Extracellular Fluid Distribution Research Articles

Calcification process dynamics in coral primary polyps as observed using a calcein incubation method

Calcification processes are largely unknown in scleractinian corals. In this study, live confocal imaging was used to elucidate the spatiotemporal dynamics of the calcification process in aposymbiotic primary polyps of the coral species Acropora digitifera. The fluorophore calcein was used as a calcium deposition marker and a visible indicator of extracellular fluid distribution at the tissue-skeleton interface (subcalicoblastic medium, SCM) in primary polyp tissues. Under continuous incubation in calcein-containing seawater, initial crystallization and skeletal growth were visualized among the calicoblastic cells in live primary polyp tissues. Additionally, the distribution of calcein-stained SCM and contraction movements of the pockets of SCM were captured at intervals of a few minutes. Our experimental system provided several new insights into coral calcification, particularly as a first step in monitoring the relationship between cellular dynamics and calcification in vivo. Our study suggests that coral calcification initiates at intercellular spaces, a finding that may contribute to the general understanding of coral calcification processes.

Distribution of Extracellular Fluid in Legs with Venous Edema and Lymphedema.

This study aimed to determine the specific fluid distribution pattern in legs with lymphedema (LE) in comparison to normal legs and legs with venous edema (VE) using bioelectrical impedance analysis (BIA). BIA was performed in 47 patients with lymphedema (LE; 63 legs), 33 patients with venous edema (VE; 60 legs), and 33 normal subjects (N; 66 legs). The ratio of intracellular fluid (ICF) resistance (Ri) to extracellular fluid (ECF) resistance (Re) of a whole leg normalized to the right arm (Ri/Re leg), a surrogate parameter for ECF/ICF, and the Ri/Re of the thigh and calf without normalization (Ri/Re thigh, Ri/Re calf, respectively) were obtained. Increases in Ri/Re leg (N 2.5 ± 0.7, VE 3.9 ± 3.7, LE 3.7 ± 1.5), Ri/Re thigh (N 1.8 ± 0.5, VE 3.2 ± 3.8, LE 3.8 ± 1.9), and Ri/Re calf (N 2.6 ± 0.6, VE 4.6 ± 1.7, LE 4.4 ± 2.2) were confirmed in VE and LE compared to normal subjects. However, the ratios of Ri/Re calf to Ri/Re thigh in normal subjects and those with untreated VE/LE were all ∼1.5 (N 1.5 ± 0.3, VE 1.5 ± 0.7, LE 1.6 ± 0.7). Fluid content was increased in legs with VE and LE compared to normal subjects, while the mode of gravitational fluid distribution was similar among all legs. Thus, no specific finding for LE was confirmed.

Intramuscular distribution of botulinum toxin—Visualized by MRI

ObjectiveA precise knowledge of the spread of botulinum toxin (BoNT) in muscle tissue is required to efficiently access endplate zones and increase BoNT's therapeutic efficacy. Here, we aimed to understand the spatiotemporal dynamics of BoNT distribution in skeletal muscle and its modulating factors, such as injected volume and exercise after injection. MethodsTo visualize distribution in muscle tissue, sagittal, dynamic, balanced fast field echo (BFFE) MRI imaging was performed during injection of 1ml BoNT/NaCl bolus in spastic biceps brachii muscles (SBB, n=4), and 1ml NaCl in the right and 2ml NaCl in the left healthy biceps brachii (HBB, n=6), with or without successive muscle exercise. The pattern of extracellular fluid distribution was evaluated by T2-weighted and diffusion tensor imaging (DTI) sequences. ResultsBFFE indicated an immediate increase in hyperintensity, parallel to the muscle fibers, in the shape of a long (5.3±1.7cm) and thin (0.52±1.3cm) layer in HBB. The layer in SBB was shorter (3.25±0.6cm, p=0.01) and tended to be thicker (0.74±2.9cm, p=0.27). In HBB, an increase in volume (2ml) resulted in an increase in thickness (0.95±0.2cm, p=0.015), but a consistent length (5.67±1.3cm, p=0.54). DTI visualized a change of diffusion, which exceeded the bolus region by approximately 0.5cm. Redistribution occurred 10min after injection and was more prominent in HBB, compared to SBB. Additional muscle activity did not alter the diffusion pattern or bolus distribution. ConclusionInjecting BoNT at different depths perpendicular to the direction of the muscle fiber might optimize the efficacy of BoNT treatment. Additional sites along muscle fibers should be considered in SBB.

