Avaliação das dimensões da sede: revisão integrativa / Assessment of the thirst dimension: integrative review

A sede é um sintoma multifatorial e subjetivo cuja mensuração requer múltiplos instrumentos. O objetivo deste estudo foi identificar as dimensões de avaliação da sede e os instrumentos de mensuração utilizados. Incluíram-se artigos publicados entre 2005 a 2015 das bases de dados Lilacs, PubMed e SciELO. A amostra final foi de 18 artigos que evidenciaram as dimensões da sede: intensidade, frequência e desconforto. Também se avaliou a xerostomia e sua intensidade. Essas dimensões foram identificadas por Escalas Visuais Analógicas, Escalas Verbais Numéricas, Escalas de Faces e Escalas Likert, empregadas no Inventário de Sede, Inventário de Xerostomia e Escala de Desconforto da Sede. Avaliou-se a sede principalmente em pacientes dialíticos e internados em unidade de terapia intensiva. Embora a sede seja um sintoma, sua avaliação concentra-se sobretudo na intensidade e é realizada em populações específicas.

Thirst is a multifactorial and subjective symptom that request multiple measuring instruments. The objective of this study was to identify the assessment dimensions of thirst and the measurement tools used. We included studies published between 2005 and 2015 from the databases Lilacs, PubMed and SciELO. Eighteen articles composed the final sample that showed thirst dimensions: intensity, frequency, and discomfort. We also assessed the xerostomia and its intensity. These dimensions were identified by Visual Analogic Scales, Verbal Numeric Scales, Face's Scales and Likert-type Scales, used in the Thirst Inventory, Xerostomia Inventory, and Thirst Discomfort Scale. We assessed thirst especially in dialytic patients and the ones admitted to the intensive care unit. Although thirst is a symptom, in general, its assessment concentrates in its intensity, and it is conducted in specific populations

Nonobstructive Bilateral Hydronephrosis & Hydroureter from Nephrogenic Diabetes Insipidus with a Novel Mutation of AQP2 Gene (p.A123G)

Nephrogenic diabetes insipidus (NDI) can cause nonobstructive hydronephrosis. Congenital NDI (CNDI) is caused by a genetic mutation. This case report presents a 12-year-old girl who was incidentally diagnosed with nonobstructive hydronephrosis due to NDI caused by AQP2 gene mutation after being evaluated for microscopic hematuria found on routine health examination at school. The patient's medical and family history was unremarkable, and she complained of nocturia only at the time of the clinic visit. Bilateral hydronephrosis on abdominal ultrasonography prompted a water deprivation test, leading to diagnosis of NDI. Genetic study confirmed p.Asn (AAC)123Ser (AGC) in exon 2 of the AQP2 gene. Polyuria and hydronephrosis improved following arginine-vasopressin therapy. CNDI responsive to treatment should be considered as a possible cause of nonobstructive hydroureter.

Histology and renal lipoperoxidation in rats exercised on a treadmill and submitted to water restriction / Histología y lipoperoxidación renal en ratas ejercitadas sobre una caminadora y sometidas a restricción de agua

Physical effort stimulates an increase in oxygen consumption in tissues, generating toxic chemical species derived from oxygen (ROS), which are considered the initiators of the lipid peroxidation process (LPO), the major mechanism of cellular injury. As the essential mechanism for maintaining the electrolyte balance depends on an effective kidney function, oxidative stress in this organ can be a key factor in the development and persistence of hypertension. This study aimed to determine the kidney changes induced by a combination of fluid restriction and exercise in rats. The study consisted of 24 male Wistar rats of 90 days of age, divided into four groups, two of which were submitted to water restriction and exercise on a treadmill.Twenty-four hours after the last training session, the animals were euthanized and the left kidney was removed.The upper part of the kidney was used for the histological procedures and the lower part for the quantification of membrane lipoperoxides.Analysis of variance was applied after testing the normality of data, and the comparison between groups was performed using the Bonferroni test, adopting a significance of p<0.05. The restriction had an influence on body weight; kidney weight; proximal tubule maximum diameter; and area, perimeter and diameter of glomeruli, whereas the exercise affected the weight and the minimum diameter of the proximal tubule. According to the TBARS (thiobarbituric acid reactive substances) method, there was a difference between the G1 (control) and G3 (sedentary with water restriction) and between the G2 (exercised with water) and G4 (exercised with water restriction) compared to G1. The treadmill exercise combined with the water restriction promoted structural changes in the glomeruli and promoted oxidative stress, although neither variable corroborated for the potentiating of lipid peroxidation.

