An Official Journal of the American Heart Association

Size: px
Start display at page:

Download "An Official Journal of the American Heart Association"

Transcription

1 Circulatin Research OCTOBER VOL. XXXI An Official Jurnal f the American Heart Assciatin Increased Plasma Aldsterne Cncentratin in Respnse t Hemdialysis in Nephrectmized Man By Rbert E. McCa, Cnnie S. McC, Dale G. Read, Jhn D. Bwer, and Arthur C. Guytn 1972 NO. 4 ABSTRACT The nephrectmized patient maintained n intermittent hemdialysis while awaiting renal transplantatin prvides an excellent mdel fr studying the influence f factrs ther than the renal renin-angitensin system that play a rle in the regulatin f plasma aldsterne cncentratin. Peripheral plasma aldsterne cncentratins were determined using a sensitive radiimmunassay methd in nine anephric patients in the recumbent psitin immediately befre and after hemdialysis. Average patient weight fell 1.5 kg fllwing 12 hurs f dialysis n the Kiil dialyzer. Plasma sdium cncentratin decreased frm 137 ±1 (SE) t 132 ± 1 meq/ liter, plasma ptassium cncentratin decreased frm 4.8 ± 0.3 t 3.2 ±0.1 meq/liter, and the rati f sdium t ptassium increased frm 31.3 ±1.9 t 41.7 ± 0.9. Plasma aldsterne cncentratin increased frm 9.7 ± 1.6 ng/100 ml plasma befre dialysis t 17.9 ±2.1 ng/100 ml plasma after dialysis despite the lack f kidneys t prduce renin. Plasma crtisl cncentratin did nt change significantly (17.5 ±2.0 /ig/100 ml plasma t 14.8 ± 1.9 yug/100 ml plasma). These results shw that plasma aldsterne cncentratin increased in anephric patients in respnse t hemdialysis. This increase ccurred withut a cncmitant increase in plasma crtisl levels, suggesting absence f an adrencrtictrpic hrmne respnse, and was independent f the renal reninangitensin system. KEY WORDS adrenal crtex kidney crtisl angitensin renin sdium Since the bservatin in 1960 f the aldsterne-stimulating effect f exgenus angitensin in man (1, 2), cnsiderable experimental evidence has accumulated indicating that the renal renin-angitensin system Frm the Department f Physilgy and Biphysics, the Department f Bichemistry, and The Artificial Kidney Unit, University f Mississippi Schl f Medicine, Jacksn, Mississippi This investigatin was supprted by U. S. Public Health Service Grant 5 R01 HL frm the Natinal Heart and Lung Institute. Received March 27, Accepted fr publicatin August 2, radiimmunassay ptassium plays a majr rle in the regulatin f aldsterne secretin. Plasma sdium and ptassium cncentratins and pituitary secretin f adrencrtictrpic hrmne (ACTH) are thught t play imprtant secndary rles in cntrlling aldsterne secretin. Our knwledge f the regulatin f aldsterne secretin wuld be enhanced by determining whether the cncentratin f aldsterne in the plasma can be maintained within nrmal physilgical limits and whether the plasma aldsterne cncentratin can change in respnse t acute stimuli independently f OrcuUiwn Reitercb, Vl. XXXI, Octber

2 474 McCAA, McCAA, READ, BOWER, GUYTON the renal renin-angitensin system. The nephrectmized human being wh must be maintained n chrnic hemdialysis while awaiting renal transplantatin prvides an excellent mdel fr studying the influence f humral factrs ther than the renal reninangitensin system that play imprtant rles in cntrlling plasma aldsterne cncentratin. The purpse f this study was t determine the effect f hemdialysis, with its remval f electrlytes, fluids, and metablites, n the plasma aldsterne cncentratin in the nephrectmized patient. Furthermre, mdificatin f a sensitive radiimmunassay prcedure (McCaa, R. E., and McCaa, C. S., unpublished results) fr determining aldsterne cncentratin in peripheral plasma allwed us t measure this sterid hrmne with a high degree f precisin and sensitivity; the methd fr this prcedure is presented in detail in this paper. O <N CO 00 IO CO ' Q O c5 m c» c 56 S O 'O O IO "O IO O S... OCOlOtO Methds Studies in Nrmal Subjects. Six healthy vlunteer subjects were used t btain a nrmal range f values. The subjects were required t stand fr 2 hurs after having been recumbent fr at least 2 hurs. Venus bld samples were drawn befre and after the perid f standing. Five f the vlunteers were placed n a lwsdium diet fr 5 days. On the fifth day, they were again required t stand fr 2 hurs after having been recumbent fr at least 2 hurs, and venus samples were drawn immediately befre and after the perid f standing. The same five subjects were then placed n a high-sdium diet fr 5 days. On the fifth day, bld samples were drawn frm these subjects. All bld samples were cllected in tubes treated with ethylenediaminetetraacetic acid (EDTA) and immediately centrifuged. The plasma samples were frzen until they culd be analyzed fr plasma aldsterne cncentratin. Studies in Anephric Patients. Nine patients wh had undergne bilateral nephrectmies 2 t 38 mnths (average 12 mnths) befre this study were used. A summary f the clinical data is given in Table 1. Als shwn are the reasns fr nephrectmy and the length f time each patient had been nephrectmized. Each patient was restricted t 34 meq/24 hurs f dietary sdium. Other restrictins in the diet are given in Table 1. The bld pressure f all the patients was under 3 S a I 1 i TH tn ^ CO a.-2 -g a..2 S t- Q J 2 m 11* ii r-> t~- b "3 "3 t 2-2 "3 E ct S a! a a I Circtdrtin Rtsurcb, Vl. XXXI, Octbtr 1972

3 PLASMA ALDOSTERONE IN ANEPHRIC MAN 475 cntrl, and nne f the patients tk any medicatin fr 1 week prir t the study. Bld samples were drawn frm the venus side f each patient's indwelling arterivenus shunt 15 minutes befre he was cnnected t the Kiil dialyzer. Each patient was then dialyzed fr 12 hurs at a dialyzer bld flw f apprximately 500 ml/min. Immediately after hemdialysis, venus bld samples were again drawn. These tw sets f bld samples, labeled predialysis and pstdialysis, were then analyzed fr plasma sdium, ptassium, crtisl, and aldsterne. Plasma Electrlytes. Plasma sdium and ptassium determinatins were perfrmed using an Instrumentatin Labratries flame phtmeter. Plasma Crtisl Plasma crtisl determinatins were perfrmed by the cmpetitive prteinbinding prcedure reprted by Murphy (3). This prcedure is cmmnly used by many labratries and des nt need t be discussed further here. Plasma Aldsterne. The radiimmunassay methd fr determinatin f plasma aldsterne cncentratin used in this study was a mdificatin f the prcedure reprted by Mayes et al. (4). This mdified prcedure increased bth the accuracy and the sensitivity f the determinatin, and, therefre, the methd and the tests f its validity are given in detail in the subsequent paragraphs. Aldsterne carbxymethxime was prduced by the reactin f aldsterne and carbxymethxylamine hemihydrchlride (Aldrich Chemical Cmpany, Inc.) in the presence f sdium acetate and methanl. The aldsterne xime derivative was cupled t bvine albumin by the carbdiimide methd (5), and the sterid-prtein cmplex was purified by dialysis at 4 C fr 36 hurs against 20 liters f distilled water. The aldsterne xime-albumin cmplex was emulsified with cmplete Freund adjuvant cntaining Mycbacterium butyricum, and an aliqut f the emulsin was injected siibcutaneusly int ten rabbits every 2 weeks fr the first three injectins and then mnthly. Six f the rabbits develped a usable antibdy fllwing the furth injectin. Sera were stred at 10 C. An antialdsterne serum preparatin at a dilutin f 1 t 75,000 was used in this series f experiments. One-tenth ml f 8 H-l,2-d-aldsterne (10,000 cunts/min), checked weekly fr purity and isaldsterne frmatin, was added t 5-, 10-, r 20-ml plasma samples, depending n the expected aldsterne cncentratin. Samples were extracted fr 6 minutes with eight vlumes f redistilled dichlrmethane. The dichlrmethane layer was separated frm the plasma layer by centrifugatin, and the plasma layer was remved by aspiratin. The dichlrmethane extract was Circulatin R*,t*rcb. Vl. XXXI, Octbtr 1972 evaprated t dryness in a water bath at 37 C under a stream f nitrgen. Each sample was disslved in ml f a methanl-acetne (1:1) slutin and applied t Whatman n. 1 chrmatgraphy paper which had been washed cntinuusly fr 48 hurs with redistilled methanl in a mdified Sxhlet extractin apparatus (Cming Glass Wrks). The paper was remved frm the wash and dried immediately befre samples were applied. The chrmatgram was equilibrated fr 2 hurs and then was develped by descending chrmatgraphy in a benzenehexane-methanl-water (9:1:5:2.5) slvent system fr 12 hurs. Aldsterne was lcated using crtisne and crtisl standards. Aldsterne was apprximately 8 cm behind crtisne and 15 cm ahead f crtisl in this system after 12 hurs f develpment. The samples were eluted frm the paper with redistilled methanl. An aliqut was remved fr liquid scintillatin cunting t allw determinatin f percent recvery, and then tw aliquts equal in vlume t the ne measured fr recvery were evaprated t dryness in a vacuum ven at 35 C fr radiimmunassay. A standard curve was cnstructed fr each series f samples analyzed. Standards cntaining 0, 10, 25, 50, 100, 200, 500, and 1,000 pg f aldsterne (Ciba) disslved in ethanl were added t test tubes, 2,500 cunts/min f s H-aldsterne was added t each standard, and the slutins were mixed well and evaprated t dryness in a vacuum ven. In additin, standards f 100, 500, and 1,000 pg f aldsterne were added t pled plasma samples and carried thrugh the cmplete purificatin prcedure with each grup f samples extracted. Dilute antiserum was prepared immediately befre use by diluting stck antiserum with brate buffer (0.05M, ph 8.0) cntaining 0.1* gamma glbulin (human immune serum glbulin, Merck, Sharp and Dhme) and 2% methanl. Threetenths ml f the dilute antiserum was added t the samples and standards, and the slutins were thrughly mixed withut faming. The tubes were cvered with Parafilm, placed in an ice bath, and incubated in a cld rm fr 2 hurs. Cld, saturated ammnium sulfate (enzyme grade) slutin (0.3 ml) was added t each tube. The cntents were mixed well, incubated fr 15 minutes in an ice bath, and centrifuged at 2,500 g fr 15 minutes at 1 C. Three-tenths ml f the supernatant slutin was transferred t a scintillatin vial. Ten ml f phsphr slutin was added t ne vial cntaining 0.3 ml f dilute antiserumsaturated ammnium sulfate (1:1, backgrund), t three vials cntaining the amunt f 8 H- aldsterne added as a recvery standard, t

