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[A novel hormone found in circulation--endogenous ouabain].

Endogenous ouabain (EO) is a recently found hormone that may be secreted from adrenal cortex. As an endogenous mammalian analogue of cardiac glycosides and an inhibitor of the sodium pump, it regulates the body fluid balance, urine sodium extraction and vasoconstrictive tone, and thus plays an important role in the pathogenesis of hypertension and some other cardiovascular disorders. This articke reviews its biological features, receptor and antibody, detection, effects on diseases and relationship with endothelial cells.

Adrenal Cortex↗

Physiological significance of increased levels of endogenous atrial natriuretic factor in human acute renal failure.

In twelve patients with acute renal failure, mean plasma levels of atrial natriuretic factor (ANF) and of its second messenger cGMP were found elevated at the early phase of the disease, but tended to return towards normal values at recovery. Variations of plasma ANF and cGMP were correlated significantly (p less than 0.05) with those of total blood volume. At the early phase of the disease, plasma ANF was also correlated with the excreted fraction of filtered sodium (FENa) (r = 0.95). Moreover, plasma ANF and FENa peaked concomitantly at the onset of the diuretic phase in the five patients who were not treated by diuretics or dialysis and were studied sequentially during the course of the disease. It is suggested that enhanced plasma ANF levels might reflect one of the mechanisms of adaptation controlling body fluid balance in acute renal failure.

Acute Kidney Injury↗

Fluid and electrolyte problems associated with diabetes insipidus and syndrome of inappropriate antidiuretic hormone.

This article has presented the complex system by which the hypothalamus regulates body fluid balance. In summary, ADH is synthesized and released via the hypothalamohypophyseal system. The supraoptic nucleus in the hypothalamus produces the ADH and the neurohypophysis stores and releases it. Osmoreceptors in the hypothalamus sense minute changes in the extracellular osmolality and stimulate or inhibit ADH synthesis and secretion. At the same time the thirst center of the hypothalamus is stimulated by the extracellular osmolality and brings conscious awareness of thirst into play. Once ADH is secreted, its target organ is the kidney, specifically the collecting ducts and distal tubules. Blood volume, blood pressure, emotional input, medications, and various pathologic conditions also affect ADH synthesis and secretion. As with any complex system there are numerous opportunities for a breakdown to occur. The most common types of pathologic conditions are the various forms of DI and SIADH. Both of these disorders have numerous causes, which must be identified prior to effective treatment. Serum and urine osmolality and sodium content are of use in diagnosing the disorders. Treatment is then geared toward correcting the underlying problem and controlling water balance, usually through pharmacologic agents. Nursing care includes meeting both the physical and psychologic needs of patients and educating them in the process of living with their transient or permanent condition.

Brain↗

[Electrophysiological studies on the central control of feeding and drinking under hyperbaric environment].

Increased urinary output, decreased fluid intake and reduction in body weight have been reported in divers exposed to hyperbaric environments. Single unit activity of hypothalamic neurons in the lateral hypothalamic area and paraventricular nucleus which control energy and body fluid balance was recorded with chronically implanted electrodes in rats. Neurons in the prefrontal cortex and central medical thalamus were also recorded for comparison. Out of 33 hypothalamic neurons, 19 reversibly decreased their firing rate to 67%, in average, under high pressure (7 atmospheres absolute) of air compared with precompression control. On the other hand, the remaining 14 neurons and all prefrontal and thalamic neurons tested were unaffected. Decreased hypothalamic unit activity was also found under normobaric hyperoxic environment and normoxic hyperbaric environment. The results suggest that hyperbaric air specifically affected the hypothalamic neurons by means of increased partial pressure of both oxygen and nitrogen.

Animals↗

Attenuation of natriuretic response to saline loading in AV3V lesioned rats.

Anteroventral third ventricle (AV3V) has been implicated in body fluid balance and blood pressure control. This study thus was to evaluate the renal response to saline loading in rats with and without AV3V lesion. Lesioned rats were prepared by electrolytic ablation 4 weeks prior to experiments. Arterial pressure (AP) and renal excretory responses were measured before and after intravenous infusion of 154 mM NaCl (0.388 ml/min) for 1 hour in anesthetized control and lesioned rats. There were no significant differences in AP (125 +/- 3 vs 121 +/- 3 mmHg) and glomerular filtration rate (GFR; 1.5 +/- 0.1 vs 1.6 +/- 0.3 ml/min/g kw) between control rats and lesioned rats. Saline loading did not significantly change AP and GFR in both groups of rats. In control rats there was a striking natriuretic (delta 2660%) and diuretic (delta 1870%) response to saline loading but the lesioned rats only exhibited 50% of the normal excretory response. A similarly attenuated natriuresis and diuresis was also found in conscious, lesioned rats with oral saline loading. These data suggest that AV3V exerts substantial influence on the regulation of sodium and water balance.

Animals↗

Some well-kept hypothalamic secrets disclosed.

The magnocellular neuropeptidergic cells of the supraoptic and paraventricular nuclei comprise much of what is known as the hypothalamoneurohypophyseal system and is involved in several functions, including body fluid balance, parturition, and lactation. In vivo experiments have not produced a clear understanding of some of the crucial features associated with the functioning of this system. In particular, questions relating to the osmosensitivity of magnocellular neurons and the mechanisms(s) by which their characteristic firing patterns are generated have not been answered by using the older approaches. Electrophysiological studies with brain slices present direct evidence for osmosensitivity, and perhaps even osmoreceptivity, of magnocellular neurons. Other evidence is reviewed indicating that the phasic bursting patterns of activity associated with vasopressin-releasing neurons: 1) occur in the absence of patterned chemical synaptic input, 2) are probably influenced by localized changes in extracellular K+ concentrations, 3) may be modulated by electrotonic conduction across gap junctions connecting magnocellular neurons, and 4) are likely to be generated by endogenous membrane currents.

Action Potentials↗

Body composition, nutrition, and fluid balance during the first two weeks of life in preterm neonates weighing less than 1500 grams.

To determine whether body weight during the first 2 weeks of life in preterm infants weighing less than 1500 gm reflects nutritional status or fluid balance, we studied total body water (TBW) (deuterium oxide dilution), extracellular volume (sucrose dilution), and plasma volume (Evans blue dilution), together with intake-output studies of nitrogen, fluid, and sodium on day 1 (median age 0.3 day), at a weight loss of 7.8% of birth weight (median age 3.4 days), and after birth weight was regained (median age 8.9 days) in eight clinically stable preterm infants (birth weight 810 to 1310 gm, gestational age 26 to 30 weeks) receiving ventilatory support. During the initial weight loss we found no evidence of catabolism. Body solids (weight--TBW) remained unchanged, there was nitrogen retention, and energy intake was sufficient to meet energy expenditure by day 2. However, we found evidence of fluid loss: TBW (mean +/- SD, -95 +/- 99 ml), extracellular volume (-98 +/- 63 ml), and interstitial volume (-102 +/- 75 ml) decreased significantly, indicating negative fluid and sodium balances. Blood volume and plasma volume remained unchanged. With the regaining of birth weight there was no increase in body solids despite a high degree of nitrogen retention, but there was a positive fluid balance although no significant increase in any body fluid compartment was found. We conclude that the observed postnatal weight changes reflect changes in interstitial volume.

Body Composition↗