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Biomedical subjects

N Horiuchi

Publications and source records attributed to N Horiuchi.

At least 37 records · Page 2Linked to original sources

[Miliary tuberculosis associated with subcutaneous tuberculous abscess].

A 62-year-old woman was admitted because of a tumor on her right thigh, fever, generalized lymphadenopathy, and diffuse nodular shadows on chest X-ray films. She was given a diagnosis of miliary tuberculosis based on the findings of a cervical lymph-node biopsy and a broncho-alveolar lavage. Acute respiratory failure and disseminated intravascular coagulation developed, but resolved after the start of anti-tuberculous therapy. The tumor on the right thigh was diagnosed as a subcutaneous tuberculous abscess because tuberculous bacilli were detected in tumor tissue samples obtained by aspiration. The patient's fever disappeared and the abnormal shadows on her chest X-ray films receded significantly after drainage of the subcutaneous abscess. These findings suggested that miliary tuberculosis was associated with the subcutaneous tuberculous abscess in this case.

Abscess↗

Hypogenesis of right hepatic lobe accompanied by portal hypertension: case report and review of 31 Japanese cases.

We report a rare case of hypogenesis of the right lobe of the liver with portal hypertension and a review of 31 cases of agenesis or hypogenesis of the right hepatic lobe reported in Japan. A 74-year-old man consulted our hospital for further examination after a mass screening for gastric cancer. On physical examination liver enlargement was palpable, but liver function tests were normal. Abdominal ultrasonography, computed tomography, technetium-99m liver scintigraphy, and endoscopic retrograde cholangiopancreatography revealed a small right hepatic lobe and moderate splenomegaly, in contrast to a hypertrophic lateral segment of the left hepatic lobe, as well as ectopic dislocation of the gallbladder. Endoscopic examination revealed esophageal varices, indicating portal hypertension. Abdominal angiography demonstrated mild shunt flow between the hepatic artery feeding from the gastroduodenal artery and the portal vein. A biopsy specimen taken from both lobes of the liver showed normal liver tissue histologically. Based on these findings, we made a definite diagnosis of hypogenesis of the right lobe of the liver with portal hypertension. The present case appears to be the first such case accompanied by portal hypertension reported in Japan.

Aged↗

A 15-year follow-up study of patients with non-insulin-dependent diabetes mellitus (NIDDM) in Osaka, Japan. Factors predictive of the prognosis of diabetic patients.

Risk factors related to the prognosis of diabetic patients were studied in a follow-up study of 1939 patients with non-insulin-dependent diabetes mellitus (NIDDM) for a mean observation period of 15 years at our institute. Age at entry into the study was the most powerful risk factor related to the survival of diabetic patients in this study. Moreover, the risk of death, computed in relation to baseline factors, was significantly increased in male patients; in patients with fasting plasma glucose (FPG) levels greater than 140 mg/dl, with hypertension, with diabetic retinopathy or with proteinuria; and in patients treated with an oral hypoglycemic agent of insulin at baseline, even after correction for age. The baseline factors were compared between the groups of patients who were alive and who had died at the end of the follow-up study. Greater age at onset of NIDDM and at entry into the study, higher FPG level, higher systolic and diastolic blood pressure, as well as an increase in the proportion of male patients and in patients with ischemic ECG changes, with diabetic retinopathy, with proteinuria, and with treatment with an oral hypoglycemic agent of insulin, were observed in the group of deceased patients. Furthermore, multiple logistic analysis indicated a significant relationship of age at entry, FPG, hypertension, retinopathy, proteinuria and therapeutic regimen to prognosis. We also found that the baseline factors predictive of prognosis were very different in each age group.

Adult↗

Mouse vitamin D-24-hydroxylase: molecular cloning, tissue distribution, and transcriptional regulation by 1alpha,25-dihydroxyvitamin D3.

