapamil-treated patients had a significantly greater, and the nifedipine-treated patients a significantly lower value than control patients. These data suggest the verapamil treatment results in significantly higher levels of cyclosporine whereas nifedipine therapy may actually result in lower cyclosporine levels for a given dose of cyclosporine than seen in patients not exposed to these drugs.

Adult↗
PubMed1990

Intraocular pressures during high-flux hemodialysis.

The intraocular pressures of 16 patients with end stage renal failure treated with high-flux dialysis were measured before and during a high-flux dialysis treatment. The patients were selected so as not to have glaucoma or history of glaucoma. Intraocular pressures did not change significantly in any patients during or following a high-flux hemodialysis treatment. These data suggest that high-flux hemodialysis does not result in increases in intraocular pressure nor does it precipitate acute glaucoma in well-dialyzed patients undergoing intermittent in-center hemodialysis.

Adult↗
PubMed1989

Loss of epithelial polarity: a novel hypothesis for reduced proximal tubule Na+ transport following ischemic injury.

Ischemia results in the marked reduction of renal proximal tubule function which is manifested by decreased Na+ and H2O reabsorption. In the present studies the possibility that altered Na+ and H2O reabsorption were due to ischemia-induced loss of surface membrane polarity was investigated. Following 15 min of renal ischemia and 2 hr of reperfusion, proximal tubule cellular ultrastructure was normal. However, abnormal redistribution of NaK-ATPase to the apical membrane domain was observed and large alterations in apical membrane lipid composition consistent with loss of surface membrane polarity were noted. These changes were associated with large decreases in Na+ (37.4 vs. 23.0%, P less than 0.01) and H2O (48.6 vs. 36.9%, P less than 0.01) reabsorption at a time when cellular morphology, apical Na+ permeability, Na+-coupled cotransport, intracellular pH and single nephron filtration rates were normal. We propose that the abnormal redistribution of NaK-ATPase to the apical membrane domain is in part responsible for reduced Na+ and H2O reabsorption following ischemic injury.

Adenosine Triphosphate↗
PubMed1989

P-31 nuclear magnetic resonance spectral changes in obstructed or dehydrated kidney.

Rat kidneys subjected to urinary obstruction or dehydration in vivo both develop marked increases in the area under a peak resonating in the phosphodiester region on their P-31 nuclear magnetic resonance spectra. The chemical species responsible for these changes were assessed using physiologic manipulations which altered the concentration of phosphate in the urine or increased the urine pH. Obstructed kidneys of rats fed a normal diet had a 140 +/- 50% increase in a peak resonating at 3.31 +/- 0.05 ppm after three hours of obstruction (P less than 0.01). Low phosphate diet which decreased urine phosphate concentration by 98% virtually eliminated this increase in peak area, where saline diuresis which decreased urine phosphate concentration by 50% markedly attenuated it. Acute phosphate loading which doubled urine phosphate concentration markedly accentuated the increase in peak area. Alkalinizing the urine with acetazolamide (changing urine pH from 6.2 +/- 0.2 to 8.0 +/- 0.1) shifted the resonance frequency of this increasing peak from 3.31 +/- 0.06 to 5.45 +/- 0.11 ppm (P less than 0.01). Rats fed a normal diet developed increases (57 +/- 15%, P less than 0.05) in a peak resonating at 2.84 +/- 0.03 ppm following 48 hours of dehydration. Rats fed a low phosphate diet had a comparable increase in the relative area of this peak (46 +/- 16%, P less than 0.05). Alkalinization of the urine did not affect the position or intensity of this peak under conditions of dehydration.(ABSTRACT TRUNCATED AT 250 WORDS)

Animals↗
PubMed1989

Brain pH effects of NaHCO3 and Carbicarb in lactic acidosis.

The effects of iv sodium bicarbonate (NaHCO3) and Carbicarb, an experimental buffer, were compared in a rat model of lactic acidosis induced by controlled hemorrhage and asphyxia. Although both NaHCO3 and Carbicarb were effective at alkalinizing the arterial blood in this model, NaHCO3 administration resulted in a rise in PaCO2 where Carbicarb did not (+9 +/- 2 vs. +2 +/- 2 torr at 2 min after infusion, p less than .01). Moreover, NaHCO3 resulted in a small decrease in intracellular brain pH as measured with P-31 nuclear magnetic resonance where Carbicarb afforded intracellular brain alkalinization (-0.03 +/- 0.01 vs. +0.08 +/- 0.02 pH units at 2 min, p less than .01). If these data are confirmed clinically, Carbicarb may offer advantages over NaHCO3 under conditions of fixed or limited ventilation.

Acidosis, Lactic↗
PubMed1989

Brain pH responses to sodium bicarbonate and Carbicarb during systemic acidosis.

Rats subjected to ammonium chloride-induced metabolic acidosis or respiratory acidosis caused by hypercapnia were given alkalinization therapy with either sodium bicarbonate or Carbicarb. Ammonium chloride induced dose-dependent systemic acidosis but did not affect intracellular brain pH. Hypercapnia caused dose-dependent systemic acidosis as well as decreases in intracellular brain pH. Sodium bicarbonate treatment resulted in systemic alkalinization and increases in arterial PCO2 in both acidosis models, but it caused intracellular brain acidification in rats with ammonium chloride acidosis. Carbicarb therapy resulted in systemic alkalinization without major changes in arterial PCO2 and intracellular brain alkalinization in both acidosis models. These data demonstrate that bicarbonate therapy of systemic acidosis may be associated with "paradoxical" intracellular brain acidosis, whereas Carbicarb causes both systemic and intracellular alkalinization under conditions of fixed ventilation.

Acidosis↗
PubMed1989

Extracorporeal bicarbonate space after bicarbonate or a bicarbonate-carbonate mixture in acidotic dogs.

The effects of sodium bicarbonate and a bicarbonate-carbonate mixture on expired CO2 and the volume of distribution of bicarbonate were studied in eight anesthetized, paralyzed, and ventilated dogs made acidotic with HCl (5 mmol/kg) infused over 90 min. Both sodium bicarbonate and Carbicarb resulted in systemic alkalinization and comparable increases in the serum bicarbonate at 50 min (7.07 +/- 0.91 vs. 7.99 +/- 0.77, respectively; P = NS). Sodium bicarbonate infusion resulted in an increase in CO2 excretion that accounted for a fractional CO2 excretion of 0.20 +/- 0.09, whereas infusion of a bicarbonate-carbonate mixture resulted in a fractional CO2 excretion of -0.06 +/- 0.09 (P less than 0.01). The uncorrected volume of distribution of bicarbonate after sodium bicarbonate infusion was higher than that seen with the bicarbonate-carbonate mixture (0.60 +/- 0.07 vs. 0.34 +/- 0.03 l/kg; P less than 0.01). However, when the volume of bicarbonate distribution was corrected for expired CO2, there was no difference between treatment with sodium bicarbonate and the bicarbonate-carbonate mixture (0.44 +/- 0.07 vs. 0.38 +/- 0.04 l/kg; P = NS). These data demonstrate that, in this animal model of acidosis, sodium bicarbonate treatment of systemic acidosis is accompanied by a generation of a considerable amount of CO2, whereas treatment with a bicarbonate-carbonate mixture is not. This suggests that in states of impaired ventilation, a bicarbonate-carbonate mixture may offer more efficient systemic alkalinization and may be associated with less CO2 generation than sodium bicarbonate.

Acid-Base Equilibrium↗