Increased volume of distribution for recombinant activated factor VII and longer plasma-derived factor VII half-life may explain their long lasting prophylactic effect

Prophylaxis with plasma-derived or recombinant activated factor VII is beneficial in severe factor VII deficiency. To understand why prophylactic treatment with both products is efficacious, we conducted a pharmacokinetic study. Ten factor VII deficient patients were treated with either recombinant activated (20 μg/kg) or plasma-derived (25 IU/kg) factor VII in a cross-over design. Pharmacokinetic parameters were analyzed through activated factor VII activity, factor VII clotting activity, and factor VII antigen levels on depicted time points. Factor VII activity half-lifes, determined by non-compartmental and one-compartmental analysis (results in brackets), were shorter for recombinant activated (1.4h; 0.7h) than for plasma-derived factor VII (6.8h; 3.2h); both recombinant activated (5.1h; 2.1h and plasma-derived factor VII (5.8h; 3.2h) resulted in longer half-lives of factor VII antigen. Activated factor VII half-lives (based on activated factor VII activity levels) were significantly higher compared to factor VII clotting activity (1.6h; 0.9h). Volumes of distribution were significantly higher for activated factor VII (236 ml/kg; 175 ml/kg, measured by activated factor VII) as compared to plasma-derived factor VII (206 ml/kg; 64 ml/kg, measured by factor FVII activity), suggesting a plasma- and extracellular fluid distribution for recombinant activated factor VII. Recombinant activated factor VII showed significantly shorter half-lifes than plasma-derived factor VII. Volumes of distribution were significantly higher for treatment with recombinant activated factor VII. The longer half-life for plasma-derived factor VII, compared to recombinant activated factor VII, and the increased volume of distribution for recombinant activated factor VII, compared to plasma-derived factor VII may further elucidate the beneficial effect of prophylactic treatment of both products.

Lymphatic Filariasis: A Method to Identify Subclinical Lower Limb Change in PNG Adolescents

Lymphedema related to lymphatic filariasis (LF) is a disabling condition that commonly manifests in adolescence. Fifty-three adolescents, 25 LF infected and 28 LF non-infected, in age and sex-matched groups, using the Binax ICT rapid card test for filarial antigen were recruited to the study. None of the participants had overt signs of lymphedema. Lymphedema assessment measures were used to assess lower limb tissue compressibility (tonometry), limb circumference (tape measure), intra- and extra-cellular fluid distribution (bioimpedance) and joint range of motion (goniometry). The mean tonometric measurements from the left, right, and dominant posterior thighs were significantly larger in participants with LF compared to participants who had tested negative for LF (p = 0.005, p = 0.004, and p = 0.003, respectively) indicating increased tissue compressibility in those adolescents with LF. ROC curve analysis to define optimal cut-off of the tonometry measurements indicated that at 3.5, sensitivity of this potential screening test is 100% (95%-CI = 86.3%, 100%) and specificity is 21.4% (95%-CI = 8.3%, 41.0%). It is proposed that this cut-off can be used to indicate tissue change characteristic of LF in an at-risk population of PNG adolescents. Further longitudinal research is required to establish if all those with tissue change subsequently develop lymphedema. However, thigh tonometry to identify early tissue change in LF positive adolescents may enable early intervention to minimize progression of lymphedema and prioritization of limited resources to those at greatest risk of developing lifetime morbidity.

Simultaneous measurement of extracellular fluid distribution and renal function with a single injection of <sup>99m</sup>Tc DTPA

