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T Wang

Publications and source records attributed to T Wang.

879 records · Page 49Linked to original sources
PubMedDate not supplied

Does a high peritoneal transport rate reflect a state of chronic inflammation?

OBJECTIVE: It has recently been reported that a high peritoneal transport rate was associated with increased mortality in continuous ambulatory peritoneal dialysis (CAPD) patients. One possible explanation is that a high peritoneal transport rate might be caused by a state of chronic inflammation, which also per se might result in increased mortality. Therefore, in this study we investigated whether high peritoneal transport rate patients are in a state of chronic inflammation. METHODS: The study included 39 clinically stable peritoneal dialysis patients (free of peritonitis) who had been on PD for more than 3 months (16.8+/-11.8 months). Seven patients were treated with continuous cycling peritoneal dialysis (CCPD) and the others were on CAPD. A 4-hour standard peritoneal equilibration test (PET) using 2.27% glucose solution was performed in each patient. Dialysate samples at 4 hours and blood samples at 2 hours were measured for interleukin-1beta (IL-1beta), tumor necrosis factor(alpha)(TNFalpha), C-reactive protein (CRP), and hyaluronan as markers of inflammation. RESULTS: There was no significant correlation between dialysate/plasma (DIP) creatinine (0.82+/-0.15, range 0.51 - 1.15) and blood concentrations of IL-1beta (11.2 ng/L, range <5 - 65.9 ng/L),TNFalpha (12.1 ng/L, range <5 - 85.4 ng/L), CRP (<10 mg/L, range <10 - 76 mg/L), nor with the blood hyaluronan concentration (165 microg/L, range 55 - 955 microg/L). The dialysate concentrations of IL-1beta and TNFalpha were below the detectable level in most of the samples. Although dialysate hyaluronan concentration (334 microg/L, range 89 - 1100 microg/L) was correlated with D/P creatinine (r= 0.36, p< 0.05), there was no correlation between the total amount of hyaluronan in the effluent and D/P creatinine. However, a significant correlation was found between serum hyaluronan concentration and glomerular filtration rate (GFR) (r = -0.49, p< 0.005); GFR also tended to be correlated with serum TNFalpha (r = -0.31, p = 0.058) but not with serum IL-1beta and serum CRP. CONCLUSION: Our results suggest that a high peritoneal transport rate is not necessarily related to a state of chronic inflammation in CAPD patients. The high mortality rate observed in high transporters may relate to other issues, such as fluid balance or abnormal nutrition and metabolism, rather than to chronic inflammation.

Biological Transport↗
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Discriminative impact of ultrafiltration on peritoneal protein transport.