4 476 McCAA, McCAA, READ, BOWER, GUYTON three vials cntaining the amunt f 8 H-aldsterne added t the aldsterne standards, and t the vials cntaining 0.3 ml f supernatant slutin frm the tubes f the standard curve, the pled plasma samples, the unknwn samples, and the blanks. All samples were cunted in a Mark II liquid scintillatin cunter (Nuclear Chicag) with autmatic standardizatin using a 188 Ba surce. The standard curve was cnstructed by pltting the percent f unbund sterid against the amunt f unlabeled aldsterne added. The cncentratin f aldsterne in the aliquts f the unknwn plasma samples was determined directly frm the standard curve. The percent f unbund aldsterne was calculated frm the fllwing equatin. percent crss-reactivity f sterid S = (x/y) X 100. Crticsterne was the nly sterid which appreciably crss-reacted, 3.5%, with the aldsterne anrisera. Other sterids which shwed a crss-reactin were crtisl, 0.05%, crtisne, 0.05*, prgesterne, , and dexycrticsterne, 0.25%. Because f the relatively large cncentratins f the ther sterids such as crtisl in plasma in relatin t the cncentratin f aldsterne, chrmatgraphic separatin f cntaminating sterids was essential. In the paper chrmatgraphic system used, a benzene-hexanemethanl-water (9:1:5:2.5) slvent system, excellent separatin f aldsterne and crtisl was achieved with the rate f migratin f crtisl being 0.5 when aldsterne was used as a reference cmpund. The separatin f alds-,,,, cunts/min f 0.3 ml f supernatant slutin Percent unbund aldsterne =» _,. : j ^ r. 0.5 (cunts/min f recvery sample) The aldsterne cntent in the samples in nangrams per 100 miuiliters was calculated frm the frmula terne and crtisne was nt as satisfactry. Hwever, by using crtisne as a standard n each chrmatgram and nly cutting ut the area cunts/min added cunts/min recvered 100 vlume plasma used /1000, where S is the amunt f aldsterne (in picgrams) in the aliqut taken fr assay as read frm the standard curve and B is the aldsterne equivalent (in picgrams) as read frm the curve fr an equal aliqut f the water blank. Crrectin fr the mass f 3 H-aldsterne added t assayed samples was nt necessary if the cunts/min in the sample tubes equaled the cunts/min in the standard tubes. Hwever, if the cunts/min f recvery differed frm the cunts/min f the 8 H-aldsterne added t the standard tubes by mre than 100 cunts/min, crrectin had t be made fr differences in mass cntributed by s H-aldsterne. The recvery f 8 H-l,2-aldsterne in the analysis f 155 plasma samples was 72 it 2.1% (SE). Samples with a recvery f less than 50% were discarded and nt subjected t radiimmunassay. Such samples ccurred infrequently and were attributed t lsses during chrmatgraphy. Specificity f the aldsterne anrisera was determined by studying the percent crss-reactivity f ther sterids cmpared with aldsterne. Calculatins f percent crss-reactivity were carried ut as described by Abraham (6). If x = picgrams f aldsterne required t displace 50% f the 8 H-aldsterne bund t the aldsterne antisera and y = picgrams f sterid S required t displace 50% f the 8 H-aldsterne bund t the aldsterne antisera, then the well behind the crtisne t assay fr aldsterne, cntaminatin by crtisne was eliminated. T determine whether this prcedure separated aldsterne and crtisne adequately, 5 ng f aldsterne, 200 ng f crtisne, and 2 X 10 s cunts/min f a H-l,2-d-aldsterne were added t five plasma samples. The specific activity f aldsterne was determined after chrmatgraphy in the rutinely used system previusly described and after tw subsequent stages f chrmatgraphy in a tluene-ethyl acetate-methanl-water (95:5:50:50) slvent system and in an isctane-fbutanl-water (10:5:9) slvent system. Althugh the last tw systems prvided excellent separatin f aldsterne and crtisne, n significant alteratin in specific activity was bserved after the initial chrmatgraphy, indicating that adequate separatin frm crtisne was btained with nly the ne chrmatgraphic system. There was n interference frm dexycrticsterne r crticsterne, since bth migrated well ahead f aldsterne in this system and, at the end f 12 hurs f develpment, were cmpletely ff the paper. T examine further the specificity f the prcedure, the results btained by radiimmunassay were cmpared with thse btained n the same plasma samples by duble-istpe dilutin (7). As shwn in Table 2, results using the tw methds were cmparable. Fr estimatin f the blank value, samples f Circulatin Rtstarcb. Vl. XXXI, Octebtr 1972

5 PLASMA ALDOSTERONE IN ANEPHRIC MAN 477 TABLE 2 Cmparisn f Aldslerne Values Obtained by Radiimmunassay and Duble-Istpe Dilutin Duble-Istpe Subject (ng aldsterne/ 100 ml plaima) (ng aldsterne/ 100 ml puama) Subjects 1-4 were nrmal yung adult vlunteers wh were n an ad libitum sdium diet and wh remained supine at 7:00 am after at least 6 hurs f recumbency. Subjects 5-7 had taken hydrchlrthiazide (100 mg/24 hur) fr 3 days and were standing at the time the sample was taken. Subject 8 was a fur-year-ld Addisnian patient. distinguished frm zer with a certainty f P = 0.01, it was fund t be abut 25 pg/5 ml plasma r 0.5 ng/100 ml plasma. T check the accuracy f the methd, variable amunts f aldsterne were added t 5-ml aliquts f pled plasma btained frm supine subjects n a high-sdium diet. A linear relatinship was btained ver the range f 1.5 t 50 ng/100 ml plasma when the aldsterne cncentratin assayed was pltted as a functin f die amunts added. T verify rutinely the accuracy, standards f 100, 500, and 1,000 pg f aldsterne were added t previusly assayed pled plasma aliquts and assayed with each series f samples. The precisin, r repeatability, f the methd was investigated by carrying ut duplicate assays fr aldsterne n a series f plasma samples. The standard deviatin was calculated frm the frmula sr> = V (2d 2 /2N), where d is the difference between duplicates and N is the number f duplicates. The SD f a grup f 20 duplicate samples was ± 0.2 ng/100 ml plasma. distilled water equal t the vlumes f plasma rutinely used were treated as plasma samples and taken thrugh the extractin and purificatin prcesses. The mean aldsterne equivalent cntent fund in 20 samples f 5 ml f distilled water was 12 ± 3 (SE) pg/sample after crrectin fr lsses thrugh the prcedure. This blank apparently was nt a result f material extracted frm water, since increasing the vlume f water extracted did nt appreciably influence the blank value. Meticulus cleaning f the glassware, washing f the paper immediately befre use with methanl, and purificatin f the slvents kept the blank in a range that culd be tlerated. A water blank was prcessed with each series f samples. When sensitivity was calculated by determining the lwest value which culd be TABLE 3 Plasma Aldsterne Cncentratin (ng/100 ml plasma) in Nrmal Subjects n Nrmal-, Subject L.H. F.L. J.L. R.C. R.H. D.L. MEAN ± SE Sex F F M M M M Nrmal diet Supine Standing Results Studies in Nrmal Subjects. Plasma aldsterne cncentratin in respnse t pstural changes was studied in six healthy vlunteers while they were recumbent befre arising in the mrning and again after 2 hurs f ambulatin during perids f lw-sdium intake and perids f high-sdium intake. The values fr the plasma aldsterne cncentratins under these cnditins are shwn in Table 3. In the six healthy subjects n an unrestricted sdium diet, there was a furfld increase in plasma aldsterne cncentratin in respnse t changes in psture. In the supine psitin, the plasma aldsterne cncentratin averaged 5.8 ±0.57 ng/100 ml Lw-tdium diet Supine Standing IAXW-, and High-Sdium Intake Higtudlum diet S pine Standing Kmtrcb, Vl. XXXI, Octbtr 1972

