Biomedical subjects

Y H Lai

Publications and source records attributed to Y H Lai.

At least 19 recordsLinked to original sources

PubMed1995

Survey of public awareness, understanding, and attitudes toward epilepsy in Taiwan.

A survey of public awareness and understanding of and attitudes toward epilepsy was made in Taipei City and Chin-San Village, Taiwan in 1992. In a population sample of 2,610 adults, 87% had read or heard about epilepsy, 70% knew someone who had epilepsy, 56% had seen someone having a seizure, 18% would object to having their children associated with persons with epilepsy, 72% would object to having their children marry a person with epilepsy, 31% believed that epileptic persons should not be employed in jobs as other persons are, 7% believed that epilepsy was a form of insanity, 34% did not know the cause of epilepsy, 13% did not know what an epileptic attack was like, and 18% did not know what to recommend if their friends or relatives had epilepsy. Youth, higher education, and upper levels of employment were correlated with answers that were more favorable concerning epilepsy in all survey questions except for the question regarding marriage, for which the reverse was noted. The attitudes toward epilepsy disclosed by this study were more favorable than those detected in a similar survey conducted in Henan Province, China. The comparison suggests that the exposure to Western culture and socioeconomic system in Taiwan might have helped reduce the discrimination against epilepsy.

Age Factors↗

PubMed1995

Impact of decreased serum transaminase levels on the evaluation of viral hepatitis in hemodialysis patients.

The value of serum transaminases (ST) in evaluating hepatitis B (HBV) and C (HCV) infection was studied in 217 hemodialysis (HD) patients and 804 normal controls. Mean serum aspartate aminotransferase (AST) was 22.3 (22.0-22.7) and 22.6 (21.6-23.6) IU/l or 0.371 (0.366-0.378) and 0.376 (0.36-0.393) mu kat/l in controls and HD patients, respectively (nonsignificant), while mean serum alanine aminotransferase (ALT) was 20.3 (19.9-20.7) and 16.3 (15.3-17.3) IU/l or 0.338 (0.331-0.345) and 0.271 (0.255-0.288) mu kat/l in these two groups (p < 0.001). However, both AST and ALT became significantly depressed in HD patients after adjusting for age, gender, HBV surface antigen (HBsAg) and anti-HCV. The usual practice of regarding AST and ALT as being 'abnormal' in evaluating viral hepatitis when they exceeded the upper reference range (40 and 46 IU/l or 0.666 and 0.766 mu kat/l in our laboratory) was then critically assessed by the receiver operating characteristic (ROC) curve. ROC analysis showed that ST was useless in detecting HBsAg, while the best cutoff point for detecting the presence of anti-HCV was 18 IU/l (0.3 mu kat/l) for AST and 16 IU/l (0.266 mu kat/l) for ALT in HD patients, respectively. These are considerably lower than the conventional criteria for an 'abnormal' ST. We conclude that ST are decreased in HD patients and that the cutoff value of ST for detecting HCV should be set at lower levels to enhance their diagnostic yield.

Alanine Transaminase↗

PubMed1995

Lack of influence of recombinant human erythropoietin on parathyroid function in hemodialysis patients with secondary hyperparathyroidism.

