bluuebunny/crossref_metadata_2025_split huggingface dataset:
Nutritional Status and Amino Acids in Granulocytes and Plasma in Patients with Chronic Renal Disease and Varying Residual Renal Function
Authors: Ivarsen P. , Tietze I.N. , Pedersen E.B. 
Published: April 2003

<i>Background:</i> Protein metabolism changes with loss of renal function resulting in deterioration of nutritional status. Whether changes in macroscopic (anthropometry and subjective global nutritional assessment (SGNA)) and cellular (plasma and granulocyte free amino acid concentration) nutritional status with loss of residual renal function are related is not known. <i>Methods:</i> Anthropometric variables, SGNA, and blood samples were measured after a night’s fast in 43 patients (age 57 years, median (range 27–77), 32 males and 11 females) with chronic renal disease. A 24-hour urine sample was collected the day before the study for calculation of creatinine clearance and protein nitrogen appearance rate. The patients were stratified according to creatinine clearance (group I: >35 ml/min/1.73 m<sup>2</sup>, group II 35–15 ml/min/1.73 m<sup>2</sup>, group III <15 ml/min/1.73 m<sup>2</sup>). <i>Results:</i> In males a significant lower body weight (p < 0.05) and upper mid-arm muscle area (p < 0.05) was found in group III compared to group I. SGNA indicated suboptimal nutritional status in 12 patients. In group I all had normal SGNA while in group II and group III, 26 and 57% respectively were malnourished. SGNA was significantly and negatively correlated to upper mid-arm muscle area (ρ = –0.37, p < 0.05) and percent body fat mass (ρ = –0.46, p < 0.01) and positively correlated to percent ideal body weight (ρ = 0.48, p < 0.01). Nine patients with malnutrition (M) were compared with 9 well-nourished (N) patients. They were comparable with respect to creatinine clearance (M: 13 ± 5 ml/min/1.73 m<sup>2</sup>; N: 16 ± 7 ml/min/1.73 m<sup>2</sup>), age and sex. In malnourished patients plasma concentration of nonessential amino acids was higher (23%, p < 0.05). The intracellular concentration was generally not affected except for sulfur amino acid methionine which was increased by a factor of 2.5 (p < 0.05) and taurine decreased by a factor of 1.6 (p < 0.05). <i>Conclusion:</i> Loss of renal residual function worsened both macroscopic and cellular nutritional status. SGNA correlated to objective measures of nutritional status and is clinically usable. In malnourished chronic renal patients, increased plasma concentration of nonessential amino acids was found which might indicate increased protein degradation.
Kidney Ischaemia-Reperfusion Injury and Polyribosome Structure
Authors: Pleština Stjepko , Gamulin Stjepan 
Published: April 2003

<i>Background:</i> Inhibition of protein synthesis and polyribosome disaggregation are the early events in cell injury provoked by various pathogenic mechanisms, including energy depletion. Polyribosome disaggregation might be expected to occur during ischaemia-reperfusion injury due to ischaemic energy depletion, but also due to detrimental effects of reactive oxygen species on various macromolecules and cellular structures. <i>Methods:</i> Mouse kidney ischaemia-reperfusion injury was provoked by temporary clamping of the renal artery. The polyribosome sedimentation pattern was analyzed by sucrose density centrifugation of kidney postmitochondrial supernatant. <i>Results and Conclusions:</i> Ischaemia for 5 min in the mouse kidney provoked polyribosome disaggregation and an increase of monomer ribosome fraction which was augmented during 10–360 min of reperfusion. Recovery of polyribosome aggregates appeared between 6 and 24 h of reperfusion. Cycloheximide pretreatment prevented only polyribosome disaggregation caused by ischaemia and not that caused by reperfusion. This indicates different mechanisms of polyribosome disaggregation during ischaemia and reperfusion. It probably occurs in the former due to inhibition of initiation of translation, resulting in accumulation of unprogrammed monomer ribosomes, and in the latter due to the splitting of mRNA and breakdown of polyribosomes. Reperfusion did not increase ribonuclease activity in kidney cytosol, but increased the tissue concentration of malonaldehyde, indicating an augmentation in oxygen free radical generation. Possibly these may have caused a non-enzymatic breakdown of polyribosomes. However, pretreatment with allopurinol did not prevent polyribosome breakdown during ischaemia-reperfusion injury.
Alloimmune Hemolysis after Renal Transplantation
Authors: Li Fu Keung , Chan Tak Mao , Lai Ka Neng 
Published: April 2003