El esfuerzo físico estimula un aumento en el consumo de oxígeno en los tejidos, generando variedades químicas tóxicas derivadas de oxígeno (ROS), que son considerados iniciadores del proceso de peroxidación lipídica (LPO), principal mecanismo de lesión celular. Como el mecanismo esencial para mantener el equilibrio de los electrolitos depende de una función renal eficaz, el estrés oxidativo en este órgano puede ser un factor clave en el desarrollo y persistencia de la hipertensión. Este estudio tuvo como objetivo determinar los cambios renales en ratas, inducidos por una combinación de restricción de líquidos y ejercicio. Esta investigación se realizó en 24 ratas Wistar machos de 90 días de edad, divididos en cuatro grupos, dos de los cuales fueron sometidos a restricción de agua, mientras que los dos grupos restantes fueron ejercitados en una caminadora. Veinticuatro horas después de la última sesión de entrenamiento, los animales fueron sacrificados y se realizó la extracción del riñón izquierdo. La parte superior del riñón se usó para los procedimientos histológicos y la parte inferior para la cuantificación de peróxidos lipídicos en la membrana. El análisis de varianza se aplicó después de probar la normalidad de los datos, y la comparación entre grupos se realizó mediante la prueba de Bonferroni, adoptando una significación de p<0,05. La restricción hídrica tuvo influencia sobre: el peso corporal, peso de los riñones, diámetro máximo del túbulo proximal, y área, perímetro y diámetro de los glomérulos. Mientras que el ejercicio afectó el peso y el diámetro mínimo del túbulo proximal de las ratas. Según el método SRAT (sustancias reactivas al ácido tiobarbitúrico), existió una diferencia entre el G1 (control) y G3 (sedentarismo con restricción de agua) y entre el G2 (ejercicio con agua) y G4 (ejercicio con restricción de agua) en comparación con G1. El ejercicio rodante combinado con la restricción de agua promovió cambios estructurales en los glomérulos y estimuló el desarrollo de estrés oxidativo, aunque ninguna variable fue corroborada para establecer la potenciación de la peroxidación lipídica.

Pulmonary Langerhans Cell Histiocytosis in an Adult Male Presenting with Central Diabetes Insipidus and Diabetes Mellitus: A Case Report / 결핵및호흡기질환

Pulmonary Langerhans cell histiocytosis is an uncommon diffuse cystic lung disease in adults. In rare cases, it can involve extrapulmonary organs and lead to endocrine abnormalities such as central diabetes insipidus. A 42-year-old man presented with polyphagia and polydipsia, as well as a dry cough and dyspnea on exertion. Magnetic resonance imaging of the hypothalamic-pituitary system failed to show the posterior pituitary, which is a typical finding in patients with central diabetes insipidus. This condition was confirmed by a water deprivation test, and the patient was also found to have type 2 diabetes mellitus. Computed tomographic scanning of the lungs revealed multiple, irregularly shaped cystic lesions and small nodules bilaterally, with sparing of the costophrenic angles. Lung biopsy through video-assisted thoracoscopic surgery revealed pulmonary Langerhans cell histiocytosis. On a follow-up visit, only 1 year after the patient had quit smoking, clinical and radiological improvement was significant. Here, we report an uncommon case of pulmonary Langerhans cell histiocytosis that simultaneously presented with diabetes insipidus and diabetes mellitus.

A Case of Septo-Optic Dysplasia Resulting in Central Diabetes Insipidus and Nonobstructive Bilateral Hydronephrosis / 대한내과학회지

A 27-year-old male with nonobstructive hydronephrosis was referred from the urology department for polyuria evaluation and management. The patient was hospitalized for urinary tract infection and cystostomy was performed due to neurogenic bladder of unknown origin. The patient was of short stature and had visual impairment. From the interview, we discovered he had been suffering from polyuria and polydipsia for more than 20 years. Urine output was 13 L/day and urine osmolarity was 85 mOsm/kg. The results of a water deprivation test were consistent with central diabetes insipidus. Septo-optic dysplasia (SOD) was observed on brain magnetic resonance imaging (MRI). SOD is a very rare condition characterized by agenesis of the septum pellucidum or corpus callosum, which may cause optic nerve aplasia or hypoplasia, midbrain abnormalities and/or hypopituitarism. After desmopressin treatment, polyuria and hydronephrosis were improved. We report a case of a 27-year-old male diagnosed with SOD including diabetes insipidus, resulting in nonobstructive hydronephrosis.