Vitamin D-24-hydroxylase (24-OHase) is a cytochrome P-450 enzyme that catalyzes the conversion of 25-hydroxyvitamin D3 (25OHD3) and 1alpha,25-dihydroxyvitamin D3 [1,25-(OH)2D3] to 24,25-dihydroxyvitamin D3 and 1,24,25-trihydroxyvitamin D3, respectively. A full-length complementary DNA for mouse 24-OHase has now been characterized. The complementary DNA consists of 3309 bp and encodes a protein of 514 amino acids that shows 82% and 95% sequence identity with the human and rat enzymes, respectively. Northern blot analysis of tissues from mice injected with 1,25-(OH)2D3 (24 pmol/g) revealed that the 3.4-kb 24-OHase messenger RNA (mRNA) is most abundant in kidney and intestine, with smaller amounts present in skin, thymus, and bone. RT-PCR and Southern blot analysis detected 24-OHase mRNA in several other tissues including lung, testis, spleen, pancreas, and heart. Intraperitoneal injection of 1,25-(OH)2D3 induced dose- and time-dependent increases in both 24-OHase mRNA abundance and enzyme activity in mouse kidney. Similarly, 1,25-(OH)2D3-induced increases in both 24-OHase mRNA and activity were apparent in the duodenum. Although 1,25-(OH)2D3 increased the amount of 24-OHase mRNA in skin, enzyme activity was not detected in this tissue. Pretreatment of mice with cycloheximide (400 microg/g), an inhibitor of protein synthesis, potentiated the increase in 24-OHase mRNA abundance, but blocked the increase in 24-OHase activity, induced by 1,25-(OH)2D3 in kidney and duodenum, suggesting that 24-OHase gene expression may be regulated not only by the vitamin D receptor but also by a short-lived repressor protein.

Amino Acid Sequence↗

Starvation-induced increase in the parathyroid hormone/PTH-related protein receptor mRNA of bone and kidney in sham-operated and thyroparathyroidectomized rats.

Parathyroid hormone (PTH) acts on bone and kidneys by binding to PTH/PTH-related protein (PTHrP) receptors and regulating calcium (Ca) and phosphorus (P) homeostasis. PTH/PTHrP receptor mRNA was expressed at high levels in PTH target tissues such as the kidneys and bone including the calvaria, femur, and tibia. Because short-term starvation influences Ca and P ion homeostasis, we measured changes in PTH/PTHrP receptor mRNA expression in the bone and kidneys. Food deprivation for 3 days decreased the serum Ca and P concentrations, and reinstitution of feeding for 2 days normalized the serum Ca level and significantly increased the serum P level. Concomitantly, rat immunoreactive PTH (riPTH) was increased during starvation and returned to the control level after 2 days of subsequent feeding. Serum 1 alpha, 25-dihydroxyvitamin D3 (1,25(OH)2D3) concentrations did not significantly change during starvation and subsequent feeding. Starvation up-regulated PTH/PTHrP receptor mRNA expression in both bone and kidney. The effects of food deprivation on the receptor transcript abundance were greater in bone (threefold increase compared with control) than in the kidney (1.8-fold increase), whereas the mRNA level increase by food deprivation was more rapid in the kidneys than in bone. The PTH-induced adenylyl cyclase activity of renal membranes increased in starvation. Feeding after starvation normalized the mRNA levels in both tissues. Serum PTH depression, initiated by thyroparathyroidectomy, did not affect PTH/PTHrP receptor mRNA levels in bone and kidney in rats that were fed or starved for 3 days. The abundance of receptor mRNA in bone and kidney was significantly lower in fed rats given either corticosterone or vehicle than in starved rats. These data indicate that starvation induces PTH/PTHrP receptor mRNA expression in bone and kidney, independently of serum PTH and corticosterone concentrations. The factors leading to up-regulated receptor mRNA induced by starvation remain unknown.

Adenylyl Cyclases↗

An adult case of Cockayne syndrome without sclerotic angiopathy.

We report an autopsy case of Cockayne syndrome (CS). A 40-year-old Japanese woman was admitted to our hospital for cachexia. She had displayed the striking features of CS, including dwarfism, mental retardation, neural deafness, ataxia, intracranial calcifications, and progeria since her childhood. Endocrinological examinations suggested normal pituitary function and a disorder of the hypothalamus or the cerebrum. She died of acute pneumonia at the age of 42. Autopsy findings showed typical abnormalities in the central nervous system compatible with CS; however, no atherosclerotic change was observed in the systemic arteries.

Adult↗

A 15 year follow-up study of patients with non-insulin dependent diabetes mellitus (NIDDM) in Osaka, Japan. Long-term prognosis and causes of death.

