Intracellular Fluid Research Articles

Effectiveness of Nurse-led Yoga Intervention on Body Composition and Biochemical Parameters in Overweight and Obese Adolescents: A Pilot Study

Introduction: Obesity in children has been on the rise globally, and India is no exception. Rapid urbanisation, changing dietary patterns, and sedentary lifestyles are contributing factors to this alarming trend. Understanding the prevalence and factors associated with childhood obesity in urban areas is crucial for developing targeted interventions and public health strategies. Aim: To investigate the effects of a nurse-led yoga intervention on body composition and biochemical parameters in overweight and obese adolescents (11-13 years) in schools. Materials and Methods: This pilot randomised controlled study used a true experimental study design, specifically the pretest and post-test control group design. Data collection was conducted in schools of Puducherry. A total of 18 overweight and obese adolescents, nine in the experimental group and nine in the control group, were included. The experimental group performed a nurse-led yoga intervention three times a week for 60 minutes for six months from March 2022 to August 2022. Study outcomes on body composition and biochemical parameters such as lipid profile, adiponectin, leptin, Apolipoprotein A, and Apolipoprotein B were measured at baseline and six months after the nurse-led yoga intervention. Data analysis was performed using Social Sciences Software {Statistical Package for the Social Sciences (SPSS) version 25.0}. Both descriptive and inferential statistical tests, such as the one-way Analysis of Variance (ANOVA) F-test, repeated measures ANOVA F-test, and paired t-test, were conducted. Results: A significant difference was noted in fat percentage, water, intracellular fluid, extracellular fluid, and body fat mass index between the pretest and post-test (p<0.05), and no significant difference was observed in Basal Metabolic Rate (BMR) and fat-free mass index (p>0.05) in the experimental group. The nurse-led yoga intervention significantly improved Lowdensity Lipoproteins (LDL), Apolipoprotein A, and adiponectin levels; however, there were no significant differences in Fasting Blood Sugar (FBS), total cholesterol, High-density Lipoproteins (HDL), Apolipoprotein B, or LDL in the experimental group. The control group showed no significant difference between the pretest and post-test in FBS, total cholesterol, LDL, HDL, Apolipoprotein A, or Apolipoprotein B (p>0.05). Conclusion: The nurse-led yoga intervention positively impacted body composition and biochemical indicators in overweight and obese adolescents.

Phlebolymphedema and bioimpedance: general concepts and personal experience

Limb phlebolymphedema (PLE) is characterized by an accumulation of fluid in the interstitial space and it is caused by an impairment of venous and lymphatic flow. From the pathophysiology point of view, PLE may be of primary and (more frequently) secondary type; it mostly occurs in post-thrombotic syndrome, after trauma, in varicose veins with dysfunctional centripetal flow pumping mechanisms, in proximal vein obstruction syndromes (e.g. May-Thurner syndrome), in phlebolymphatic congenital malformations (e.g. Klippel Trenaunay syndrome). To improve diagnostics of limb PLE, bioimpedance technology has been proposed, both under the form of bioimpedance analysis and under the form of the more accurate bioimpedance spectroscopy (BIS); the latter is based on multiple frequencies which investigate tissues with a higher degree of accuracy, compared to bioimpedance analysis which is usually based on one or two frequencies. By means of BIS it is possible to measure and monitor the variations in the extracellular (interstitial) and intracellular fluids as well as in the tissue composition. More importantly, this biotechnology permits a segmental assessment of the edema, thus both limbs may be individually investigated, as well as the fluid accumulation/tissue conditions of the single limb or part of it may be assessed. Similarly, this method may contribute to monitor therapy outcomes and it may also have a relevant prognostic role after oncologic therapy (e.g. breast cancer treatment) to anticipate the risk of lymphedema/PLE onset. Beside the classical L-Dex index which compares the two limbs in terms of impedance, the analysis of raw data permits to extrapolate absolute figures concerning a series of relevant parameters such as: a) resistance which is the expression of the extracellular fluids, b) reactance and c) cell membrane capacitance (CMC) which are both indexes of tissue composition/health. Furthermore, BIS provides a wide range of data concerning body composition in terms of fat and lean mass, water and general health (for example through phase angle index); this way, a more comprehensive approach to the possible concomitant chronic diseases (e.g. obesity, cardiovascular diseases, diabetes, cancer) in the PLE patient is pursued.

