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Extracellular fluid volume and renal indices in essential hypertension.

Extracellular fluid volume (EFV), total blood volume (TBV), and renal indices were determined in 53 permanent essential hypertensive patients with normal renal function and balanced sodium intake and urinary output. In comparison with normal subjects, hypertensives had normal EFV values while TBV and the TBV/EFV ratio were significantly reduced (p less than 0.001). In hypertensives, a significant negative relationship (r = -0.40; p less than 0.005) was observed between the TBV/EFV ratio and diastolic arterial pressure. No correlation existed between TBV and diastolic pressure, whereas EFV (and also interstitial fluid volume) was positively related to diastolic arterial pressure (r = +0.41; p less than 0.005). Extracellular fluid volume and interstitial fluid volume were both directly correlated to the renal filtration fraction (r = +0.45; p less than 0.005). The study suggests that, in the disturbed partition of the extracellular fluid of hypertensives, changes in the interstitial space are involved and are related to variations in the renal indices.

Adult↗

Demonstration of altered signaling responses in bone marrow extracellular fluid during increased hematopoiesis in rats using a centrifugation method.

The composition and characteristics of the bone marrow extracellular fluid supposedly modify the transport of cytokines, drugs, and other signaling molecules involved in the regulation of bone marrow function. Direct access to the bone marrow extracellular fluid surrounding hematopoietic cells is complicated by the virtually noncompliant surrounding bone tissue. We examined the applicability of a centrifugation method to obtain representative samples of bone marrow extracellular fluid from rats and humans. Perforated rat bones or human bone marrow biopsies were wrapped in nylon mesh baskets before being centrifuged at 180-239 g. In the rats, we found an only minor contribution of fluid from other sources than the bone marrow extracellular fluid as indicated by the average ratio of centrifugate-to-plasma activity of the extracellular tracer fluid 51Cr-labeled EDTA of 0.85. The colloid osmotic pressure in the centrifugate was consistently lower than that in the corresponding plasma in both species. In rats and humans, high-performance liquid chromatography showed a protein elution pattern from the bone marrow fluid similar to that of plasma, except for a peak eluting in the approximately 40-kDa molecular mass range. Western blotting of the cytokines erythropoietin and granulocyte colony-stimulating factor revealed generally higher amounts in the centrifugate than in the plasma. This difference was augmented during increased hematopoietic activity induced by inflammation or bleeding in rats. We conclude that the centrifugation method provides representative samples of bone marrow extracellular fluid and that extracellular signaling responses to altered hematopoiesis are more clearly reflected locally in the bone marrow interstitium than in plasma.

Adult↗

Clinical assessment of extracellular fluid volume in hyponatremia.

Assessment of the status of extracellular fluid volume is important in evaluating the cause and selecting appropriate therapy for hyponatremic disorders. Since the sensitivity and specificity of clinical assessment of extracellular fluid volume status in hyponatremic states remain unknown, 58 non-edematous patients with serum sodium less than 130 meq/liter were prospectively evaluated. Patients were judged to be either normovolemic (no response of serum sodium to saline infusion) or hypovolemic (saline infusion significantly corrected hyponatremia). Hypovolemic patients had significantly higher plasma renin activity (5.0 +/- 1.5 versus 2.5 +/- 0.5 ng/ml per three hours, p less than 0.05) and norepinephrine (1,054 +/- 252 versus 519 +/- 55 pg/ml, p less than 0.05) concentrations than did normovolemic patients. Clinical assessment correctly identified only 47 percent of hypovolemic patients and 48 percent of normovolemic patients. Thus, clinical assessment was of limited sensitivity and specificity in identifying extracellular fluid volume status in these hyponatremic patients. However, the concentration of sodium in a spot urine sample clearly separated hypovolemic (mean UNa = 18.4 +/- 3.1 meq/liter) from normovolemic (mean UNa = 72 +/- 3.7 meq/liter, p less than 0.001) hyponatremic patients.

Extracellular Space↗

Role of parathyroid hormone in the phosphaturia of extracellular fluid volume expansion.

Role of parathyroid hormone in the phosphaturia of extracellular fluid volume expansion. Acute expansion of the extracellular fluid volume increases the urinary excretion of phosphate. The present study examined the importance of increased plasma parathyroid hormone concentration in the phosphaturia accompanying acute extracellular fluid volume expansion (ECVE). Infusion of a calcium-free Ringer's solution into dogs was associated with increased urinary phosphateexcretion and serum immunoreactive parathyroid hormone concentration (iPTH), the latter being significantly correlated with a decrease in plasma ionized calcium concentration. Prevention of the fall in plasma ionized calcium concentration by infusion of a calcium containing Ringer's solution prevented the increase in serum iPTH but the magnitude of the phosphaturia was not affected.

Animals↗

Effects of intestinal obstruction of plasma water and extracellular fluid volumes in the rat.

Total and regional plasma water and extracellular fluid volumes were measured in rats after obstruction of the small intestine. The rats lost 12.6 per cent of their initial weight. The volume of the sequestrated fluid in the obstructed intestine corresponded to 91 per cent of the plasma water volume. Intestinal obstruction caused a 19 per cent reduction of the total plasma water volume, while the total extracellular fluid volume was unchanged. Regional extracellular fluid volumes were diminished in the lung, liver and gastric antrum and increased in omental fat. The results indicate regional differences in fluid space responses to obstruction of the small intestine.

