Quantitative Determination of H2 in Human Blood by 22Ne-aided Gas Chromatography-Mass Spectrometry Using a Single Quadrupole Instrument

Here, we present a quantitative method for H2 detection by gas chromatography-selected ion monitoring-mass spectrometry (GC-SIM-MS) using a single quadrupole instrument. Additionally, the developed method was applied to the detection of H2 in human blood by GC-SIM-MS analysis using the existing 22Ne in air as an internal standard (IS). H2 was analyzed by GC-SIM-MS using a single quadrupole instrument with double TC-Molsieve 5A capillary columns for the separation of permanent gases. The detections of H2 (analyte) and 22Ne (IS) were performed at m/z 2 and 22, respectively, by GC-SIM-MS. The analyte and IS were separated using He as the carrier gas. The ratio of the peak area of H2 to 22Ne was employed to obtain a calibration curve for H2 determination in the gas phase. The proposed GC-SIM-MS method exhibited high sensitivity in terms of the limits of detection (LOD) (1.7 ppm) and quantitation (LOQ) (5.8 ppm) for H2 analysis. The developed quantitative assay of H2 in the headspace of blood samples achieved high repeatability with a relative standard deviation (RSD) of 1.4 - 4.7%. We successfully detected and quantified H2 in the headspaces of vacuum blood-collection tubes containing whole blood from 11 deceased individuals with several causes of death by employing the developed GC-SIM-MS method. The quantitative value of H2 ranged from 5 to 905 ppm. The proposed GC-SIM-MS method was applicable to the quantitative assay of H2 in biological samples without tedious pretreatment requirements.

Pharmacokinetics of a single inhalation of hydrogen gas in pigs

The benefits of inhaling hydrogen gas (H2) have been widely reported but its pharmacokinetics have not yet been sufficiently analyzed. We developed a new experimental system in pigs to closely evaluate the process by which H2 is absorbed in the lungs, enters the bloodstream, and is distributed, metabolized, and excreted. We inserted and secured catheters into the carotid artery (CA), portal vein (PV), and supra-hepatic inferior vena cava (IVC) to allow repeated blood sampling and performed bilateral thoracotomy to collapse the lungs. Then, using a hydrogen-absorbing alloy canister, we filled the lungs to the maximum inspiratory level with 100% H2. The pig was maintained for 30 seconds without resuming breathing, as if they were holding their breath. We collected blood from the three intravascular catheters after 0, 3, 10, 30, and 60 minutes and measured H2 concentration by gas chromatography. H2 concentration in the CA peaked immediately after breath holding; 3 min later, it dropped to 1/40 of the peak value. Peak H2 concentrations in the PV and IVC were 40% and 14% of that in the CA, respectively. However, H2 concentration decay in the PV and IVC (half-life: 310 s and 350 s, respectively) was slower than in the CA (half-life: 92 s). At 10 min, H2 concentration was significantly higher in venous blood than in arterial blood. At 60 min, H2 was detected in the portal blood at a concentration of 6.9-53 nL/mL higher than at steady state, and in the SVC 14-29 nL/mL higher than at steady state. In contrast, H2 concentration in the CA decreased to steady state levels. This is the first report showing that inhaled H2 is transported to the whole body by advection diffusion and metabolized dynamically.

Lifetime of Parahydrogen in Aqueous Solutions and Human Blood

Molecular hydrogen has unique nuclear spin properties. Its nuclear spin isomer, parahydrogen (pH2 ), was instrumental in the early days of quantum mechanics and allows to boost the NMR signal by several orders of magnitude. pH2- induced polarization (PHIP) is based on the survival of pH2 spin order in solution, yet its lifetime has not been investigated in aqueous or biological media required for in vivo applications. Herein, we report longitudinal relaxation times (T1 ) and lifetimes of pH2 ( τ P O C ) in methanol and water, with or without O2 , NaCl, rhodium-catalyst or human blood. Furthermore, we present a relaxation model that uses T1 and τ P O C for more precise theoretical predictions of the H2 spin state in PHIP experiments. All measured T1 values were in the range of 1.4-2 s and τ P O C values were of the order of 10-300 minutes. These relatively long lifetimes hold great promise for emerging in vivo implementations and applications of PHIP.

Simultaneous oral and inhalational intake of molecular hydrogen additively suppresses signaling pathways in rodents

Molecular hydrogen (H2) is an agent with potential applications in oxidative stress-related and/or inflammatory disorders. H2 is usually administered by inhaling H2-containing air (HCA) or by oral intake of H2-rich water (HRW). Despite mounting evidence, the molecular mechanism underlying the therapeutic effects and the optimal method of H2 administration remain unclear. Here, we investigated whether H2 affects signaling pathways and gene expression in a dosage- or dose regimen-dependent manner. We first examined the H2 concentrations in blood and organs after its administration and found that oral intake of HRW rapidly but transiently increased H2 concentrations in the liver and atrial blood, while H2 concentrations in arterial blood and the kidney were one-tenth of those in the liver and atrial blood. In contrast, inhalation of HCA increased H2 equally in both atrial and arterial blood. We next examined whether H2 alters gene expression in normal mouse livers using DNA microarray analysis after administration of HCA and HRW. Ingenuity Pathway Analysis revealed that H2 suppressed the expression of nuclear factor-kappa B (NF-κB)-regulated genes. Western blot analysis showed that H2 attenuated ERK, p38 MAPK, and NF-κB signaling in mouse livers. Finally, we evaluated whether the changes in gene expression were influenced by the route of H2 administration and found that the combination of both HRW and HCA had the most potent effects on signaling pathways and gene expression in systemic organs, suggesting that H2 may act not only through a dose-dependent mechanism but also through a complex molecular network.

Assessment of renal function by the stable oxygen and hydrogen isotopes in human blood plasma

Water (H(2)O) is the most abundant and important molecule of life. Natural water contains small amount of heavy isotopes. Previously, few animal model studies have shown that the isotopic composition of body water could play important roles in physiology and pathophysiology. Here we study the stable isotopic ratios of hydrogen (δ(2)H) and oxygen (δ(18)O) in human blood plasma. The stable isotopic ratio is defined and determined by δ(sample) = [(R(sample)/R(STD))-1] * 1000, where R is the molar ratio of rare to abundant, for example, (18)O/(16)O. We observe that the δ(2)H and the δ(18)O in human blood plasma are associated with the human renal functions. The water isotope ratios of the δ(2)H and δ(18)O in human blood plasma of the control subjects are comparable to those of the diabetes subjects (with healthy kidney), but are statistically higher than those of the end stage renal disease subjects (p<0.001 for both ANOVA and Student's t-test). In addition, our data indicate the existence of the biological homeostasis of water isotopes in all subjects, except the end stage renal disease subjects under the haemodialysis treatment. Furthermore, the unexpected water contents (δ(2)H and δ(18)O) in blood plasma of body water may shed light on a novel assessment of renal functions.

Hydrogen may inhibit collagen-induced platelet aggregation: an ex vivo and in vivo study

OBJECTIVE

Hydrogen selectively reduces hydroxyl radicals and peroxynitrite, and numerous experimental and clinical studies suggest that hydrogen can exert potent cellular protective effects against a wide variety of diseases. Furthermore, there is increasing evidence that antioxidants can modulate platelet activation. The aim of the present study was to investigate the relationship between hydrogen and collagen-induced platelet aggregation.

METHODS

For human ex vivo studies, we collected blood samples from six healthy humans and added normal saline or hydrogen-rich saline to blood and platelet-rich plasma. We found that collagen (1 µg/mL)-induced platelet aggregation was significantly inhibited by hydrogen-rich saline compared with a normal saline group (p=0.044). For rat in vivo studies, animals (n=17) were exposed to either nitrogen-based mixed gas with hydrogen (H2 gas group; n=9) or without hydrogen (non-H2 gas group; n=8). Additionally, another animals (n=13) administered either normal (NS group; n=7) or hydrogen-rich saline (HS group; n=6) (5 ml/kg) via intravenous infusion. Blood samples were drawn from the vena cava before treatment and from the right ventricle after treatment. Collagen (12 µg/mL)-induced platelet aggregation was then measured.