A 15 year follow-up study of diabetic patients was performed in Osaka, Japan. The subjects studied were 1939 patients with non-insulin dependent diabetes mellitus (NIDDM), of whom 1000 (51.5%) were alive, 880 (45.4%) had died and 59 (3.0%) were untraceable at the end of 1993. The mortality rate per 1000 person-years of the subjects increased from 28.94 in 1960-1984 to 35.74 in 1985-1993, but the ratio of numbers of observed to expected deaths (O/E ratio) declined from 1.77 to 1.52 for the corresponding periods, suggesting an improvement in the prognosis for diabetic patients, with the exception of patients 65 years or over at the time of entry. Cerebro-cardiovascular and renal diseases were major causes of death, accounting for 48.4% of all deaths. In particular, disease of the heart was the cause of death in 20.5% of all deaths, cerebrovascular disease in 14.5% and renal disease in 12.0%. The O/E ratio was 11.30 for renal disease, which was remarkably high. The O/E ratios were 1.48 for malignant neoplasms, 3.02 for cancer of the liver and 2.15 for cancer of the pancreas. In the subjects less than 65 years of age at entry, a significant decrease in the O/E ratio for overall deaths, malignant neoplasms, disease of the heart, cerebrovascular disease and renal disease was observed, but no notable difference in the O/E ratio for ischemic heart disease was found between the periods 1960-1984 and 1985-1993. By contrast, in the case of subjects 65 years or more at entry, the O/E ratios for overall deaths, malignant neoplasms, disease of the heart, ischemic heart disease and cerebrovascular disease increased markedly in the later period, while there was a considerable decline in renal disease indicated during this period. The analysis suggested a structural change in causes of death of Japanese diabetic patients in recent years, with a relative increase in ischemic heart disease and a relative decrease in renal disease.

Adult↗

[An elderly patient with gastric cancer surviving long after chemotherapy using UFT alone].

A 77-year-old patient with low activity of daily life (ADL) having advanced gastric cancer was treated by low dose UFT alone (300 mg/day) for more than 11 years. He survived, and neither remarkable progression nor metastasis of the gastric cancer has been observed in more than an 11-year hospital-free survival period. He has maintained his low ADL, and no side effects of the chemotherapy were observed. This case is probably rare, but suggestive in the choice of treatment for elderly patients.

Activities of Daily Living↗

Mortality from coronary heart disease and cerebrovascular disease and associated risk factors in diabetic patients in Osaka District, Japan.

Mortality from coronary heart disease (CHD) and cerebrovascular disease (CVD), as well as associated risk factors, were examined. The subjects studied were 1939 non-insulin-dependent diabetic (NIDDM) patients and 503 deaths were observed during a mean follow-up period of 9.4 years. Of these deaths, 62 were CHD deaths and 84 were CVD deaths. The mortality rates per 1000 person-years from CHD were 3.95 for males and 2.57 for females and those from CVD were 5.12 and 3.86 for males and females, respectively, showing a higher mortality for males and an increasing trend with age. The baseline factors associated with CHD mortality were age at entry into the study, hypertension, ischemic ECG changes, serum cholesterol level, diabetic retinopathy and albuminuria, while those associated with CVD were age at entry, hypertension, ischemic ECG changes, diabetic retinopathy, albuminuria and therapeutic regimen, all of which were found to be significant by univariate analysis. The relationships were further analyzed by the multiple logistic method. In addition, the baseline characteristics of the patients who died of CHD and CVD were compared with those of patients who died from other causes. The baseline characteristics in cases of deaths from CHD and CVD were significantly different from those of deaths from other causes in terms of obesity, ischemic ECG changes, serum cholesterol level and serum triglycerides level for deaths from CHD and in terms of age at onset, age at death and hypertension for deaths from CVD.

Adult↗

Synthesis of 25-hydroxyvitamin D3-26,23-lactone but not 24,25-dihydroxyvitamin D3 from 25-hydroxyvitamin D3 in opossum kidney cells treated with 1 alpha, 25-dihydroxyvitamin D3.