OBJECTIVE: The dialysate concentration of large proteins increases, on average, linearly during the whole peritoneal dialysis dwell, and this linear pattern seems to be independent of the rate of ultrafiltration induced by dialysis fluid. However, we observed a high variability of protein kinetics in individual dwell studies. Therefore, we studied the details of the kinetic pattern of peritoneal transport. DESIGN AND METHODS: Kinetics of beta2-microglobulin, albumin, and total protein was examined in 23 clinically stable continuous ambulatory peritoneal dialysis patients using Dianeal 3.86% (15 dwell studies) or Dianeal 1.36% (9 dwell studies) dialysis fluid. Dialysate volume was measured using radioisotopically labeled albumin as a volume marker, with corrections for sample volume and absorption of fluid and marker from the peritoneal cavity. The generalized version of the Babb-Randerson-Farrell model was applied to estimate diffusive mass transport coefficient (K(BD)) and sieving coefficient (S) for proteins and small solutes (urea, creatinine, glucose, sodium, potassium). To quantify deviations from the linear pattern of protein dialysate concentration increase, the ratio (SR) of the slope of the linear regression line for the initial 3-30 minutes, divided by the slope for the next 60 - 360 minutes, was evaluated for albumin. RESULTS: In 5 dwell studies with Dianeal 3.86% fluid, SR was lower than 1 [low albumin transport (LAT) group, median SR = 0.49, range -4.39 - 0.71], while in the other 10 dwell studies with this solution, SR was higher than 1 [high albumin transport (HAT) group, median SR = 2.77, range 1.32 - 7.56]. Clearances of albumin up to 120 minutes were higher in the HAT group than in the LAT group. The transport of fluid, beta2-microglobulin, and small solutes did not differ between the LAT and the HAT groups. K(BD) values for proteins did not differ between the groups, but S values for albumin and total protein were lower for the LAT group than for the HAT group. A similar diversity was found in the dwell studies with Dianeal 1.36%: In three dwell studies, SR for albumin was lower than 1 (median SR = 0.95, range 0.70 - 0.97), and in six dwells it was higher than 1 (median SR = 1.55, range 1.23 - 1.98). In general, the SR values observed with Dianeal 1.36% were closer to 1 than those for Dianeal 3.86%. CONCLUSIONS: Ultrafiltration may affect the initial kinetic patterns of large protein (such as albumin) transport in two opposing ways: (1) by slowing the increase of protein concentration in dialysate (due to a low sieving coefficient, LAT group), and (2) by speeding up the increase of protein concentration in dialysate (due to a high sieving coefficient, HAT group). The average pattern in a non-selected group of studies is, however, close to a steady (linear) increase.

Albumins↗
PubMedDate not supplied

Fluid and solute transport using different sodium concentrations in peritoneal dialysis solutions.

BACKGROUND: Fluid and sodium balance is important for the success of long-term peritoneal dialysis. Convective transport is the major determinant for sodium removal during peritoneal dialysis using conventional dialysis solutions. However, recent studies showed that lower sodium concentration in dialysate could significantly increase sodium removal by increasing the diffusion gradient, thereby increasing diffusive transport. In the present study, we investigated the influence of the sodium concentration gradient on the diffusive transport coefficient, K(BD) for sodium. METHODS: A 4-hour dwell study was done in Sprague-Dawley rats using 25 mL 5% glucose (NS), 5% glucose + 0.3% NaCl (LS), 5% glucose + 0.6% NaCl (MS), or 5% glucose + 0.9% NaCl (HS), with frequent dialysate and blood sampling. Radiolabeled human albumin (RISA) was added to the solution as an intraperitoneal volume marker. The peritoneal fluid and sodium transport characteristics were evaluated. RESULTS: Significant ultrafiltration (both net ultrafiltration and transcapillary ultrafiltration) was observed in each group despite the osmolality of the 5% glucose solution being slightly lower than the plasma osmolality. There was no difference in peritoneal fluid absorption rate and direct lymphatic absorption among the four groups. With the sieving coefficient for sodium set to 0.55, a significantly higher K(BD) for sodium was found in the NS compared to the HS group. The K(BD) for sodium was 0.21+/-0.01, 0.20+/-0.01, 0.17+/-0.01, and 0.09+/-0.01 mL/min for the NS, LS, MS, and HS groups, respectively. The K(BD) values for glucose were significantly lower in the NS and LS groups compared to the MS and HS groups. CONCLUSIONS: Our results suggest that (1) sodium concentration may affect peritoneal sodium K(BD)--as the sodium concentration gradient increased, the K(BD) decreased; (2) 5% glucose solution could induce significant peritoneal ultrafiltration in normal rats despite its initial hypo-osmotic nature, this was due to the significantly lower glucose transport rate than sodium transport rate; and (3) a lower dialysate sodium concentration may decrease peritoneal glucose absorption.

Animals↗
PubMedDate not supplied

Hyaluronan preserves peritoneal membrane transport properties.