6 478 McCAA, McCAA, READ, BOWER, GUYTON plasma and increased t 22.9 ±2.15 ng/100 ml plasma after 2 hurs f ambulatin. Fllwing a perid f lw-sdium intake, the plasma aldsterne cncentratin averaged 18.3 ±1.70 ng/100 ml plasma in the supine psitin and increased t 37.1 ± 2.42 ng/100 ml plasma after 2 hurs f ambulatin. Fllwing a perid f high-sdium intake, plasma aldsterne cncentratin averaged 1.9 ±0.26 ng/100 ml plasma and increased t 3.7 ±0.29 ng/100 ml plasma after 2 hurs f ambulatin. Althugh there was nly a N=9 P<0.000l pj- N=9 twfld increase in plasma aldsterne cncentratin in respnse t pstural changes fllwing perids f lw- and high-sdium intake, these values were significant in bth instances (P< 0.001). Studies in Anephric Patients. Mean values fr plasma sdium, ptassium, aldsterne, and crtisl cncentratins and fr the rati f sdium t ptassium btained fr nine nephrectmized patients immediately befre and after hemdialysis are shwn in Figures 1 and 2. When the patients were dialyzed against a dialysate with the cmpsitin f 130 meq sdium/liter and 2.0 meq ptassium/liter, there was an average patient weight lss f 1.5 kg. Nrmally, plasma sdium cncentratin changes nly slightly in respnse t hemdialysis. In this study, plasma sdium cncentratin decreased an average f 5 meq/liter frm 137 ±1 (SE) meq/liter t 132 ± 1 meq/liter (P < 0.04). Hwever, by cllecting the used dialysate frm the dialyzer and measuring the sdium cncentratin in the dialysate as well OUJ 4.0 E E CO; EUJ CO * P< N=9 N=9 N=9 P<0.04 Pre Dialysis FIGURE 1 Pst Dialysis Plasma sdium and ptassium cncentratins and the rati f sdium t ptassium in nephrectmized patients immediately befre and after 12 hurs f hemdialysis. Vertical lines indicate ±SE. N = number f patients tested. V) a E _ Q_ E ^-«EC/) 15- g> ^E ^^ c m N=9 N S P<0.02 Pre Dialysis Pst Dialysis FIGURE 2 Plasma aldsterne and crtisl cncentratins in nephrectmized patients immediately befre and after 12 hurs f hemdialysis. Vertical lines indicate ±SE. NS = nt significant, N = number f patients tested. Circulatin Research, Vl. XXXI, Octber 1972

7 PLASMA ALDOSTERONE IN ANEPHRIC MAN 479 as the sdium cncentratin in a prtin f the dialysate befre its passage thrugh the dialyzer, it was fund that an apprximate average f 450 meq f sdium was remved by the prcess f hemdialysis. Als, an apprximate average f 150 meq f ptassium was remved, resulting in a decrease f plasma ptassium frm 4.8 ± 0.3 meq/liter t 3.2 ±0.1 meq/liter (P< 0.001). The remval f sdium and ptassium frm the bdy by the prcess f hemdialysis resulted in an increase in the rati f sdium t ptassium frm 31.3 ± 1.9 t 41.7 ± 0.9 (P< 0.001). Peripheral plasma aldsterne cncentratin averaged 9.7 ± 1.6 ng/100 ml plasma in the predialysis samples and increased t 17.9 ±2.1 ng/100 ml plasma in the pstdialysis samples (P<0.02). There was n significant change in plasma crtisl cncentratin in respnse t hemdialysis, althugh crtisl cncentratin actually decreased frm 17.5 ± 2.0 /^g/100 ml plasma in the predialysis samples t 14.8 ± 1.9 ^ig/100 ml plasma in the pstdialysis samples. Discussin In the present study, plasma aldsterne cncentratin was in the upper nrmal physilgical range in nephrectmized man despite the lack f kidneys t prduce renin. Recent studies by Bayard et al. (8) als indicate that plasma aldsterne cncentratin is maintained within nrmal physilgical limits in the absence f the renal reninangitensin system. These investigatrs reprted a high psitive crrelatin between plasma aldsterne cncentratin and serum ptassium cncentratin in anephric man, and preventin f the rise in serum ptassium by the administratin f Kayexalate (sdium plystyrene sulfnate) between perids f dialysis caused the plasma aldsterne cncentratin t remain at lw levels in these patients. In the present study, we fund a twfld increase in plasma aldsterne cncentratin in respnse t hemdialysis. Weidmann et al. (9) reprted similar bservatins. Peart (10) and Mitra et al. (11) fund n alteratin in CiratUttn Rasurcb, Vl. XXXI, Octbtr 1972 plasma aldsterne cncentratin in anephric patients in respnse t gradual dehydratin induced by peritneal dialysis. Furthermre, in ur study, plasma crtisl cncentratin actually decreased during the perid f dialysis, indicating that there was n increase in secretin f ACTH t accunt fr the increase in plasma aldsterne cncentratin. Als, there was a decrease in plasma ptassium cncentratin during hemdialysis. The remval f sdium and ptassium by the prcess f dialysis resulted in an increase in the rati f sdium t ptassium. Bth the decrease in plasma ptassium and the increase in the rati f sdium t ptassium wuld nrmally be a negative stimulus fr aldsterne secretin. Apparently, therefre, the increased plasma aldsterne cncentratin in respnse t hemdialysis was nt mediated by angitensin II, ACTH, r ptassium ins. Hwever, preliminary studies in ur labratry indicate that the sensitivity f the zna glmerulsa t ACTH is increased after hemdialysis (12). A pssible cause f the increased plasma aldsterne cncentratin which we bserved in respnse t hemdialysis might be that the remval f sdium frm the bdy, resulting in decreased plasma sdium cncentratin, is a mre pwerful direct stimulus t aldsterne secretin than mst investigatrs have believed. As an alternate explanatin, the increase in plasma aldsterne cncentratin culd result frm the remval f apprximately 300 ml f bld frm the cardivascular system when the bld is diverted thrugh the Kiil dialyzer. In effect, this represents acute hemrrhage. Anther pssible explanatin culd be that hemdialysis causes increased plasma aldsterne cncentratin by decreasing the metablic clearance rate f aldsterne rather than by influencing the rate f secretin. In studies n dgs, Jhnsn et al. (13) reprted a significant decrease in hepatic bld flw with hemrrhage and sdium depletin, and bservatins by Davis et al. (14) revealed a decline in the metablic clearance rate f aldsterne. And yet anther pssible explanatin, f curse, is that there