The pathway from 25-hydroxyvitamin D3(25[OH]D3) to 25-hydroxyvitamin D3-26,23-lactone (25[OH]D3-26,23-lactone) is important in the renal degradation of vitamin D metabolites. Our objective was to investigate the regulation of 25(OH)D3 metabolism in the opossum kidney (OK) cell line which has been used for studying the actions of the calcium-regulating hormones. While the untreated OK cells did not produce 25(OH)D3 metabolites, the synthesis of the lactone was increased dose-dependently by 20h pretreatment with 1 alpha,25-dihydroxyvitamin D3 (1,25[OH]2D3), peaked at 10(-7) M 1,25(OH)2D3, and decreased with higher concentrations. Little production of 24,25-dihydroxyvitamin D3 (24,25[OH]2D3) was observed after any dose of 1,25(OH)2D3. The increase in the production of lactone induced by 10(-7) M 1,25(OH)2D3 was detectable at 2 h, peaked between 4 and 24 h, and decreased gradually until 48 h. Its induction was inhibited by actinomycin D and cycloheximide, suggesting that de novo protein synthesis is required for such induction. After treatment with 10(-7) M 1,25(OH)2D3 for 20 h, 24-hydroxylase (24-OHase) mRNA was not detected in OK cells, but was found evident in COS-7 cells (a renal cell line). Moreover, the COS-7 cells treated with 10(-7) M 1,25(OH)2D3 metabolized 25(OH)D3 to 24,25(OH)2D3. These results indicate that 1,25(OH)2D3 stimulates the synthesis of 25(OH)D3-26,23-lactone in a dose- and time-dependent manner, but does not induce the gene expression or activity of 24-OHase in OK cells.

24,25-Dihydroxyvitamin D 3↗

Induction of vitamin D 24-hydroxylase messenger RNA and activity by 22-oxacalcitriol in mouse kidney and duodenum. Possible role in decrease of plasma 1 alpha,25-dihydroxyvitamin D3.

The synthetic analog of 1 alpha,25-dihydroxyvitamin D3 [1,25(OH)2D3], 22-oxacalcitriol (OCT), retains most of the properties of 1,25(OH)2D3 but exhibits much less hypercalcemic action than the parent compound. The effects of OCT on plasma calcium, phosphorus, and 1 alpha,25-dihydroxyvitamin D [1,25(OH)2D] concentrations were examined in mice. Administration of a single dose (24 pmol/g body wt, i.p.) of OCT had no effect on plasma calcium for up to 48 hr, significantly increased plasma phosphorus at 4 and 8 hr and significantly reduced the concentration of 1,25(OH)2D in plasma between 4 and 48 hr. Both OCT and 1,25(OH)2D3 at 24 pmol/g body wt (i.p.) induced a single, 3.4-kb mRNA encoding vitamin D 24-hydroxylase (24-OHase), the cytochrome P450 enzyme responsible for 1,25(OH)2D3 degradation, in kidney and duodenum. The OCT-induced increase in 24-OHase mRNA and an increase in enzyme activity were marked at 2 and 4 hr in both tissues. In kidney, mRNA abundance had decreased by 8 hr but remained above basal values for up to 30 hr; activity remained relatively high for up to 48 hr. In duodenum, 24-OHase mRNA abundance returned virtually to control values by 8 hr after OCT treatment; activity remained at nearly maximal levels for up to 30 hr but was decreased at 48 hr. The effects of OCT and 1,25(OH)2D3 on 24-OHase mRNA abundance and enzyme activity were dose-dependent in kidney and duodenum. Whereas the dose-response relations for the effects of both compounds on 24-OHase mRNA were similar, OCT was slightly more potent than 1,25(OH)2D3 in stimulating 24-OHase activity in both tissues. These results suggest that the OCT-induced decrease in plasma 1,25(OH)2D3 is attributable, at least in part, to an increased degradation of 1,25(OH)2D3, which results from an increase in 24-OHase abundance and enzyme activity.

Animals↗

Adhesion of NFS-60 myeloid leukemia cells to MC3T3-G2/PA6 stromal cells induces granulocyte colony-stimulating factor production.

To examine the interaction between immature myeloid cells and stromal cells in the induction of granulocyte colony-stimulating factor (G-CSF) production, stromal cells of the MC3T3-G2/PA6 (PA6) murine cell line, which has preadipocyte characteristics and can support hematopoiesis, were cocultured with various myeloid cell lines and G-CSF mRNA expression was examined by Northern and reverse transcriptase-polymerase chain reaction analyses. A significant amount of G-CSF mRNA was induced by the culture of an interleukin-3/G-CSF-dependent murine myeloid leukemia cell line, NFS-60, on PA6 stromal cells for 16 hours. Using a G-CSF-dependent subline of DA-1 (DA-1N), the biologic activity of G-CSF was also detected in PA6/NFS-60 coculture supernatants, but not in the culture supernatant of PA6 or NFS-60 alone. Direct contact of NFS-60 cells with the PA6 stromal layer was essential for the induction of G-CSF mRNA, as indicated by the following observations: (1) NFS-60 cells efficiently adhered to PA6 cells; (2) medium conditioned by NFS-60 cells did not contain the activity to induce G-CSF mRNA in PA6 cells; and (3) induction of G-CSF mRNA was not observed when NFS-60 cells were separated from PA6 cells by a microporous membrane (0.45-microns pore size). Several other myeloid cell lines, including FDC-P2, 32Dcl3, WEHI-3, and DA-1, did not induce G-CSF mRNA expression after the coculture with PA6 cells, although significant numbers of these cells adhered to PA6 cells. Therefore, NFS-60 cells may express or overexpress a molecule that is involved in adhesion-mediated induction of G-CSF production.