The effects of recombinant human erythropoietin (rHuEPO) treatment on parathyroid function in patients on maintenance hemodialysis (HD) with secondary hyperparathyroidism (HPT) is poorly understood. We compared the levels of serum intact parathyroid hormone (PTH) and the suppressibility of PTH by intravenous calcium infusion before and after 12 weeks of rHuEPO treatment in 8 HD patients with secondary HPT. The suppressibility of PTH by calcium infusion in HD patients was also compared with that of normal subjects. After rHuEPO treatment, in HD patients hematocrit and hemoglobin levels increased significantly from 20.1 +/- 1.3% and 6.65 +/- 0.46 g/dl to 28.7 +/- 1.0% and 9.68 +/- 0.39 g/dl, respectively. The serum intact PTH levels did not change significantly (541.9 +/- 65.3 pg/ml before versus 572.9 +/- 75.3 pg/ml after rHuEPO treatment), nor did serum ionized calcium, phosphate, magnesium, aluminum, alkaline phosphatase, and 1.25(OH)2D levels. Calcium infusion significantly increased serum ionized calcium and suppressed serum PTH levels. However, the increment in serum calcium levels and the percent decrement of serum PTH showed no significant differences before and after rHuEPO treatment in HD patients. Elevations in serum calcium levels during calcium infusions were not significantly different between normal subjects and HD patients. However, the percent maximal decrement in serum PTH level was less in HD patients both before and after rHuEPO treatment than in normal subjects (-75.4 +/- 3.9 and -76.4 +/- 4.1% versus -91.4 +/- 1.4%). We conclude that rHuEPO treatment has no influence on parathyroid function in maintenance HD patients with secondary HPT. In addition, PTH secretion is less suppressed by calcium infusion in the same group of patients.

Adult↗

PubMed1995

Decrease of renal endothelin 1 content and gene expression in diabetic rats with moderate hyperglycemia.

To investigate the intrarenal endothelin 1 (ET-1) synthesis in streptozocin (STZ) diabetic rats with moderate hyperglycemia, we measured plasma ET-1, renal ET-1 mRNA, and renal tissue ET-1 levels. The renal ET-1 mRNA expression progressively decreased from the 2nd to the 6th week after induction of diabetes by STZ. The renal ET-1 mRNA expression and the renal tissue ET-1 content were significantly reduced in 8 diabetic rats with a mean blood glucose level of 21.0 +/- 0.4 mM as compared with 7 normal rats sacrificed at the 6th week after STZ or citric buffer injection. The reduction of renal ET-1 and mRNA levels was ameliorated in 9 diabetic rats with a mean blood glucose level of 6.9 +/- 0.7 mM after strict glycemic control by insulin treatment. Kidney weight and glomerular filtration rate in moderately hyperglycemic rats were significantly increased as compared with normal rats at the 6th week after STZ injection. The mean plasma ET-1 levels in moderately hyperglycemic diabetic rats were not different from those of the other two groups. This study demonstrates that moderate hyperglycemia in diabetic rats is associated with a reduction in renal ET-1 synthesis. Whether decreased renal ET-1 synthesis is an adaptive phenomenon of a renal hemodynamic change during the early stage of diabetes is worthy of further investigation.

Animals↗

PubMed1995

Stroke in China, 1986 through 1990.

BACKGROUND AND PURPOSE: Incidence of stroke varies markedly in different world populations. In seven Chinese cities, the effect of a program of risk factor modification on the incidence and mortality of stroke was studied and compared with a control population. This article describes the incidence of stroke in the control populations for the years 1986 through 1990. METHODS: Incidence (first-ever strokes only) for 1986 was obtained by door-to-door interview with heads of households with subsequent verification on examination by a neurologist and review of medical and/or hospital records. In subsequent years, cases were ascertained with a three-tier monitoring system: by community health workers, local medical centers, and the Beijing Neurosurgical Institute. RESULTS: Average annual age-adjusted incidence per 100,000 was 215.6 (261.5 for males, 174.5 for females; P < .001). There was a significant drop in the total number of cases from 137 in 1986 to 106 in 1990, but the age-adjusted rate showed a significant drop for males only (322.3 to 182.5, P < .001). Marked differences in average annual age-adjusted rates existed among the seven cities, from 486.4 for Harbin to 80.9 for Shanghai. This difference in rate among cities was found for both sexes but was more pronounced in males. CONCLUSIONS: The stroke incidence rates in China, like those in Japan, are among the higher ones in the world. In recent years, there has been an apparent decline in stroke incidence. Marked differences in rates were found between males and females with decline in incidence occurring almost exclusively in males. There were also marked differences in stroke incidence among the cities studied. These differences may result in part from differences in diet, alcohol and cigarette consumption, or prevalence of hypertension.