The initial rate of renal uptake of 99mTc DTPA is equal to the product of injected dose and the glomerular filtration rate (GFR):plasma volume (PV) ratio, whilst later the plasma clearance rate constant is equal to the GFR:extracellular fluid volume (ECF) ratio. Expressing GFR in terms of body fluid volumes has several attractions, and techniques for measuring it in this form may be useful. GFR/PV was determined from a Patlak plot in 82 studies in 47 patients undergoing routine gamma-camera 99mTc DTPA renography and compared with GFR/ECV, determined from the terminal slope of the plasma clearance curve. GFR/PV (y) correlated significantly with GFR/ECV (x): y = 3.2.x + 5.3 ml/min/l (r = 0.82, n = 82, P < 0.001). The ratio, GFR/PV:GFR/ECV is ECV/PV, which (x) correlated significantly with a regional estimate (y) of ECV/PV (rECV/rPV) derived from a Patlak plot applied to a subrenal ROI: y = 0.47x + 1.14 (r = 0.61, n = 52, P < 0.001). The initial rate constant of disappearance of 99mTc DTPA from the blood, determined from a ROI over the left ventricle, reflects tracer clearance from plasma to interstitial fluid plus GFR/PV: Subtraction of GFR/PV yields a rate constant which reflects extrarenal 99mTc DTPA clearance, Z, as a fraction of PV. A regional estimate of 99mTc DTPA clearance from plasma to interstitial fluid, rZ, was derived from the Patlak plot applied to the subrenal ROI and expressed in relation to rPV. Z/PV (y) correlated significantly with rZ/rPV (x): y = 2.2x + 0.02 min-1 (r = 0.56, n = 52, P < 0.001). The distribution of ECF between plasma and interstitial fluid was related to extrarenal 99mTc DTPA clearance. Thus rZ/rPV correlated significantly with ECV/PV (r = 0.55, n = 52, P < 0.001) and Z/PV correlated significantly with rECV/rPV (r = 0.6, n = 52, P < 0.001). There was no correlation between renal function and extrarenal 99mTc DTPA clearance or distribution of ECF. GFR can be measured in terms of PV and ECF volume from a single injection of 99mTc DTPA. ECV/PV, rECV/rPV, and variables representing the clearance of 99mTc DTPA across the microvasculature can be measured at the same time.

Fluid Distribution and Pulmonary Dysfunction Following Burn Shock

Respiratory function and body fluid changes were measured in 46 burned patients for up to 7 days postburn (DPB). The patients in this prospective study were divided into an HLS group [n = 17, burn size 61 +/- 0.5% BSA (mean +/- SEM), resuscitated with hypertonic lactated saline] and an iso-Na group (n = 29, burn size 60 +/- 4.5% BSA, resuscitated with lactated Ringer's solution). During DPB 3 to 5, the Respiratory Index (A-aDO2/PaO2), functional extracellular fluid volume (f-ECFV), an ratio of plasma volume to interstitial fluid volume (PV/ISFV) were increased in the iso-Na group compared with the HLS group. During the same period, the Respiratory Index and PV/ISFV correlated significantly; respiratory dysfunction was less in the HLS group. Nearly 50% of the iso-Na group required endotracheal intubation. Sodium loads were the same in both groups; the HLS group required less water. These results suggest that extracellular fluid distribution differs between the two treatments; HLS may be associated with ameliorated respiratory function not only because of less volume loading during resuscitation, but also because the PV/ISFV ratio is less than when lactated Ringer's is administered.

Electrical measurement of fluid distribution in legs and arms.

Intra- and extra-cellular fluid distribution is very important to know the physiological and clinical state of living subjects. However, it is quite difficult to measure the distribution in vivo. Electrical impedance of living tissue is mainly affected by extra-cellular fluid at an applied frequency lower than the beta-dispersion frequency, and is affected by both extra- and intra-cellular fluid at higher applied frequencies than that. In this paper, we discuss the problems of measurement of intra- and extra-cellular fluid distribution in living tissues by means of electrical impedance. The intra- and extra-cellular fluid distribution is related to some physiological parameters, such as blood circulation, metabolism of tissues, and the electrolytic concentration of intra- and extra-cellular fluids. Therefore, the information about the distribution of fluids in tissues is quite useful for the diagnosis of various diseases, the monitoring of seriously ill patients, and in medical treatments such as artificial dialysis. We discuss the method of measurement and the results of experiments.