Adult Multisystem Langerhans Cell Histiocytosis Presenting with Central Diabetes Insipidus Successfully Treated with Chemotherapy

We report the rare case of an adult who was diagnosed with recurrent multisystem Langerhans cell histiocytosis (LCH) involving the pituitary stalk and lung who present with central diabetes insipidus and was successfully treated with systemic steroids and chemotherapy. A 49-year-old man visited our hospital due to symptoms of polydipsia and polyuria that started 1 month prior. Two years prior to presentation, he underwent excision of right 6th and 7th rib lesions for the osteolytic lesion and chest pain, which were later confirmed to be LCH on pathology. After admission, the water deprivation test was done and the result indicated that he had central diabetes insipidus. Sella magnetic resonance imaging showed a mass on the pituitary stalk with loss of normal bright spot at the posterior lobe of the pituitary. Multiple patchy infiltrations were detected in both lung fields by computed tomography (CT). He was diagnosed with recurrent LCH and was subsequently treated with inhaled desmopressin, systemic steroids, vinblastine, and mercaptopurine. The pituitary mass disappeared after two months and both lungs were clear on chest CT after 11 months. Although clinical remission in multisystem LCH in adults is reportedly rare, our case of adult-onset multisystem LCH was treated successfully with systemic chemotherapy using prednisolone, vinblastine, and 6-mercaptopurine, which was well tolerated.

Maternal water deprivation affects the spermatogenesis of the offspring rats / La privación del agua en la etapa materna de ratas afecta la espermatogénesis de sus crías

Prenatal stresses such as water deprivation affect developmental process of embryo. This study evaluated the effects of water deprivation in pregnant mother on histological parameters of testis of offspring. Pregnant rats were divided into two groups (control and experimental). In experimental animals, water was removed from the ewes for 48h at the end of third trimester of gestation (19-21th days). Histopathology and histomorphic analysis and also TUNEL assay on offspring's testes were performed at pubertal age (60 days). The sperm motility either compared between two groups. The results showed that prenatal water deprivation induced histopathological alteration such as epithelium vacuolization, sloughing and detachments (P<0.01). Morphometrical data showed that prenatal water deprivation decreased tubular diameter and reduce epithelium height (P<0.01). Johnsen's score showed poor spermatogenesis in experimental group (P=0.001). The percent of germ cell apoptosis was increased in offspring's testes of rats born to mothers exposed to stress during pregnancy (P=0.000). The increased number of Multinucleated cells in the seminiferous lumen (P=0.000) in parallel with decreased number of sertoli cells (P=0.03) showed adverse effect of prenatal water deprivation on blood testis barrier. Present study revealed that prenatal water deprivation had injurious effect on developmental process of testes that affects on both germ cells and sertoli cells and had noxious effect on sperm parameters. These data confirm that prenatal stress disrupts normal spermatogenesis of offspring.

El estrés prenatal, como la privación del agua, afecta el proceso de desarrollo embrionario. Este estudio evaluó los efectos de la falta de agua en la rata preñada sobre los parámetros histológicos del testículo de las crías. Las ratas preñadas fueron divididas en dos grupos (control y experimental). En los animales de experimentación, se eliminó el agua durante 48 h al final del término de la gestación (19-21 días). Junto al análisis histopatológico e histomorfométrico se realizó el ensayo TUNEL en los testículos de las crías en la edad puberal (60 días). La motilidad de los espermatozoides se comparó entre los dos grupos. Los resultados mostraron que la privación de agua prenatal induce alteraciones histopatológicas tales como vacuolización del epitelio, descamación y desunión (P<0,01). Los datos morfométricos mostraron que con la privación de agua prenatal hubo disminución del diámetro tubular y se redujo la altura del epitelio (P<0,01). El score de Johnsen mostró una espermatogénesis deficiente en el grupo experimental (p = 0,001). El porcentaje de apoptosis de las células germinales se incrementó en los testículos de las crías de las ratas nacidas de madres expuestas a estrés durante el embarazo (p = 0,000). Un aumento del número de células multinucleadas en el lumen seminífero (P = 0,000) junto a la disminución del número de células de Sustento (P = 0,03) demostró el efecto adverso de la privación de agua prenatal en la barrera hemato-testicular. El presente estudio reveló que la falta de agua prenatal tuvo un efecto perjudicial en el proceso de desarrollo de los testículos, lo que afecta a las células germinales y los sustentocitos, y tuvo un efecto nocivo sobre los parámetros seminales. Estos datos confirman que el estrés prenatal altera la espermatogénesis normal de la descendencia.