Study of Serum Magnesium, Potassium and Calcium in Acute Myocardial Infarction Patients

Introduction: A myocardial infarction happens when blood flow stops or decreases to the coronary arteries of the myocardial muscle, resulting in damage to the heart muscle. Magnesium is important electrolyte plays vital role in suppressing arrhythmias during myocardial ischemia and during reperfusion. Potassium is the most abundant cation of intracellular fluid. A significant correlation between hypokalemia and ventricular fibrillation is recorded. Calcium plays a vital role in myocardial muscle contraction. Aim: To study serum levels of magnesium, potassium and calcium in acute myocardial infarction patients. Material and methods: This was a prospective case control study conducted in Prathima Institute of medical sciences Nagunur, Karimnagar, Telangana state, India between January 2015 to December 2015. A total 50 acute myocardial infarction patients and 50 normal age and sex matched healthy controls selected for study. Serum magnesium estimated by colorimetric xylidyl blue complex method, serum potassium estimated by ion selective electrode method and serum calcium by OCPC method. Statistical analysis carried out using statistical software SPSS version 16 and p-value < 0.05 considered statistically significant. Results: Serum levels of magnesium, potassium and calcium were significantly decreased in acute myocardial infarction patients when compared healthy controls and is statistically significant (<0.05) Conclusion: The above study suggested decreased serum level of key elements such as magnesium, potassium and calcium in acute myocardial infarction patients when compared to healthy controls. Estimation and correction of these elements may play a pivotal role in management of patients with acute myocardial infarction

The condition of the fluid compartments by the method of bioimpedancemetry in victims with a blast injury

BACKGROUND. According to the modern standards, in case of an acute blood loss, the pathogenetic provision of fluid therapy is based on the ROSE/D concept. According to this concept, after the initial emergency restoration of circulating blood volume, the fluid compartments should be optimized with further stabilization of the condition.
 OBJECTIVE. To study the fluid compartments in mine-explosive injuries victims.
 MATERIALS AND METHODS. 28 servicemen aged 20 to 51 years (average age 34.6±10.3 years) who were in the intensive care unit (ICU) with mine-explosive injuries of various localization (chest, abdomen, limbs) were examined. The victims were given fluid therapy in a restrictive mode. The condition of fluid compartments was determined by the method of bioimpedance measurement and calculation methods.
 RESULTS. On the first day of ICU stay, the total amount of water in the body exceeded the norm by 3 %. At the same time, the volume of intracellular water was significantly lower than normal by 22 %. On the second day, the total amount of water in the body normalized, but the indicator of intracellular water increased by 9.5 % of the reference.
 CONCLUSIONS. It is shown that despite the restoration of the circulating blood volume, there is an intracellular fluid deficit, which, even in the conditions of the restrictive fluid therapy, is replaced by a slight compensatory intracellular hyperhydration the next day when the intravascular volume of fluid is normalized.

A Prospective Observational Study Evaluating Extracellular Water to Total Body Water Ratio By Using the Bioelectrical Impedance Analysis in Elderly Patients with Hematologic Malignancies