Animals↗

Oral mucosa malignant melanoma in situ with involvement of the perioral skin.

A 66-year-old Japanese woman had a pigmented macule spreading from the internal aspect of the cheek to the vermilion border and perioral skin. Histology was that of in situ malignant melanoma. This case appears to be unique as it implies a longer period of radial growth than is usually observed in malignant melanoma of the oral mucosa.

Aged↗

Regulated production and intracrine action of 1,25-dihydroxyvitamin D3 in the chick myelomonocytic cell line HD-11.

To better understand the extrarenal production of active vitamin D metabolites by cells of the monocyte/macrophage lineage, we investigated the 25-hydroxyvitamin D (25OHD)-1-hydroxylation reaction in the v-myc-transformed chick myelomonocytic cell line HD-11; the 1-hydroxylation reaction in this cell line has a high affinity for 25-hydroxylated vitamin D substrates, is localized to mitochondria, and is associated with cytochrome P450 activity. In this study we demonstrated that the HD-11 cell 1-hydroxylation reaction in vitro is not affected by the majority of extracellular regulatory factors that modulate expression of the renal 25OHD-1-hydroxylase in vivo. A 50% increase in extracellular calcium and phosphate concentrations, physiological inhibitory events for renal 1,25-dihydroxyvitamin D [1,25-(OH)2D] synthesis, did not decrease basal expression of the HD-11 cell 1-hydroxylation reaction, nor did a 50% decrease in extracellular calcium and phosphate concentrations, stimulatory signals for the 1-hydroxylase in vivo, increase 1,25-(OH)2D3 synthesis in vitro. Receptor-saturating concentrations of PTH and PTH-related peptide were similarly without effect. In contrast, the HD-11 1-hydroxylation reaction was significantly stimulated in a dose-dependent fashion by the macrophage stimulatory agents lipopolysaccharide [P < 0.001 at a maximum effective concentration (EC100) of 25 micrograms/ml] and interferon-gamma (P < 0.001 at EC100 of 1000 IU/ml) and by insulin-like growth factor-I (P < 0.01 at EC100 of 15 nM) with the rank order of stimulation being interferon-gamma > lipopolysaccharide > insulin-like growth factor-I. Dexamethasone (> or = 10 nM) and the cytochrome P450 inhibitors (EC100, 20 microM), ketoconazole, clotrimazole, and menadione, all significantly inhibited the HD-11 cell 1-hydroxylation reaction. The naphthoquinone menadione, which blocks electron transfer to the P450-associated enzyme, was the most effective inhibitor of the reaction in both intact cells (3 +/- 1% of basal expression; P < or = 0.002) and after reconstitution of HD-11 cell mitochondrial extracts with a ferredoxin, reductase, O2, and NADPH (5 +/- 1% of basal; P < or = 0.02). We have also shown that 1,25-(OH)2D3 produced from substrate 25OHD3 appears to exert an endogenous (intracrine) inhibitory effect on HD-11 cell growth; incubation of HD-11 cells with a concentration of ketoconazole (10 microM) known to reduce 1,25-(OH)2D3 production by roughly 50% restored 50% of the growth deficit induced by 1,25-(OH)2D3 (EC100, 100 nM).(ABSTRACT TRUNCATED AT 400 WORDS)

Animals↗

The proportion of death certificates of diabetic patients that mentioned diabetes in Osaka District, Japan.