Polyuria with the Concurrent manifestation of Central Diabetes Insipidus (CDI) & Type 2 Diabetes Mellitus (DM)

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 microg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.

A Case of Syndrome of Inappropriate Scretion of Anti-Diuretic Hormone Associated with Sodium Valproate

We report a rare case of the concurrent manifestation of central diabetes insipidus (CDI) and type 2 diabetes mellitus (DM). A 56 year-old man was diagnosed as a type 2 DM on the basis of hyperglycemia with polyuria and polydipsia at a local clinic two months ago and started an oral hypoglycemic medication, but resulted in no symptomatic improvement at all. Upon admission to the university hospital, the patient's initial fasting blood sugar level was 140 mg/dL, and he showed polydipsic and polyuric conditions more than 8 L urine/day. Despite the hyperglycemia controlled with metformin and diet, his symptoms persisted. Further investigations including water deprivation test confirmed the coexisting CDI of unknown origin, and the patient's symptoms including an intense thirst were markedly improved by desmopressin nasal spray (10 microg/day). The possibility of a common origin of CDI and type 2 DM is raised in a review of the few relevant adult cases in the literature.

Prenatal Water Deprivation Induces Apoptosis in Sexual Dimorphic Nucleus of the Brain of Male New Born Sprague-Dawley Rats / Deprivación Prenatal de Agua Induce Apoptosis en Núcleos Dimórficos Sexuales del Ccrebro de Ratas Sprague-Dawley Macho Recién Nacidas

Considering the size of some nuclei and area, sex hormones control the sexual development of the brain. The sexual development of the brain can also be influenced by environmental stress. This study aimed to clear the effect of prenatal water deprivation on the development of sexual dimorphic nucleus (SDN) of the brain. In this research, pregnant rats were divided into two groups (control and treated). For the treated animals, water was removed from the ewes for 48 h at the end of third trimester of gestation (19-21 days). TUNEL staining was used for detection of apoptosis in paraffin embedded diencephalon selected sections. The ratio of apoptotic cells to non- apoptotic ones was calculated as apoptotic index. Differences of apoptotic index and serum testosterone were examined for statistical significance using Paired T- test (p<0.05). The apoptotic index was 0.0160±.01174 percent for control and 0.1870±.02541 percent for treated groups. The concentration of serum testosterone was 22.4±1.3 for control and 13.37±3.3 for treated groups. Prenatal water deprivation induces apoptosis in developing SDN nucleus of male rats that is derived by reducing the concentration of serum testosterone. The study shows the importance of low concentration acting testosterone for development of SDN nucleus that can be affected by environmental stress.

Considerando el tamaño de algunos núcleos y áreas, las hormonas sexuales controlan el desarrollo sexual del cerebro. El desarrollo sexual del cerebro también puede verse influido por el estrés ambiental. Este estudio tuvo como objetivo establecer el efecto de la privación prenatal de agua en el desarrollo del núcleo dimórfico sexual (NDS) del cerebro. Las ratas preñadas fueron divididas en dos grupos (control y tratados). Para los animales tratados, el agua se retiró de los bebederos durante 48h al final del tercer trimestre de gestación (días 19-21). La técnica TUNEL se utilizó para detectar apoptosis en secciones del diencéfalo incluidas en parafina. La proporción de células apoptóticas y no-apoptóticas fue calculada como índice de apoptosis. Las diferencias del índice de apoptosis y testosterona sérica fueron examinadas para observar significación estadística mediante t de Student pareado (p <0,05). El índice de apoptosis fue 0,0160±0,01174 por ciento para el control y 0,1870±0,02541 por ciento para los grupos tratados. La concentración de testosterona en suero fue de 22,4±1,3 para el grupo control y 13,37±3,3 para los grupos tratados. La privación de agua prenatal indujo la apoptosis en el desarrollo del NDS de las ratas macho derivadas por la reducción de concentración de testosterona sérica. El estudio muestra la importancia de una baja concentración de testosterona para el desarrollo de los NDS, que pueden verse afectados por el estrés ambiental.