Animals↗

Free phenytoin concentration measurement in brain extracellular fluid: a pilot study.

This article investigates the relationship between brain extracellular fluid free phenytoin concentration and plasma free phenytoin concentration in adults with acute brain injury. Daily cerebral microdialysate free phenytoin concentration was measured in eight adults with acute brain injury and compared with simultaneous measurement of plasma free phenytoin concentration. The group data revealed no significant correlation between microdialysate and plasma free phenytoin concentration (r = 0.34, p = 0.41). However, in two patients, with a sufficient number of samples for intra-individual analysis, there was a significant correlation between microdialysate and plasma free phenytoin concentration (r = 0.92, p < 0.001 and r = 0.88, p < 0.01). In vitro microdialysis relative recovery for phenytoin was 2.1%. In the context of acute brain injury, measurement of free plasma phenytoin concentration may not provide an accurate reflection of regional brain extracellular fluid free phenytoin concentration and may have limitations with respect to achieving reproducible brain extracellular fluid free phenytoin concentrations. This has implications for dosing regimens relying on plasma phenytoin levels.

Adolescent↗

Afferent signaling and forebrain mechanisms in the behavioral control of extracellular fluid volume.

The body defends against reduced extracellular fluid volume both by activation of autonomic and endocrine reflexes and by mobilization of behavioral mechanisms. The behaviors that are required to correct an extracellular fluid deficit involve the ingestion of both water and sodium. It is reasonable to hypothesize that afferent neural input from both arterial and cardiopulmonary high pressure and volume receptors, and afferent humoral input in the form of ANG II, are important systemically-generated signals acting as afferent mediators of extracellular depletion-induced thirst and sodium appetite. Neural information from these signals has been shown to converge on forebrain structures located along the lamina terminalis where processing and integration of this input is likely to take place. This paper describes an analysis of the mechanisms of afferent signaling that accompanies a form of rapidly induced sodium appetite. Because volume and pressure-related input in concert with elevated activity of the renin-angiotensin system is likely to be important for generating this form of induced hypertonic sodium chloride and water intake, we have focused on the structures of the lamina terminalis, specifically the SFO, MnPO, and OVLT. Investigations that employ immunocytochemical methods for the detection of the early oncogene, c-fos, indicate that neurons in the lamina terminalis, as well as the SON and PVN, are activated by the composite of systemically derived signals necessary for producing thirst and sodium appetite. So far, there is no thorough understanding of how these visceral signals activate the neural substrates for these motivated behaviors. However, these studies, combining both functional and neuroanatomical approaches, provide a strategy for investigating the neurobiological basis of the behavioral and physiological control systems that maintain fluid balance and cardiovascular homeostasis. This paper describes an analysis of the mechanisms of afferent signaling that accompanies a form of rapidly induced sodium appetite. Because volume and pressure-related input, in concert with elevated activity of the renin-angiotensin system, is likely to be important for generating this form of induced hypertonic sodium chloride and water intake, we have focused on the structures of the lamina terminalis, specifically the SFO, MnPO, and OVLT. Investigations that employ immunocytochemical methods for the detection of the early oncogene, c-fos, indicate that neurons in the lamina terminalis, as well as the SON and PVN, are activated by the composite of systemically derived signals necessary for producing thirst and sodium appetite. So far, there is no thorough understanding of how these visceral sensory-related signals activate the neural substrates for these motivated behaviors.(ABSTRACT TRUNCATED AT 400 WORDS)

Afferent Pathways↗

Magnetic resonance imaging study of extracellular fluid tracer movement in brains of immature rats with hydrocephalus.

Hydrocephalus is associated with brain compression and accumulation of neurotransmitter waste products in the brain and cerebrospinal fluid. We postulated that the extracellular compartment is compressed and specifically hypothesized that extracellular fluid tracer movement through brain would differ between control and hydrocephalic rats. Gadolinium diethylenetriamine pentaacetic acid (Gd-DTPA) was injected into the cerebral cortex of 4-week-old rats, 7-11 days after induction of hydrocephalus by kaolin injection into the cisterna magna. The movement of this soluble paramagnetic compound was followed over successive timed intervals from 20 min to 180 min with T1-weighted magnetic resonance imaging. Non-hydrocephalic controls exhibited greater spread of the tracer and greater change in T1-weighted signal intensity in the ipsilateral cortex than hydrocephalic animals. Hydrocephalic animals exhibited preferential accumulation of tracer in edematous white matter. Gd-DTPA penetrated the lateral ventricles within 30 min in both control and hydrocephalic rats. The results suggest that there is a relative impairment of extracellular fluid movement through the cerebral cortex of young hydrocephalic rats.

Animals↗

[Extracellular fluid and total potassium content in obesity patients].

The content of extracellular fluid and total potassium was studied by total-body radiometry with 82Br and according to 40K in 162 females aged 41 to 55 years suffering from obesity. It was established that in patients with obesity the volume of extracellular tissue, in per cent, and the amount of total potassium, in gramms and millieequivalent per unit of actual body mass, were reduced. An increase in the content of extracellular fluid and a decrease in the level of total potassium in obese patients with circulatory insufficiency may be revealed only when the real content of extracellular fluid and the total potassium are stimated in relation to the unit of body surface. In obese patients with no signs of circulatory insufficiency these relative values hardly differ from the control values.

Adult↗