RESULTS

Collagen-induced platelet aggregation was significantly decreased in H2 gas and HS group rats (p=0.042, 0.018, respectively), while there was no difference in non-H2 gas and NS group rats before and after treatment.

CONCLUSION

In summary, these data suggest that hydrogen may inhibit collagen-induced platelet aggregation.

Net acid excretion capacity is related to blood hydrogen ion and serum carbon dioxide

Acid-base imbalance due to dietary food patterns has emerged as one of the hypotheses leading to modern-day diseases. This study examined if a new method to assess the renal ability to excrete an acid load, that is, the net acid excretion capacity (NAEC), constructed from net acid excretion (NAE) and urine pH, relates to blood hydrogen ion concentration ([H+]) and serum carbon dioxide concentration ([CO2]). In a second analysis, NAE to pH relationship was examined, and is de facto treated to be linear. This study used historical, cross-sectional data of 58 repeated measurements from 8 subjects for the primary measurements of NAEC, blood [H+], and serum [CO2]. Using fixed models, higher NAEC associated with lower [H+] and higher [CO2]. Using hierarchical models, the interindividual variations in [H+] and [CO2] explained the variations in NAEC. In the second analysis (n = 59), a quadratic NAE to pH relationship (NAE = -846.77 + 341.47 pH - 31.50 pH(2)) can be reported. Net acid excretion capacity, a noninvasive tool to assess the renal ability to excrete an acid load, has a physiologic base to it, in that it captures the inherent nonlinear relations of NAE to pH explaining endogenous [H+] retention/excretion. A higher vegetable and fruit consumption might relieve NAEC and allow excess [H+] loss via both renal and respiratory routes.

Dietary sodium chloride intake independently predicts the degree of hyperchloremic metabolic acidosis in healthy humans consuming a net acid-producing diet

We previously demonstrated that typical American net acid-producing diets predict a low-grade metabolic acidosis of severity proportional to the diet net acid load as indexed by the steady-state renal net acid excretion rate (NAE). We now investigate whether a sodium (Na) chloride (Cl) containing diet likewise associates with a low-grade metabolic acidosis of severity proportional to the sodium chloride content of the diet as indexed by the steady-state Na and Cl excretion rates. In the steady-state preintervention periods of our previously reported studies comprising 77 healthy subjects, we averaged in each subject three to six values of blood hydrogen ion concentration ([H]b), plasma bicarbonate concentration ([HCO3−]p), the partial pressure of carbon dioxide (Pco2), the urinary excretion rates of Na, Cl, NAE, and renal function as measured by creatinine clearance (CrCl), and performed multivariate analyses. Dietary Cl strongly correlated positively with dietary Na ( P < 0.001) and was an independent negative predictor of [HCO3−]p after adjustment for diet net acid load, Pco2 and CrCl, and positive and negative predictors, respectively, of [H]b and [HCO3−]p after adjustment for diet acid load and Pco2. These data provide the first evidence that, in healthy humans, the diet loads of NaCl and net acid independently predict systemic acid-base status, with increasing degrees of low-grade hyperchloremic metabolic acidosis as the loads increase. Assuming a causal relationship, over their respective ranges of variation, NaCl has ∼50–100% of the acidosis-producing effect of the diet net acid load.

Severe Variable Decelerations and Fetal Pulse Oximetry during the Second Stage of Labor

OBJECTIVES

The aim of the study was to investigate the usefulness of fetal pulse oximetry in cases of severe variable decelerations in the second stage of labor.

METHODS

It is a prospective study including 58 patients. Thirty-eight patients (group A) had a normal uncomplicated labor and 20 patients (group B) developed severe variable decelerations during the second stage of labor. All patients were primiparous with normal pregnancies and had electronic fetal monitoring of labor in conjunction with fetal pulse oximetry. An estimation of fetal pH and base deficit was performed at delivery in all patients.

RESULTS

There was no statistically significant difference in relation to maternal age and gestational age between the two groups. Group A patients did not delivered neonates with metabolic acidosis. Six out of 20 (group B) patients delivered neonates with a pH <7.10 despite a fetal pulse oximetry reading of >30%.

CONCLUSIONS

It appears that fetal pulse oximetry is not capable of detecting pre-acidotic or acidotic fetuses during the second stage of labor in patients with severe variable decelerations and the management of such patients should be supported by fetal scalp pH when indicated or otherwise the obstetrician should expedite delivery either with assisted operative delivery or cesarean section. Fetal heart rate monitoring was introduced into clinical practice over 30 years ago. It continues to be the predominant method of intrapartum fetal surveillance despite worries about its accuracy and efficacy.

[Selection of the SHF discharge type for the processing of carbon dioxide and hydrogen in a physical-chemical life support system]

Compared are contrasted are moving, stationary, and combined SHF-discharges, methods of discharge generation and diagnostics of the discharge temperature, electron concentration in the discharge tube. and SHF contribution. A combination of the SHF and arc discharges was selected for prototyping the carbon dioxide and hydrogen processor within a physical-chemical life support system. To sustain temperature in the interval between 1000 and 3500 degrees C to support the initial Bosch reaction, a low-power (30-50 mA) glow discharge will be used instead of the continuous current arc (3-5 A). This combination increases plasma efficiency and is suitable for designing a non-inertia air supply within the space life support system.

Pre dialysis of blood prime in continuous hemodialysis normalizes pH and electrolytes

In critically ill children weighing <10 kg, it is necessary to use blood as a priming solution for the extracorporeal continuous renal replacement therapy (CRRT) circuit before initiating CRRT to prevent hemodilution and maintain adequate oxygenation. However, blood bank blood usually contains supra-physiological electrolyte concentrations and a non-physiological acid-base balance that may exacerbate the patient's condition. The objective of this trial was to develop a simple protocol to pre-treat blood bank-derived blood to yield a more physiological blood priming solution. Expired human blood in a recirculating in vitro CRRT circuit was dialyzed prior to the initiation of CRRT using a physiological dialysate solution. Serial blood samples were assessed for electrolyte and pH content. Regimens using maximal blood flow rates (180-200 ml/min) and aggressive dialysate flow rates (33-42 ml/min) were able to correct severely hyperkalemic and acidemic blood within 7.5 min. Initially elevated blood potassium concentrations >20 mEq/l were normalized to below 5 mEq/l within 7.5 min of dialysis in all cases. Blood bank-derived blood can be "conditioned" quickly to physiological pH and electrolyte concentrations using these simple pre-dialysis regimens. Unlike some blood preparation regimens that have been published, the technique used in this trial requires no special equipment or added medications that are not already used in CRRT.

[Selection of a SHF-plasma device for carbon dioxide and hydrogen recycling in a physical-chemical life support system]

A waveguide SHF plasmotron was chosen for carbon dioxide and hydrogen recycling in a low-temperature plasma in the Bosch reactor. To increase electric intensity within the discharge capacitor, thickness of the waveguide thin wall was changed for 10 mm. A method for calculating the compensated exponential smooth transition to align two similar lines (waveguides) with sections of 72 x 34 mm and 72 x 10 mm to transfer SHF energies from the generator to plasma was proposed. Calculation of the smooth transition has been used in final refinement of the HSF plasmotron design as a component of a physical-chemical LSS.

Near-infrared spectrometric determination of blood pH

BACKGROUND

Reflectance near-infrared spectroscopy (600-2200 nm) can noninvasively probe deep into tissues. Blood is the predominant absorber of near-infrared light in biological tissues. We investigated the feasibility of using reflectance near-infrared spectroscopy to measure blood pH in vitro.