Adolescent↗

PubMed1994

Induction of heparin-binding epidermal growth factor-like growth factor mRNA by protein kinase C activators.

Heparin-binding epidermal growth factor-like growth factor (HB-EGF) is a potent smooth muscle cell mitogen of macrophage origin. To determine whether the HB-EGF gene is transcribed and regulated in mesangial cells, we measured HB-EGF mRNA levels in cultured rat mesangial cells by RNA blot analysis. A 2.5-kb HB-EGF mRNA was detected in unstimulated mesangial cells. The protein kinase C activator 12-O-tetradecanoylphorbol 13-acetate (TPA) increased HB-EGF mRNA levels by 15-fold in mesangial cells, and this induction of HB-EGF mRNA by TPA was both time- and dose-dependent. HB-EGF mRNA could also be stimulated by 10% fetal calf serum, ionomycin, thrombin, and endothelin-1. Staurosporine, a protein kinase C inhibitor, abolished the induction of HB-EGF mRNA by TPA and serum. To determine whether HB-EGF is mitogenic for mesangial cells, we transfected COS cells with HB-EGF expression plasmids. Culture medium from COS cells transfected with these plasmids increased 3H-thymidine incorporation in mesangial cells in a dose-dependent manner. To our knowledge, this is the first report that HB-EGF is expressed in renal cells. This inducible transcription of HB-EGF suggests that it may have an autocrine role in mesangial cell proliferation in kidney disease.

Alkaloids↗

PubMed1994

Brain natriuretic peptide is synthesized in the human adrenal medulla and its messenger ribonucleic acid expression along with that of atrial natriuretic peptide are enhanced in patients with primary aldosteronism.

The present study was designed to determine whether brain natriuretic peptide (BNP) is synthesized in the human adrenal gland and, if so, to investigate the BNP content of adrenal tissue and the changes in BNP messenger ribonucleic acid (mRNA) in patients with primary aldosteronism. A considerable amount of BNP-like immunoreactive substances was extracted from the adrenal glands of kidney donors for transplantation (0.21 +/- 0.02 pmol/g wet tissue; n = 3) and the remnant nontumorous adrenal glands of patients with primary aldosteronism (0.20 +/- 0.05 pmol/g wet tissue; n = 3; mean +/- SEM). Immunohistochemical study with a specific antihuman BNP antibody revealed that BNP-like immunoreactivity was localized in the adrenal medullary area, and an in situ hybridization study indicated that the BNP mRNA was mainly expressed in the cells of adrenal medulla. Using a reverse transcription and polymerase chain reaction technique, BNP complementary DNA was cloned from the human adrenal gland, and the sequence was identical to that of BNP identified in the atria. The level of BNP mRNA in the adrenal glands of patients with primary aldosteronism (n = 4) was obviously elevated compared to that in the kidney donors (n = 4), as determined by Northern blot analysis. Quantitative polymerase chain reaction measurements of BNP and atrial natriuretic peptide (ANP) mRNAs showed that both of the adrenomedullary natriuretic peptide gene transcriptions were enhanced in patients with primary aldosteronism, but the amount of ANP mRNA was far higher than that of BNP mRNA in the human adrenal gland. Our results are the first to indicate that BNP is synthesized in the human adrenal medulla, and that such medullary BNP synthesis increases in patients with primary aldosteronism. These facts support the proposal that adrenomedullary BNP along with ANP may play some role in water and electrolyte homeostasis or act in a paracrine manner to regulate adrenocortical functions.

Adrenal Medulla↗

PubMed1994

Response of regenerative tissues to plaque: a histological study in monkeys.