8 480 McCAA, McCAA, READ, BOWER, GUYTON might be sme unidentified mechanism that respnds t decreased sdium r fluid vlume t cntrl the secretin f aldsterne. The significance f these data is that the nephrectmized patient can respnd t acute stimuli with increased plasma aldsterne cncentratin in the absence f the renal renin-angitensin system. Regardless f the precise mechanism(s) regulating aldsterne, these data indicate that pwerful cntrl mechanisms are still active after remval f the kidneys. Acknwledgment We wish t thank Miss Betty Prestn, Mrs. Terry Grss, Mrs. Judy Blackburn, and Mrs. Sharn Kcher fr their technical assistance in The Artificial Kidney Unit. We are als grateful t Dr. C. A. Nugent fr his advice in develpment f the radiimmunassay technique. References 1. BmN, P., Kiw, E., NOWACZYNSKI, W., BROUTLLET, J., AND GENEST, J.: Effects f intravenus infusins f valine-5-angitensin II and ther pressr agents n urinary electrlytes and crticsterids, including aldsterne. J Clin Invest 40: , LARACH, J.H., ANGERS, M., KELLY, W.G., AND LIKBERMAN, S.: Hyptensive agents and pressr substances: Effect f epinephrine, nrepinephrine, angitensin II, and thers n the secretry rate f aldsterne in man. JAMA 174: , MURPHY, B.E.P.: Sme studies f the prteinbinding f sterids and their applicatin t the rutine micr and ultra-micr measurement f varius sterids in bdy fluids by cmpetitive prtein-binding radiassay. J Clin Endcrinl Metab 27: , MAYES, D., FUHUYAMA, S., KEM, D.C., AND NUGENT, C.A.: Radiimmunassay fr plasma aldsterne. J Clin Endcrinl Metab 30: , GOODFHIEND, T.L., LEVINE, L., AND FASMAN, G.D.: Antibdies t bradykinin and angitensin: Use f carbdiimides in immunlgy. Science 144: , ABRAHAM, G.E.: Slid-base radiimmunassay f estradil-17/9. J Clin Endcrinl Metab 29: , COCHLAN, J.P., AND SCOGGINS, B.A.: Measurement f aldsterne in peripheral bld f man and sheep. J Clin Endcrinl Metab 27: , BAYAHD, F., COOKE, C.R., TILLER, D.J., BETTINS, I.Z., KOWAHSKI, A., WALKER, W.G., AND MIGEON, C.J.: Regulatin f aldsterne secretin in anephric man. J Clin Invest 50: , WEIDMANN, P., HORTON, R., FRANKLIN, S., FICHMAN, M., GRAL, T., LUPU, A., AND MAXWELL, M.: Dynamic studies f aldsterne in anephric man (abstr.). Clin Res 20:201, PEABT, W.S.: Renin and angitensin in relatin t aldsterne. Am J Clin Pathl 54: , MITRA, S., GENUTH, S.M., BERMAN, L.G., AND VEHTES, V.: Aldsterne secretin in anephric patients. N Engl J Med 286:61-64, MCCAA, R.E., READ, V.H., BOWER, J.D., MCCAA, C.S., AND GUYTON, A.C.: Adrenal crtical respnse t hemdialysis, ACTH and angitensin II in anephric man (abstr.). Circulatin 44(suppl. H): 11-67, JOHNSON, J.A., DAVIS, J.O., BAUMBER, J.S., AND SCHNEIDER, E.G.: Effects f hemrrhage and chrnic sdium depletin n hepatic clearance f renin. Am J Physil 220: , DAVIS, J.O., OLICHNEY, M.J., BROWN, T.C., AND BINNION, P.F.: Metablism f aldsterne in several experimental situatins with altered aldsterne secretin. J Clin Invest 44: , Ciradati Rtstsrcb, Vl. XXXI, Oabtr 1972

A Plasma Humoral Factor of Extrarenal Origin Causing Release of Reninlike Activity in Hypotensive Dogs

A Plasma Humoral Factor of Extrarenal Origin Causing Release of Reninlike Activity in Hypotensive Dogs A Plasma Humral Factr f Extrarenal Origin Causing Release f Reninlike Activity in Hyptensive Dgs By E. De Vit, C. Wilsn, R. E. Shipley, R. P. Miller, and B. L. Mrtx ABSTRACT Plasma reninlike activity significantly

More information

METHOD 8032 ACRYLAMIDE BY GAS CHROMATOGRAPHY

METHOD 8032 ACRYLAMIDE BY GAS CHROMATOGRAPHY METHOD 8032 ACRYLAMIDE BY GAS CHROMATOGRAPHY 1.0 SCOPE AND APPLICATION 1.1 Methd 8032 is used t determine trace amunts f acrylamide mnmer in aqueus matrices. This methd may be applicable t ther matrices.

More information

Measurement of Renin Activity in Human Plasma

Measurement of Renin Activity in Human Plasma Measurement f Renin Activity in Human Plasma By Peter T. Pickens, M.B., M.R.C.P., F. Merlin Bumpus, Ph.D., A. Murray Llyd, M.B., M.R.A.C.P., Rbert R. Smeby, Ph.D., and Irvine H. Page, M.D. Many methds

More information

The estimator, X, is unbiased and, if one assumes that the variance of X7 is constant from week to week, then the variance of X7 is given by

The estimator, X, is unbiased and, if one assumes that the variance of X7 is constant from week to week, then the variance of X7 is given by ESTIMATION PROCEDURES USED TO PRODUCE WEEKLY FLU STATISTICS FROM THE HEALTH INTERVIEW SURVEY James T. Massey, Gail S. Pe, Walt R. Simmns Natinal Center fr Health Statistics. INTRODUCTION In April 97, the

More information

CONSENT FOR KYBELLA INJECTABLE FAT REDUCTION

CONSENT FOR KYBELLA INJECTABLE FAT REDUCTION CONSENT FOR KYBELLA INJECTABLE FAT REDUCTION INSTRUCTIONS This is an infrmed cnsent dcument which has been prepared t help yur Dctr infrm yu cncerning fat reductin with an injectable medicatin, its risks,

More information

Urinary Kallikrein in Rats Bred for Their Susceptibility and Resistance to the Hypertensive Effect of Salt

Urinary Kallikrein in Rats Bred for Their Susceptibility and Resistance to the Hypertensive Effect of Salt 727 Urinary in Rats Bred fr Their Susceptibility and Resistance t the Hypertensive Effect f Salt A New Radiimmunassay fr Its Direct Determinatin OSCAR A. CARRETERO, VASUDEV M. AMIN, TERESA OCHOLIK, ALFONSO

More information

Further Studies on the Influence of Steroids on

Further Studies on the Influence of Steroids on INFECTION AND IMMUNITY, Aug. 1973, p. 151-155 Cpyright ( 1973 American Sciety fr Micrbilgy Vl. 8, N. 2 Printed in U.S.A. Further Studies n the Influence f Sterids n Viral Infectin in Mice D. J. GIRON,

More information

Protocol. Preparation Protocol for the Non-Targeted Vevo MicroMarker Contrast Agent

Protocol. Preparation Protocol for the Non-Targeted Vevo MicroMarker Contrast Agent Prtcl Preparatin Prtcl fr the Nn-Targeted Vev MicrMarker Cntrast Agent System Cmpatibility: This guide cntains instructins and suggestins fr wrk n the Vev2100, VevLAZR, Vev 3100 systems and transducers

More information

Monensin and Extruded Urea-Grain for Range Beef Cows

Monensin and Extruded Urea-Grain for Range Beef Cows Mnensin and Extruded Urea-Grain fr Range Beef Cws R. P. Lemenager, F. N. Owens, w. E. Sharp, Merwin Cmptn and Rbert Ttusek Stry in Brief Tw trials were cnducted t evaluate the supplemental value f mnensin

More information

PROTOCOL 1850 Millrace Drive, Suite 3A Eugene, Oregon

PROTOCOL 1850 Millrace Drive, Suite 3A Eugene, Oregon PROTOCOL Cmplex II Enzyme Activity Micrplate Assay Kit 1850 Millrace Drive, Suite 3A Eugene, Oregn 97403 MS241 Rev.0 DESCRIPTION Cmplex II Enzyme Activity Micrplate Assay Kit Sufficient materials are prvided

More information

M.J. Guthriel, D.G. Wagner2

M.J. Guthriel, D.G. Wagner2 EFFECT OF SUPPLEMENTAL PROTEIN OR GRAIN ON INTAKE AND UTILIZATION OF MEDIUM QUALITY PRAIRIE HAY BY STEERS M.J. Guthriel, D.G. Wagner2 and D.C. Weakley3 Stry in Brief Sixteen 1,053 lb tw-year-ld Herefrd

More information

A RECENT INVESTIGATION 7 of methods for determination of ovulation suggested

A RECENT INVESTIGATION 7 of methods for determination of ovulation suggested The Relatin f Urine V lume t the Menstrual Cycle and Ovulatin WAYNE L. RYAN, PH.D., ROBERT J. LUBY, M.D., AND MICHAEL J. HALLER, A.B. A RECENT INVESTIGATION 7 f methds fr determinatin f vulatin suggested

More information

ALCAT FREQUENTLY ASKED QUESTIONS

ALCAT FREQUENTLY ASKED QUESTIONS 1. Is fasting required befre taking the Alcat Test? N. It is recmmended t drink water and t avid stimulants like caffeine prir t the test. 2. With regard t testing children, must a child be a certain age

More information

FDA Dietary Supplement cgmp

FDA Dietary Supplement cgmp FDA Dietary Supplement cgmp FEBRUARY 2009 OVERVIEW Summary The Fd and Drug Administratin (FDA) has issued a final rule regarding current gd manufacturing practices (cgmp) fr dietary supplements that establishes

More information

M.R.C.Path. causes to the raised plasma urea in patients admitted

M.R.C.Path. causes to the raised plasma urea in patients admitted Pstgradcuate Medical Jurnal (January 1979) 55, 1-14 The cause f the raised plasma urea f acute heart failure R D THOMAS MRCP D B MORGAN MRCPath ALISON NWILL AIMLS Departments f Cardilgy and Chemical Pathlgy,