METHODS

Reflectance near-infrared spectra (600-2200 nm) were obtained with a fiberoptic probe immersed in diluted human packed red blood cells maintained at 37 degrees C. Changes in pH (6.800-7.600) were induced by: (1) varying the partial pressure of carbon dioxide by the bubbling of mixtures of humidified carbon dioxide and nitrogen gas through the blood; and (2) adding 1 N HCl/NaOH. Humidified oxygen gas was bubbled through the blood to generate variations in oxygen saturation. After each titration of pH, the spectrum was recorded and blood was sampled for the measurement of: pH, pCO(2), and pO(2) using blood gas analysis; and hemoglobin concentration and oxygen saturation using co-oximetry. Samples from three separate pH titrations were combined (120 total samples) and analyzed using partial least-squares analysis to generate a mathematical model relating spectral changes to pH (calibration set). This model was then used to predict the pH of a set of 36 pH titrations (prediction set).

RESULTS

Quantitative and qualitiative analyses of the spectra in the calibration set found that spectral changes in the wavelength range, 650-1050 nm, were directly related to changes in pH. First-derivative-treated spectra from the calibration set, analyzed using partial least-squares analysis, generated a mathematical model with a cross-validated r(2) of 0.939 and a standard error of calibration of 0.046 pH unit. When this model was applied to the prediction set, with an offset correction, the r(2) was 0.936 with a standard error of prediction of 0.050 pH unit.

CONCLUSION

Blood pH can be predicted in vitro with clinical significance using reflectance near-infrared spectroscopy (650-1050 nm) within a standard error of 0.050 pH unit.

Kinetics of intravenous L-lactic acid in anaesthetized minipigs under normoxic/normocapnic/normohydrogenaemic conditions

A mild and transitory increase in L-lactic acid (LAC) levels can be achieved by LAC infusion under normoxic/normocapnic/normohydrogenaemic conditions. This increase is probably sufficient to confer some protection to cholinesterases from inhibition by organophosphates.

Effects of sevoflurane on hypoxic pulmonary vasoconstriction in anaesthetized piglets

In vitro, halogenated agents reduce the pulmonary vasoconstrictor response to alveolar hypoxia in isolated perfused lungs. However, studies in intact animals have been less convincing. The aim of the present study was to assess the effect of sevoflurane on hypoxic pulmonary vasoconstriction (HPV) in anaesthetized piglets using the pressure/cardiac index relationship (P/Q). Ten large white piglets were anaesthetized and mechanically ventilated, alternately in hyperoxia (FIO2 = 0.4) and hypoxia (FIO2 = 0.12). Multipoint plots of pulmonary arterial pressure (PAP) or differences between PAP and left atrial pressure (LAP) against Q were generated by gradual inflation of a balloon introduced into the inferior vena cava. P/Q relationships were established in hyperoxia and hypoxia at baseline, and then with sevoflurane. In hypoxia, pressure gradients (PAP-LAP) increased at every level of Q, thus demonstrating active pulmonary vasoconstriction. Sevoflurane at 1 MAC did not affect these P/Q relationships in hyperoxia or hypoxia as compared with baseline. Sevoflurane at a clinically relevant concentration (1 MAC) has no significant effect on HPV in anaesthetized piglets.

Variations of intracellular pH in human erythrocytes via K(+)(Na(+))/H(+) exchange under low ionic strength conditions

The change of intracellular pH of erythrocytes under different experimental conditions was investigated using the pH-sensitive fluorescent dye BCECF and correlated with (ouabain + bumetanide + EGTA)-insensitive K(+) efflux and Cl(-) loss. When human erythrocytes were suspended in a physiological NaCl solution (pH(o) = 7.4), the measured pH(i) was 7.19 + or - 0.04 and remained constant for 30 min. When erythrocytes were transferred into a low ionic strength (LIS) solution, an immediate alkalinization increased the pH(i) to 7.70 + or - 0.15, which was followed by a slower cell acidification. The alkalinization of cells in LIS media was ascribed to a band 3 mediated effect since a rapid loss of approximately 80% of intracellular Cl(-) content was observed, which was sensitive to known anion transport inhibitors. In the case of cellular acidification, a comparison of the calculated H(+) influx with the measured unidirectional K(+) efflux at different extracellular ionic strengths showed a correlation with a nearly 1:1 stoichiometry. Both fluxes were enhanced by decreasing the ionic strength of the solution resulting in a H(+) influx and a K(+) efflux in LIS solution of 108.2 + or - 20.4 mmol (l(cells) hr)(-1) and 98.7 + or - 19.3 mmol (l(cells) hr)(-1), respectively. For bovine and porcine erythrocytes, in LIS media, H(+) influx and K(+) efflux were of comparable magnitude, but only about 10% of the fluxes observed in human erythrocytes under LIS conditions. Quinacrine, a known inhibitor of the mitochondrial K(+)(Na(+))/H(+) exchanger, inhibited the K(+) efflux in LIS solution by about 80%. Our results provide evidence for the existence of a K(+)(Na(+))/H(+) exchanger in the human erythrocyte membrane.

Changes in blood pH, lactate concentration and pulmonary ventilation during incremental testing protocol on cycle ergometer

We investigated mutual changes in the blood lactate concentration ([LA]), blood pH and pulmonary ventilation (VE) to obtain insight into the regulation of pH at different levels of the exercise intensity. For this purpose the ratio VE/[LA] (1/min/mmol/l) was determined at each particular pH corresponding to exercise intensity in seven healthy subjects on the cycle ergometer during incremental exercise test. Changes in VE/[LA] ratio were found to exhibit three phases. In the first phase, the ratio increased without significant changes in [LA] and pH until it reached certain individual peak value. In the second phase, VE/[LA] decreased because increases in [LA] were considerably bigger than those of VE. Decreases in blood pH followed those of VE/[LA], nevertheless differences existed among subjects depending on how successful individual subjects regulated their blood pH. In the third phase with the VE/[LA] values stabilized between 15 and 22 and pH values between 7.32 and 7.26, whereas differences between subjects became negligible. Similar trends to VE/[LA] were observed in case of the Onset of Blood Lactate Accumulation (OBLA) throughout the test at pH values below 7.32, as was manifested by the correlation coefficient. We conclude that blood pH regulation due to respiratory compensation of the lactate acidosis is more successful in subjects with better endurance (higher OBLA) but only when [LA] is slightly increased or at slight acidosis.

Thermodiffusion for continuous quantification of hepatic microcirculation--validation and potential in liver transplantation

Hepatic microcirculation is a main determinant of reperfusion injury and graft quality in liver transplantation. Methods available for the quantification of hepatic microcirculation are indirect, are invasive, or preclude postoperative application. The aim of this study was the validation of thermodiffusion in a new modification allowing long-term use in the clinical setting. In six pigs Doppler flowmeters were positioned around the hepatic artery and portal vein for the measurement of total liver blood flow. Liver perfusion was quantified by thermodiffusion and compared to H(2) clearance as an established technique under baseline conditions, during different degrees of portal venous obstruction and during occlusion of the hepatic artery. Thermodiffusion measurements were recorded for five days postoperatively followed by histological evaluation of the hepatic puncture site. Perfusion data obtained by thermodiffusion were significantly correlated to H(2) clearance (r = 0.94, P < 0. 001) and to liver blood flow (r = 0.9, P < 0.05). The agreement between thermodiffusion and H(2) clearance was excellent (mean difference -2.1 ml/100 g/min; limits of agreement -12.5 and 8.3 ml/100 g/min). Occlusion of the portal vein or hepatic artery was immediately detected by thermodiffusion, indicating a decrease of perfusion by 64 +/- 7% or 27 +/- 5% of baseline, respectively. Perfusion values at baseline and during vascular occlusion were reproducible during the entire observation period. Histological changes of the liver tissue adjacent to the thermodiffusion probes were minute and did not influence long-term measurements. In vivo validation proved that enhanced thermodiffusion is a minimally invasive technique for the continuous, real-time quantification of hepatic microcirculation. Changes in liver perfusion can be safely detected over several days postoperatively. The implication for liver transplantation has led to the clinical application of thermodiffusion.