The importance of plasma protein for blood volume and blood pressure homeostasis

To evaluate the influence of plasma protein concentration and colloid osmotic pressure (COP) on blood volume and blood pressure, we studied 40 patients with the nephrotic syndrome (plasma protein 41.1 +/- 5.3 g/liter, COP 10.9 +/- 2.2 mm Hg) and 43 patients with chronic renal failure (plasma protein 65.0 +/- 5.8 g/liter, COP 22.4 +/- 3.0 mm Hg) at overhydration, during gradual edema removal to normal hydration, and occasionally, to mild dehydration. The number of measure points was 113 in the nephrotic syndrome and 92 in renal failure. In both groups blood volume was normal at normal extracellular fluid volume (ECFV). Elevation of ECFV to 300% of normal in the nephrotic syndrome occurred with only a modest elevation of blood volume (NS). Elevation of ECFV to 200% of normal in the patients with renal failure was attended by a major elevation of blood volume (P less than 0.01). Reduction of ECFV to about 10% below normal was accompanied by parallel blood volume reduction in both groups. Blood pressure was comparable at normohydration, and increased to clearly hypertensive levels only in the renal failure group with increasing ECFV and blood volume (P less than 0.01). No major blood pressure difference was observed between normal and subnormal hydration, but hypotension was observed twice in the nephrotic group. Apparently, patients with severe hypoproteinemia due to the nephrotic syndrome are generally able to preserve their blood volume even when free of edema. However, their blood volume is not elevated in overhydration, in contrast to patients with renal failure who are normoproteinemic. This difference in regulation of extracellular fluid distribution is probably related to the hypoproteinemia, and its effect to reduce tissue-fluid protein.

Blood to interstitial fluid volume ratio in chronic hypokalaemic states

The distribution of extracellular fluid over the intra- and extravascular spaces was determined in hypokalaemic and normokalaemic patients. In six patients with Bartter's syndrome, four with pseudo-Bartter's syndrome, and twenty with essential hypertension (EH) chronically treated with chlorthalidone, serum potassium (serum K+) and extracellular fluid volume (ECFV) were decreased, while plasma volume (PV) and blood volume (BV) were normal (see Table 1 for means, standard deviations, and levels of significance). Consequently, the ratio of BV to interstitial fluid volume (IFV) was increased. In ten patients with EH on long-term combined enalapril chlorthalidone therapy, eight EH patients on long-term spironolactone treatment, and twenty-three EH patients treated by short-term sodium restriction, PV, BV, and ECFV were decreased, but serum K+ and BV/IFV were normal. In six patients with primary hyperaldosteronism (PHA) serum K+ was decreased, while PV, BV, and BV/IFV were elevated. Significant negative correlations between sK and BV/IFV were found in the Bartter patients (r = -0.88) and the pooled data of all patients (r = -0.50). These findings suggest an association between chronic hypokalaemia and a fluid shift from the extra- into the intravascular space. The hypothesis that this phenomenon is due to a decreased venous resistance as a consequence of chronic hypokalaemia is discussed.

The extrarenal effects of aldosterone on the distribution of extracellular fluid in conscious adrenalectomized-nephrectomized rats.

In order to examine the extrarenal roles of aldosterone in cardiovascular homeostasis, the present study compared blood pressure, extracellular fluid volume (ECFV) and plasma volume (PV) in the three following groups: 10 nephrectomized (NX) rats, 10 nephrectomized-adrenalectomized (NX-AX) rats, and 10 NX-AX and aldosterone-treated (NX-AX-A) rats. Two-hundred and fifty micrograms of aldosterone, mixed with sesame oil, was given subcutaneously in the NX-AX-A rats. Mean arterial pressure (MAP) was recorded through previously implanted carotid catheters. ECFV and PV were measured using 35S-Na2SO4 and 131I-RISA, respectively, 24 h after the operation. These measurements were performed in an unanesthetized and unrestricted condition. MAP gradually increased in the NX group, while a gradual decrease was observed in the other groups. However, MAP was significantly higher in the NX-AX-A group than in the NX-AX group 6 h after the operation and thereafter. Changes in body weight were comparable in the three groups 24 h after the operation. ECFV and PV were both reduced in the NX-AX and the NX-AX-A groups as compared to the NX group (P less than 0.001 NX-AX vs NX, and P less than 0.05 and P less than 0.025 NX-AX-A vs NX, respectively). Although ECFV was comparable in the NX-AX and the NX-AX-A groups, PV was significantly greater in the NX-AX-A group than in the NX-AX group (P less than 0.05). There was a significant positive correlation between MAP and PV in the rats as a whole (r = 0.68, P less than 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Distribution of extracellular fluid over the intra- and extravascular space in hypertensive patients.