More information

ASSESSMENT OF PITUITARY FUNCTION IN PATIENTS WITH SERUM PROLACTIN LEVELS GREATER THAN 100 NG/ML*t

ASSESSMENT OF PITUITARY FUNCTION IN PATIENTS WITH SERUM PROLACTIN LEVELS GREATER THAN 100 NG/ML*t FERTILITY AND STERILITY Cpyright 1979 The American Fertility Sciety Vl. 32, N.2, August 1979 Printed in U.s.A. ASSESSMENT OF PITUITARY FUNCTION IN PATIENTS WITH SERUM PROLACTIN LEVELS GREATER THAN 100

More information

Frequently Asked Questions: IS RT-Q-PCR Testing

Frequently Asked Questions: IS RT-Q-PCR Testing Questins 1. What is chrnic myelid leukemia (CML)? 2. Hw des smene knw if they have CML? 3. Hw is smene diagnsed with CML? Frequently Asked Questins: IS RT-Q-PCR Testing Answers CML is a cancer f the bld

More information

Effect of the Angiotensin II Blocker 1-Sar-8-Ala-Angiotensin II on Renal Artery Clip Hypertension in the Rat

Effect of the Angiotensin II Blocker 1-Sar-8-Ala-Angiotensin II on Renal Artery Clip Hypertension in the Rat Effect f the Angitensin II Blcker 1-Sar-8-Ala-Angitensin II n Renal Artery Clip Hypertensin in the Rat By Graham J. Macdnald, Graham W. Byd, and W. Stanley Peart ABSTRACT Twenty-fur cnscius male Wistar

More information

Swindon Joint Strategic Needs Assessment Bulletin

Swindon Joint Strategic Needs Assessment Bulletin Swindn Jint Strategic Needs Assessment Bulletin Swindn Diabetes 2017 Key Pints: This JSNA gives health facts abut peple with diabetes r peple wh might get diabetes in Swindn. This helps us t plan fr medical

More information

THE RABBIT maintained on a highcholesterol

THE RABBIT maintained on a highcholesterol Fatty Acid Cmpsitin f Serum and Artic Intimal Lipids in Rabbits Fed Lw- and High-Chlesterl Diets By DONALD B. ZILVEKSMIT, PH.D., CHARLES C. SWEELEY, PH.D., AND HOWARD A. I. NEWMAN, PH.D. THE RABBIT maintained

More information

AP Biology Lab 12: Introduction to the Scientific Method and Animal Behavior

AP Biology Lab 12: Introduction to the Scientific Method and Animal Behavior Name: AP Bilgy Lab 12: Intrductin t the Scientific Methd and Animal Behavir Overview In this lab yu will: -Observe an rganism and design an experiment t investigate their respnses t envirnmental variables.

More information

Percutaneous Nephrolithotomy (PCNL)

Percutaneous Nephrolithotomy (PCNL) Percutaneus Nephrlithtmy (PCNL) What is a percutaneus nephrlithtmy? is the mst effective f the cmmnly perfrmed prcedures fr kidney stnes. It is the best prcedure fr large and cmplex stnes. T perfrm this

More information

Circadian Changes in Plasma Renin Activity and Plasma Aldosterone Concentration in Two-Kidney Hypertensive Rats

Circadian Changes in Plasma Renin Activity and Plasma Aldosterone Concentration in Two-Kidney Hypertensive Rats Circadian Changes in Plasma Renin Activity and Plasma Aldsterne Cncentratin in Tw-Kidney Hypertensive Rats JACK M. DEFORREST, PH.D., JAMES O. DAVIS, PH.D., M.D., RONALD H. FREEMAN, PH.D., GREGORY A. STEPHENS,

More information

Variation in Tissue Carnitine Concentrations with Age and Sex in the Rat

Variation in Tissue Carnitine Concentrations with Age and Sex in the Rat Bichem. J. (1978) 176, 677-681 Printed in Great Britain 677 Variatin in Tissue Carnitine Cncentratins with Age and Sex in the Rat By PEGGY R. BORUM Divisin fnutritin, Department fbichemistry, Vanderbilt

More information

DATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 2016 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS

DATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 2016 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS DATA RELEASE: UPDATED PRELIMINARY ANALYSIS ON 216 HEALTH & LIFESTYLE SURVEY ELECTRONIC CIGARETTE QUESTIONS This briefing has been specifically prepared fr the Ministry f Health t prvide infrmatin frm this

More information

Increased Plasma Norepinephrine in Young Patients with Essential Hypertension under Three Sodium Intakes ATSUSHI YAMATODANI, M.D., AND HIROSHI WADA,

Increased Plasma Norepinephrine in Young Patients with Essential Hypertension under Three Sodium Intakes ATSUSHI YAMATODANI, M.D., AND HIROSHI WADA, Increased Plasma Nrepinephrine in Yung Patients with Essential Hypertensin under Three Sdium Intakes KAZUKO MASUO, M.D., TOSHIO OGIHARA, M.D., Yuicm KUMAHARA, M.D., ATSUSHI YAMATODANI, M.D., AND HIROSHI

More information

The demonstration of lysosomes by the controlled temperature freezing-sectioning method By LUCILLE BITENSKY

The demonstration of lysosomes by the controlled temperature freezing-sectioning method By LUCILLE BITENSKY 205 The demnstratin f lyssmes by the cntrlled temperature freezing-sectining methd By LUCILLE BITESKY (Frm the Department f Pathlgy, Ryal Cllege f Surgens f England, Lincln's Inn Fields, Lndn, W.C. 2)

More information

* Manuscript received August 25, t Horticultural Research Section, CSIRO, Glen Osmond, South Australia.

* Manuscript received August 25, t Horticultural Research Section, CSIRO, Glen Osmond, South Australia. SUCROSE BREAKDOWN AND SYNTHESIS IN THE RIPENING GRAPE BERRY* By P. J. HARDyt Sucrse is the majr translcated sugar in the grapevine (Swansn and EIShishiny 1958), but in the berry glucse and fructse tgether

More information

A pre-conference should include the following: an introduction, a discussion based on the review of lesson materials, and a summary of next steps.

A pre-conference should include the following: an introduction, a discussion based on the review of lesson materials, and a summary of next steps. NAU Mdel Observatin Prtcl The mdel prtcl was develped with supprt and expertise frm the Natinal Institute fr Excellence in Teaching (NIET) and is based in great part n NIET s extensive experience cnducting

More information

STUDIES WITH HUMAN INFLUENZA VIRUS CULTIVATED IN ARTIFICIAL MEDIUM

STUDIES WITH HUMAN INFLUENZA VIRUS CULTIVATED IN ARTIFICIAL MEDIUM Published Online: 1 June, 1936 Supp Inf: http://di.rg/1.184/jem.63.6.83 Dwnladed frm jem.rupress.rg n August 13, 218 STUDIES WITH HUMAN INFLUENZA VIRUS CULTIVATED IN ARTIFICIAL MEDIUM BY T. P. MAGILL,

More information

Name: Date: Period: Notes: The Blood and Lymphatic System

Name: Date: Period: Notes: The Blood and Lymphatic System Name: Date: Perid: Cmpsitin f Bld and their Functins Red Bld Cells (aka ) Structure Ntes: The Bld and Lymphatic System D nt have a like ther cells d Cntain a specialized prtein called Hemglbin cntains

More information

Extraction of oleic acid from jojoba oil, soybean oil and olive oil Phase diagrams

Extraction of oleic acid from jojoba oil, soybean oil and olive oil Phase diagrams IndianJurnalfChemicalTechnlgy Vl.3, Nvember1996,pp. 299-305 Extractin f leic acid frm jjba il, sybean il and live il Phase diagrams JaimeWisniak*,AlexanderApelblat&Ahu-AkelKhaled epartmentfchemicalengineering,ben-gurianuniversityf

More information

Thyroglobulin levels in serum and saliva of patients with differentiated thyroid carcinoma

Thyroglobulin levels in serum and saliva of patients with differentiated thyroid carcinoma Pre, Indian Acad. Sci., Vl. 87 B (Experimental Bilgy-J), N.7, July 1978. pp. 169-1". @ printed in India Thyrglbulin levels in serum and saliva f patients with differentiated thyrid carcinma D SHAH, S DANDEKAR

More information

(From the Laboratories of the International Health Division of The Rockefeller Foundation, New York)

(From the Laboratories of the International Health Division of The Rockefeller Foundation, New York) THE QUANTITATIVE DETERMINATION OF INFLUENZA VIRUS AND ANTIBODIES BY MEANS OF RED CELL AGGLUTINATION BY GEORGE K. HLRST, M.D. (Frm the Labratries f the Internatinal Health Divisin f The Rckefeller Fundatin,

More information

TREATMENT OF POLYCYTHEMIA VERA

TREATMENT OF POLYCYTHEMIA VERA RUSSELL L. HADEN, M.D. Plycythemia vera is characterized by an increase in the number f red bld cells. This disease is insidius in rigin, chrnic, and withut pathgnmnic symptms r physical findings. Early