This study was designed to determine the histologic response of regenerated tissue to plaque, using an adult Taiwan monkey model with chronically-inflamed, surgically-created, periodontal defects. Standardized 2-walled periodontal defects were surgically created at the mesial of the mandibular lateral incisor on one side. Sutures, 3-0 braided silk, were placed for 8 weeks and tissues positioned so that denuded root surfaces were exposed to plaque, with the subsequent development of the chronically-inflamed periodontal tissues. At 8 weeks the defects were subjected to guided tissue regeneration procedures using expanded polytetrafluoroethylene membrane and allowed to heal for 6 months. Contralateral clinically healthy sites, without surgical procedures, were used as controls. In both experimental (membrane) and control sites, silk ligatures were placed to allow plaque accumulation for 2 or 10 weeks. Four monkeys were sacrificed at each time point and specimens processed for histologic and histometric study. The results indicated that plaque-induced inflammation was less at sites treated by guided tissue regenerative procedures when compared to originally clinically-healthy sites exposed to plaque for the same duration. However, histologically the newly formed osseous tissue was compromised under these conditions.

Alveolar Bone Loss↗

PubMed1994

[Mechanism and prevention of hemolysis in jaundiced infants in phototherapy].

It has been reported that the prolonged phototherapy results in decreased glutathione reductase (GR) activity in red blood cells. We found short-term phototherapy had the same side-effect. Besides it aggravates hemolysis of newborns during the therapy. This side-effect can be prevented by oral administration of Vit B2. Eighteen jaundiced infants who were given Vit B2 5mg three times a day during the phototherapy, and the control group of 16 patients were not given Vit B2. The results showed that the decrease of hemoglobin and the time of jaundice disappearance during the phototherapy were more favourable in the oral Vit B2 group than those of the control. These results indicated that the short-term phototherapy not only results in decreased GR activity in red blood cell, but also results in hemolysis of the newborn. This side-effect can be prevented by oral administration of Vit B2.

Anemia, Hemolytic↗

PubMed1992

Comparisons of the effects of calcium carbonate and calcium acetate on zinc tolerance test in hemodialysis patients.

Because aluminum hydroxide, as a phosphate binder, lowered intestinal zinc absorption, we studied the effects of calcium carbonate (CaCO3) and calcium acetate (CaAc), two other phosphate binders, on intestinal Zn absorption in nine patients on hemodialysis and in 11 controls by measuring 1- and 2-hour serum Zn levels after oral administration of 50 mg of elemental Zn as Zn gluconate with or without concomitant administration of 2 g CaCO3 (800 mg elemental Ca) or 3 g CaAc (750 mg elemental Ca). Fasting serum Zn levels were not different between patients and controls (14.0 +/- 2.3 v 14.1 +/- 1.2 mumol/L [91.8 +/- 14.9 v 92.3 +/- 8.0 micrograms/dL]), but the area under the curve of serum Zn increment (AUC) 2 hours after an oral Zn challenge without or with either of two of phosphate binders used was significantly smaller in patients than in controls (P less than 0.05). The AUC after concomitant administration of Zn with CaCO3 did not differ from that of Zn alone in either patients or controls, but it was significantly less in Zn with CaAc than in Zn alone or in Zn with CaCO3 in both groups. The results demonstrate that intestinal Zn absorption after an oral Zn challenge decreased in patients on hemodialysis and concomitant administration of CaAc, but CaCO3 did not decrease intestinal Zn absorption in either group.

Acetates↗

PubMed1991

Plasma atrial natriuretic peptide and natriuretic response to water immersion in patients with nephrotic syndrome.