Effects of CO2 and H+ on laryngeal receptor activity in the perfused larynx in anaesthetized cats

1. Intralaryngeal CO2 reflexly decreases ventilation and increases upper airway muscle activity. Topical anaesthesia of the laryngeal mucosa or cutting the superior laryngeal nerves (SLNs) abolishes these reflexes, indicating that the receptors responsible are superficially located and that their afferent fibres are in the SLN. Intralaryngeal CO2 affects the activity of receptors recorded from the SLN. 2. An isolated, luminally perfused laryngeal preparation was developed in anaesthetized, paralysed cats in order to compare the effects of solutions with varying levels of pH and PCO2 on pressure-sensitive laryngeal receptor activity. Since the pH of tracheal surface fluid is reported to be approximately 7.0, two neutral (pH 7.4 and 7.0) and two acidic (pH 6.8 and 6.3) solutions were used. 3. Compared with neutral acapnic control solutions, neutral hypercapnic (PCO2 64 mmHg) solutions either excited or inhibited the discharge of 113 out of 211 pressure-sensitive SLN afferents. In 24 receptors, the effects of hypercapnic solutions with either neutral or acidic pH were similar in both direction and magnitude. In 50 receptors affected by neutral hypercapnic solutions, acidic acapnic solutions had no effect on 66 % of units and significantly smaller effects in the remaining units. In 17 receptors, the effects of neutral solutions with a PCO2 of 35 mmHg were significantly less than for neutral solution with a PCO2 of 64 mmHg. 4. These results show that the effects of CO2 on laryngeal pressure-sensitive receptors are independent of the pH of the perfusing media, and suggest that acidification of the receptor cell or its microenvironment is the main mechanism of CO2 chemoreception.

Retinopathy associated with enterococcus enteropathy in the neonatal rat

PURPOSE

Preretinal neovascularization has been previously observed in neonatal rats with spontaneously occurring diarrhea. This neovascularization appears analogous to retinopathy of prematurity (ROP), which occurs in human neonates. A new enterococcus species, designated Enterococcus rattus, has been isolated from the duodenum of these rats. In the present controlled study, the effect of the enteropathy induced by this organism on the retinal vasculature in the neonatal rat was further investigated.

METHODS

One hundred fifty newborn Sprague-Dawley rats were randomly assigned to 6 expanded litters (n = 25). On the second day of life, animals were gavaged with either 100 microl of E. rattus suspension (1.0 X 10(7) colony forming units, inoculated group, n = 100 rats) or 100 microl saline (control group, n = 50 rats). All rats were raised in room air and were killed on day 13 of life. Duodenal and blood samples were cultured. The retinal vasculature was assessed using fluorescent microscopy and ADPase staining in a masked manner. Two additional inoculated litters and one control litter were studied for evaluation of arterial blood gases and validation of the grading method for preretinal neovascularization.

RESULTS

One hundred percent of rats in the inoculated group developed severe diarrhea and had duodenal cultures positive for E. rattus compared with 0% in the control group. Preretinal neovascularization similar to ROP occurred in 55% of rats in the inoculated group compared with 2% in the control group (P = 0.001). Retinal vascular areas were reduced in the inoculated group (mean +/- SD, 89% +/- 5% versus 96% +/- 2%; P < 0.001). Rats in the inoculated group demonstrated severe growth retardation (final weight, 9.7 +/- 2.2 versus 16.7 +/- 2.7 g, P < 0.001). Inoculated animals also experienced acidosis (pH 7.31 +/- 0.06 versus 7.39 +/- 0.06 control, P = 0.04).

CONCLUSIONS

A previously undescribed enterococcal enteropathy was associated with preretinal neovascularization similar to ROP in the neonatal rat. This supports an independent role for factors other than inspired oxygen in the development of ROP.

Central thermoregulatory effects of lactate in the toad Bufo paracnemis

Hypoxia induces a regulated decrease in body temperature (Tb; anapyrexia) in organisms ranging from protozoans to mammals, but very little is known about the mechanisms involved. Several candidates have been suggested to mediate hypoxia-induced anapyrexia, among them lactate, which is a classical compansion of hypoxic stress in vertebrates. The present study was designed to assess the central thermoregulatory effects of lactate in Bujo paracnemis. Toads equipped with a temperature probe were tested over a thermal gradient (10-40 degrees C). Lactate injected systemically (4.0 mmol kg-1) caused a significant reduction of Tb from 24.6 +/- 2.1 to 17.4 +/- 3.9 degrees C. To assess the role of central thermoregulatory mechanisms, a lower dose (0.4 mmol kg-1) of lactate was injected into the fourth cerebral ventricle or systemically. Intracerebroventricular injection of lactate caused a similar decrease in Tb, whereas systemic injection caused no change. The data indicate that lactate may play a role in hypoxia-induced anapyrexia in central rather than peripheral sites.

Evaluation of absolute cerebral blood flow by laser-Doppler scanning-- comparison with hydrogen clearance

A major limitation of laser-Doppler (LD) flowmetry, which enables noninvasive and continuous recording of tissue perfusion, is its inability to evaluate the absolute cerebral blood flow (CBF). Using a computer-controlled micromanipulator, the LD scanning technique provides information on the brain microcirculation in many different locations, information which is not available from a single stationary probe. The purpose of the current study was to examine whether LD scanning estimates can be calibrated for the absolute CBF by comparing LD scanning with the hydrogen clearance (HC) method. In Wistar rats (n = 31) including old rats (122-123 weeks old, n = 8), the CBF was altered using the global ischemia model by bilateral carotid artery occlusion coupled with hypobaric hypotension. The CBF was determined simultaneously by the LD scanning technique and HC at each mean arterial blood pressure step, and the correlation of CBF between the two techniques was analyzed. CBF measured by LD scanning was expressed as LD units. Absolute CBF values obtained by methods were correlated (r = 0.87), and the formula to calibrate absolute CBF values from LD units was y = 1.8x - 0.6. On the other hand, in old rats the formula to calibrate the absolute values was different (y = 1.3x + 8.3, r = 0.85). The results suggest that CBF data obtained by LD scanning could be calibrated into absolute blood flow values in particular circumstances, and that LD scanning could compensate in part for the weakness of LD flowmetry.

Blood flow rate in normal and tumor-bearing rats in conscious state, under urethane anesthesia, and during systemic hypothermia

The blood flow rates of 14 tissues in the body were determined by microsphere method using normal and tumor-bearing rats kept conscious or under urethane anesthesia. The effects on the blood flow rate in the tissues were assessed for multimodal therapy, systemic hypothermia for ischemic brain injury, and local hyperthermia and angiotensin II-induced hypertensive chemotherapy for cancer. Urethane anesthesia showed no effect on cardiac output, while there was a tendency of decrease of blood flow rate and % of cardiac output in each tissue other than muscle tissue, in which they increased as a counterbalance, in normal and tumor-bearing rats. Systemic hypothermia gave results similar to those of urethane anesthesia in normal rats, but for tumor-bearing rats, it decreased cardiac output, and consequently the blood flow rate in most tissues. Brain blood flow rate was about half of that in the conscious rats. Local hyperthermia also decreased the cardiac output and blood flow rate in each tissue, including the tumor tissue. Angiotensin II-induced hypertension showed no effect on cardiac output, had various effects on blood flow rate in each tissue, and led to no increase in the tumor blood flow rate. Simulations based on the physiological pharmacokinetic modeling suggested that intramuscular injection of a lung-specific derivative of ceftazidime would provide the ideal biodistribution to ensure its optimal therapeutic efficacy during systemic hypothermia. This methodology, namely the pharmacokinetic simulation based on the physiological values of the body, will provide a useful piece of information on drug delivery systems under various conditions.