A Case of Turner Syndrome Associated with Idiopathic Central Diabetes Insipidus / 대한소아내분비학회지

We report a case of Turner syndrome associated with idiopathic central diabetes insipidus in a 12-year-old girl, who presented with polyuria and polydipsia after a year. The patient was very short and and centrally obese, and was initially diagnosed with Turner syndrome, hyperlipidema, and diabetes mellitus. A water deprivation test revealed central diabetes insipidus, and sellar magnetic resonance imaging (MRI) showed a thickening of the pituitary stalk, with normal high signal intensity in the posterior pituitary gland. Replacement therapy with desmopressin was initiated, and follow-up sellar MRI findings after two years showed spontaneous regression of the thickened pituitary stalk. There are only few reports of concomitant Turner syndrome with central diabetes insipidus worldwide. Further observation is needed in order to disclose the cause of central diabetes insipidus in patients having Turner syndrome.

A Case of Turner Syndrome Associated with Idiopathic Central Diabetes Insipidus / 대한소아내분비학회지

We report a case of Turner syndrome associated with idiopathic central diabetes insipidus in a 12-year-old girl, who presented with polyuria and polydipsia after a year. The patient was very short and and centrally obese, and was initially diagnosed with Turner syndrome, hyperlipidema, and diabetes mellitus. A water deprivation test revealed central diabetes insipidus, and sellar magnetic resonance imaging (MRI) showed a thickening of the pituitary stalk, with normal high signal intensity in the posterior pituitary gland. Replacement therapy with desmopressin was initiated, and follow-up sellar MRI findings after two years showed spontaneous regression of the thickened pituitary stalk. There are only few reports of concomitant Turner syndrome with central diabetes insipidus worldwide. Further observation is needed in order to disclose the cause of central diabetes insipidus in patients having Turner syndrome.

Central diabetic insipidus associated with suspected pituitary gland tumor in a dog / 대한수의학회지

A 12-year-old spayed female Yorkshire terrier dog was presented with two-weeks history of lethargy, mental dullness and polydipsia. Neurologic examination revealed proprioceptive defect of all limbs and loss of swallowing gag reflex. The dog revealed persistent dehydration, hypernatremia, hyperosmolarity and hyposthenuria. On magnetic resornance imaging (MRI), the mass were heterogeneous signality on T1 weighted images, hyperintense signality on T2 weighted image with contrast enhancement on hypothalamohypophyseal lesion. Based on these findings, the dog was suspected as having pituitary gland tumor. Through water deprivation test and response to desmopressin acetate (1-deamino-8-D-arginine, DDAVP), this case was diagnosed by central diabetes insipidus (CDI). This paper reports the clinical sign, MRI, response to the exogenous antidiuretic hormone of CDI due to suspected pituitary tumor in a dog and DDAVP administration was evaluated effective therapy to correct hypernatremia induced by CDI.

Diabetes insípida en pediatría: serie clínica y revisión de la literatura / Diabetes insipidus in pediatrics

Introduction: Diabetes insipidus (DI) is a syndrome characterized by polyuria and polydipsia secondary to a decreased secretion or action of the antidiuretic hormone (ADH). An early diagnosis is essential. Diagnosis is made by measuring plasma and urinary osmolarity and their changes under water deprivation and after DDAVP administration. Objective: Lo describe the clinical, radiological characteristics as well as the initial treatment of eight children with DI, 3 of them nephrogenic DI (DIN) and 5 with central DI. Methods: A Retrospective, descriptive study in DI patients under control at the Catholic University of Chile and Sotero del Rio Hospital between 1998-2008 is presented. Clinical files were evaluated collecting clinical, epidemiologic, biochemical and image data. Serum (Sosm) and urinary osmolarity (Uosm) were registered. DI was diagnosed with a Sosm > 300 and Usm < 600 mOsm/L. Central DI was defined as the inability to reach a Uosm > 600 or a 50 percent-increase after DDAVP treatment. Otherwise DI was classified as DIN. Results: Eight patients (5 males) were studied. Chief complaints were polydipsia/polyuria (5/8), hyperthermia (2/8), and failure to grow (1/8). MRI showed endocraneal lesion in all patients with Central DI. All of these utilized oral or inhalatory DDAVP treatment. Patients with Nephrogenic DI were trated with Hydrochlrothiazide. Conclusion: Polydipsia, polyuria, hyperthermia with hypernatremia are suggestive of DI in the first year of life. Water deprivation test is diagnostic in differentiating Central and Nephrogenic DI. MRI is an essential diagnostic tool in CDI. Manegement should be multidisciplinary, including a pediatician, nephrologist, endocrinologist and nutricionist.

