POTASSIUM ACCELERATES URINARY SODIUM EXCRETION DURING SALT LOADING WITHOUT STIMULATING ATRIAL NATRIURETIC POLYPEPTIDE SECRETION

1. Effects of potassium (K) supplementation (100 mEq/day) on urinary sodium (Na) excretion and on the secretion of atrial natriuretic polypeptide (ANP) during salt loading (350 mEq/day) were studied in 12 healthy salt-resistant normotensives under strictly controlled metabolic ward conditions. 2. Urinary volume and Na excretion on the first day of the high salt period (HSP) were significantly greater in the K-supplemented group (KG) than in the control group (CG). 3. There was a significant gain in bodyweight after salt loading in both groups, with a significantly greater gain in CG on the second day of HSP. Haematocrit decreased significantly during salt loading in both groups, the degree of which was significantly greater in CG. 4. Plasma norepinephrine decreased significantly during salt loading in both groups, the degree of which was significantly less in KG than in CG. A significant increase in plasma ANP was observed in CG on and after the second day of HSP, while a significant increase in plasma ANP was observed on the fifth day of HSP in KG. 5. These findings indicate that K supplementation accelerates diuresis and natriuresis, resulting in moderate suppression of volume expansion induced by salt loading and that this accelerated diuresis and natriuresis is not a result of the action of ANP.     

Evaluation of vertebral volumetric vs. areal bone mineral density during growth

Bone mineral “density” (BMD) measured by dual-energy X-ray absorptiometry (DEXA) does not represent the volumetric density (grams per cubic centimeter), but rather the areal density (grams per square centimeter). This distinction is important during growth. The purpose of this study was to measure vertebral dimensions in cadavers of young pigtail macaques (Macaca nemestrina), and to derive equations to predict the volumetric bone density from noninvasive measurements. We measured the areal bone density by DEXA, vertebral volume by underwater weighing, mineral content by ashing, dimensions of lumbar vertebrae by calipers, and dimensions of vertebrae by radiography. Somatometric measurements of the female lumbar vertebral bodies showed that the shape changed during growth. The bone mineral content from the densitometer correlated significantly with the ash weight (r = 0.99, error 8.7%). The correlation coefficient between the volumetric bone mineral density and areal BMD measurement was significant (r = 0.68, p < 0.0001) with a 9.5% error; this improved significantly to 0.82 (7.2% error) when the BMD was divided by the vertebral depth from the radiograph. Areal BMD showed a strong correlation with age (r = 0.82, p < 0.0001), with an average increase of 7.4%/year. In contrast, volumetric mineral density showed a weak relationship with age (r = 0.43, p < 0.01), for an average increase of 1.5%/year. When studying bone mineral density during growth, the differences between volumetric and areal bone mineral density should be taken into consideration. (     

Computation of Time-Constant Histograms from the Forced Expired Volume-Time Curves

An efficient BASIC program was established on Apple-Ⅱmicrocomputer with the CHESTAC-35F pulmonary function testing system tocalculate the time-constant histogram from the spirogram.By a set of analogousstudies,we confirmed that the recovered time-constant histogram was within onecompartment of the assumed one and that the root of mean square values of theresiduals between the experimental and model volume-time curves was 0.02.Infour healthy adult subjects,the mean value of time-constant histograms(TCx)hadthe variation coefficient 6.6％.The results show that our method is reliable andreproducible,and it can be used for clinical investigation.     

SP-C对重组肺表面活性物质活性的影响

目的 探讨不同浓度的肺表面活性物质(PS)相关蛋白C(SP-C)与合成脂质构成的重组PS活性的变化。方法 从新鲜猪肺的灌洗液中提取PS,从PS中分离出SP-C。将二棕榈酰磷脂酰胆碱、二油酰磷脂酰胆碱和棕榈酰油酰磷脂酰甘油按60:20:20的重量比混合,即为合成脂质(SL),将SP-C按1％、2％、3％(与脂质的重量比)加入SL中,制成三种重组PS:RS-1、RS-2和RS-3。将上述物质溶于生理盐水中即为实验液体。用气泡型表面张力计测定各实验液体的表面张力。将PS缺如的未成熟胎兔随机分为4组:PS、SL、RS-3和对照组。分别向PS、SL和RS-3组气道内注入PS、SL、RS-3液;对照组未注入任何物质。然后进行人工通气,通气后5、10、15、20min测定各组潮气量。结果 PS的最小表面张力(γmin)为(0.9±0.3)mN/m,SL的γmin为(22.6±1.3)mN/m,明显高于PS(P<0.01);随SP-C浓度的增加γmin逐渐降低,RS-3的γmin降至(0.7±0.1)mN/m(与PS相比,P>0.05)。通气20min时,PS组、RS-3动物的潮气量分别达到(25±7)ml/kg、(25±4)ml/kg,明显高于对照组和SL组(P<0.01)。结论 不含SP-C的合成脂质表面活性低,加入SP-C后构成的重组PS表面活性明显增强。     