A 35-year-old patient with blood group AB developed hemolysis 1 week after receiving a blood group B cadaveric kidney transplant. The patient’s serum was shown to contain anti-A antibody, which was likely to have been derived from passenger lymphocytes transplanted concurrently with the graft. The alloimmune hemolysis subsided spontaneously without treatment. The present case underscores the potential complication of ABO blood group-compatible but nonidentical organ transplantation. Clinical vigilance is important to differentiate from other more sinister causes of posttransplant hemolysis.
The Effect of Estrogen on Renal Phosphorus Handling in the Rat
Authors: Dick Ian M. , Prince Richard L. 
Published: April 2003

<i>Background/Aims:</i> Phosphorus reabsorption in the kidney is regulated by parathyroid action on the sodium phosphorus cotransporter (Na-Pi cotransporter). There is some evidence that estrogen may also regulate renal phosphorus handling but it is not known if this is an effect of estrogen on filtered phosphorus load. <i>Methods:</i> This study examined the effect of estrogen on renal phosphorus handling during infusion with calcium or EDTA. Six month old Sprague Dawley rats were bilaterally oophorectomized (OOX) or underwent a sham operation under ether anaesthesia 6 weeks before undergoing infusion with calcium chloride or EDTA. A second study examined renal phosphorus handling after estrogen replacement in the OOX rat injected with 20 µg estradiol valerate, or vehicle alone, prior to calcium infusion. <i>Results:</i> A comparison of filtered phosphorus load with renal phosphorus excretion indicated that the estrogen replete rat had a higher renal excretion of phosphorus when infused with both calcium (p = 0.004) and EDTA (p = 0.037) at all filtered phosphorus loads. A similar analysis in calcium infused, estrogen replaced, OOX rats indicated an effect of estrogen to increase renal phosphorus excretion (p = 0.007) at all filtered phosphorus loads. OOX resulted in a mild metabolic alkalosis, an effect not reversed by estrogen administration, that was not related to renal phosphorus excretion. OOX decreased renal sodium excretion and uncoupled the relation between renal phosphorus and sodium excretion, an effect reversed by estrogen replacement. <i>Conclusion:</i> Ovarian hormone deficiency in the rat results in a decrease in renal phosphorus excretion. This finding is comparable to effects of the menopause and hormone replacement therapy in postmenopausal women.
Low-Protein Diet Suppresses Serum Insulin-Like Growth Factor-1 and Decelerates the Progression of Growth Hormone-Induced Glomerulosclerosis
Authors: Doi Sonia Q. , Rasaiah Suvi , Tack Ivan , Mysore Jagannatha , Kopchick John J. , Moore Jack , Hirszel Przemyslaw , Striker Liliane J. , Striker Gary E. 
Published: April 2003