[Introduction] Body composition assessment is often used in clinical practice for evaluating and monitoring sarcopenia and nutritional status. Bioelectrical impedance analysis (BIA), which uses the conductivity of the body's intracellular and extracellular fluids to respond to cell and tissue functions, has gradually become widely used in clinical practice because of its non-invasiveness, convenience, and low cost. The ratio of extracellular water to total body water (ECW/TBW) measured by BIA has been found to be related to the prognosis of many diseases, but its application value for patients with hematologic malignancies still needs to be further explored. The purpose of this study was to further explore the application value of ECW/TBW measured by BIA in elderly patients with hematologic malignancies. [Patients and Methods] We prospectively analyzed 82 elderly patients aged≥60 years with hematologic malignancies diagnosed at our institution between 2015 and 2018. Appendicular skeletal muscle mass (ASM) and ECW/TBW ratio were measured by using multifrequency BIA (InBody 720). In this study, the ECW/TBW cut off value to predict survival was determined by a receiver operating characteristic (ROC) curve analysis. The ECW/TBW ratio cut offs was 0.397 (sensitivity 67.3% and specificity 54.5%, area under the curve (AUC) 0.586, [95% confidence interval (CI) 0.46-0.711]) for all 82 patients. Patients with ECW/TBW < 0.397 were sorted into the non-overhydrated group (NOH-group) and those with ECW/TBW > 0.397 into the overhydrated group (OH-group). Skeletal muscle index (SMI) was defined as the ratio of ASM divided by height in square centimeters. Sarcopenia was defined according to the AWGS2019 algorithm, in which the patient has low muscle mass, and low muscle strength or low physical performance. The study protocol was approved by the Institutional Review Board of Yokohama Municipal Citizen's Hospital, and it was carried out in accordance with the Declaration of Helsinki. This trial was registered in the UMIN clinical trial registry (UMIN000035834). [Results] Median age at diagnosis was 78 years (60-93 years), with 46 males and 36 females. The diagnosis included non-Hodgkin lymphoma (NHL, n=51), multiple myeloma (MM, n=11), myelodysplastic syndrome (MDS, n=12), and acute myeloid leukemia (AML, n=8). The mean ECW/TBW ratio of all 82 patients was 0.397±0.014. There was no significant difference in the mean ECW/TBW ratio between disease types. Thirty-four patients (41%) were classified as OH-group and 48 patients (59%) were classified as NOH-group. The median age in the OH- and NOH- groups was 83 and 74 years (p<0.001). The mean BMI did not differ between the two groups (22.17 vs. 22.16 kg/m2, respectively, p = 0.99). The prevalence of sarcopenia was 41.4% (34/82). There was no significant difference in overall survival (OS) between the sarcopenia and the non-sarcopenia group (3-year OS, 58.1% vs. 63.3%, p=0.96). On the other hand, patients with OH-group had shorter OS than those with NOH-group (3-year OS, 46.8% vs. 70.5%, p=0.03). We next performed a subgroup analysis of NHL patients. Among 51 NHL patients, 30 (59%) had aggressive lymphoma and 21 (41%) had indolent lymphoma. Twenty patients (39%) were classified as OH-group and 31 patients (61%) were classified as NOH-group. Patients with OH-group had shorter OS than those with NOH-group (3-year OS, 67.1% vs. 90.3%, p=0.02). The prevalence of sarcopenia was 37.3% (19/51) and sarcopenia was not correlated with survival in NHL patients. Among 30 aggressive lymphoma patients, the overhydrated status was closely associated with poor outcome (3-year OS was 57.1% in the OH-group and 88.9% in the NOH-group, p=0.01). On the other hand, there was no significant difference in OS between the OH- and NOH- groups among 21 indolent lymphoma patients. Multivariate analysis showed that the overhydrated status (high-ECW/TBW ratio) was an independent prognostic factor for OS in patients with aggressive lymphoma (HR, 5.30; 95%CI, 1.01-27.7, p=0.04). [Conclusion] The present study demonstrated that high-ECW/TBW ratio was associated with poor outcome in elderly patients with hematologic malignancies. Especially, the overhydrated status was closely associated with poor outcome in elderly aggressive lymphoma patients. Since our results are based on a small-sized analysis, further large prospective studies are warranted to verify this conclusion.

Conflicting Associations among Bioelectrical Impedance and Cardiometabolic Health Parameters in Young White and Black Adults.

The purpose of this cross-sectional evaluation was to determine the associations between raw bioelectrical impedance and cardiometabolic health parameters in a sample of young non-Hispanic White and African American adults. A total of 96 (female: 52, male: 44) non-Hispanic White ( n = 45) and African American adults ( n = 51) between the ages of 19 and 37 yr (22.7 ± 3.83 yr) completed several fasted assessments including resting systolic blood pressure (rSBP), blood glucose (FBG), blood lipids, and bioelectrical impedance spectroscopy. Bioelectrical impedance spectroscopy-derived measurements included phase angle, bioimpedance index (BI), impedance ratio (IR), reactance index (XCi), fat-free mass (FFM), FFM index (FFMi), and absolute (a) and relative (%) total body water (TBW) and extracellular (ECF) and intracellular fluid (ICF). All bioelectric variables were collected at 50 kHz other than IR (250 kHz/5 kHz). Multiple regressions were conducted and adjusted for sex, age, and body mass index. rSBP was positively, and HDL was inversely, associated with all bioelectrical impedance and absolute hydration variables (all P ≤ 0.050) other than XCi for rSBP and XCi and FFMi for HDL. rSBP ( P < 0.001) was inversely, and HDL ( P = 0.034) was positively, associated with IR. FBG was positively associated with BI, XCi, FFM, TBWa, and ECFa (all P < 0.050). Metabolic syndrome severity was positively associated with BI, FFM, TBWa, and ECFa for women (all P ≤ 0.050) and with ICFa for African American women ( P = 0.016). Given the rapid increase in the prevalence of cardiometabolic health risks among young adults and the broad use of bioelectrical impedance in practice, the conflicting associations we observed in this age group suggest that bioelectrical impedance parameters should be used with caution in the context of cardiometabolic health risks and age.