磁共振灌注成像在脑胶质瘤中的应用与评价

目的 :评价磁共振 (MR)灌注成像在脑胶质瘤病理分级诊断中的价值。　方法 :对 2 8例脑胶质瘤患者术前行MR灌注成像 ,采用GRE EPI序列 ,重建相对脑血容量 (rCBV)彩图后 ,以肿瘤对侧对应部位和对侧正常脑白质为参照 ,分别计算出肿瘤最大rCBV1及rCBV2 ,并与病理学分级进行对照分析。　结果 :低、高度恶性胶质瘤的最大rCBV1值分别为 1.38± 0 .36和 4 .32± 3.4 1,最大rCBV2值分别为 2 .83± 0 .76和 9.71± 6 .2 3;低、高度恶性胶质瘤的rCBV1或rCBV2值与病理分级之间差异均有显著性意义。另外 ,rCBV1、rCBV2间有高度相关性 (r =0 .736 ,P <0 .0 0 1)。　结论 :MR灌注成像对脑胶质瘤的术前分级诊断有重要价值。     

Restricted field of view magnetic resonance imaging of a dynamic time series.

A restricted field of view (rFOV) approach for imaging a dynamic time series of volumes of limited spatial extent within a larger subject is described. The shorter readout with rFOV-MRI can be exploited to either limit image artifacts or increase spatial resolution. To accomplish rFOV imaging of a multislice volume for a dynamic series, an outer volume suppression (OVS) preparation that saturates signal external to a cylinder through the subject is followed by slice-selective excitation and a spiral readout. The pass- and stopband efficiencies of the OVS in an agar gel phantom were 97% (+/-1.5%) and 3% (+/-1%), respectively. Profiles of the temporal signal-to-noise ratio (SNR) were measured in a phantom and an adult brain. The rFOV sequence reduced distortions from off-resonance signal and T2*-induced blurring compared to a conventional sequence. Sequence utility is demonstrated for high-resolution rFOV functional MRI (fMRI) in the visual cortex. The rFOV sequence may prove to be useful for other multislice dynamic and high-resolution imaging applications.     

Fiber Matrix Descriptors from Permeability Data Without Requiring Membrane Thickness: Theory,Results, and Optimization

Objective: Permeability of basement membrane and all other barriers contains a term for membrane thickness (Δx). This naturally leads to development of methods for measuring Δx that are imprecise, inaccurate, expensive, subject to preparation artifact, and inattentive to variability. Although height and shape of permeability (P) vs. probe radius (α) curves are sensitive to Δx, ln(P) or ln(P/free diffusivity or D_o) curves have shapes independent of Δx. It should, thus, be possible using such characteristics to determine fiber radius (r_f) and void volume ratio (ε) without Δx. We developed such a method to derive membrane structure by the standard model of Ogston and present its experimental evaluation. Methods: Basement membranes were self-assembled using 1: 1 Matrigel: 0.01 M Tris/150 mM NaCl/1.0 mM CaCl₂ buffer on 0.4-μ polycarbonate supports with transport measured in diffusion chambers using FITC-labeled hydroxyethyl starch probes from 25 to 102 Å in radius. Sampling was at 0.5 hr and then for each hour up to 5. Other membranes were measured 7 days after formation. Results: The best fit of the new technique occurred at 3 hr with R² = 0.949 ± 0.003 SEM, r_f = 36.8 ± 2.4 Å, and ε = 0.87 ± 0.02. Membranes studied for 7 days showed more variability but essentially the same characteristics. Conclusions: Membrane thickness is not necessary to reduce permeability of basement membrane to structure, and optimum sampling time is 3 hr.     