A comparison of 1H8- and 2H8-toluene toxicokinetics in men

1. To examine the bioequivalence of an isotope-labelled tracer to study toxicant disposition, we conducted 33 controlled human exposures to a mixture of 50 ppm 1H8-toluene and 50 ppm 2H8-toluene for 2 h, and measured concentrations in blood and breath, and metabolite levels in urine for 100 h post-exposure. 2. A physiologically based kinetic (PBK) model found that compared with 1H8-toluene, 2H8-toluene had a 6.4+/-13% (mean+/-SD) lower AUC, a 6.5+/-13% higher systemic clearance (1.46+/-0.27 versus 1.38+/-0.25 l/h-kg), a 17+/-22% larger terminal volume of distribution (66.4+/-14 versus 57.2+/-10 l/kg) and a 9.7+/-26% longer terminal half-life (38+/-12 versus 34+/-10 h) (p < 0.05 for all comparisons). 3. The higher 2H8-toluene clearance may have been due to an increased rate of ring oxidation, consistent with the 17% higher observed fraction of 2H5- versus 1H5-cresol metabolites in urine. 4. The larger terminal volume and half-lives for 2H8-toluene suggested a higher adipose tissue/blood partition coefficient. 5. Observed isotope differences were small compared with interindividual differences in 1H8-toluene kinetics from previous studies. 6. The PBK model allowed us to ascribe observed isotope differences in solvent toxicokinetics to underlying physiologic mechanisms.

Effects of exhausting exercise and catecholamines on K+ balance, acid-base status and blood respiratory properties in carp

The potential role of adrenergic mechanisms in the recovery of potassium balance and acid-base status following 5 min of exhausting exercise was studied in carp. The extracellular metabolic H+ load after exercise matched the lactate load, suggesting similar release rates of H+ and lactate from white muscle. Blockage of alpha-adrenoceptors by phentolamine or beta-adrenoceptors by propranolol neither influenced absolute magnitudes nor recovery kinetics of extracellular H+ and lactate loads. The arterial oxygen tension increased following exercise, but blood oxygen transport was not improved via a red cell beta-adrenergic response or modulation of the red cell nucleoside triphosphate content. Exercise induced an increase in extracellular [K+] which was corrected within 30-60 min of recovery. The recovery of K+ balance was not influenced by blockage of adrenergic receptors. Red cell [K+] changed only insignificantly following exercise, whereby a possible function of the red cells as a temporary depository for K+ during the extracellular hyperkalaemia could not be established. The minimal influence of catecholamines on the measured parameters during recovery from exercise was supported by an absence of change in these parameters upon adrenaline injection in resting carp.

Alcoholism and carcinoma change the intracellular pH and activate platelet Na+/H+-exchange in men

The occurrence of carcinoma in chronic alcoholics exceeds that of the general population. Cytoplasmic alkalinization, due to the influence of different factors on the transmembrane Na+/H+ exchange (NHE), has been put forward as a triggering event in cell growth and division. In accordance with these findings, the carcinogenic potential of NHE deficient cell types is reported to be diminished. The aim of this study was to investigate whether the intracellular pH and the NHE activity is altered in chronic alcoholics. Seventy-two Caucasian males were assigned to one of four groups: non-alcoholics without carcinoma, chronic alcoholics without carcinoma, non-alcoholics with carcinoma and chronic alcoholics with carcinoma. Alcoholism was diagnosed according to DSM-III-R. The groups did not differ in relation to basic patient characteristics, such as age and blood pressure. Intracellular calcium, pH and NHE in platelets were determined by spectrofluorometry before and after thrombin stimulation. In chronic alcoholics with carcinoma, the intracellular pH was significantly more alkaline and the NHE activity was elevated. In contrast, a decrease in intracellular pH associated with an increased activity of NHE and a more acidic set point was found in chronic alcoholics without carcinoma. Basal and thrombin stimulated intracellular Ca2+ did not differ between groups except in chronic alcoholics with carcinoma in whom a thrombin-induced increase of Ca2+ due to liberation of Ca2+ from intracellular stores was demonstrated. In chronic alcoholics with carcinoma, cytoplasmic alkalinization was observed and this may be an indication of an increase in cell proliferation. The possibility that the increased incidence of carcinomas in chronic alcoholics is related to the increased activity of NHE and whether this may be prevented by NHE inhibitors requires further investigation.

Enhanced red cell sodium-hydrogen exchange in microvascular angina

OBJECTIVES

Enhanced calcium content in arterial smooth muscle cells and altered reactivity of coronary vessels to alkalinization have been reported in angina pectoris due to impaired motility of coronary arteries. An altered function of sodium-hydrogen exchange, a ubiquitous membrane transport system that links proton efflux to calcium drifts, may mediate these phenomena.

DESIGN AND SUBJECTS

Twenty patients with microvascular angina (stable effort angina, reversible perfusion defects during effort thallium 201 heart scintigraphy, and angiographically normal coronary arteries) were compared to 20 patients with stable effort angina due to coronary atherosclerosis and 20 healthy subjects. The sodium-hydrogen exchange was defined as the initial fraction of the amiloride-sensitive proton efflux from red cells with inhibited anion exchanger (pHi 6.00-6.05) into an Na(+)-containing medium (pHo 8.00-8.05). 12-0-tetradecanoylphorbol-13-acetate (TPA, 600 nmol.l-1) and staurosporine (100 nmol.l-1) were used as phosphorylation modulators in vitro.

RESULTS

The mean red blood cell Na+/H+ exchange was increased in patients with microvascular angina (451 +/- 37 vs 142 +/- 17 and 124 +/- 21 umol H+.1 cells-1.min-1, P < 0.01). TPA and staurosporine abolished differences between the groups.

CONCLUSIONS

Microvascular angina is associated with enhanced Na+/H+ exchange in erythrocytes, probably due to more extensive phosphorylation of the membrane antiporter sites.

Mechanism of the exercise hyperkalemia: an alternate hypothesis

A progressive hyperkalemia is observed as exercise intensity increases. The current most popular hypothesis for the hyperkalemia is that the Na+-K+ pump cannot keep pace with the K+ efflux from muscle during the depolarization-repolarization process of the sarcolemmal membrane during muscle contraction. In this report, we present data that suggest an alternate hypothesis to those previously described. Because phosphocreatine (PCr) is a highly dissociated acid and creatine is neutral at cell pH, the concentration of nondiffusible anions decreases, and an alkaline reaction takes place when PCr hydrolyzes. This creates a state of cation (K+) excess and H+ depletion in the cell. To examine the balance of K+ and H+ for exercising muscle during the early period of exercise when PCr changes most rapidly, catheters were inserted into the brachial artery and femoral vein (FV) in five healthy subjects who performed two 6-min cycle ergometer exercise tests at 40 and 85% of peak oxygen uptake. FV blood was sampled every 5 s during the first 2 min, then every 30 s for the remaining 4 min of exercise and the first 3 min of recovery, and then less frequently for the next 12 min. Arterial sampling was every 30 s during exercise and simultaneous with FV sampling during recovery. Arterial K+ concentration ([K+]) increase lagged FV [K+] increase. The hyperkalemia observed during early exercise results from K+ release from skeletal muscle. FV [K+] increased by 5 s of the start of exercise and followed the rate of H+ loss from the FV blood for the first 30 s of exercise. FV lactate and Na+ kinetics differed from K+ kinetics during exercise and recovery. As predicted from the PCr hydrolysis reaction, the exercising limb took up H+ and released K+ at the start of exercise (first 30 s) at both exercise intensities, resulting in a FV metabolic alkalosis. K+ release was essentially complete by 3 min, the time at which oxygen uptake (and, presumably, PCr) reached its asymptote. These findings lead us to hypothesize that the early K+ release by the cell takes place with H+ exchange and that the major mechanism for the exercise hyperkalemia is the reduction in nondiffusible intracellular anions in the myocyte as PCr hydrolyzes.