Design and spectral-luminescent properties of a triad consisting of two BODIPY chromophores axially bound to a Sn(IV)-porphyrin in aqueous and aqueous micellar media

In this work, we designed and studied the emissive properties of a triad consisting of two BODIPY chromophores axially bound to a Sn(IV)-porphyrin via a methylphenolate bridge in aqueous and aqueous micellar media. It has been shown that the fluorescent properties of the porphyrin fragment of the triad, due to photoinduced energy transfer from the axial fragments to the macrocycle, are most sensitive to small changes in viscosity in the range from 3 to 6 cP, which corresponds to the viscosity of the blood of a healthy person (4–6 cP). The localization of the triad in the spherical CTAB micelles increases its emission in aqueous media. The structure–property dependencies established in the study can be applied to design molecular devices for sensing local viscosity of aqueous and aqueous micellar media, which could be of great interest for non-contact detection of physical properties of intracellular or lymphatic fluids.

Regulation of Transporters for Organic Cations by High Glucose.

Endogenous positively charged organic substances, including neurotransmitters and cationic uremic toxins, as well as exogenous organic cations such as the anti-diabetic medication metformin, serve as substrates for organic cation transporters (OCTs) and multidrug and toxin extrusion proteins (MATEs). These proteins facilitate their transport across cell membranes. Vectorial transport through the OCT/MATE axis mediates the hepatic and renal excretion of organic cations, regulating their systemic and local concentrations. Organic cation transporters are part of the remote sensing and signaling system, whose activity can be regulated to cope with changes in the composition of extra- and intracellular fluids. Glucose, as a source of energy, can also function as a crucial signaling molecule, regulating gene expression in various organs and tissues. Its concentration in the blood may fluctuate in specific physiological and pathophysiological conditions. In this work, the regulation of the activity of organic cation transporters was measured by incubating human embryonic kidney cells stably expressing human OCT1 (hOCT1), hOCT2, or hMATE1 with high glucose concentrations (16.7 mM). Incubation with this high glucose concentration for 48 h significantly stimulated the activity of hOCT1, hOCT2, and hMATE1 by increasing their maximal velocity (Vmax), but without significantly changing their affinity for the substrates. These effects were independent of changes in osmolarity, as the addition of equimolar concentrations of mannitol did not alter transporter activity. The stimulation of transporter activity was associated with a significant increase in transporter mRNA expression. Inhibition of the mechanistic target of rapamycin (mTOR) kinase with Torin-1 suppressed the transporter stimulation induced by incubation with 16.7 mM glucose. Focusing on hOCT2, it was shown that incubation with 16.7 mM glucose increased hOCT2 protein expression in the plasma membrane. Interestingly, an apparent trend towards higher hOCT2 mRNA expression was observed in kidneys from diabetic patients, a pathology characterized by high serum glucose levels. Due to the small number of samples from diabetic patients (three), this observation must be interpreted with caution. In conclusion, incubation for 48 h with a high glucose concentration of 16.7 mM stimulated the activity and expression of organic cation transporters compared to those measured in the presence of 5.6 mM glucose. This stimulation by a diabetic environment could increase cellular uptake of the anti-diabetic drug metformin and increase renal tubular secretion of organic cations in an early stage of diabetes.

New GABA-Targeting Therapies for the Treatment of Seizures and Epilepsy: I. Role of GABA as a Modulator of Seizure Activity and Recently Approved Medications Acting on the GABA System.