BACKGROUND: We have shown that intraperitoneal (i.p.) addition of hyaluronan (HA) in a single dwell study in rat could increase peritoneal fluid removal by decreasing the peritoneal fluid absorption rate. In this study, we investigated the impact of repeated use of HA on peritoneal membrane transport characteristics. METHODS: Twelve male Sprague-Dawley rats received a once-daily i.p. injection of 25 mL 4.25% glucose dialysis solution without (HP group, n = 6) or with 0.025% HA (HA group, n = 6) for 1 week. Forty-eight hours after the last injection, a 4-hour dwell using 25 mL 4.25% glucose dialysis solution with i.p. volume marker and frequent dialysate and blood samplings was performed in each rat as well as in rats that did not receive any injection (control group, n = 8). RESULTS: Although the i.p. volumes were significantly lower in the HP and HA groups compared to the control group, i.p. volume in the HA group was significantly higher than in the HP group. Net ultrafiltration at 4 hours was 5.6 +/- 1.3 mL, 10.2 +/- 1.8 mL, and 13.2 +/- 0.6 mL for the HP, HA, and control group, respectively. The peritoneal fluid absorption rate decreased by 45% in the HA group compared to the HP group. There was no significant difference in peritoneal fluid absorption rate between the HA and the control group. No difference was found in the direct lymphatic absorption rate between the HP and HA groups [0.010 +/- 0.003 mL/minute in the HP group and 0.011 +/- 0.004 mL/min in the HA group] although they were both higher than that of the control group (0.004 +/- 0.001 mL/min). The solute transport rates were in general significantly higher in the HP group compared to the HA and control groups, and there was no significant difference between the latter two groups, except that protein transport rate was significantly lower in the HA group compared to the control group. CONCLUSIONS: The present study suggests that (1) repeated exposure to hypertonic glucose-based dialysis solution results in increased peritoneal solute transport rates, as well as increased peritoneal fluid absorption rates; and (2) these changes, reflecting a highly permeable peritoneal membrane, were ameliorated by repeated i.p. addition of hyaluronan. The similar changes in the direct lymphatic absorption rate in rats that received daily i.p. injection of dialysis solution suggest that direct peritoneal lymphatic absorption was not influenced by hyaluronan.

Absorption↗
PubMedDate not supplied

Freezing preservation of the mammalian heart explant. III. Tissue dehydration and cryoprotection by polyethylene glycol.

Isolated rat hearts perfused with hyperosmotic Krebs-Henseleit buffer containing 60 mmol/L NaCl lose 10% of their tissue water. Perfusion of the rat hearts with Krebs-Henseleit buffer containing polyethylene glycol 8000 caused a concentration-dependent reduction in tissue water. In a study of the effect of different cryoprotectants on cardiac preservation, isolated rat hearts were flushed with a cardioplegic solution (CP-14), or CP-14 with either 50 mmol/L glycerol (CP-15), or 5% polyethylene glycol (CP-16) and frozen at -1.4 degrees C for 5 hours. Thawed hearts were reperfused in working mode to assess function. There was no recovery in CP-14 hearts. Hearts treated with CP-15 recovered 39.3% +/- 2.9% (mean +/- SEM) of control cardiac output. CP-16 boosted the recovery of cardiac output to 54.4% +/- 5.7% (p less than 0.05 vs CP-15). Glycerol significantly reduced tissue ice content; PEG further decreased the ice content to 31.7% +/- 0.6%, which was distinctively lower than that in CP-14 (44.7% +/- 1.1%) and in CP-15 hearts (34.6% +/- 1.1%). Tissue water content of CP-14 and CP-15 hearts was similar (3.83 and 3.87 gm H2O/gm dry weight). Polyethylene glycol reduced the tissue water content to 3.24 +/- 0.04 gm H2O/gm dry (p less than 0.01 vs CP-14 and CP-15 by ANOVA). Thus both glycerol and polyethylene glycol offered cryoprotection to the heart explant by reducing tissue ice formation. Polyethylene glycol was superior to glycerol by dehydrating myocardial tissue and further minimizing freezing damage.

Animals↗
PubMedDate not supplied

Use of transgenic mice in acid-base balance studies.