Eight nonnatriuretic (daily Na excretion less than 50 mEq), 4 natriuretic (daily Na excretion greater than 50 mEq), and 4 steroid-responsive nephrotic patients, and 12 normal controls were studied with a 4-hour water immersion with measurements of electrolytes, plasma atrial natriuretic peptide (ANP), plasma renin activity (PRA), and plasma aldosterone (PA) [corrected]. Four nonnatriuretic patients further received 25 g albumin infusion, with a subsequent 2-hour water immersion study. The results are as follows: (1) In the nonnatriuretic patients, the extremely low basal Na excretion rate, high PRA, and PA levels indicated a state of active Na retention. In spite of the water-immersion induced suppression of PRA and PA and a comparable magnitude of plasma ANP increment, the natriuretic response to water immersion was blunted in the nonnatriuretic patients. (2) In the natriuretic patients, water immersion resulted in a similar magnitude of natriuresis but a higher degree of plasma ANP increment in comparison to the normal controls. (3) Natriuretic and plasma ANP responses to water immersion were not different between the steroid-responsive patients and normal controls. (4) The increase in plasma ANP and the suppression of PRA and PA after 25 g albumin infusion did not result in natriuresis until the further suppression of PRA and PA and the further stimulation of plasma ANP by subsequent water immersion. The above results indicate that the natriuretic and plasma ANP responses to water immersion are related to the basal Na status in nephrotic patients.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1991

Epidermal growth factor in renal hypertrophy in streptozotocin-diabetic rats.

Epidermal growth factor (EGF) concentrations in the plasma, kidneys and urine of 31 streptozotocin-diabetic rats and 21 insulin-treated diabetic rats were measured to study the role of EGF in initiating renal hypertrophy in the diabetic rats. Renal hypertrophy occurred from day 7 in the diabetic rats, but not in the insulin-treated rats. Renal EGF was not different between the diabetic and control rats, while that in the insulin-treated rats was significantly less than in the diabetic rats. There were no significant changes in plasma EGF in any of the rats. Urine EGF was 119 +/- 7.9 ng/day at day 7 in the control rats but it was significantly increased from day 2 in the diabetic rats (320 +/- 52.9 ng/day at day 2 and 298 +/- 18.4 ng/day at day 7), while in the insulin-treated rats it was significantly less than that in the diabetic rats (134 +/- 8.34 ng/day at day 2 and 220 +/- 15.2 ng/day at day 7). Since the kidney is the main source of urine EGF and EGF has been shown to induce renal growth both in vitro and in vivo, we conclude that EGF may have initiated renal hypertrophy in diabetic rats.

Animals↗

PubMed1991

Clinical efficacy of recombinant human erythropoietin in the treatment of anemia in hemodialysis patients: influence of dosing regimen, iron status, and serum aluminum.

To evaluate the clinical efficacy of recombinant human erythropoietin (EPO) and its influencing factors in the treatment of anemia in hemodialysis (HD) patients, 17 chronic stable HD patients (10 males, 7 females; mean age: 46.0 +/- 2.6 years) with severe anemia were enrolled in this study. The study period (ranging from 5 to 11 months) was divided into the initial 12 weeks of correction phase and the subsequent maintenance phase. EPO, 1500 U initially, was administered intravenously twice weekly (BIW group, n = 10) or thrice weekly (TIW group, n = 7) at the end of each HD. Dose was doubled every 4 weeks until up to a maximum dose of 6000 U if increment of hematocrit (Hct) was less than 3%. At the end of correction phase, anemia was markedly improved. Hct and hemoglobin (Hb) increased from 19.3 +/- 0.8 to 28.7 +/- 1.1% and from 6.5 +/- 0.3 to 9.6 +/- 0.4 g/dl, respectively. Fifteen patients (88%) reached to the target Hct of 30% at 13.7 +/- 1.2 weeks. At the end of study, Hct and Hb was maintained at 29.1 +/- 0.7% and 9.6 +/- 0.3 g/dl, respectively. Requirement of EPO dose to reach the target and maintain the stable Hct (greater than or equal to 28%) was 99 +/- 14 and 62 +/- 11 U/kg/week, respectively. Laboratory parameters showed that serum iron, transferrin saturation, sugar and triglyceride decreased significantly and uric acid and aluminum (Al) increased significantly. There was no significant change in predialysis blood pressure, body weight, cardiac ratio, and ECG. Quality of life was markedly improved with the better subjective feelings, physical activity and Karnorfsky index. Common adverse effects included exacerbated hypertension (23%), hyperphosphatemia (18%), hyperkalemia (18%), and flu-like syndrome (12%). All of them could be managed by medical and dialysis treatment. Investigation of influencing factors on response to EPO suggests that 1) TIW group had a better response than BIW group 2) Response was better in patients with more adequate iron status and less severe Al burden. 3) Time to target Hct correlated approximately with basal serum Al levels but did not correlate with basal serum parathyroid hormone levels. In conclusion, low dose of EPO therapy corrects anemia effectively with minimal adverse effects in HD patients. Dosing regimen, iron status, and serum Al will influence the response to EPO.