Augmented sympathetic tone alters muscle metabolism with exercise: lack of evidence for functional sympatholysis

It is unclear whether sympathetic tone opposes dilator influences in exercising skeletal muscle. We examined high levels of sympathetic tone, evoked by lower body negative pressure (LBNP, -60 mmHg) on intramuscular pH and phosphocreatine (PCr) levels (31P-nuclear magnetic resonance spectroscopy) during graded rhythmic handgrip (30 contractions/min; approximately 17, 34, 52 and 69% maximal voluntary contraction). Exercise was performed with LBNP and without LBNP (Control). At the end of exercise, LBNP caused lower levels of muscle pH (6.59 +/- 0.09) compared with Control (6.78 +/- 0.05; P < 0.05). PCr recovery, an index of mitochondrial respiration, was less during the recovery phase of the LBNP trial. Exercise mean arterial pressure was not altered by LBNP. The protocols were repeated with measurements of forearm blood flow velocity and deep venous samples (active forearm) of hemoglobin (Hb) saturation, pH, and lactate. With LBNP, mean blood velocity was reduced at rest, during exercise, and during recovery compared with Control (P < 0.05). Also, venous Hb saturation and pH levels during exercise and recovery were lower with LBNP and lactate was higher compared with Control (P < 0.05). We conclude that LBNP enhanced sympathetic tone and reduced oxygen transport. At high workloads, there was a greater reliance on nonoxidative metabolism. In other words, sympatholysis did not occur.

Spironolactone prevents Na+/H+ exchange enhancement in primary aldosteronism

The study was undertaken to determine the possible effect of an aldosterone antagonist, spironolactone (SP), on red blood cell sodium-hydrogen exchange (NHE) enhancement in primary aldosteronism (PA) and essential hypertension (EH). NHE was measured as the amiloride-inhibited fraction of H+ efflux (V max) from erythrocytes (pHi 6.40 +/- 0.05) into a Na+-containing medium (pHo 8.00 +/- 0.05). Subjects were 12 hypertensive patients with aldosterone-producing adrenal adenoma (six treated with 200 mg/day spironolactone for an least 5 days and six drug-free), 20 essential hypertensives (10 treated with the same regimen of spironolactone and 10 drug-free), and 20 healthy controls. Treatment with spironolactone decreased NHE in PA patients but did not change the mean NHE in essential hypertensives. It is concluded that SP may be useful to differentiate between elevated NHE in PA and essential hypertension.

Effect of age on blood acid-base composition in adult humans: role of age-related renal functional decline

In 64 apparently healthy adult humans (ages 17-74 yr) ingesting controlled diets, we investigated the separate and combined effects of age, glomerular filtration rate (GFR, index of age-related renal functional decline), renal net acid excretion [NAE, index of endogenous acid production (EAP)], and blood PCO2 (PbCO2, index of respiratory set point) on steady-state blood hydrogen ion ([H+]b) and plasma bicarbonate concentration ([HCO3-]p). Independent predictors of [H+]b and [HCO3-]p were PbCO2, NAE, and either age or GFR, but not both, because the two were highly correlated (inversely). [H+]b increased with increasing PbCO2, NAE, and age and with decreasing GFR. [HCO3-]p decreased with increasing NAE and age but increased with increasing PbCO2 and GFR. Age (or GFR) at constant NAE had greater effect on both [H+]b and [HCO3-]p than did NAE at constant age (or GFR). Neither PbCO2 nor NAE correlated with age or GFR. Thus two metabolic factors, diet-dependent EAP and age (or GFR), operate independently to determine blood acid-base composition in adult humans. Otherwise healthy adults manifest a low-grade diet-dependent metabolic acidosis, the severity of which increases with age at constant EAP, apparently due in part to the normal age-related decline of renal function.

Effect of acute pH change on serum anion gap

The serum anion gap is decreased in hyperchloremic (HCl) acidosis and increased in diuretic-induced alkalosis. These anion gap changes have been largely attributed to titration-induced variations in the net negative charge of the serum proteins, which are the predominant non-HCO3 buffers of serum. It has recently been shown, however, that albumin has all of the net protein charge, and titration-induced changes in charge are smaller than have been widely believed. Because the non-HCO3 buffers are also titrated in acute hypocapnia and hypercapnia, these disorders were induced in 16 anesthetized dogs for 10 min in order to assess the effect of acute changes in pH on the anion gap. Although the mean arterial pH varied from 7.04 to 7.65, the calculated mean albumin charge only varied from 6.8 to 9.0 mEq/L. When the anion gap was computed with HCO3 (AGHCO3 = Na + K - Cl - HCO3), the change in AGHCO3 per 0.1 change in pH (delta AGHCO3/ delta pH) was only 0.15 mEq/L per 0.1 pH. When the anion gap was computed with total CO2 content (AGTCO2 = Na + K - Cl - TCO2), delta AGTCO2/delta pH was larger (0.51 mEq/L per 0.1 pH) because of the effect of variable PCO2 levels on TCO2. In a review of 22 previous studies in humans and dogs, similar estimates of delta AG/delta pH were obtained (after adjusting for the lower albumin level in dogs). These results show that simple titration processes that occur within 10 min of a change in pH cause minimal changes in the anion gap. Titration of the known non-HCO3 buffers of serum does not explain the much larger anion gap changes of HCl acidosis and diuretic alkalosis.

High muscle blood flows are not attenuated by recruitment of additional muscle mass

Recent studies have demonstrated that single-leg knee extensor (KE) exercise elicits high mass-specific blood flow (Q) which, if incremented toward maximum, in the presence of additional muscle recruitment would soon outstrip the heart's pumping capacity and blood pressure would fall. Thus incremental KE exercise provides the opportunity to determine the intensity at which, if at all, quadriceps muscle hemodynamics are altered during incremental exercise that involves a substantially greater muscle mass. Leg Q was measured during incremental KE exercise and again with superimposed incremental two-legged knee extensor exercise with incremental arm cranking (A+L) in trained subjects (n = 5). Leg Q and vascular conductance (VC) increased with work rate (WR) to reach high levels [Q = 385.7 +/- 26 and 342.3 +/- 15 ml.min-1.100 g-1 for KE and A+L exercise, respectively; VC at 90% of maximum WR (WRmax) = 79 +/- 5 and 75 +/- 6 ml.min-1. mmHg-1 for KE and A+L exercise, respectively], but the Q/WR and VC/WR relationships in KE and A+L exercise were not different. Maximum O2 consumption (VO2max) and the VO2max/WR relationship of the quadriceps were also unaffected by the additional muscle mass recruited. Despite a significantly greater net femoral venous norepinephrine (NE) outflow at both 90 and 100% of WRmax in A+L exercise (WRmax = 4,216 +/- 1,601 and 901 +/- 99 ng/ml for A+L and KE exercise, respectively; P < 0.05), leg Q continued to rise linearly with WR.(ABSTRACT TRUNCATED AT 250 WORDS)

Effect of blood pH on pulmonary artery pressure, left atrial pressure and fluid filtration rate in isolated rabbit lung

To determine the effects of pH changes on Pulmonary Artery Pressure (PAP), 18 isolated rabbit lung preparations, perfused with autologous blood mixture and constant PaCO2 have been studied. Each preparation was studied under 3 conditions: Baseline: 30 minutes equilibration period. Acidosis: pH was decreased by 0.2 N HCl infusion, the ventilatory rate was changed and different CO2 mixtures were used to maintain the PCO2 within the initial parameters. Compensated Acidosis (CA): pH was returned to normal values by 0.7 N NaHCO3 infusion maintaining PCO2 in its initial values. The decrease in pH (acidosis) from 7.36 +/- 0.05 to 7.18 +/- 0.06 at constant PCO2, generated a significant increase in PAP (13.6 +/- 3.2 cm H2O to 18.8 +/- 5.2 cm H2O, p < 0.01). The pH increase (CA) from 7.18 +/- 0.06 to 7.40 +/- 0.09 caused the PAP to decrease (18.8 +/- 5.2 cm H2O to 15.9 +/- 4.2 cm H2O); the fluid filtration rate remained unchanged during the whole experiment. It is concluded that blood pH changes at constant PCO2 result in significant changes of PAP. Acidemia produces pulmonary vasoconstriction, which may be a contributing factor in the genesis of pulmonary hypertension in clinical conditions with increased hydrogen ion concentration [H+].