In vitro determination of lung airway compliance in small animals

An in vitro method for obtaining pressure/volume curves from the lungs of small animals is described. The excised lungs were inflated and deflated with saline or air by a motor-driven syringe controlled by a microcomputer. The computer was programmed to display the curves in real time, correcting when necessary for the compressibility of air in the system. Volume compliance (K=dV/dP×1/V) was calculated by differentiating a polynomial fitted to the measured pressure/volume points. Repeatable curves were obtained from mice aged 24h (body weight 1·3±0·14g (SD), residual lung volume 8·43±1·5 μl (SD). A nonlinear decrease in differential compliance (K=dV/dP×1/V) with increasing strain was observed while the ratio K_saline/K_air increased from 2·5 to 10 over the range of strains investigated (ε=1–5). The relative surface tension (calculated from the difference between the pressures required to inflate the air and saline-filled organs to a given volume) increased exponentially with increasing volume. We conclude that it is now possible to obtain reproducible pressure/volume curves for lungs with a residual volume of less than 10 μl, from animals weighing approximately 1·5 g and, from these curves, estimate airway compliance and surface tension.     

Effective pulmonary blood flow in children with acute asthma attack requiring hospitalization

In children with acute obstructive lung disease gas exchange is affected by ventilation-perfusion mismatch and the degree of bronchoconstriction. Standard lung function measurements do not reflect the impairment in gas exchange. Alternatively, the effective pulmonary blood flow (EPBF), that is, the proportion of the cardiac output that is supplying well-ventilated lung units, can give accurate and noninvasive estimates of ventilation-perfusion mismatch. We measured EPBF with the argon freon ?22 rebreathing technique in children with acute severe asthma to assess their response to nebulized salbutamol and to determine whether induced changes in the EPBF could be predicted from baseline measurements. Twenty-four children admitted with an acute asthma attack had spirometry and triplicate EPBF measurements before and after nebulized salbutamol. Eighteen patients had repeated tests 50 days later when fully recovered; 4 patients were taking methylxanthines on at least one occasion. The mean forced expiratory volume in 1 sec (FEV₁) rose from 55% of predicted to 66% after salbutamol and to 83% with recovery. The mean coefficients of variation for EPBF measurements on the three test occasions were 11.3%, 8.2%, and 9%. Except in children on methylxanthines, the EPBF values were reduced during the acute asthma attack (median, 2.53 L/min/m²; range, 1.99–3.60 L/min/m²) compared with paired values obtained after recovery (median, 2.89 L/min/m²; range, 2.2Eb4.04 L/min/m²) (P = 0.009). Salbutamol caused a highly significant increase in EPBF from 2.88 L/min/m² (range, 1.86–3.80) before treatment to 3.34 L/min/m² (range, 2.264.65) immediately afterwards (P = 0.0003). The spirometric indices did not relate to the changes in the EPBF values. However, when the effective stroke volume index was calculated in 11 patients, the changes induced by nebulized salbutamol had a significant inverse relation with the pretreatment FEV, (P = 0.61; P = 0.02). In conclusion, the argon freon-22 rebreathing technique can be used successfully and reproducibly to measure EPBF in children with an acute asthma attack. Except in children taking methylxanthines, EPBF during the acute attack is reduced and rises significantly after salbutamol. EPBF values after recovery were significantly higher than the presalbutamol values during the attack. Spirometric indices do not relate to the EPBF changes but are inversely related to the effective stroke volume changes. Pediatr Pulmonol. 1994; 17:370–377. © 1994 Wiley-Liss, Inc.     

Mesial temporal sclerosis and volumetric investigations

Volumetric MRI data acquisition permits reliable and accurate measurement of mesial temporal lobe structures. In normal subjects, these structures are very symmetric. A high degree of pathological specificity is associated with the finding of even minor volume asymmetries. Definition in this manner allows precise estimation of both absolute and relative volume differences, and precise anatomical localisation of volume loss within the hippocampus. There are good EEG and clinical correlates with the distribution of volume loss defined on MRI studies. Volumetric assessment is fast, reliable, non-invasive, and a relatively inexpensive component of the pre-operative work-up. It is the method of choice when imaging patients with clinical temporal lobe epilepsy undergoing pre-surgical evaluation. The finding of significant hippocampal volume asymmetry in a patient with clinical temporal lobe seizures being evaluated for epilepsy surgery may obviate the need for alternative sophisticated, invasive, or expensive investigative procedures. At our centre, such MRI allows "fast track" cases to proceed to surgery without further invasive investigations, and is likely to have a dramatic effect on pre-operative evaluation in most centres practising epilepsy surgery.