A low-protein (LP) diet has been associated with amelioration of renal function in glomerulosclerosis (GS). However, the mechanisms involved are still unclear. We have used a mouse transgenic for bovine growth hormone (GH), which develops progressive GS and exhibits consistently elevated levels of circulating GH and insulin-like growth factor (IGF)-1, to study the effect of dietary protein restriction. LP (6% protein) and normal-protein (NP, 20% protein) diets were maintained for 30 weeks in mice with established GS of mild/moderate degree. The degree of GS was markedly attenuated in LP compared to NP mice. Quantitative analysis revealed a significantly lower GS index (1.4 ± 0.9 in LP vs. 2.8 ± 0.8 in NP) and glomerular volume (0.8 × 10<sup>6</sup> ± 0.1 × 10<sup>6</sup> µm<sup>3</sup> in LP vs. 1.2 × 10<sup>6</sup> ± 0.1 × 10<sup>6</sup> µm<sup>3</sup> in NP) in mice with restricted protein intake. These morphologic changes were accompanied by a significant reduction in renal expression of α<sub>1</sub> type-IV collagen (2.4-fold) and tenascin (1.4-fold) in LP mice. Serum IGF-1 decreased by 40% and showed a significant correlation with α<sub>1</sub> type-IV collagen expression with the LP diet. The present finding supports the use of the LP diet to decelerate the progression of GS and furthermore suggests that one of the mechanisms involved in this process is the GH/IGF-1 regulation by protein intake.
Solvent Effect in vitro of Anticolana Valley Water on Renal Stones: Analytical-Instrumental Study
Authors: De Angelis Curtis S. , Curini R. , Fraioli A. , Petronio B.M. , Ricciuti G. , D’Ascenzo G. 
Published: April 2003

The presence of humic and fulvic acids in the Anticolana Valley (Fiuggi) water has been established. On the basis of this evidence we investigated the capacity of Anticolana Valley (Fiuggi) water to dissolve renal calculi in vitro. Crystals of calcium oxalate monohydrate to simulate a kidney stone were prepared. Human renal stones of calcium oxalate monohydrate were obtained by courtesy of the Division of Urology of ‘La Sapienza’ University (Rome), the Division of Urology of the University of Havana (Cuba) and the ASTIF of Fiuggi. The study was performed using the Anticolana Valley (Fiuggi) water, distilled water and tap water (ACEA, Rome), in a specially designed Perspex apparatus. Each calculus was subjected to a water flow of 2 liters/24 h. The capacity of the Anticolana Valley (Fiuggi) water to dissolve human and synthetic calculi was found to be much higher than that of distilled water which in turn was significantly more effective than tap (ACEA) water.
Monocytoid B Cell Lymphoma Associated with Antibodies to Myelin-Associated Glycoprotein and Sulphated Glucuronyl Paragloboside
Authors: Donfrid M. , Apostolski S. , Suvajdžić N. , Janković G. , Čemerikić-Martinović V. , Atkinson H.D.E. , Čolovic M. 
Published: April 2003

Monocytoid B cell lymphoma (MBCL) is an immunologically and morphologically well-defined low-grade lymphoma with a predilection for lymph nodes of the parotid region. We describe an association of MBCL with anti-myelin-associated glycoprotein (MAG) polyneuropathy in a 53-year-old male. The diagnosis of stage IV MBCL with nodular bone marrow infiltration, Sjögren’s syndrome and sensorimotor polyneuropathy was made in October 1996. Serum immunoelectrophoresis demonstrated IgMĸ paraprotein. This was then cross-reacted with epitopes of MAG and sulphated glucuronyl paragloboside (SGPG) on myelin sheaths, and detected by thin layer chromatography and Western blot. Direct immunofluorescence of a sural nerve biopsy showed loss of myelin fibres, segmental demyelinization and IgM deposits on the myelin sheaths. The cerebrospinal fluid was normal. After six cycles of chemotherapy (ChlVPP protocol), all the patient’s haematological parameters normalized accompanied by an improvement in neurological signs. The improvement of the polyneuropathy after chemotherapy indicates that the autoimmune anti-MAG and anti-SGPG antibodies resulted from the neoplastic lymphoid proliferation.
Efficacious Response with Low-Dose Indapamide Therapy in the Treatment of Type II Diabetic Patients with Normal Renal Function or Moderate Renal Insufficiency and Moderate Hypertension
Authors: Madkour Hosameldin , Ali Kareim , Nosrati Saeid , Massry Shaul G. 
Published: April 2003