Endotoxin-induced ileal mucosal hyperpermeability in pigs: role of tissue acidosis

Administration of lipopolysaccharide (LPS) to experimental animals leads to diminished mesenteric perfusion, increased ileal mucosal [H+] , and increased gut epithelial permeability to hydrophilic solutes. We sought to determine whether these phenomena are causally related. Experiments were performed in anesthetized pigs. Permeability was assessed by measuring the plasma-to-lumen clearance of fluorescein isothiocyanate dextran (4,000 Da; FD-4) by a segment of ileum perfused with Ringer lactate solution. Mucosal perfusion (Qmuc) and [H4+] were estimated using laser-Doppler flowmetry and tonometry, respectively. In an initial series of experiments, we showed that mucosal permeability was linearly correlated with mucosal [H+] in animals subjected to graded degrees of mechanically induced mesenteric ischemia (n = 14, R2 = 0.58, P < 0.002) or injected with graded doses of LPS (n = 11, R2 = 0.93, P < 0.0001). In a second series of experiments, we induced mucosal acidosis in normal pigs by mechanical ventilation with either a hypoxic (n = 7) or a hypercapnic (n = 5) gas mixture. In both groups, ileal mucosal permeability to FD-4 increased significantly (P < 0.05), although transmesenteric release of lactate increased significantly only in the hypoxic group. Qmuc was unchanged in both groups. These data suggest that mucosal acidosis, even in the absence of tissue ischemia or hypoxia, increases intestinal permeability to a macromolecular hydrophilic solute. Tissue acidosis may be an important factor contributing to LPS-induced gut mucosal hyperpermeability.

Mathematical modeling of hydrogen clearance blood flow measurements in peripheral nerve

The hydrogen clearance technique of blood flow measurement often yields biexponential washout curves. In peripheral nerve, arteriovenous shunt vessels may clear hydrogen gas, causing the fast component of a biexponential curve. We simulated the washout of hydrogen from nerve tissue in the vicinity of a large shunt vessel by modeling the diffusion of hydrogen through tissue to the vessel and its removal by a network of capillaries. We then determined the fast and slow clearance rates and the relative weights or contributions of the fast and slow components and found that they are affected by all of the model parameters.

Effect of acid-base balance on the growth hormone response to acute high-intensity cycle exercise

To investigate the effect of acid-base balance on serum human growth hormone (hGH) concentration after an acute high-intensity anaerobic exercise bout, 10 untrained but normally active men [age, 24.6 +/- 1.5 (SE) yr] participated in a randomized double-blind counterbalanced experiment. Each subject reported in a fasted state at the same time of day for two experimental sessions separated by 1 wk. For each session, subjects were administered a decaffeinated tea solution containing either 0.3 g NaHCO3/kg body wt [alkalosis (ALK)] or 0.04 g NaCl/kg body wt [control (CTRL)] over a 45-min ingestion period. Venous blood samples were obtained before [baseline (BL)] and 75 min after the ingestion period, as well as postexercise at 0, 5, 10, 15, 20, and 30 min. The exercise task immediately followed the preexercise blood draw and consisted of 90 s of maximal-effort cycle ergometry against an opposing force of 0.49 N (0.05 kg)/kg body wt. There were no differences between the ALK and CTRL conditions in mean or peak power output or total work during the exercise task. Whole blood pH was significantly (P < or = 0.05) elevated in ALK above CTRL at all time points except BL. Postexercise serum hGH concentration significantly increased above BL at 10, 15, 20, and 30 min in CTRL and at 20 and 30 min in ALK. The hGH concentration was significantly lower in ALK than in CTRL at 15, 20, and 30 min postexercise. These data indicate that an increase in blood hydrogen ion concentration may be partly responsible for the hGH response to acute high-intensity anaerobic exercise.

Hydrogen inhalation for detecting intracardiac left-to-right shunting in adults

The hydrogen inhalation technique is easily performed and exquisitely sensitive for detecting intracardiac left-to-right shunting. Previous studies of this technique relied heavily on data from infants and children, and the distinction between "normal" and "abnormal" was imprecise and somewhat arbitrary. The present study was done to assess the results of hydrogen inhalation in adults with and without intracardiac left-to-right shunting. In 45 adult subjects (15 men, 30 women, aged 18 to 72 years) (18 without and 27 with intracardiac left-to-right shunting), the elapsed time from hydrogen inhalation to its appearance in the pulmonary artery was measured. The 18 patients without shunting had an appearance time of 12 +/- 3 (mean +/- SD) seconds, and it was > or = 9 seconds in all. In contrast, the 27 subjects with shunting had an appearance time of 1.5 +/- 0.7 second, with only 1 of 27 being > or = 3 seconds. There was no relation between the magnitude of left-to-right shunting and the hydrogen appearance time. Thus, the hydrogen inhalation technique easily and reliably separates adult subjects with and without intracardiac left-to-right shunting, with no overlap between the 2 groups.

Comparative effects of ischemia and hypoxemia on left ventricular systolic and diastolic function in humans

BACKGROUND

During the initial phase of an ischemic insult, left ventricular (LV) performance depends on the complex interaction between oxygen deprivation, vascular turgor, and accumulation of metabolites. In experimental preparations, low-flow ischemia decreases systolic shortening and increases diastolic LV distensibility, whereas pacing-induced ischemia or hypoxic perfusion produces smaller decreases in systolic shortening but decreases LV diastolic distensibility. The purpose of this study was to investigate the different effects of low-flow ischemia, pacing-induced ischemia, and hypoxemic perfusion on LV performance in humans.

METHODS AND RESULTS

In 20 patients with a significant stenosis in the left anterior descending coronary artery, micromanometer-tip LV pressure recordings (n = 20), LV angiography (n = 18), and coronary sinus blood sampling (n = 11) were obtained at rest and during the following conditions: pacing-induced ischemia (PI) (n = 11), low-flow ischemia of balloon coronary occlusion (CO) (n = 20), and hypoxemia induced by balloon coronary occlusion with hypoxemic perfusion distal to the occlusion (CO+P) (n = 11). LV stroke work index fell from 75 +/- 17 g.m at rest to 43 +/- 14 g.m at the end of CO (n = 18; P < .001). In addition, LV stroke work index was lower at the end of CO than during PI (50 +/- 11 vs 77 +/- 15 g.m; n = 11; P < .002) and was lower at the end of CO than at the end of CO+P (35 +/- 7 vs 46 +/- 9 g.m; n = 9; P < .02). LV end-diastolic pressure rose from 16 +/- 5 mm Hg at rest to 23 +/- 6 mm Hg at the end of CO (n = 20; P < .001). However, LV end-diastolic pressure was lower at the end of CO than during PI (20 +/- 5 vs 30 +/- 5 mm Hg; n = 11; P < .002) and was lower at the end of CO than at the end of CO+P (26 +/- 5 vs 34 +/- 7 mm Hg; n = 11; P < .01). LV end-diastolic volume index increased from 75 +/- 14 mL/m2 at rest to 79 +/- 15 mL/m2 at the end of CO (n = 18; P < .05). Left ventricular end-diastolic volume index increased to values similar to those for CO during PI (79 +/- 13 mL/m2; n = 11; P = NS) and at the end of CO+P (78 +/- 14 mL/m2; n = 9; P = NS). Higher values of LV end-diastolic pressure and unchanged values of LV end-diastolic volume index for PI and CO+P, compared with CO, suggested a lower end-diastolic LV distensibility during PI and during hypoxemia, as compared with low-flow ischemia. Upward shifts of individual diastolic LV pressure-volume curves during PI (9 of 11 patients) and at the end of CO+P (7 of 9 patients), compared with CO, were also consistent with lower LV diastolic distensibility during pacing-induced ischemia and during hypoxemia, compared with low-flow ischemia. Coronary sinus lactate, H+, and K+ levels increased after balloon deflation (CO and CO+P) and during pacing (PI).