More information

ABIOpure TM Total RNA (version 2.0)

ABIOpure TM Total RNA (version 2.0) ABIOpure TM Ttal RNA (versin 2.0) Bld Extractin Handbk Cat N: M541RP50-B FOR RESEARCH USE ONLY Table f Cntents Cntents Page Kit Cmpnents 3 Precautins 3 Stability & Strage 4 General Descriptin 4 Limitatins

More information

Lecture 9 PCL201 Drug Distribution

Lecture 9 PCL201 Drug Distribution Lecture 9 PCL201 Drug Distributin Where d drugs distribute? Drug distributin (and ptentially cncentratin) will depend n bld flw and the physichemical prperties f the chemical Lipid and water slubility

More information

INTRODUCTION TO THE CIRCULATORY SYSTEM

INTRODUCTION TO THE CIRCULATORY SYSTEM INTRODUCTION TO THE CIRCULATORY SYSTEM What des bld d? 5. What makes this pssible? : In rder fr there t be an efficient exchange f xygen, waste and nutrients there must be a high surface area between the

More information

Analysis of Pesticide Residues in Citrus Oils by GCxGC-TOFMS with Minimal Sample Preparation

Analysis of Pesticide Residues in Citrus Oils by GCxGC-TOFMS with Minimal Sample Preparation Analysis f Pesticide Residues in Citrus Oils by GCxGC-TOFMS with Minimal Sample Preparatin LECO Crpratin; Saint Jseph, Michigan USA Key Wrds: GCxGC-TOFMS, Classificatins, Decnvlutin, Quantificatin, Sample

More information

Measure Specific Guidelines for Comprehensive Diabetes Care (CDC)

Measure Specific Guidelines for Comprehensive Diabetes Care (CDC) Measure Specific Guidelines fr Cmprehensive Diabetes Care (CDC) Descriptin: Members age 18-75 years f age with diabetes (Type 1 and Type 2)* that had all f the fllwing: *Members in hspice are excluded

More information

Vaccine Information Statement: PNEUMOCOCCAL CONJUGATE VACCINE

Vaccine Information Statement: PNEUMOCOCCAL CONJUGATE VACCINE Vaccine Infrmatin Statement: PNEUMOCOCCAL CONJUGATE VACCINE Many Vaccine Infrmatin Statements are available in Spanish and ther languages. See www.immunize.rg/vis. Hjas de Infrmacián Sbre Vacunas están

More information

Effect of Plasma Sodium on Aldosterone Secretion During Angiotensin II Stimulation in Normal Humans

Effect of Plasma Sodium on Aldosterone Secretion During Angiotensin II Stimulation in Normal Humans 164 Effect f Plasma Sdium n Aldsterne Secretin During Angitensin II Stimulatin in Nrmal Humans David C. Merrill, Thmas J. Ebert, Meredith M. Skeltn, and Allen W. Cwley Jr. Studies were carried ut in nrmal

More information

The clinical trial information provided in this public disclosure synopsis is supplied for informational purposes only.

The clinical trial information provided in this public disclosure synopsis is supplied for informational purposes only. The clinical trial infrmatin prvided in this public disclsure synpsis is supplied fr infrmatinal purpses nly. Please nte that the results reprted in any single trial may nt reflect the verall ptential

More information

Children with Adrenal Hyperplasia *

Children with Adrenal Hyperplasia * Jurnal f Clinical Investigatin Vl. 45, N. 3, 1966 Aldsterne Excretin in Nrmal Children and in Children with Adrenal Hyperplasia * MARIA I. NEW,t BARBARA MILLER, AND RALPH E. PETERSON t (Frm the Departments

More information

BRCA1 and BRCA2 Mutations

BRCA1 and BRCA2 Mutations BRCA1 and BRCA2 Mutatins ROBERT LEVITT, MD JESSICA BERGER-WEISS, MD ADRIENNE POTTS, MD HARTAJ POWELL, MD, MPH COURTNEY LEVENSON, MD LAUREN BURNS, MSN, RN, WHNP OBGYNCWC.COM v Cancer is a cmplex disease

More information

US Public Health Service Clinical Practice Guidelines for PrEP

US Public Health Service Clinical Practice Guidelines for PrEP Webcast 1.3 US Public Health Service Clinical Practice Guidelines fr PrEP P R E S ENTED BY: M A R K T H R U N, M D A S S O C I AT E P R O F E S S O R, U N I V E R S I T Y O F C O L O R A D O, D I V I S

More information

PROTOCOL. SOD2 Protein Quantity Microplate Assay Kit. MS746 Rev.0 DESCRIPTION INTRODUCTION

PROTOCOL. SOD2 Protein Quantity Microplate Assay Kit. MS746 Rev.0 DESCRIPTION INTRODUCTION PROTOCOL SOD2 Prtein Quantity Micrplate Assay Kit 1850 Millrace Drive, Suite 3A Eugene, Oregn 97403 MS746 Rev.0 DESCRIPTION SOD2 Prtein Quantity Micrplate Assay Kit Sufficient materials are prvided fr

More information

INVESTIGATIVE OPHTHALMOLOGY. Dexamethasone testing in Southwestern Indians

INVESTIGATIVE OPHTHALMOLOGY. Dexamethasone testing in Southwestern Indians May 1970 Vlume 9, Number 5 INVESTIGATIVE OPHTHALMOLOGY Dexamethasne testing in Suthwestern Luis J. Rsenbaum, Ellen Altn, and Bernard Becker f the Suthwestern United States demnstrated prevalences f primary

More information

Completing the NPA online Patient Safety Incident Report form: 2016

Completing the NPA online Patient Safety Incident Report form: 2016 Cmpleting the NPA nline Patient Safety Incident Reprt frm: 2016 The infrmatin cntained within this dcument is in line with the current Data Prtectin Act (DPA) requirements. This infrmatin may be subject

More information

ALLERGY. The effect of alternate-day prednisone on the white blood count in children with chronic asthma

ALLERGY. The effect of alternate-day prednisone on the white blood count in children with chronic asthma The Jurnal f ALLERGY and CLINICAL IMMUNOLOGY VOLUME 51 NUMBER 2 The effect f alternate-day prednisne n the white bld cunt in children with chrnic asthma H. Cha, M.D., and A. Gilbert, M.T. Denver, Cl. Children

More information

Taste-sickness associations in youngrats over varying delays, stimulus, and test conditions

Taste-sickness associations in youngrats over varying delays, stimulus, and test conditions Animal Learning & Behavir 1980, 8(4), 529-533 Taste-sickness assciatins in yungrats ver varying delays, stimulus, and test cnditins GERARD M. MARTIN and W. K. TIMMINS Australian Natinal University, Canberra,

More information

A Phase I Study of CEP-701 in Patients with Refractory Neuroblastoma NANT (01-03) A New Approaches to Neuroblastoma Therapy (NANT) treatment protocol.

A Phase I Study of CEP-701 in Patients with Refractory Neuroblastoma NANT (01-03) A New Approaches to Neuroblastoma Therapy (NANT) treatment protocol. SAMPLE INFORMED CONSENT A Phase I Study f CEP-701 in Patients with Refractry Neurblastma NANT (01-03) A New Appraches t Neurblastma Therapy (NANT) treatment prtcl. The wrd yu used thrughut this dcument

More information

Year 10 Food Technology. Assessment Task 1: Foods for Special Needs. Name: Teacher:

Year 10 Food Technology. Assessment Task 1: Foods for Special Needs. Name: Teacher: Year 10 Fd Technlgy Assessment Task 1: Fds fr Special Needs Name: Teacher: Due Date: Term 2, Week 1 Type f Task: Design Task Planning Fd Requirements Cllectin f Assessment: Submit in Class Assessment Plicy:

More information

Comparison of three parathyroid hormone assays

Comparison of three parathyroid hormone assays Ann Clin Bichem 198; 23: 429-433 Cmparisn f three parathyrid hrmne assays JIFR A ISBT Frm the Department f Chemical Pathlgy, St. Gerge's Hspital and Medical Schl, Lndn SW17, UK SUMMARY. The efficiency

More information

HIV Diagnostic Tests. HIV Testing Algorithm at SydPath (National Reference Laboratory)

HIV Diagnostic Tests. HIV Testing Algorithm at SydPath (National Reference Laboratory) HIV Diagnstic Tests HIV Testing Algrithm at SydPath (Natinal Reference Labratry) HIV1/2 Ab/Ag Cmbi is Architect HIV- 1 Ab/Ag EIA is Genscreen Sandwich EIA 4 th Generatin HIV Ab/Ag Chemiluminescene Micr

More information

VITAPRO. Detoxification properties of Apple pectin formulation, PROPECTIN. CENTRE D ETUDE ET DE VALORISATION DES ALGUES FINAL REPORT.