Introducción: La diabetes insípida (DI) se caracteriza por poliuria y polidipsia, secundario a una disminución de la secreción o acción de la hormona antidiurética. Su diagnóstico precoz es fundamental. Objetivo: Describir las características clínicas, radiológicas y tratamiento inicial de una serie de ocho pacientes con DI. Diseño: Estudio descriptivo-restrospectivo. Universo: Pacientes con DI evaluados en la Universidad Católica de Chile y Hospital Dr. Sótero del Río entre 1998-2008. Pacientes y Métodos: Desde la ficha clínica se analizaron variables clínicas, epidemiológicas, bioquímicas e imágenes. Se determinó Osmolaridad sérica (OsmS) y urinaria (OsmU). Se consideró DI sí la OsmS > 300 mOsm con OsmU < 600 mOsm, Di-central (DIC) sí posterior a DDAVP la OsmU aumento > 50 por ciento ó > 600 mOsm, de los contrario se clasificó como nefrogénica (DIN). Resultados: Se reclutaron ocho pacientes con DI (5 varones), fueron DIN 3/8. El motivo de consulta fue: polidipsia-poliuria (5/8), hipertermia (2/8) y talla baja (1/8). La RNM mostró lesión intracraneana en todos los pacientes con DIC: nodulo hipofisiario, aracnoidocele selar, Histiocitosis X, germinoma y un paciente sin se±al de neurohipófisis. Los sujetos con DIC usaron DDAVP inhalatoria (4) y oral (1). Los sujetos con DIN usaron hidroclorotiazida. Conclusión: Polidipsia, poliuria, hipertermia con hipernatremia y falla de medro en lactantes son sugerentes de DI. La prueba de deprivación hídrica es fundamental en la diferenciación de DIC y DIN. La RNM cerebral es una herramienta diagnóstica imprescindible en la DIC. El tratamiento de estos pacientes debe ser multidiciplinario interactuando pediatra, nefrólogo, endocrinólogo y nutricionista.

Antidipsogenic effects of central adenosine-5'-triphosphate

Besides other physiological functions, adenosine-5'-triphosphate (ATP) is also a neurotransmitter that acts on purinergic receptors. In spite of the presence of purinergic receptors in forebrain areas involved with fluid-electrolyte balance, the effect of ATP on water intake has not been investigated. Therefore, we studied the effects of intracerebroventricular (icv) injections of ATP (100, 200 and 300 nmol/µL) alone or combined with DPCPX or PPADS (P1 and P2 purinergic antagonists, respectively, 25 nmol/µL) on water intake induced by water deprivation. In addition, the effect of icv ATP was also tested on water intake induced by intragastric load of 12 percent NaCl (2 mL/rat), acute treatment with the diuretic/natriuretic furosemide (20 mg/kg), icv angiotensin II (50 ng/µL) or icv carbachol (a cholinergic agonist, 4 nmol/µL), on sodium depletion-induced 1.8 percent NaCl intake, and on food intake induced by food deprivation. Male Holtzman rats (280-320 g, N = 7-11) had cannulas implanted into the lateral ventricle. Icv ATP (300 nmol/µL) reduced water intake induced by water deprivation (13.1 ± 1.9 vs saline: 19.0 ± 1.4 mL/2 h; P < 0.05), an effect blocked by pre-treatment with PPADS, but not DPCPX. Icv ATP also reduced water intake induced by NaCl intragastric load (5.6 ± 0.9 vs saline: 10.3 ± 1.4 mL/2 h; P < 0.05), acute furosemide treatment (0.5 ± 0.2 vs saline: 2.3 ± 0.6 mL/15 min; P < 0.05), and icv angiotensin II (2.2 ± 0.8 vs saline: 10.4 ± 2.0 mL/2 h; P < 0.05), without changing icv carbachol-induced water intake, sodium depletion-induced 1.8 percent NaCl intake and food deprivation-induced food intake. These data suggest that central ATP, acting on purinergic P2 receptors, reduces water intake induced by intracellular and extracellular dehydration.