CONCLUSIONS

Thus, during low-flow ischemia, LV systolic performance was lower and LV diastolic distensibility larger than during pacing-induced ischemia or hypoxemia. The variable response of the human myocardium to different types of ischemia was probably related to the degree of vascular turgor and accumulation of tissue metabolites.

Na+/H+ exchange activity induced by thrombin is not inhibited by protein kinase inhibitors, staurosporine, K-252a, H-7 and sphingosine, in human platelets

In human platelets stimulated with thrombin (40 mU/ml), Na+/H+ exchange activity [the ethylisopropylamiloride (EIPA)-sensitive increase of cytoplasmic pH (pHc)] and protein kinase C (PKC) activity [phosphorylation of 47 kDa protein (P47), a substrate for PKC] were determined in the presence of protein kinase inhibitors, staurosporine (0.05-1 microM), K-252a (0.5-10 microM), H-7 (100 microM) and sphingosine (20-40 microM). Staurosporine and K-252a completely blocked PKC activity. H-7 and sphingosine reduced the P47 phosphorylation to 64% and 35%, respectively. On the contrary, the thrombin-induced pHc increase was not inhibited by staurosporine, K-252a or H-7. Sphingosine elevated the resting pHc by 0.26-0.42 independently of the Na+/H+ exchanger and inhibited the thrombin-induced pHc increase. However, after the resting pHc elevated by sphingosine had been reduced to the initial level by adding sodium propionate, the thrombin-induced pHc increase was observed again. These results suggested that sphingosine inhibited the thrombin-induced pHc increase by elevating the resting pHc. Thus, we concluded that the Na+/H+ exchanger was activated by thrombin through a pathway independent of PKC.

Platelet Na+/H+ antiport activity in patients with insulin-dependent diabetes mellitus with and without diabetic nephropathy

The incidence of diabetic nephropathy in patients with insulin-dependent diabetes mellitus (IDDM) may depend on factors other than the quality of diabetes control. Hypertension is an additional factor associated with a high degree of renal involvement in IDDM. One abnormality consistently observed in various tissues of patients with essential hypertension is enhanced activity of the Na+/H+ antiport. In the present study we have therefore studied platelet antiport activity in 41 healthy subjects (control), in 22 patients with untreated essential hypertension (EH), and in 35 normotensive IDDM patients (type 1). Of these patients 17 exhibited signs of diabetic nephropathy (group 1) while 18 had no evidence for renal involvement of IDDM in spite of a duration of IDDM of at least 10 years (group 2). The two IDDM patient groups were undistinguishable with respect to age, body mass index, and arterial blood pressure (group 1, 117.9 +/- 2.4/78.4 +/- 1.5 mmHg; group 2, 113.9 +/- 3.6/76.1 +/- 1.8 mmHg). Antiporter activity was determined from the rate of cell volume changes induced by propionic acid. Platelet Na+/H+ exchange activity averaged 23.43 +/- 0.43 10(-3).s-1 in control subjects and was markedly elevated in EH (28.38 +/- 0.62 10(-3).s-1; P < 0.01). Antiport activity in group 2 patients without nephropathy averaged 24.54 +/- 0.57 10(-3).s-1 and was undistinguishable from the control group. However, platelet Na+/H+ antiport activity was significantly stimulated in group 1 patients with nephropathy as compared to group 2 (26.95 +/- 0.73 10(-3). s-1; P < 0.025). Our results show that renal involvement in IDDM is associated with enhanced activity of the platelet Na+/H+ antiport.

Regulation of Na+/H+ exchange and pH in erythrocytes of fish

1. The function of trout RBC Na+/H+ antiport is unrelated to cell volume or cell pH regulation. Its role is to improve oxygen transport capacity when the supply of oxygen becomes limited. 2. Antiport activation, mediated by cAMP, promotes complex changes in blood pH which have been analyzed in vivo and in vitro. 3. The regulation of antiport (activation, desensitization, control by molecular oxygen and by a newly discovered cytosolic protein, arrestin) is presented. 4. Molecular cloning of the antiport shows that two typical site motifs of phosphorylation by cAMP-dependent protein kinase are localized on the cytoplasmic region.

[Effects of ultraviolet irradiation on the Na/H exchange rate in erythrocytes of healthy subjects and patients with atherosclerosis of lower limb arteries]

Na+/H+ exchange rate in erythrocytes of patients with atherosclerosis of lower limb arteries is less than in erythrocytes of healthy subjects. Ultraviolet exposure of the patients blood in vitro activates Na/H exchange in erythrocytes.

Cell volume and ph regulation by the Amphiuma red blood cell: A model for hypoxia-induced cell injury

The Amphiuma red blood cell is one of the model systems employed early in the study of vertebrate cell volume regulation. Following both cell swelling and shrinkage the Amphiuma red blood cell demonstrates volume regulation to virtual completion in 90-120 min. When swollen the Amphiuma red blood cell loses K, Cl and osmotically obliged water, while following shrinkage volume regulation is the result of Na, Cl and therefore water uptake. The main contribution of the Amphiuma red cell as a model is that it was the first cell in which volume regulation was demonstrated to be electroneutral and more specifically that K/H and Na/H exchangers were responsible for regulation following cell swelling and shrinkage, respectively. Additionally, the Amphiuma red blood cell K/H and Na/H exchangers have been demonstrated to function in a pH regulatory capacity. The latter observation in turn led to the demonstration of the mutually exclusive and contradictory nature of volume and pH regulation predicted upon Na/H exchanger activity. These observations prompted our recent investigations of the Na/H exchanger as a contributor to hypoxia-induced cell damage, using the rabbit heart as a model. These studies illustrated that Na, and Ca imbalances characteristic of hypoxia-induced cell damage are ultimately referable to the Na/H exchanger's function in a pH regulatory capacity, which contributes fundamentally to cell volume and Ca derangement and ultimately cell injury.

Sodium-hydrogen exchange in erythrocytes of patients with acute deep venous thromboses

The rate of delta microH(+)-induced Na/H-exchange in erythrocytes of patients with occlusive and with floating types of acute deep venous thromboses, and in control volunteers, was estimated. In patients with occlusive thrombi Na/H-exchange was revealed to be fourfold higher in comparison with patients with floating thrombi and with controls, while no difference was observed between the two latter groups.

Tissue PH2 measurement for continuous estimation of blood flow changes in rat kidney cortex and medulla

A method is described for estimation of local blood flow changes in the renal cortex and medulla, based on continuous polarographic measurement of tissue pressure of electrochemically generated hydrogen (PH2). The technique was used in anaesthetized female Wistar rats. The changes in cortical PH2 were negatively correlated with those in flow velocity in the renal artery (Doppler probe). To evaluate the method, PH2 responses to a reduction of renal perfusion pressure (RPP) and to angiotensin II were examined. RPP reduction from 130 mmHg to 104 mmHg increased the cortical PH2 by 3.5% and medullary PH2 by 6.9% (difference significant at P less than 0.02). With RPP reduction from 113 mmHg to 76 mmHg the values were 6.9% and 11% respectively (difference significant at P less than 0.001). Angiotensin II infusion increased cortical PH2 by 8.7% and medullary PH2 by 4.1% (difference significant at P less than 0.005). It is concluded that the method enables continuous estimation of blood flow changes in the renal cortex and medulla.

Development of collateral circulation in a replanted rat hindlimb model

The development of collateral circulation was studied in a replanted rat hindlimb model by use of the hemodynamic techniques of hydrogen washout and laser Doppler capillary perfusion monitoring. Collateral development occurred and provided blood flow whose magnitude increased linearly over time. Twenty-seven percent of preligation blood flow was present at 2 weeks after replantation, 39% at 4 to 5 weeks, and 77% at 8 to 9 weeks by laser Doppler assessment. Laser Doppler correlated more closely with limb survival than did the hydrogen washout technique. Uniform necrosis (eight of eight) occurred after pedicle interruption in the 2-week group. Partial limb survival was noted in five of eight replants at 4 to 5 weeks on transection of the vascular pedicle, while complete survival of all replants (nine of nine) was seen at 8 to 9 weeks.