The kidney is essential in maintaining body acid-base status. Recently, the use of transgenic mice has largely contributed to the understanding of the mechanisms involved. Important issues have been addressed in terms of the function of proteins or their regulation. In the proximal tubule, the role of Na+/HCO3-cotransport has been established, although further studies are needed to understand how its mutations lead to renal disease. Na+/H+ exchange has also been extensively studied, and its role in diuretic and natriuretic responses following an increase in blood pressure has been elucidated. The interaction of other transport proteins, such as the Na+/phosphate cotransporter NaPi II-a, with the Na+/H+ exchanger has also been investigated. In the medullary thick ascending limb of Henle's loop (MTAL), a role for NHE1 in transepithelial HCO3- absorption has been demonstrated: basolateral NHE1 controls the function of apical NHE3. As for the distal nephron, the majority of observations suggest that the regulation of H+-ATPase activity in response to acid-base status is mediated by the trafficking of pumps or pump sub-units, especially for the a4 subunit, rather than changes in subunit expression levels. Furthermore, the function of pendrin, a chloride/anion exchanger, has been assessed in response to changes in acid-base status. Important results have been obtained regarding the regulation of proximal tubule transport by several mechanisms, such as microvilli changes and the inducible and endothelial isoform of nitric oxide synthase (NOS). Finally, the interaction of chloride channels and potassium-chloride cotransporter with proton secretion has been evaluated. These findings highlight the importance of knockout animal models in studying kidney regulation of acid-base balance.

Acid-Base Equilibrium↗
PubMedDate not supplied

Long-term hypothermic storage of the cardiac explant. Comparison of four solutions.

This study compared the capabilities of 4 storage solutions in protecting the cardiac explant. Isolated rat heart was flushed with and stored in one of the storage solutions at 0 degrees C for 7 hours. The recovery of function was assessed using the working heart perfusion. Cardiac output returned to 34 +/- 6, 59 +/- 3 76 +/- 5, and 75 +/- 8% (mean +/- SE) of the control level in hearts stored in Euro-Collins, St. Thomas' Hospital cardioplegic, a modified University of Wisconsin (MUW) solutions, and a solution developed by us (CP-8), respectively. Therefore, MUW and CP-8 were superior to the other two solutions. During post-storage reperfusion, the coronary flow correlated directly with the aortic flow (r = 0.98), suggesting that preservation of coronary perfusion may be crucial to the recovery of function. There was also a good correlation between myocardial ATP levels and the cardiac output (r = 0.81). Thus, measurements towards the enhancement of ATP preservation and regeneration may be beneficial to the stored cardiac explant.

Adenine Nucleotides↗
PubMedDate not supplied

[Myofibroblasts in connective tissue of the human amnion].

Connective tissue of the human amnion at 14, 19, 21 and 33 weeks of gestation and at full term was examined by electron microscopy. Myofibroblasts which have not been described in the amnion so far were identified in addition to fibroblasts and macrophages (Hofbauer cells). Myofibroblasts display the following morphological characteristics: 1. The nuclei have multiple indentations and deep folds. 2. Numerous bundls of filaments (5 nm and 10 nm in diameter) are present within the cytoplasm. The bundles of 5 nm-filaments contain dense bodies. 3. Frequently they are connected to each other by desmosomes or by gap junctions. 4. The plasma membrane shows many hemidesmosome-like zones of thickening. 5. The cell surface is partly covered by basement membrane. Since these cells possess the ability of contraction, we suggest that they may contribute to the protection of the amniontic membrane from overdistension.

Amnion↗
PubMedDate not supplied

Diagnosis of Strongyloides stercoralis in sputum cytology.

A unique case of hyperinfection with Strongyloides stercoralis in an apparently immunosuppressed host is reported. The organism in various stages of maturation was initially detected by routine sputum cytology. Papanicolaou-stained smears from scrapings of jejunal and colonic mucosa provided specific confirmation of the parasite. Postmortem examination also showed massive tissue and vascular invasion in the intestine with cerebral and pulmonary dissemination.