γ-Aminobutyric acid (GABA) is the most prevalent inhibitory neurotransmitter in the mammalian brain and has been found to play an important role in the pathogenesis or the expression of many neurological diseases, including epilepsy. Although GABA can act on different receptor subtypes, the component of the GABA system that is most critical to modulation of seizure activity is the GABAA-receptor-chloride (Cl-) channel complex, which controls the movement of Cl- ions across the neuronal membrane. In the mature brain, binding of GABA to GABAA receptors evokes a hyperpolarising (anticonvulsant) response, which is mediated by influx of Cl- into the cell driven by its concentration gradient between extracellular and intracellular fluid. However, in the immature brain and under certain pathological conditions, GABA can exert a paradoxical depolarising (proconvulsant) effect as a result of an efflux of chloride from high intracellular to lower extracellular Cl- levels. Extensive preclinical and clinical evidence indicates that alterations in GABAergic inhibition caused by drugs, toxins, gene defects or other disease states (including seizures themselves) play a causative or contributing role in facilitating or maintaning seizure activity. Conversely, enhancement of GABAergic transmission through pharmacological modulation of the GABA system is a major mechanism by which different antiseizure medications exert their therapeutic effect. In this article, we review the pharmacology and function of the GABA system and its perturbation in seizure disorders, and highlight how improved understanding of this system offers opportunities to develop more efficacious and better tolerated antiseizure medications. We also review the available data for the two most recently approved antiseizure medications that act, at least in part, through GABAergic mechanisms, namely cenobamate and ganaxolone. Differences in the mode of drug discovery, pharmacological profile, pharmacokinetic properties, drug-drug interaction potential, and clinical efficacy and tolerability of these agents are discussed.

Intracellular and Extracellular Water Balance in Patients with Lipedema.

Background: The presence of edema in patients with lipedema has been investigated in many studies. However, no study has been found that examines the amount of intracellular (ICF) and extracellular fluid (ECF) in these patients together. The aim of this study is to examine the amount of ICF and ECF in patients with stage 2 lipedema. Methods and Results: Twenty-four patients diagnosed with stage 2 lipedema were included in the study. Bioimpedance spectroscopy was applied to measure extracellular and intracellular water levels. The mean age of the participants was 44.58 ± 2.95 years. The mean body mass index (BMI) of the participants was 33.9 ± 1.84 kg/m2. It was observed that the amount of ECF in the patients was above the normal values (p < 0.001), whereas the amount of ICF was within the normal range (p = 0.801). In addition, it was observed that there was a moderate relationship between BMI and the amount of ECF. Conclusion: Although the amount of ICF is within the normal range in patients with lipedema, an increase in ECF is observed. The reason why edema is not observed in these patients despite the increase in ECF may be the increase in glycosaminoglycan and proteoglycan synthesis. In addition, the attention of these patients to weight control may contribute to slowing the course of the disease by preventing the increase in the amount of ECF. For a better diagnosis of lipedema, it is considered important to evaluate the amount of ECF in addition to routine evaluations.

Determination of Extra- and Intra-Cellular pH Using Characteristic Absorption of Water by Near-Infrared Spectroscopy

Accurate determination of extra-cellular pH (pHe) and intra-cellular pH (pHi) is important to cancer diagnosis and treatment because tumor cells exhibit a lower pHe and a slightly higher pHi than normal cells. In this work, the characteristic absorption of water in the near-infrared (NIR) region was utilized for the determination of pHe and pHi. Dulbecco’s modified eagle medium (DMEM) and bis (2-ethylhexyl) succinate sodium sulfonate reverse micelles (RM) were employed to simulate the extra- and intra-cellular fluids, respectively. Continuous wavelet transform (CWT) was used to enhance the resolution of the spectra. Quantitative models for pHe and pHi were established using partial least squares (PLS) regression, producing relative errors of validation samples in a range of −0.74–2.07% and −1.40–0.83%, respectively. Variable selection was performed, and the correspondence between the selected wavenumbers and water structures was obtained. Therefore, water with different hydrogen bonds may serve as a good probe to sense pH within biological systems.

Possibility of directly sensing plant stress under environment temperature changes using electrochemical impedance spectroscopy

Electrochemical impedance spectroscopy (EIS) was used to examine the possibility of directly sensing plant stress under temperature environment changes. Changes in the extracellular and intracellular fluid resistances (Ro and Ri, respectively) were affected by changes in the cell phenomena under the temperature environment because Ro and Ri reflect the ionic fluctuations caused by the activation of cell membranes and change in solute viscosity, respectively, under the changing environment temperature. Examination of the effects of temperature environment change on plant cells via EIS measurements and theoretical calculations using the Okajima model can be used for in situ monitoring.