To determine the accuracy of the stated causes of death in diabetic patients, we analyzed 503 death certificates of diabetic patients who had been followed up for 9.4 years on average at Osaka Medical Center for Adulthood Diseases and had died during the observation period from 1960 to 1984. Of the certificates examined, only 213 (42.4%) mentioned diabetes, either as the underlying cause or as a contributory condition. The proportion of certificates that mentioned diabetes was related to the underlying cause of death; it was 18.7% for malignant neoplasms, 40.5% for cerebrovascular disease and 46.9% for disease of the heart, while it was 81.8% for renal disease. The proportion was higher for females (48.7%) than for males (39.5%), and a significant difference was observed between the sexes in the proportion in the case of disease of the heart. The proportion was not related to any significant extent to the year of death or the age at death. However, it was related to fasting plasma glucose (FPG) level and type of treatment. It was 37.8% and 54.4% for patients with FPG < 200 mg/dl and FPG > or = 200 mg/dl, respectively, 24.1% for those treated with diet, 51.4% for those treated with oral hypoglycemic agent and 80.7% for those treated with insulin. As a result, it was found that the proportion of death certificates that mentioned diabetes was related to the accompanying complications and the severity of diabetes.(ABSTRACT TRUNCATED AT 250 WORDS)

Cause of Death↗

Increase of renal 25-hydroxyvitamin D3-24-hydroxylase activity and its messenger ribonucleic acid level in 1 alpha-hydroxyvitamin D3-administered rats: possibility of the presence of two forms of 24-hydroxylase.

Messenger ribonucleic acid (mRNA) levels and activities of renal 25-hydroxyvitamin D3-24-hydroxylase (24-OHase) were determined in 3 groups of rats: vitamin D-deficient, normal, and 1 alpha-hydroxyvitamin D3 (1 alpha OHD3)-administered rats. To measure renal 24-OHase mRNA, a DNA probe complementary to the reported sequence of the recently cloned P450 component was employed. The DNA probe hybridized with 24-OHase mRNA. Northern blot analysis indicated that the size of the transcript was approximately 3.4 kb, which was similar in size to that of the previous report. Oral administration of 1 alpha OHD3 (2 micrograms/kg bw/day x 7 days) markedly increased the plasma concentration of 1,25-dihydroxyvitamin D (1,25(OH)2D), renal 24-OHase activity and the renal 24-OHase mRNA level. However, the levels of 24-OHase mRNA were undetectable in vitamin D-deficient and normal rat kidneys, while a significant amount of 24-OHase activity was observed in the normal rat kidney. In vitamin D-deficient rats, renal 25-hydroxyvitamin D3-1 alpha-hydroxylase activity was markedly elevated and 24-OHase activity was completely abolished. When an oligonucleotide probe complementary to coding sequence of heme binding region was used for dot blot analysis, the mRNA was clearly detected in normal rat kidney. Furthermore, activity of the enzyme was attenuated by human parathyroid hormone (1-34) but the mRNA abundance did not change with 2 nmol (every 4 h, 5 times) of hormone treatment in 1 alpha OHD3-dosed thyroparathyroidectomized rats. The present study demonstrates that induction of 24-OHase activity by 1,25(OH)2D3 occurs at least in large part through increase of the gene expression in the kidney. Furthermore, these findings suggest that 2 forms (inducible and constitutive) of 24-OHase exist in rat kidney, and that the previously cloned P450 component is the inducible form of 24-OHase.

Administration, Oral↗

Skin metastasis in laryngeal carcinoma.

Cutaneous metastases from carcinoma of the larynx are very rare. We observed a 64-year-old Japanese patient with squamous cell carcinoma of the larynx who developed a subcutaneous nodule on the abdomen. It was found to be a metastatic tumour from the laryngeal cancer, histopathologically as well as histochemically.

Carcinoma, Squamous Cell↗

Clinical effects of long-term use of neutralized dialysate for continuous ambulatory peritoneal dialysis.

The long-term effects of neutralized dialysate used in continuous ambulatory peritoneal dialysis (CAPD) were evaluated in 8 well-controlled patients. Twelve milliliters of 8.4% sodium bicarbonate was added to Dianeal PD-1 immediately before every administration. The final pH was 6.8 and the concentration of sodium bicarbonate was 6 mmol/l. The final sodium level was 138 mEq/l. This dialysate was used for 5 months. For 2 months before and 3 months after this period, Dianeal PD-2 was used as the dialysate for comparison. Blood bicarbonate levels significantly improved during the use of the neutralized dialysate. Blood sodium, chloride and magnesium levels and the effluent volume significantly increased. Sodium balance improved during the period when neutralized dialysate was used. Total leukocyte counts in the effluent decreased, and leukocyte viability increased. Abdominal distention, abdominal pain during instillation, nausea and headache improved. No side effects, including peritonitis, occurred during the trial of neutralized dialysate. The results suggest that this dialysate was less irritating to the peritoneal membrane than the control dialysate and that the therapeutic effects were satisfactory.

Blood Urea Nitrogen↗