Expression of Aquaporin-2 in the Inner Ear of Water-Deprived Guinea Pigs / 대한이비인후과학회지

BACKGROUND AND OBJECTIVES: Although the role of aquaporin-2 (AQP2) in the kidney has been well defined, its role in the inner ear remains to be determined. The present study was to investigate the effect of water deprivation on the expression of AQP2 in the inner ear. MATERIALS AND METHOD: Healthy male guinea pigs weighing 250 g were used. The experimental group underwent water restriction and the control underwent water loading with sucrose-containing water for 3 days. Concentrations of plasma arginine-vasopressin (AVP) were determined and electrocochleography (ECoG) recordings were made. An RT-PCR, real-time PCR and Westernblotting analysis were used for quantitative analysis of AQP2 mRNA and AQP2 protein expression. Immunohistochemistry was also used to evaluate the distribution of AQP2 water channel proteins in the inner ear. RESULTS: AQP2 was mainly expressed in the epithelium of endolymphatic sac, spiral limbus, spiral ligament and stria vascularis of scala media. The concentrations of plasma AVP were 9.2+/- 0.8 pg/mL in the experimental group and 0.78+/-0.3 pg/mL in the control. The summation potential/ action potential (SP/AP) ratio in ECoG was markedly increased in the experimental group (0.55 in the experimental and 0.29 in the control). RT-PCR and real time PCR as well as Western blot analysis showed that the level of AQP2 mRNA and protein in the cochlea and endolymphactic sac of the water-deprived group was significantly higher than those in the control group. CONCLUSION: These data suggest that AQP2 is one of the important water channels in fluid homeostasis in the inner ear. Moreover, the volume of endolymphatic space can be increased via AVP-AQP2 system in response to water deprivation.

[Comparative study of biochemical mechanisms of resistance to water stress in two varies of durum wheat]

In Morocco, cereal crops, important crops, concentrate mainly in arid and semi arid areas where climatic conditions limit severely the production potential. Due to the unpredictable nature of the water stress, tolerance is the most effective strategy in the situation of severe and prolonged stress. During this tolerance we assist in modification of structures or functions that increase the probability of survival and production plants in these conditions. The purpose of this study is to evaluate the effect of water stress on molecular parameters such as the synthesis of proline, total and reducing sugars and proteins total, and to examine the differences in these parameters between two varieties of durum wheat Karim et Tomouh. The examination results showed that at the restriction of water supply, the behaviour of plants manifests itself differently in stressful day to another and from one variety to another. In general, water conditions have resulted in two varieties studied a reduction of water potential, an accumulation of osmolytes whose proline and sugars total and reducing and an increase in protein synthesis. In conclusion, the study showed that the two varieties studied used the same strategies of tolerance vis-a-vis the water stress but the only difference is at the rate of synthesis of molecular markers studied

Water deprivation and the double- depletion hypothesis: common neural mechanisms underlie thirst and salt appetite

Water deprivation-induced thirst is explained by the double-depletion hypothesis, which predicts that dehydration of the two major body fluid compartments, the extracellular and intracellular compartments, activates signals that combine centrally to induce water intake. However, sodium appetite is also elicited by water deprivation. In this brief review, we stress the importance of the water-depletion and partial extracellular fluid-repletion protocol which permits the distinction between sodium appetite and thirst. Consistent enhancement or a de novo production of sodium intake induced by deactivation of inhibitory nuclei (e.g., lateral parabrachial nucleus) or hormones (oxytocin, atrial natriuretic peptide), in water-deprived, extracellular-dehydrated or, contrary to tradition, intracellular-dehydrated rats, suggests that sodium appetite and thirst share more mechanisms than previously thought. Water deprivation has physiological and health effects in humans that might be related to the salt craving shown by our species.

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus / 대한내분비학회지

Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.

A Case of Sheehan's Syndrome Presenting Central Diabetes Insipidus / 대한내분비학회지

Sheehan's syndrome occurs as a result of ischemic pituitary necrosis due to severe postpartum hemorrhage. The manifestations of this clinical syndrome are most often caused by a deficiency in the hormones produced by the anterior pituitary gland, whereas the neurohypophysis is usually preserved but can be involved in severe cases that manifest as diabetes insipidus. This is a report of Sheehan's syndrome that manifested with diabetes insipidus as presenting symptom 2 month's after delivery. The patient suffered massive bleeding, so received a blood transfusion. A combined pituitary stimulation and water deprivation test revealed deficiencies of not only anterior pituitary hormones, such as growth hormone and prolactin, but also of anti-diuretic hormone. We report this case, with a review of the literature.