Evaluation of hydrodynamic flows of cellular fluid in artificially formed continuums of plant material structure

Aim. The aim of the research is to evaluate hydrodynamic flows of cellular fluid in artificially formed channels of the structure of plant materials as a result of exposure to atmospheric spark discharge. The article presents some features of the flow of cellular fluid in artificially formed channels of plant materials after passing an atmospheric spark discharge. Expressions of hydrodynamics of idealized physical models are used to describe them. As a confirmation of the received data, the experimental part has been set.The Methods. The authors consider the case when the initial plant material is pre-treated with a spark discharge; its influence arises a new continuum in the structure of the material in the form of a throughinduced channel. Expressions of intracellular fluid outflow time and pressure power based on Poiseuille's law are given for electrically induced channels. The experimental part of the work includes spark discharge treatment of plant material – carrots cut into discs with a diameter of 24 mm and a thickness of 3 and 9 mm to determine the dependence of the amount of released cellular fluid on the duration of the experiment and the discharge current mode.The Results. It has been established that atmospheric spark discharge treatment contributes to the formation of new continuums in the structure of plant materials. With an increase in the intensity of treatment, the area of the moisture trace from the carrot disk increases and, as a result, the amount of released intracellular fluid. For the sake of clarity of the experiments, graphs of the dependence of the processing intensity on the amount of liquid released have been presented, corresponding expressions given.Conclusion. The obtained experimental data and dependencies will be useful when considering more complex mass transfer processes in capillary-porous bodies using preliminary electrophysical processing.

Neural activity induces strongly coupled electro-chemo-mechanical interactions and fluid flow in astrocyte networks and extracellular space-A computational study.

The complex interplay between chemical, electrical, and mechanical factors is fundamental to the function and homeostasis of the brain, but the effect of electrochemical gradients on brain interstitial fluid flow, solute transport, and clearance remains poorly quantified. Here, via in-silico experiments based on biophysical modeling, we estimate water movement across astrocyte cell membranes, within astrocyte networks, and within the extracellular space (ECS) induced by neuronal activity, and quantify the relative role of different forces (osmotic, hydrostatic, and electrical) on transport and fluid flow under such conditions. We find that neuronal activity alone may induce intracellular fluid velocities in astrocyte networks of up to 14μm/min, and fluid velocities in the ECS of similar magnitude. These velocities are dominated by an osmotic contribution in the intracellular compartment; without it, the estimated fluid velocities drop by a factor of ×34-45. Further, the compartmental fluid flow has a pronounced effect on transport: advection accelerates ionic transport within astrocytic networks by a factor of ×1-5 compared to diffusion alone.

Role of Vena Cava Inferior Ultrasound in Volume Assesment

Regulation of body fluid volume is a key concern for physicians in intensive care units. In intensive care, it is most important to determine the intracellular fluid status because it directly affects the volume status of the patient. Ultrasonography appears to be a useful tool for the assessment of body fluid status. The gold standard for measuring central venous pressure (CVP) is a central venous catheter. Vena cava inferior ultrasound (US-VCI) has been proposed as the non-invasive technique of choice for CVP assessment due to its wide availability, low costs, and ease of use. While a depleted IVC is often observed in hypovolemic patients, typically the IVC is dilated in a hypervolemic condition with a less pronounced or null respiratory collapse in the appropriate clinical context. respiratory variability in VCI diameteris known as the caval index (collapsibility index=VCImaxVCImin /VCImax) and is considered to reflect the intravascular volume state. According to the current updated American and European guidelines, an IVC diameter ≤2.1 cm and collapsibility &gt;50% during inspiration suggest a RAP between 0–5 mm Hg while a diameter &gt;2.1 cm with &lt;50% inspiratory collapse indicates a high RAP of 10–20 mmHg. Primarily because of complicated pathophysiological mechanisms, ultrasound measurement of VCI should not be used as the only parameter in the assessment of volemic status.