Brain Abscess↗
PubMedDate not supplied

Twenty-four hour intermittent perfusion storage of the isolated rat heart: the effect of perfusion intervals on functional preservation.

We investigated the effect of intermittent perfusion intervals on heart preservation. The isolated rat heart was flushed with a cardioplegic solution, CP-11EB, and stored at 0 degrees C for 24 hours. During storage, the heart was perfused periodically at 60 mm Hg for 3 minutes with 25 degrees C oxygenated CP-11EB. The perfusion schedules were as follows: group I, every 4 hours; group II, every 6 hours; group III, every 8 hours; group IV, every 10 hours; group V, 10 and 17 hours of storage; group VI, every 11 hours. Poststorage function was assessed after 30 minutes of working reperfusion. Function of the unstored hearts including aortic flow (51.5 +/- 2.5 ml/min), coronary flow (24.5 +/- 1.3 ml/min), cardiac output (75.6 +/- 3.0 ml/min) and work (85.0 +/- 5.4 g-ml/min) served as controls. Group V hearts were best preserved with aortic flow recovered to 65%; coronary flow 44%; cardiac output 58%; and work 53% of the control. Recovery in group IV was comparable with group V. Groups I, II, III, and VI recovered significantly less than group V. Myocardial adenosine triphosphate content (micromoles per gram dry) in group V was 23.8 +/- 1.7, 20.8 +/- 0.9, 13.5 +/- 2.4, and 15.0 +/- 4.0, at 0, 10, 17, and 24 hours of storage, respectively. Intermittent perfusion at 10 and 17 hours elevated adenosine triphosphate to 99% and 88% of prestorage level. Poststorage reperfusion did not improve improve adenosine triphosphate content (16.2 +/- 2.4) over the end-storage level.(ABSTRACT TRUNCATED AT 250 WORDS)

Adenosine Triphosphate↗
PubMedDate not supplied

Daily exposure to dialysis fluid results in changes in peritoneal transport.

OBJECTIVE: To study the effects of daily infusion of peritoneal dialysis fluids on peritoneal transport characteristics. DESIGN: Twenty-four rats were randomly divided into three groups: group A, daily infusions of 20 mL 3.86% glucose dialysis function for 10 days (8 rats); group B, daily infusions of 1.36% glucose dialysis solution for 10 days (8 rats); group C, no daily infusion, the control group (8 rats). Twenty-four hours after the last infusion, a 4-hour dwell study using 25 mL 3.86% glucose dialysis solution with frequency dialysate and blood samples was performed in each rat. Radio-labeled human albumin (RISA) was added to the solution as an intraperitoneal volume marker. EXPERIMENTAL ANIMALS: Twenty-four male Sprague-Dawley rats (300 g) were used. MAIN OUTCOME: Fluid and small solute (glucose, urea, sodium, potassium, phosphate, and urate) transport characteristics were evaluated. RESULTS: After 10 days of exposure to dialysis fluid, the fluid absorption rate increased in the 3.86% dialysate group compared to the other groups (p < 0.05). The clearance of RISA to plasma (an estimation of lymphatic absorption), and the absorption of glucose were significantly increased in the two experimental groups compared to the control group but there was no difference between the two experimental groups. The dialysate/plasma ratio for urea, potassium and urate, and the sieving coefficient for phosphate and urate were significantly higher in the 3.86% dialysate group compared to the other two groups, but there was no significant difference between the 1.36% dialysate group and the control group. The clearances of sodium and potassium were significantly lower in the 3.86% dialysate group compared to the control group. CONCLUSION: Our results suggest that (1) daily infusion of dialysis fluid into the peritoneal cavity may increase peritoneal lymphatic absorption: (2) daily infusion of 3.86% glucose dialysate may increase peritoneal transport for small solutes.

Absorption↗
PubMedDate not supplied

Peritoneal fluid and solute transport with different polyglucose formulations.

