The Influence of Nonselective Beta-Adrenergic Blockade (carteolol) and ACE Inhibitor (captopril) in Plasma Potassium on Maintenance hemodialysis / 대한내과학회지

OBJECTIVES: The degree of hyperkalemia and effects of potassium removal by hemodialysis on the plasma potassium concentration to see the influence of nonselective beta-adrenergic blockade(carteolol) and ACE inhibitor(captopril) on patients in maintenance hemodialysis were evaluated. METHODS: This study was done on 16 patients with end-stage renal disease undergoing maintenance hemodialysis. These patients were classified two groups; group 1-patients with carteolol or captopril(9 patients) and group 2-patients without medication(7 patients). Measurement of plasma potassium and arterial blood gas analyses were performed at pre-dialysis and during hemodialysis(4 hours). To analysis the distribution of potassium kinetics during hemodialysis, dialysis potassium clearance rate was introduced in this study. RESULTS: 1) Among 16 patients studied, the mean age was 43 years old and the ratio of male to female was 2: 1 and the mean duration of hemodialysis was 17.9 months. The underlying cause of end-stage renal disease was chronic glomerulonephritis in the most patients. 2) The mean predialysis plasma potassium concentration of all patients, group 1 on medication, and group 2 without medication was 5.13 +/- 1.04mEq/L, 5.67 +/- 1.01mEq/L and 4.410.55mEq/L, with high significance(p<0.001) between groups 1 and 2. 3) The mean postdialysis plasma potassium concentration of group 1 on medication and group 2 without medication was 348 +/- 0.40mEq/L and 3.39 +/- 0.56mEq/L with insignificance between groups 1 and 2. 4) The pre- and post-dialysis concentration of plasma sodium, pH and bicarbonate between group 1 and group 2 was similar except glucose. 5) Despite the fall in absolute plasma concentration in group 1 more than twice than in group 2, the difference in dialysis potassium clearance rate measured at 1 hour of hemodialysis in group 1 compared to that of group 2 was only 12M. CONCLUSION: These data are consistent with at least a two-compartment distribution of plasma potassium rather than single pool in addition to frequent hyperkalemia on maintenance hemodialysis on nonselective beta-adrenergic blocker or ACE inhibitor contributed to partial impairment of extrarenal transcellular shifts of potassium during inter- and intra-dialytic phase.

Evaluation of Angiogenin Concentrations using ELISA in Sera from the Patients with Chronic Liver Diseases / 대한간학회지

BACKGROUND: Liver fibrosis by the progression of the chronic processes of the liver diseases induces deforrned microcirculations of the hepatic lobules. And this eventually resolted in portal hypertension. On the other hands, angiogenic stimu4nt factors are physiologically activated in order to repair the tissue damage. Overexpression of angiogenic factors, however, can stimulate neovascularization as in a fonnation of the tumor that liberates uncontrolled overgrowing of the tumor cells. METHODS: To elucidate the dynamic changes of the serum concentration of angiogenin in chronic liver diseases, this study is intended to employ an ELISA in 44 pathologically proven patients. Quantikiae human angiogenin kit (R and D,systems Inc. Mmneapolis, MN) was used for this investigation. RESULTS: Mean value and standard error of angiogenin concentration (ng/ml) of the sera was 238.92+/-50.95 in 5 cases of chronic persistent hepatitis, 184.47+/-12.75 in 6 cases of chronic active hepatitis, 131.36+/-10.99 in 19 cases of liver cirrhosis, and 211.03+/-19.08 in 14 cases of hepatocellular carcinoma, respectively. Serum angiogenin level in the liver cirrhosis was significantly lower than in chronic persistent hepatitis(p=0.00336), and than in chronic active hepatitis(p=0.018673). Angiogenin concentration in hepatocellular carcinomas was significantly higher than the level of the liver cirrhosis investigated(p=0.00569). CONCLUSIONS: These data support that persistent inflammatory insults in the chronic hepatitis were compensated by the elevation of angiogenin but complete fibrosis as in liver cirrhosis showed the depressed level. And emerging of the hepatocellular carcinoma is accompanied by the elevated stimuli of angiogenin for the neovascularization.

Clinical Significance of the Correlation of Serum Procollagen I and III Propeptide Concentrations in Chronic Liver Diseases / 대한간학회지

BACKGROUND/AIMS: Most liver diseases lead to a pathobiochemical reaction termed liver fibrosis. Hepatic fibrosis is not a uniform phenomenon and it comprises increased deposition of the liver connective tissue components(collagen, noncollagenous glycoprotein, proteoglycan) in the intercellular space, leading to disturbances of intrahepatic blood flow and hindrance of exchange processes between blood and cells, Fibrosis can be determined by morphological examination o f the liver, but this approach cannot be used to assess accurately the activity of collagen synthesis at any given point in time, Thus, the development of biochemical markers of hepatic fihrosis might allow a promising diagnostic approach for the identification and quantitation of this process, Aminoterminal procollagen III pn) peptide(PIIINP) and carboxytermina1 procollagen I propeptide(PICP) are known as the most widely used parameter for evaluating liver fibrosis, but it is diAicult to find previous report discribing the correlation ot each other. To elucidate the clinical significance of the corretation of PICP(x) and PIIINP(y) concentrations in patients with chronic liver diseases, radioimmunoassay was employed in this investigation. METHODS: Sera tested were obtained from pathologically proven 43 patients;4 cases of fatly liver, 11 cases of chronic persistent hepatitis, 13 cases of chronic active hepatitis, l5 cases of liver cirrhosis. All the patients except 4 cases ot fatty liver were shown positivity of HBsAg. PICP and PIIlNP radioimmunoassay kits(Farrnos Diagnostica, Oulunsalo, Finland) wcre purchased for this study. RESULTS: In the patients among the three groups of chronic active hepatitis, liver cirrhosis, chmnic persistent hepatitis, the correlations were significant in orders(y= - 10.27 +0.l3938x, r=0.92286, p=0.000007;y=-1.185+0.06611x, r=0.73656, p=0.001737;y=1.1174+0.03273x, r=0.56879, p=0.067849). Four cases of fatty liver reveal no signiticant correlation (y=4,8671- 0,0079x, r= 0.1959, p=0.804054). CONCLUSION: 0n the basis of these data, we s st that the correlation of each showed a significant increase with heightening degree of inflammation, activity of diseases and fibrosis.