Adult↗

PubMed1991

Continuous ambulatory peritoneal dialysis in diabetic patients with end-stage renal disease: experience with intraperitoneal insulin therapy.

Continuous ambulatory peritoneal dialysis (CAPD) is a valuable alternative to hemodialysis in treating uremic diabetics, and insulin can be injected directly into dialysate and absorbed intraperitoneally (IP). We evaluated the effect of IP supply of insulin in 9 uremic diabetics undergoing CAPD therapy. The 9 patients included 5 males and 4 females, with a mean age of 57 +/- 12 years old. The study showed that serum biochemistry was stationary during the treatment period except for the variable elevations of serum triglyceride and cholesterol. Hypertension was easily controlled in most patients. The insulin requirements ranged from 50 to 180 (129 +/- 34) units/day, which was 4.2 +/- 1.6 times higher than the subcutaneous doses before dialysis. Insulin added to the dialysate showed a high percentage of adsorption (55% to 65%) onto the plastic bag. The blood glucose levels varied less after an IP supply of insulin. The overall incidence of peritonitis was 8 episodes in 135 patient months (one episode every 16.9 patient months), and the average duration of hospitalization was 14.9 +/- 11.2 days/year. The cumulative survival rates were 89% in the first year and 74% in the second year. Our experience indicates that CAPD is an ideal treatment modality for uremic diabetics, and IP supply of insulin results in a good control of diabetes.

Adult↗

PubMed1990

Renal changes in heterozygous Fabry's disease--a family study.

Two sisters, one with a long history of proteinuria and the other of hematuria, came for examination. Physical examination and routine laboratory workups did not show any significant abnormalities. The renal ultrastructural changes in case 1 showed marked enlargement and foamy vacuolation of all the glomerular capillary visceral epithelial cells, which was not found in other glomerular cells. The renal changes in case 2 showed similar lesions but with fewer cells involved and also with less severity, but the involved cells showed marked lamellation within the vacuoles. The serum alpha-galactosidase activity was 4.9 and 3.0 nmol/h/mL serum, respectively (normal values, 12.1 +/- 1.6 nmol/h/mL serum, mean +/- SD, n = 11), thus confirming the heterozygous variety of Fabry's disease. Our findings in these two cases reveal that patients with heterozygous Fabry's disease may present with renal symptoms only, which may be either proteinuria or hematuria.

Fabry Disease↗

PubMed1990

Plasma atrial natriuretic peptide in patients with chronic renal failure.