The time course of hemodynamic responses to long-standing sodium overload was studied in humans. The study involved six patients who became hypertensive on exposure to excessive mineralocorticoid activity. Arterial pressure, cardiac output, and body fluid volumes were measured with noninvasive methods at weekly intervals for at least 6 weeks and at longer intervals for periods up to 2 years. Extracellular fluid volume was expanded by approximately 20%, and arterial blood pressure rose by 20-40%. Initially, cardiac output was the dominant factor for the pressure rise. But in a later stage the pressure remained high or rose even further, although cardiac output and body fluid volumes fell toward normal. In some cases, particularly in young subjects, it took weeks or months before the total peripheral resistance began to rise, and there was no quantitative relationship between the initial rise in cardiac output and the subsequent rise in resistance. These findings argue against a direct cause-and-effect relation between flow and resistance changes. Preferential expansion of the intravascular compartment was associated with high cardiac output, whereas preferential expansion of the interstitial fluid compartment was associated with high resistance. Thus, the hemodynamic pattern of sodium-induced hypertension seems somehow related to the distribution of extracellular fluid over the intra- and extravascular compartments.

An extrarenal role of aldosterone on the regulation of blood pressure

This study was designed to examine the effects of aldosterone on the distribution of extracellular fluid between the intra- and extra-vascular compartments, and to relate the changes in the fluid distribution to blood pressure in nephrectomized and nephrectomized-adrenalectomized male Wistar rats. Polyethylene catheters were inserted into the right common carotid artery and the right jugular vein, and bilateral nephrectomy with or without adrenalectomy was performed. The animals were divided into three groups: 10 nephrectomized rats (NX), 10 nephrectomized-adrenalectomized rats (NX-AX), and 10 nephrectomized-adrenalectomized and aldosterone treated rats (NX-AX-A). Aldosterone (250 micrograms/rat: Aldocorten, Ciba), mixed with sesame oil, was given subcutaneously in the NX-AX-A. After these procedures, food and water were withheld. Twenty four hours later, blood pressure and body fluid volumes were measured in the unanesthetized unrestricted condition. Mean arterial pressure (MAP) was directly recorded through the carotid catheter using electric manomater. Plasma volume (PV) and extracellular fluid volume (ECFV) were measured according to the dilution principle using 131I-RISA and 35S-Na2SO4, respectively. Interstitial fluid volume (IF) defined as ECFV minus PV and PV/IF ratio was also calculated. In NX, NX-AX and NX-AX-A, the transcapillary escape rate of albumin (TER) was determined after 6 hours. TER was obtained by measuring the disappearance of intravenously injected 131I-RISA for 2 hours after injection. The initial body weight and the changes in body weight were similar among the three groups. MAP was definitely higher in the NX than in the NX-AX and the NX-AX-A. Moreover, it was significantly higher in the NX-AX-A than in the NX-AX (p less than 0.001). Although ECFV and IF were equally and significantly reduced in the NX-AX-A and the NX-AX as compared to the NX, PV was significantly higher in the NX-AX-A than in the NX-AX (p less than 0.01), leading to a significantly lower PV/IF ratio in the latter than in the former (p less than 0.02). When a relationship between MAP and PV was examined in the rats as a whole, a significant positive correlation was found between the two parameters (r = 0.69, p less than 0.001). This relationship still held in the NX-AX and the NX-AX-A in combination (r = 0.69, p less than 0.001). TER was significantly higher in the NX-AX than in the others (p less than 0.001 vs NX, and p less than 0.02 vs NX-AX-A).(ABSTRACT TRUNCATED AT 400 WORDS)

Effect of sodium dialysate concentration on the extracellular fluid distribution during hemodialysis.

Effect of sodium dialysate concentration on the extracellular fluid distribution during hemodialysis.

Electrical measurement of fluid distribution in human legs: estimation of extra- and intra-cellular fluid volume.

In this paper, we discuss the problems of measurement of intra- and extra-cellular fluid distribution in living tissues by means of electrical impedance. The intra- and extra-cellular fluid distribution is related to some physiological parameters, such as blood circulation, metabolism of tissues, and the electrolytic concentration of intra- and extra-cellular fluids. Therefore, the information about the distribution of fluids in tissues is quite useful for the diagnosis of various diseases, the monitoring of seriously ill patients, and in medical treatments such as artificial dialysis. We discuss the method of measurement and the results of experiments.