We examined the efficacy of low daily dose (1.25 mg/day) of indapamide in the treatment of high blood pressure in patients with diabetes mellitus with normal renal function and those with moderate renal insufficiency (serum creatinine <1.5 mg/dl). The study was an open label one of four months duration. Twenty-eight patients were enrolled in the study and only 15 completed it. Within 2 weeks of therapy, systolic blood pressure fell from 173 ± 4.5 to 144 ± 2.0 mm Hg and diastolic blood pressure from 96 ± 2.1 to 80 ± 1.8 mm Hg (p < 0.01) and blood pressure remained at these levels throughout the study. The results show that low dose indapamide is effective in the treatment of moderate hypertension in patients with diabetes mellitus who have normal renal function or moderate renal insufficiency. Therefore, this dose of 1.25 mg/day is recommended for the treatment of such patients.
Using Artificial Intelligence to Predict the Equilibrated Postdialysis Blood Urea Concentration
Authors: Fernández Elmer A. , Valtuille Rodolfo , Willshaw Peter , Perazzo Carlos A. 
Published: April 2003

Total dialysis dose (Kt/V) is considered to be a major determinant of morbidity and mortality in hemodialyzed patients. The continuous growth of the blood urea concentration over the 30- to 60-min period following dialysis, a phenomenon known as urea rebound, is a critical factor in determining the true dose of hemodialysis. The misestimation of the equilibrated (true) postdialysis blood urea or equilibrated Kt/V results in an inadequate hemodialysis prescription, with predictably poor clinical outcomes for the patients. The estimation of the equilibrated postdialysis blood urea (eqU) is therefore crucial in order to estimate the equilibrated (true) Kt/V. In this work we propose a supervised neural network to predict the eqU at 60 min after the end of hemodialysis. The use of this model is new in this field and is shown to be better than the currently accepted methods (Smye for eqU and Daugirdas for eqKt/V). With this approach we achieve a mean difference error of 0.22 ± 7.71 mg/ml (mean % error: 1.88 ± 13.46) on the eqU prediction and a mean difference error for eqKt/V of –0.01 ± 0.15 (mean % error: –0.95 ± 14.73). The equilibrated Kt/V estimated with the eqU calculated using the Smye formula is not appropriate because it showed a great dispersion. The Daugirdas double-pool Kt/V estimation formula appeared to be accurate and in agreement with the results of the HEMO study.
A Comparative Study of Blood Pressure Control with Short In-Center versus Long Home Hemodialysis
Authors: McGregor David O. , Buttimore Adrian L. , Lynn Kelvin L. , Nicholls M. Gary , Jardine David L. 
Published: April 2003

We conducted a randomized crossover trial to establish, within patients, whether long-slow hemodialysis (HD) was associated with better blood pressure (BP) control than standard HD. Nine home HD patients, not on antihypertensive drugs, were dialyzed to the same eKt/V<sub>urea</sub> and target weights for 6–8 h (LD) at home and for 3.5–4.5 h (SD) in the dialysis center 3 times weekly in randomized sequence, with each phase lasting 8 weeks. Ambulatory BP, bioimpedance, neurohormones and autonomic function were measured in each phase. Pre- and postdialysis systolic, ambulatory systolic and diastolic BP were all higher with SD than with LD and intradialysis hypotension was more common. Weight, ECF volume and neurohormones did not differ between treatments. Muscle sympathetic activity was increased in both phases and cardiac sympathetic activity tended higher during SD. These findings suggest that additional factors to ECF volume may contribute to the superior BP control produced by long-slow HD.
Changes in Heart Rate Variability in Chronic Uremic Patients during Ultrafiltration and Hemodialysis
Authors: Galetta Fabio , Cupisti Adamasco , Franzoni Ferdinando , Morelli Ester , Caprioli Raffaele , Rindi Paolo , Barsotti Giuliano 
Published: April 2003