Prediction of Passive Membrane Permeability of Linagliptin

Linagliptin is a highly selective inhibitor of dipeptidyl peptidase-4 and therefore clinically utilized to treat adults with type 2 diabetes mellitus. The objective of this study was to predict how the ions normally found in extracellular or intracellular fluids within the body system will influence the linagliptin’s rate of passive diffusion across a cell membrane. The methodology involved measuring linagliptin partition coefficient in a chloroform-water system containing the salts at 25 oC by the shake flask method. The results indicate that at the highest concentration (0.5 M) of the salts studied, sodium chloride was found to give the highest partition coefficient value when compared to the control. In conclusion, physiological ions would have little or no effect on the drug’s molecular state within extracellular or intracellular fluid as the salts failed to significantly alter the partition coefficient of the drug, hence will not alter passive membrane permeability of linagliptin.

Multi-segment bioimpedance in the evaluation of treatment for secondary lower limb lymphedema: Gynecological cancer

&lt;b&gt;Aim&lt;/b&gt;: The present aimed study was to report the mobilization of body fluids after five days of intensive treatment for secondary lower limb lymphedema.&lt;br /&gt; &lt;b&gt;Materials and methods&lt;/b&gt;: A crossover clinical trial was conducted involving the analysis of changes in intracellular and extracellular fluids in all extremities and the trunk in women with lower limb lymphedema secondary to treatment for gynecological cancer. Evaluations were performed with multi-segment bio impedance analysis before and after intensive treatment using Godoy Method® eight hours per day for five days. Comparisons were made using Wilcoxon signed-ranks test.&lt;br /&gt; &lt;b&gt;Results&lt;/b&gt;: Significant changes in intracellular and extracellular fluids were found in all extremities and the trunk (p&amp;lt;0.0001 for all comparisons).&lt;br /&gt; &lt;b&gt;Conclusion&lt;/b&gt;: Intensive Godoy Method® leads to important changes in the distribution of body fluids in the treatment of lower limb lymphedema following treatment for gynecological cancer, with a significant increase in fluids in the upper limbs and trunk as well as significant reductions in the lower limb and in intracellular and extracellular water.

Simulation of microtubule-cytoplasm interaction revealed the importance of fluid dynamics in determining the organization of microtubules.

Although microtubules in plant cells have been extensively studied, the mechanisms that regulate the spatial organization of microtubules are poorly understood. We hypothesize that the interaction between microtubules and cytoplasmic flow plays an important role in the assembly and orientation of microtubules. To test this hypothesis, we developed a new computational modeling framework for microtubules based on theory and methods from the fluid-structure interaction. We employed the immersed boundary method to track the movement of microtubules in cytoplasmic flow. We also incorporated details of the encounter dynamics when two microtubules collide with each other. We verified our computational model through several numerical tests before applying it to the simulation of the microtubule-cytoplasm interaction in a growing plant cell. Our computational investigation demonstrated that microtubules are primarily oriented in the direction orthogonal to the axis of cell elongation. We validated the simulation results through a comparison with the measurement from laboratory experiments. We found that our computational model, with further calibration, was capable of generating microtubule orientation patterns that were qualitatively and quantitatively consistent with the experimental results. The computational model proposed in this study can be naturally extended to many other cellular systems that involve the interaction between microstructures and the intracellular fluid.

Understanding Hypervolemia in Chronic Kidney Disease

Introduction: Chronic Kidney Disease (CKD) is a progressive and irreversible decline in kidney function and a decreased Glomerular Filtration Rate (GFR). Decreased kidney function contributes to decreased water excretion and fluid overload caused by decreased GFR. A progressive decrease in GFR in renal disease leads to hypertension, sodium retention, and fluid overload. Discussion: CKD is kidney damage or also defined as a decrease in glomerular filtration rate (GFR) of less than 60 ml/minute/1.73m2 that occurs for 3 months or more. CKD is most caused by Diabetes Mellitus 64.1% and Hypertension 80.7%. One clinical manifestation in patients with CKD is an increase in fluid volume (hypervolemia). Hypervolemia is one of the nursing problems in the nursing care process. Based on the Indonesian Nursing Diagnosis Standard Book, hypervolemia is an increase in intravascular, interstitial, and/or intracellular fluid volume. The etiology of hypervolemia in CKD patients is a regulatory mechanism disorder associated with decreased GFR. Signs and symptoms both major and minor in hypervolemia nursing problems show that most patients have peripheral oedema of 53.8%, the prevalence of anemia is 52.3%, the prevalence of Haemoglobin 7-10 mg/dl is 68.3%, and the prevalence of oliguria is 16.3%. One of the actual nursing diagnosis in patients with CKD is hypervolemia related to the disturbance of regulatory mechanisms (a decrease in GFR). A progressive decrease in GFR can lead to sodium and fluid retention which causes fluid balance disturbances.