Extracellular fluid distribution in rats with chronic one- and two-kidney Goldblatt hypertension.

1. The influence of the intact kidney on blood pressure, extracellular fluid volume (ECF, ferrocyanide space) and ECF volume distribution was studied in rats 60 days after constriction of the contralateral renal artery. 2. Renal artery constriction increased both blood pressure and ECF levels. The rise of both variables was more pronounced in rats with the contralateral kidney removed (one-kidney rats) than with the contralateral kidney intact (two-kidney rats). 3. The interstitial fluid volume increased similarly in both experimental groups, the more pronounced ECF increase in the more severly hypertensive one-kidney rats being due to increased plasma volume. In the less hypertensive two-kidney group the plasma volume was not increased significantly but correlated positively with the blood pressure levels. 4. The plasma volume/interstitial fluid volume ratio was decreased in the two-kidney group but did not differ from control values in the one-kidney group thus resembling the ECF partition reported in the hypo-and hypervolaemic type of essential hypertension, respectively. 5. It is suggested that the antihypertensive influence of the intact kidney may be partly due to its ability to escape from the sodium-retaining mechanism activated by renal artery stenosis, which determines the degree of plasma volume expansion and, in connection with this, also the degree of blood pressure elevation.

Extracellular fluid distribution in salt-hypertensive monkeys.

In salt-hypertensive monkeys, a decrease in plasma volume was found, inversely related to blood pressure level and not accompanied by a corresponding change in interstitial fluid volume.

Hemodynamic role of extracellular fluid in hypertension.

Plasma volume is usually lower in patients with essential hypertension than in normal subjects. Normal or expanded plasma volume in some hypertensive patients may respect either a specific hypervolemic subset of the disease or the upper end of a continuum of volume values. Difficulties in defining these groups stem from the small numbers of subjects studied, from the need for a reliable reference index for volume measurements, and from the multiple factors which may affect intravascular volume. Differences in plasma volume cap influence choice of antihypertensive therapy; patients with expanded volume tend also to have slightly exchangeable sodium and greater extracellular fluid (ECF) volume and to respond well to diuretic therapy. There is also some evidence that low plasma renin activity is more frequent among hypervolemic patients. Essential hypertensives as a group have low plasma to interstitial fluid volume ratio (PV/IF), indicating that ECF distribution between the intravascular and interstitial compartments is shifted toward the latter. This is probably related to altered capillary filtration pressure due to increased venous resistance. Hypovolemic essential hypertensives have significantly lower (P less than 0.01) PV/IF ratio than hypervolemic, but whether this is related to differences in neural venous tone is only speculative. Hemodynamic studies revealed no difference in cardiac output between hypertensive patients with contracted blood volume and those with hypervolemia; total peripheral resistance was even higher in the latter, suggesting that "vasoconstriction" is not different between the two groups. It is widely believed that the relationship between ECF expansion and hypertension depends on the development of hypervolemia, increased cardiac output, and subsequent rise in total peripheral resistance reducing volume expansion and normalizing systemic flow while maintaining a high blood pressure. This sequence of events has been demonstrated in some human and experimental forms of hypertension but not in all. Metyrapone-induced hypertension in dogs could be sustained for up to 6 weeks by increased output with no evidence of "autoregulation" developing, and similar observations were reported in some anephric patients. Complementing these findings are observations of elevated cardiac output in some patients with long-standing essential hypertension or primary aldosteronism. It is therefore suggested that the spectrum of hemodynamic changes associated with volume disturbances in hypertension is too wide to be forced under one hypothesis alone and that neurogenic and other factors may play an important role in that complex relationship.

Separate effects of aldosterone, DOCA, and methylprednisolone on renal Na-K-ATPase,.

Separate effects of aldosterone, DOCA, and methylprednisolone on renal Na-K-ATPase,.

Proceedings: Changes in extracellular fluid distribution and interstitial space compliance in rats shortly after nephrectomy.

Proceedings: Changes in extracellular fluid distribution and interstitial space compliance in rats shortly after nephrectomy.