OBJECTIVE: To study peritoneal fluid and solute transport characteristics using different polyglucose solutions with and without the addition of glucose. DESIGN: Thirty-one rats were divided into three groups. A 4-hour dwell study with frequent dialysate and blood samples was performed in each rat using 25 mL of 7.5% polyglucose solution (PG, n = 11), 7.5% polyglucose + 0.35% glucose solution (PG1, n = 12), or 3.75% polyglucose + 1.93% glucose solution (PG2, n = 8). Radiolabeled human albumin (RISA) was added to the solutions as an intraperitoneal volume (i.p.V) marker. In addition, polyglucose degradation was evaluated ex vivo over 24 hours. EXPERIMENTAL ANIMALS: Thirty-one male Sprague-Dawley rats (300 g) were used. MAIN OUTCOME MEASURES: Fluid and solute (glucose, urea, sodium, potassium, and total protein) transport characteristics as well as changes in dialysate osmolality were evaluated. RESULTS: The i.p.V was higher in the PG1 and PG2 groups than in the PG group during the first 2 hours of the dwell. The i.p.V, in fact, decreased during the first hour of the dwell in the PG group. However, the net ultrafiltration at 4 hours tended to be lower in the PG2 (3.2 +/- 1.5 mL) group compared to the PG (5.1 +/- 2.3 mL) and the PG1 groups (5.2 +/- 2.1 mL) (p = 0.07), and no significant difference was found between the PG and PG1 groups. Adding glucose to the PG solution increased the RISA elimination rate (KE, representing the fluid absorption rate from the peritoneal cavity): 25.5 +/- 8.2, 37.5 +/- 12.2, and 42.5 +/- 8.9 microL/min for the PG, PG1, and the PG2 group, respectively, p < 0.01. Dialysate osmolality (D[OS]) increased with the dwell time in the PG and PG1 groups but decreased in the PG2 group.The increase in D(OS) was partially due to the degradation of glucose polymer, which was supported by the marked increase in osmolality over 24 hours of incubation of PG solution with peritoneal fluid, ex vivo. The diffusive mass transport coefficient for the investigated solutes did not differ among the three groups (except for glucose, which was significantly lower in the PG group). The sieving coefficient for sodium was significantly higher in the PG group compared to the PG1 group (p < 0.05). CONCLUSION: Our results suggest that, although there was an initial decrease in the intraperitoneal dialysate volume, significant amounts of fluid can be removed by polyglucose solution during a single 4-hour dwell in rats, despite the low osmolality of the solution. The positive fluid removal induced by the PG solution is partially due to the lower fluid absorption rate associated with this solution and may, to some extent, also be due to the degradation of glucose polymer within the peritoneal cavity, resulting in increased dialysate osmolality. The addition of glucose to the polyglucose solution does not seem to improve ultrafiltration in a 4-hour dwell in the rat model. However, the peritoneal fluid absorption rate may be increased, and peritoneal transport of glucose and sodium may be altered, by adding glucose to the polyglucose solution.

Animals↗
PubMedDate not supplied

A case-control study of the relationship between dietary factors and risk of lung cancer in women of Shenyang, China.

A 1:1 case-control study of lung cancer incidence among women in Shenyang was conducted to explore the relationship between diet and the risk of lung cancer, with emphasis on the potential effects of a list of specific dietary constituents on modifying lung cancer risks. Dietary information on 290 cases and population-matched controls was obtained by personal interviews. Multiple logistic regression models were used for the statistical analysis and summarization of the data. A significant difference was found between cases and controls with respect to intake of beta-carotene, vitamin C and fibers, all of which reduced the risk for lung cancer in a dose-dependent manner; yielding calculated odds ratio (OR) of 0.84, 0.75, and 0.46, respectively. The apparent effects of these nutrients persisted after adjusting for cigarette smoking;suggesting that they may function as protective factors to reduce the risk for lung cancer in Chinese women.

Adult↗