Plasma atrial natriuretic peptide (ANP) levels were measured in non-dialyzed and dialyzed chronic renal failure (CRF) patients and in normal subjects. Changes in plasma ANP in response to hemodialysis (HD) and to isolated ultrafiltration (UF) were also investigated in dialyzed CRF patients. Plasma ANP levels were significantly higher in 28 non-dialyzed CRF patients than in 27 normal subjects (mean +/- SEM, 174.0 +/- 25.9 vs 25.0 +/- 1.9 pg/ml, p less than 0.001). Plasma ANP levels did not correlate with blood urea nitrogen or serum creatinine, however patients with advanced renal failure (creatinine clearance less than 10 ml/min) with cardiomegaly (cardiothoracic ratio greater than 50%) or hypertension (BP greater than 140/90 mmHg) had significantly higher plasma ANP levels than those who were not. A 6-hour HD significantly decreased the plasma ANP level (423.4 +/- 71.3 to 220.6 +/- 40.0 pg/ml, p less than 0.001) and body weight in 21 dialyzed CRF patients, and the decrement in plasma ANP showed a positive correlation with the decrement in body weight (r = 0.425, p = 0.056). In 8 dialyzed CRF patients, we further performed a 1-hour isolated UF for removal of isoosmotic intravascular fluid without changes in the solute concentrations, followed by a subsequent 5-hour HD. The decrease in plasma ANP during the 1-hour UF period was 68% of the total ANP decrement for the whole 6-hour study. The average plasma ANP level was decreased with 94.6 +/- 42.5 pg/ml/kg/h in the UF period compared to 3.5 +/- 1.4 pg/ml/kg/h in the HD period (p less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

[Neuroelectrophysiological study in patients on long-term hemodialysis].

Uremic neuropathy is a common complication in patients on hemodialysis. Although there are still controversies over the pathogenesis of uremic neuropathy, neuroelectrophysiological study offers an objective and quantitative method of detecting this neuropathy, whether it is a question of axonal degeneration vs demyelination, sensory vs motor type, or distal vs proximal involvement. We also used the segmental latency of the median nerve to differentiate polyneuropathy from the carpal tunnel syndrome. Furthermore, this study also may serve as an important parameter for planning changes in different hemodialysis programs. Via the Medelec Mystro machine, we carried out an electrophysiological study of 38 hemodialysis patients. This study included motor and sensory nerve-conduction velocity studies and an H-reflex study of the tibial nerve. The incidence of polyneuropathy in patients on hemodialysis was 73.68%. Compared with normal controls, the velocity and amplitude of all tested nerves decreased significantly (P less than 0.01). The highest abnormal rate was the tibial nerve (73.7%). We found the severity of neuropathy did not closely correlate with the duration of hemodialysis (P greater than 0.05). Prolonged distal latency of the median motor and sensory nerves was about 50.0% and 31.6% respectively but prolonged segmental latency of the median sensory nerve was around 20% only. H-reflex of the tibial nerve was also significantly prolonged (P less than 0.01). We drew the following conclusions. First, polyneuropathy and carpal tunnel syndrome are common complications in patients on hemodialysis. Secondly, adequate hemodialysis can prevent the progression of uremic neuropathy. Thirdly, neuroelectrophysiological study may be used as one of the parameters for determining adequate hemodialysis.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗

PubMed1990

Comparisons of peritoneal function between diabetic and nondiabetic patients with end stage renal disease.

Peritoneal function is the major determinant of the efficiency of peritoneal dialysis. To understand whether diabetes affects the peritoneal function, we performed the peritoneal clearance study in 9 diabetic and 16 nondiabetic patients with end stage renal disease. The ultrafiltration volume tended to be lower in diabetics after infusion of 1.5% Dianeal, although there were no statistically significant differences between them. The same results were obtained after infusion of 4.25% Dianeal. The glucose uptake after infusion of both 1.5% and 4.25% Dianeal was not significantly different between the two groups. The dialysate/plasma(D/P) concentration ratio was also not significantly different between the two groups, however the D/P ratio for BUN and uric acid was slightly higher in the diabetic group. The peritoneal clearance of smaller molecules such as BUN, creatinine, uric acid and phosphate also tended to be higher in diabetics after infusion of 1.5% Dianeal for 4 hours. The peritoneal clearance became higher when more hyperosmotic dialysate were used in both diabetics and nondiabetics. The above results indicated that diabetic patients with end stage renal disease might have a normal peritoneal function compared to nondiabetics.

Aged↗