VITAPRO. Detoxification properties of Apple pectin formulation, PROPECTIN. CENTRE D ETUDE ET DE VALORISATION DES ALGUES FINAL REPORT. CENTRE D ETUDE & DE VALORISATION DES ALGUES 2400 Detxificatin prperties f Apple pectin frmulatin, PROPECTIN. VITAPRO FINAL REPORT PrPectin July 2015 CENTRE D ETUDE ET DE VALORISATION DES ALGUES PRESQU

More information

Simultaneous Determination of Urinary

Simultaneous Determination of Urinary Simultaneus Determinatin f Urinary Ascrbic Acid and Creatinine by Highperfrmance Liquid Chrmatgraphy (Accepted n Mar. 26, 1996) Yshihir Shimada Sanae K Key wrds : Urinary Ascrbic Acid, Creatinine, High-perfrmance

More information

by Springer-Verlag 1977

by Springer-Verlag 1977 Diabetlgia 13, 615-61 (177) Diabetlgia @ by Springer-Verlag 177 Prevalence f Residual B-Cell Functin in Insulin-Treated Diabetics Evaluated by the Plasma C-Peptide Respnse t Intravenus Giucagn C. Hendriksen,

More information

EURL-SRM - Analytical Observations Report

EURL-SRM - Analytical Observations Report cncerning the fllwing EURL-SRM - Analytical Observatins Reprt Cmpund(s): Pymetrzine Cmmdities: Varius cmmdities f plant rigin Methd(s): QuEChERS, adjustment f ph Instrumentatin: LC-MS/MS Analysis f Pymetrzine

More information

NFS284 Lecture 3. How much of a nutrient is required to maintain health? Types and amounts of foods to maintain health

NFS284 Lecture 3. How much of a nutrient is required to maintain health? Types and amounts of foods to maintain health NFS284 Lecture 3 Chapter 2: Nutritin: Guidelines: Applying the Science f Nutritin 2.1 Nutritin Recmmendatin fr the Canadian Diet Nutrient-based apprach Hw much f a nutrient is required t maintain health?

More information

BIOLOGY 101. CHAPTER 7: Membrane Structure and Function: Life at the Edge

BIOLOGY 101. CHAPTER 7: Membrane Structure and Function: Life at the Edge BIOLOGY 101 CHAPTER 7: Membrane Structure and Functin: Life at the Edge Membrane Structure and Functin: Life at the Edge CONCEPTS: 7.1 Cellular membranes are fluid msaics f lipids and prteins 7.2 Membrane

More information

H1N1 Influenza 09 Guidance for Residential Aged Care

H1N1 Influenza 09 Guidance for Residential Aged Care H1N1 Influenza 09 Guidance fr Residential Aged Care 11 June 2009 As knwledge abut H1N1 Influenza 09 develps, further advice will be prvided. Please check www.healthemergency.gv.au fr the latest infrmatin.

More information

Topic 12: Endocrine System. Function: Group of glands that produces regulatory chemicals ( )

Topic 12: Endocrine System. Function: Group of glands that produces regulatory chemicals ( ) Tpic 12: Endcrine System Functin: Grup f glands that prduces regulatry chemicals ( ) Hrmnes: Chemical messengers released directly int the bldstream that regulate: *May have wide-spread effects r nly affect

More information

Q 5: Is relaxation training better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder?

Q 5: Is relaxation training better (more effective than/as safe as) than treatment as usual in adults with depressive episode/disorder? updated 2012 Relaxatin training Q 5: Is relaxatin training better (mre effective than/as safe as) than treatment as usual in adults with depressive episde/disrder? Backgrund The number f general health

More information

P02-03 CALA Program Description Proficiency Testing Policy for Accreditation Revision 1.9 July 26, 2017

P02-03 CALA Program Description Proficiency Testing Policy for Accreditation Revision 1.9 July 26, 2017 P02-03 CALA Prgram Descriptin Prficiency Testing Plicy fr Accreditatin Revisin 1.9 July 26, 2017 P02-03 CALA Prgram Descriptin Prficiency Testing Plicy fr Accreditatin TABLE OF CONTENTS TABLE OF CONTENTS...

More information

Corporate Governance Code for Funds: What Will it Mean?

Corporate Governance Code for Funds: What Will it Mean? Crprate Gvernance Cde fr Funds: What Will it Mean? The Irish Funds Industry Assciatin has circulated a draft Vluntary Crprate Gvernance Cde fr the Funds Industry in Ireland. 1. Backgrund On 13 June 2011,

More information

23/11/2015. Introduction & Aims. Methods. Methods. Survey response. Patient Survey (baseline)

23/11/2015. Introduction & Aims. Methods. Methods. Survey response. Patient Survey (baseline) Intrductin & Aims Drug and Alchl Cnsultatin Liaisn (AOD CL) services aim t imprve identificatin and treatment f patients with AOD mrbidity. The csts and cnsequences f targeting AOD patients presenting

More information

SECTION O. MEDICATIONS

SECTION O. MEDICATIONS SECTION O. MEDICATIONS 1. NUMBER OF MEDICA TIONS (Recrd the number f different medicatins used in the last 7 days; enter "0" if nne used) O1. Number f Medicatins (7-day lk back) Intent: Prcess: Cding:

More information

SURGICAL NOTE. Surgical Recommendations to Optimize Femoral/Iliac Artery Cannulation

SURGICAL NOTE. Surgical Recommendations to Optimize Femoral/Iliac Artery Cannulation SURGICAL NOTE Surgical Recmmendatins t Optimize Femral/Iliac Artery Cannulatin Due t its size, lcatin, and ease f access, the femral artery is frequently used fr bld pressure catheter placement. Less frequently,

More information

Interaction of Vasopressin and the Baroreceptor Reflex System in the Regulation of Arterial Blood Pressure in the Dog

Interaction of Vasopressin and the Baroreceptor Reflex System in the Regulation of Arterial Blood Pressure in the Dog Interactin f Vaspressin and the Barreceptr Reflex System in the Regulatin f Arterial Bld Pressure in the Dg By Allen W. Cwley, Jr., Emil Mns, and Arthur C. Guytn ABSTRACT The hemdynamic effects f 1-hur

More information

Effects of compost maturity on growth of komatsuna (brassica rapa var. pervidis) in neubauer's pot

Effects of compost maturity on growth of komatsuna (brassica rapa var. pervidis) in neubauer's pot Sil Science and Plant Nutritin ISSN: 0038-0768 (Print) 1747-0765 (Online) Jurnal hmepage: https://www.tandfnline.cm/li/tssp20 Effects f cmpst maturity n grwth f kmatsuna (brassica rapa var. pervidis) in

More information

Signature Assignment. Course. ANTH 2346: General Anthropology. Assignment ID (to be assigned) Outcomes/Rubrics to be Assessed by the Assignment

Signature Assignment. Course. ANTH 2346: General Anthropology. Assignment ID (to be assigned) Outcomes/Rubrics to be Assessed by the Assignment Signature Assignment ANTH 2346: General Anthrplgy Outcmes/Rubrics t be Assessed by the Assignment Cmmunicatin Critical Thinking Empirical and Quantitative Reasning Scial Respnsibility Assignment Descriptin

More information

Relationship Between Fertility and the Nonprotein Sulfhydryl Concentration of Seminal Fluid in the Thoroughbred Stallion

Relationship Between Fertility and the Nonprotein Sulfhydryl Concentration of Seminal Fluid in the Thoroughbred Stallion Relatinship Between Fertility and the Nnprtein Sulfhydryl Cncentratin f Seminal Fluid in the Thrughbred Stallin Frederick M. Haag, D.V.M., * and N. T. Werthessen, Ph.D. IN AN EARLIER REPORT! it was shwn

More information

Hepatic and Pulmonary Clearance of Exogenous Vasoactive Intestinal Peptide in the Rat

Hepatic and Pulmonary Clearance of Exogenous Vasoactive Intestinal Peptide in the Rat GASTROENTEROLOGY 77:55-60, 1979 Hepatic and Pulmnary Clearance f Exgenus Vasactive Intestinal Peptide in the Rat CHRISTOPHER S. HUMPHREY, PHILLIP MURRAY, AMIN M. EBEID, and JOSEF E. FISCHER The Department

More information

FILTRATION AND REABSORPTION OF PROTEIN BY THE KIDNEY* BY ALVIN L. SELLERS, M.D., NEILYN GRIGGS, JESSIE MARMORSTON, M.D., AND HOWARD C. GOODMAN, M.D.