<i>Background:</i> The analysis of heart rate variability (HRV) is a useful tool to evaluate cardiac autonomic modulation, which is frequently impaired in chronic uremia. <i>Aims:</i> The aim of this study was to evaluate HRV in chronic uremics and to separately investigate the acute changes induced by volume depletion and solute removal during a hemodialysis session. <i>Methods:</i> Fourteen uremic patients (8 males and 6 females, aged 50 ± 15 years) on maintenance hemodialysis and 14 sex- and age-matched healthy controls were studied. Both groups underwent ambulatory electrocardiogram monitoring to evaluate the HRV time and frequency domain indices. The hemodialysis session was performed by 1 h of high-rate isolated ultrafiltration followed by 3 h of bicarbonate diffusive procedure. <i>Results:</i> In uremic patients, the overall variability in the frequency [low-frequency power (LF): 505 ± 473, vs. 1,446 ± 654; high-frequency power (HF): 133 ± 162 vs. 512 ± 417; p < 0.001] and time domain indices (standard deviation of normal R-R intervals: 101.9 ± 33.3 vs. 181.7 ± 44.1 ms; p < 0.001) was markedly reduced compared to controls, whereas mean heart rate (83 ± 12.4 vs. 60.9 ± 8.8 bpm; p < 0.001) and LF/HF ratio (5.8 ± 3.5 vs. 2.2 ± 0.8; p < 0.001) were increased. Isolated ultrafiltration produced a marked further decrease in HRV indices, but the subsequent diffusive hemodialysis procedure, with a low ultrafiltration rate, made HRV increase again. <i>Conclusions:</i> Chronic uremics showed abnormal autonomic modulation with sympathetic-vagal imbalance. The unbalanced hypersympathetic response to body fluid depletion is related to the ultrafiltration rate. Low interdialytic weight gain and a low ultrafiltration rate, associated with adequate hemodialysis, should be the preferable strategy for uremic patients with autonomic dysfunction.
Performance of Twin Central Venous Catheters: Influence of the Inversion of Inlet and Outlet on Recirculation
Authors: Level Claude , Lasseur Catherine , Chauveau Philippe , Bonarek Hervé , Perrault Luc , Combe Christian 
Published: April 2003

<i>Background:</i> The use of a central venous catheter as a permanent vascular access is constantly growing. The recirculation rate in this type of vascular access varies depending on the site of insertion, the length of the catheter, the blood flow and the time elapsed since catheter insertion. When the in/out flow of the lumens of the catheter is reduced, it is sometimes necessary to inverse the arterial and venous lines of the catheter at the beginning or in the course of the dialysis session. The impact of such a practice on the recirculation rate has only been assessed by the low flow urea dilution method. <i>Methods:</i> The blood recirculation rate was measured using the ultrasound dilution velocity method (Transonic<sup>®</sup> system, Ithaca, N.Y.) in 14 patients (aged 64 ± 15 years), with a right internal jugular (n = 9) or right subclavian (n = 5) central catheter (Twincath, Medcomp<sup>®</sup>), used over a mean period of 16.3 (range 1–42) months. No clinical dysfunction of the catheter was apparently noted. The distance between the vein and the artery end of the catheter was 3.9 ± 2.8 cm, measured on chest radiography. The recirculation rate was measured over a single dialysis session at increasing blood flows in the normal and inversed position of the catheter. <i>Results:</i> The difference between the prescribed and effective blood flow was significant with an effective blood flow of 180± 16 ml/min for 200 ml/min, 264 ± 27 ml/min for 300 ml/min and 329 ± 16 ml/min for 400 ml/min prescribed blood flow. There was no relationship between the recirculation rate and blood flow whatever the position of the lines on the catheter. There was also no relationship between the recirculation rate and the distance between the catheter ends. However, reversing the catheter ends significantly increased the recirculation rates from 2.9 ± 5 to 12 ± 9% whatever the blood flow. <i>Conclusion:</i> The use of central catheters in an inversed position can result in a higher recirculation rate. Reversing the lines of the central catheters may lead to less effective hemodialysis and it seems particularly important for the nursing staff to be aware of this phenomenon. Thus, measurement of the effective blood flow and recirculation by ultrasound velocity should be included in quality monitoring and maintenance.
Ancrod in the Treatment of Acute Ischemic Stroke
Authors: Atkinson Richard P. 
Published: April 2003