#4969 AN ADEQUATE HYDRATION MANAGEMENT IMPROVES THE EFFICIENCY OF INTRADIALYTIC PHOSPHATE REMOVAL

Abstract Background and Aims The excess of phosphate (P) is one of the major risk factors for death in patients undergoing hemodialysis (HD). Improving P removal efficiency should ameliorate their prognosis. We previously reported, increased urea nitrogen (UN) removal efficiency results in increased the removal efficiency of P from extracellular fluid (ECF), but did not improve that from intracellular fluid (ICF) (NDT, Vol 35, Sup3, P1401, 2020). We also reported that P removal from ICF accounted for in average about 44% of total intradialytic P removal. For improving total P removal efficiency, removal efficiency of P from ICF should be increased. As P is one of the major osmotic agents in ICF, water outflow from ICF will accompany P outflow. We explored correlation between intracellular P removal and intracellular water (ICW) reduction. And we also sought for the strategy which efficiently derive water from ICF in HD patients in order to increase intracellular P removal. Method Eighty-six patients undergoing 4-hour HD were enrolled this study. ICW, extracellular water (ECW) volume and body fat mass (BFM) in each patient were measured with biochemical impedance analysis method before and after HD session. Total body water (TBW) was calculated by ICW + ECW. The amount of intradialytic P removal from ICF and from ECF in each patient was calculated as previously reported (NDT, Vol 35, Sup3, P1401, 2020). The correlation between the amount of intradialytic P removal from ICF and the amount of ICW reduction was investigated. All patients were divided into three groups according to the amount of ICW reduction as high reduction (HR) group, middle reduction (MR) group and low reduction (LR) group. The amount of P removal from ICF was compared between these groups. ICW volume change (ΔICW%) was calculated as (preICW – postICW)/preICW in each patient. Where preICW = ICW volume at the starting of HD, postICW = ICW volume at the end of HD. Circulating plasma volume change (ΔCPV%) was calculated as (postTP – preTP)/postTP in each patient. Where postTP = serum total protein concentration (TP) at the end of HD, preTP = TP at the end of HD. Lean body mass (LBM) was calculated as BW – BFM. Body weight (BW) change (ΔBW%), LBM change (ΔLBM%) and TBW volume change (ΔTBW%) were calculated in the same way as ΔICW%. To seek factors that effectively reduce ICW, the correlation with ΔICW% in ECW/TBW ratio, ΔCPV%, ΔCPV%/ΔBW% ratio, ΔCPV%/ΔLBM% ratio and ΔCPV%/ΔTBW% ratio was examined. Results The amount of intradialytic P removal from ICF positively correlated to the amount of ICW volume reduction (R = 0.279, y = 66.3x+285, p = 0.0076). It indicates an average of 66.3mg of P was removed from ICF per 1L of ICW reduction. In HR group, the amount of P removal from ICF was significantly larger than that in LR group (315.6±117.8mg vs 383.7±121.7mg, p = 0.019). ΔICW% negatively correlated to ECW/TBW ratio (R = 0.481, p = 0.000057). High ECW/TBW ratio indicates excess of ECW, which suggests having edema. ΔICW% positively correlated to ΔCPV% (R = 0.511, p = 0.0000051). Low ΔCPV% suggests insufficient of ultrafiltration. ΔICW% negatively correlated to ΔCPV%/ΔTBW% ratio (R = 0.421, p = 0.00011). High ΔCPV%/ΔTBW% ratio indicates insufficient plasma refilling for ultrafiltration rate, which suggests overrate of ultrafiltration. But ΔICW% did not correlate to ΔCPV%/ΔBW% ratio (R = 0.184, p = 0.10) nor ΔCPV%/ΔLBM% ratio (R = 0.176, p = 0.12). Conclusion The amount of intradialytic P removal from ICF correlated to the amount of ICW reduction. For efficient reduction of ICW, low ECW/TBW ratio, high ΔCPV% and low ΔCPV%/ΔTBW% ratio were required. It was suggested that efficient P removal was achieved when non-edematous patients get ultrafiltration of appropriate rate and dose.