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Biomedical subjects

S Adler

Publications and source records attributed to S Adler.

At least 235 records · Page 13Linked to original sources
PubMed1977

Correction of hyperkalemia by bicarbonate despite constant blood pH.

Patients having hyperkalemia often are given bicarbonate to raise blood pH and shift extracellular potassium into cells. Blood pH in many hyperkalemic patients, however, is compensated. To determine whether bicarbonate, independent of its pH action, affects plasma potassium, 14 hyperkalemic patients were treated with bicarbonate in 5% dextrose. In five patients (changed pH group), blood pH rose at least 0.08, while in nine (constant pH group), it changed less than 0.04. In the first group, pH rose 0.12, bicarbonate rose 5.9 mEq/liter, and plasma potassium fell 1.6 mEq/liter, and plasma potassium fell 1.4 mEq/liter. The correlation between changes in plasma potassium and bicarbonate was identical in the two groups and independent of urinary potassium excretion. Four additional patients, who were treated with 5% dextrose alone, did not significantly lower their plasma potassium, although subsequent treatment with bicarbonate in 5% dextrose lowered their plasma potassium. Thus, bicarbonate lowers plasma potassium, independent of its effect on blood pH, and despite a risk of volume overload, should be used to treat hyperkalemia in compensated acid-base disorders, even in the presence of renal failure, provided the plasma bicarbonate concentration is decreased.

Adult↗
PubMed1977

Potassium and intracellular pH.

Recent work has clarified some of the complex interrelationships between cell pH and potassium. These studies have been limited by the techniques available for accurately measuring cell pH. At present it is obvious that intracellular pH is a major regulator of the cellular potassium concentration, but the precise relationship between these two is still uncertain. It has become increasingly clear, however, that no simple relationship exists between the intracellular to extracellular hydrogen ion and potassium ion ratios. Many experiments do demonstrate that the extracellular metabolic alkalosis of potassium depletion is accompanied by a decrease in skeletal muscle pH in rat, rabbit, and probably dog. The response of cardiac and renal tubular cell pH to potassium depletion is less clear, although most evidence indicates that there is also a reduction in the pH of these tissues. This effect on cell pH appears to be independent of chloride. By contrast, hyperkalemia seems to raise muscle cell pH at the same time it induces an extracellular metabolic acidosis. The metabolic and physiologic consequences of potassium-induced alterations in cell pH have yet to be fully elucidated.

Acid-Base Equilibrium↗
PubMed1977

[Obesity in childhood, seen by the pediatrician (author's transl)].

Presently, obesity is beginning more and more in early childhood. This is one of negative factors of civilization. Author describes biochemical properties and the sequelae of obesity (high morbidity and mortality). The role of psychic resp. educational factors is stressed. A program of a fasting cure in a childrens clinic is dealt with.

Adipose Tissue↗
PubMed1976

[Cerebrospinal fluid protein electrophoresis in non-inflammatory central nervous system diseases].

Cerebrospinal fluids (CSF) (N = 365) from patients with non-inflammatory diseases of the central nervous system were analyzed for protein distribution by agar gel microelectrophoresis. After subdivision into diagnostically well defined groups, these patients were compared with 79 normal controls. Most of the diseases investigated were found to follow the "plasma-type" pattern. In some of them the deviations from normal were so extensive that a CSF-protein pattern similar to the "acute-phase reaction" in the serum occurred. Moreover, the following characteristics were found: a considerable increase in total protein and the gamma-globulin fractions in neurinomas; a reproducible increase in the alpha1-globulins in metastases of the central nervous system; and a statistically significant difference of CSF protein findings between male and female patients with protrusion of lumbar intervertebral discs.

Albumins↗
PubMed1976

Isohydric regulation of plasma potassium by bicarbonate in the rat.

pH and bicarbonate affect many metabolic reactions but each may change independently. To study bicarbonate's effect onplasma potassium, blood bicarbonate in normal, hypokalemic or hyperkalemic rats was either maintained constant, lowered by hydrochloric acid or raised by sodium bicarbonate administraion. Blood pH was maintained constant by changing PCO2. In normokalemia lowering bicarbonate increased plasma potassium 2.0mEq above values obtained in the other groups. To eliminate urinary potassium losses, experiments were also performed in rats with bilateral ureteral ligation. Again, plasma potassium concentration rose significantly more in the lowered bicarbonate group. Similarly, in hypokalemia, plasma potassium rose 1.2 and 0.4mEq in the lowered and unchanged groups, but fell 0.2mEq/liter in the elevated group. Differences could not be ascribed to renal potassium losses as potassium excretion was essentially zero in each group. In hyperkalemia, plasma potassium concentration remained elevated for 150 min in the lowered bicarbonate group but fell 1.3 and 2.0mEq in the unchanged and elevated groups, respectively. Urinary potassium losses in the three groups were statistically identical. In all experiments blood pH was maintained unchanged during the experiment. The data show that bicarbonate, independent of blood pH, alters transcellular potassium distribution suggesting the usefulness of bicarbonate therapy in hyperkalemia even at a compensated blood pH.