Although ancrod has been used in Europe and Canada since 1968 for various conditions including heparin-induced thrombocytopenia [1], peripheral vascular disease [2] and deep-vein thrombosis [3], its first described use for stroke patients was in 1983 [4]. Since then one large double-blind placebo-controlled randomized study treating acute stroke patients within 6 h has been completed and published [5]. Another larger study, treating patients within 3 h of stroke onset, is nearing completion in 1997.
Evaluation of the Secretory Pattern of Plasma Arginine Vasopressin in Stroke Patients
Authors: Barreca T. , Gandolfo C. , Corsini G. , Del Sette M. , Cataldi A. , Rolandi E. , Franceschini R. 
Published: April 2003

Arginine vasopressin (AVP) may play a role in the development of ischemic brain edema and/or cerebral vasospasm. Data available on AVP plasma levels in ischemic stroke are few and discordant. In order to ascertain whether changes in AVP plasma levels occur in ischemic stroke, plasma AVP levels, plasma osmolality and mean arterial pressure were determined in 24 patients with unprecedented ischemic cerebral infarction and in 15 controls over a 24-hour period. In stroke patients, mean 24-hour plasma AVP levels (7.2 ± 0.8 ng/l) were higher (p < 0.05) than in control subjects (2.4 ± 0.3 ng/l), and correlated with the severity score of the neurologic deficit and the mean size of the lesion. In patients with a more severe neurologic deficit, the mean 24-hour plasma AVP levels (8.7 ± 1.0 ng/l) were higher than in patients with a less severe neurologic deficit (5.2 ± 0.8 ng/l). Data indicate that in ischemic stroke an increased AVP secretion occurs independently of osmotic or baroreceptorial mechanisms. The possibility that AVP may play a role in neuronal cell damage following cerebral ischemia warrants further attention.
Diffusion-Weighted MR in Cerebral Venous Thrombosis
Authors: Lövblad Karl-Olof , Bassetti Claudio , Schneider Jacques , Guzman Raphael , El-Koussy Marwan , Remonda Luca , Schroth Gerhard 
Published: April 2003

The diagnosis of cerebral venous thrombosis is often difficult both clinically and radiologically and until now there is no method available to predict if brain lesions, detected clinically and using conventional brain imaging methods, may lead to full recovery, as expected in vasogenic edema or ischemic infarcts and even a hematoma. New fast neuroimaging techniques such as diffusion-weighted imaging (DWI) are sensitive to different reasons of changes in local tissular water concentration thus giving further insight into the pathophysiological mechanism as well as prognosis of cerebral venous thrombosis. We report the cases of 18 consecutive patients with a diagnosis of cerebral venous thrombosis based on clinical and imaging criteria. All patients underwent magnetic resonance imaging (MRI) of the brain, which comprised isotropic diffusion-weighted MR. Diffusion-weighted MRI showed positive findings in 17/18 cases. In 7 cases the clot could be directly visualized as an area of hyperintensity in the affected vein on DWI. In 7 cases DWI showed areas of signal loss corresponding to hematomas. In 6 cases DWI showed changes in signal intensity that were more subtle. In 4 cases of superficial venous thrombosis, there were areas of decreased ADC values (0.65–0.79 × 10<sup>–3</sup> mm<sup>2</sup>/s) whereas in 2 cases of deep venous thrombosis, increased DWI intensities could be found that corresponded to both an increase and a decrease in ADC, corresponding to a coexistence of cytotoxic and vasogenic edemas. Diffusion-weighted MRI can demonstrate directly the presence of an intravenous clot in a select number of patients. It can also demonstrate early ischemic changes, and can differentiate conventional T2-weighted MR areas of cytotoxic from vasogenic edema.