FILTRATION AND REABSORPTION OF PROTEIN BY THE KIDNEY* BY ALVIN L. SELLERS, M.D., NEILYN GRIGGS, JESSIE MARMORSTON, M.D., AND HOWARD C. GOODMAN, M.D. Published Online: 1 July, 1954 Supp Inf: http://di.rg/1.184/jem.1.1.1 Dwnladed frm jem.rupress.rg n August 21, 218 FILTRATION AND REABSORPTION OF PROTEIN BY THE KIDNEY* BY ALVIN L. SELLERS, M.D., NEILYN

More information

Introduction Teaching Interpretation

Introduction Teaching Interpretation Intrductin Teaching Interpretatin AUTHOR: Kyle Vanderwall Grandville High Schl, Grandville, MI Intrductin The AP U.S. Histry Curriculum Framewrk defines interpretatin in the fllwing way: Interpretatin

More information

The Dynamics of the Lung Fluid Filtration System in Dogs with Edema

The Dynamics of the Lung Fluid Filtration System in Dogs with Edema 796 The Dynamics f the Lung Fluid Filtratin System in Dgs with Edema MARLYS H. GEE AND JAMES A. SPATH, JR. SUMMARY We studied the relatinship between pulmnary micrvasculature fluid filtratin pressures

More information

OUR STUDIES on the seeming loss of

OUR STUDIES on the seeming loss of Evaluatin f Bld Vlume Measurement Techniques By JOHN W. REMINGTON, PH.D., AND CARLETON H. BAKEB, PH.D. OUR STUDIES n the seeming lss f plasma frm the circulatin after transfusin and the mbilizatin f plasma

More information

Osteoporosis Fast Facts

Osteoporosis Fast Facts Osteprsis Fast Facts Fast Facts n Osteprsis Definitin Osteprsis, r prus bne, is a disease characterized by lw bne mass and structural deteriratin f bne tissue, leading t bne fragility and an increased

More information

Assessment Field Activity Collaborative Assessment, Planning, and Support: Safety and Risk in Teams

Assessment Field Activity Collaborative Assessment, Planning, and Support: Safety and Risk in Teams Assessment Field Activity Cllabrative Assessment, Planning, and Supprt: Safety and Risk in Teams OBSERVATION Identify a case fr which a team meeting t discuss safety and/r safety planning is needed r scheduled.

More information

Social Learning Theories

Social Learning Theories Scial Learning Theries - Careful scientific prcedures and methdlgy that characterize the behaviurist apprach Albert Bandura - Brn in small twn Alberta - Plish decent - Only sn with 5 sisters - Interested

More information

The role of prostaglandin A in the control of sodium homeostasis and blood pressure

The role of prostaglandin A in the control of sodium homeostasis and blood pressure Yale University lischlar A Digital Platfrm fr Schlarly Publishing at Yale Yale Medicine Thesis Digital Library Schl f Medicine 1973 The rle f prstaglandin A in the cntrl f sdium hmestasis and bld pressure

More information

SQA-VISION VALIDATION REPORT

SQA-VISION VALIDATION REPORT Objective SQA-VISION VALIDATION REPORT T test the new cnvenience features f the SQA-Visin vs. the SQA-V and manual semen assessment: Swim-up Density Gradient Lngevity Vitality Mrphlgy Cunter Scanning Debris/Rund

More information

For Research Use Only Ver

For Research Use Only Ver INSTRUCTION MANUAL Quick-cfRNA Serum & Plasma Kit Catalg N. R1059 Highlights High-quality cell-free RNA is easily and rbustly purified frm up t 3 ml f plasma, serum, r ther bilgical fluids. Purified cell-free

More information

METHYL TESTOSTERONE IN PREMATURE INFANTS

METHYL TESTOSTERONE IN PREMATURE INFANTS METHYL TESTOSTERONE IN PREMATURE INFANTS BY URSULA JAMES and B. L. COLES Frm the General Lying-In and Annie McCall Hspitals, Lndn (RECE:IVED FOR PUBLICATiN crber 18. 195 1) It is an established fact that

More information

ROBERT FRASER, PH.D., CARLO BERETTA-PICCOLI, M.D., JEHOIADA J. BROWN, M.B., ALISON M. M. CUMMING, R.G.N., ANTHONY F. LEVER, M.B.,

ROBERT FRASER, PH.D., CARLO BERETTA-PICCOLI, M.D., JEHOIADA J. BROWN, M.B., ALISON M. M. CUMMING, R.G.N., ANTHONY F. LEVER, M.B., Respnse f Aldsterne and 18-Hydrxycrticsterne t Angitensin II in Subjects and Patients with Essential Hypertensin, 's Syndrme, and Nntumrus Hyperaldsternism ROBERT FRASER, PH.D., CARLO BERETTA-PICCOLI,

More information

THROUGH 1979, immunosuppressive

THROUGH 1979, immunosuppressive Five-Year Survival After Liver Transplantatin THROUGH 1979, immunsuppressive therapy fr liver transplantatin at ur center was with aathiprine (r cyclphsphamide) and sterids, t which antilymphcyte glublin

More information

Module 6: Goal Setting

Module 6: Goal Setting Mdule 6: Gal Setting Objectives T understand the cncept f gal setting in Brief CBT T acquire skills t set feasible and apprpriate gals in Brief CBT What is gal setting, and why is it imprtant t set gals

More information

RADIOIMMUNOASSAY FOR GASTRIC INHIBITORY POLYPEPTIDE

RADIOIMMUNOASSAY FOR GASTRIC INHIBITORY POLYPEPTIDE GASTROENTEROLOGY 66:357-364, 1974 Cpyright 1974 by The Williams & Wilkins C, Vl. 66. N.3 Printed in U.S.A. RADIOIMMUNOASSAY FOR GASTRIC INIBITORY POLYPEPTIDE MARYANNE KUZIO, JILL R. DRYBURG, KATLEEN M.

More information

RI International Peer Employment Training

RI International Peer Employment Training RI Internatinal Peer Emplyment Training In Peer Supprt, mind and heart matter. Since 2000, we have successfully recruited and trained Peer Supprt Specialists at RI Internatinal (frmerly Recvery Innvatins)

More information

Steroids: A Timeless Fascination

Steroids: A Timeless Fascination GENERAL I ARTICLE Sterids: A Timeless Fascinatin Chlesterl and its Bi-prducts SHari Prasad SHari Prasad teaches medicinal rganic chemistry and rganic spectrscpy t pst graduate students at the Chemistry

More information

Significance of Chronic Kidney Disease in 2015

Significance of Chronic Kidney Disease in 2015 1 Significance f Chrnic Kidney Disease in 2015 There is still a requirement within QOF t keep a register f peple with CKD stages 3-5. The ther CKD QOF targets have been retired. This is because CKD care

More information

Appendix C Guidelines for treating status epilepticus in adults and children

Appendix C Guidelines for treating status epilepticus in adults and children Appendix C Guidelines fr treating status epilepticus in adults and children 1.1 Treating cnvulsive status epilepticus in adults General measures 1st stage (0 10 minutes) Secure airway and resuscitate Administer

More information

disease at the time of study. The age range was from 23 to 49 years. All observations were made with the

disease at the time of study. The age range was from 23 to 49 years. All observations were made with the OBSERVATIONS ON THE EARLY ELEVATION OF SERUM POTASSIUM DURING RESPIRATORY ALKALOSIS 1 By JOHN B. HICKAM, WILLIAM P. WILSON, AND REGINA FRAYSER (Frm The Departments f Medicine and Psychiatry, Duke University

More information

Intravenous Fluid & Acidbase Balance for Surgical. Patients

Intravenous Fluid & Acidbase Balance for Surgical. Patients Intravenus Fluid & Acidbase Balance fr Surgical Patients Dr. Abdullah F Alshehri, MBBS, FRCSC, MSc Assistant prfessr, cnsultant pediatric surgen What is Intravenus fluid? Why is understanding IV fluid

More information

Plasma converting enzyme activity during the development and maintenance of experimental and spontaneous in rats

Plasma converting enzyme activity during the development and maintenance of experimental and spontaneous in rats Atlanta University Center DigitalCmmns@Rbert W. Wdruff Library, Atlanta University Center ETD Cllectin fr AUC Rbert W. Wdruff Library 12-1-1976 Plasma cnverting enzyme activity during the develpment and

More information

THE PLACENTAL TRANSMISSION OF ANTIBODIES IN THE SKIN SENSITIVE TYPE OF HUMAN ALLERGY

THE PLACENTAL TRANSMISSION OF ANTIBODIES IN THE SKIN SENSITIVE TYPE OF HUMAN ALLERGY THE PLACENTAL TRANSMISSION OF ANTIBODIES IN THE SKIN SENSITIVE TYPE OF HUMAN ALLERGY BY WILLIAM B. SHERMAN, M.D., STANLEY F. HAMPTON, M.D., ANn ROBERT A. COOKE, M.D. (Frm the Department f Allergy, The

More information

FOUNDATIONS OF DECISION-MAKING...

FOUNDATIONS OF DECISION-MAKING... Table f Cntents FOUNDATIONS OF DECISION-MAKING... Errr! Bkmark nt Describe the decisin-making prcess pp.62-66... Errr! Bkmark nt Explain the three appraches managers can use t make decisins pp.67-70 Errr!

More information