Acid-Base Equilibrium↗
PubMed1975

Splenectomy for hematologic depression in lymphocytic lymphoma and leukemia.

Fifty patients with lymphocytic lymphoma and chronic lymphocytic leukemia underwent splenectomy for various combinations of anemia, thrombocytopenia, and leukopenia. All of these patients had advanced lymphoproliferative disease, and most had infiltration of bone marrow by neoplastic cells. Good response in all hematologic parameters was obtained in 27 of 48 evaluable patients. An additional 13 patients responded in one or two parameters; there were only 8 complete failures. The over-all surgical mortality was 8%. The median duration of response was 4 months, and the mean, 7 months. Increased tolerance to further antitumor therapy and a decreased transfusion requirement were seen among responding patients. Those patients with anemia who had evidence of shortened erythrocyte survival and splenic sequestration of 51Cr-labelled erythrocytes uniformly responded with rises in hemoglobin. However, half of the patients with negative splenic sequestration also showed improvement of anemia. Preoperative diagnostic studies failed to predict favorable responses of patients with thrombocytopenia or leukopenia. The classical criteria for the diagnosis of hypersplenism are not applicable in many cases of neoplastic lymphoproliferative disease; splenectomy could have been considered "contraindicated" in most of the patients in this series. We conclude that splenectomy is worth undertaking in patients with lymphoproliferative disease complicated by hematologic depression regardless of marrow findings or the results of other diagnostic studies.

Adult↗
PubMed1975

Nondependence of cell pH on sodium transport in rat diaphragm muscle.

Both sodium and hydrogen ions are in lower concentration in muscle cell water than would be predicted from thermodynamic considerations alone, indicating active transport of these two ions out of muscle cells, To determine whether their transport is coupled, intact rat diaphragms were incubated at an external pH of 7.40, and sodium efflux was altered by exposure to ouabain. Despite a sixfold increase in intracellular sodium concentration, cell pH measured simultaneously by the distribution of both a weak acid (pH DMO) and a weak base (pH nicotine) was unaffected. Similarly, when sodium influx was decreased by incubating intact diaphragms in low sodium isoosmolar buffer, pH DMO and pH nicotine were unaltered. In addition, a pH-sensitive reaction, the evolution of 14CO2 from 1, 4-14C citrate by rat hemidiaphragm, was not changed by exposure to ouabain or low sodium media. These experiments demonstrate that in diaphragm muscle sodium and hydrogen ion transport appear not to be coupled, since alterations in sodium transport are unaccompanied by a change in cell pH. Although changes in membrane potential may explain part of the results, the data are most consistent with the hypothesis that active hydrogen ion transport in skeletal muscle in directly coupled to metabolic energy-producing reactions.

Animals↗
PubMed1975

Cathodic oxygen consumption and electrically induced osteogenesis.

Small amounts of electric current stimulate bone formation in the region of a cathode. The purpose of this experiment is to compare changes in oxygen and hydroxyl ion concentration that occur at the cathode at current levels known to be capable of inducing osteogenesis (10-20 muamps) with those changes that occur at current levels known to be toxic to bone (100 muamps). An oxygen consumption chamber containing an oxygen electrode is fitted with two stainless steel electrodes which are connected to a constant current source. At the cathode, with a current of 100 muamps, oxygen is consumed at nearly stoichiometric rates. At higher current (100 muamps) levels, cathodic oxygen consumption gives way to hydrogen evolution. Cathodic hydroxyl ion production is directly proportional to current. It is concluded from these in vitro experiments that at 10-20 muamps the oxygen tension in the vicinity of the cathode is lowered and the pH is moderately increased. At 100 muamps the oxygen tension is not lowered, but the pH is increased dramatically. If these same changes occur in the vicinity of a cathode in vivo, then lowering the local tissue oxygen tension and raising the local pH may be mechanisms operative in electrically induced bone formation.

Chemical Phenomena↗