Department of Anesthesiology School of Medicine University of Alabama at Birmingham Birmingham, AL 35294, USA
sotirios@uab.edu
Sotirios Zarogiannis is a Visiting Assistant Professor at the Department of Anesthesiology of the University of Alabama at Birmingham.
Sotirios Zarogiannis studied Medical Biochemistry in the School of Medicine of the University of Thessaly in Greece, where he also received his PhD in Physiology in 2006 for work on the permeability of serosal membranes after adrenergic stimulation.
Following a year at the University of California, San Francisco (UCSF) where he worked under the mentorship of Prof. Verkman mainly on the development of biophysical methods for the study of transmembrane channel rotational diffusion, he moved to University of Alabama at Birmingham (UAB).
Currently he is a European Respiratory Society Fellow in UAB working with Prof. Matalon, and he is interested in the study of Acute Lung Injury induced by Influenza A virus and noxious gases as well as in Nanotoxicology. His research interests extend further into Cell Volume Regulation and Membrane Biophysics.
Abstract: Most episodes of peritoneal dialysis (PD)-related peritonitis could be attributed to a single organism, but in almost 10% of peritonitis episodes multiple organisms are identified. Polymicrobial peritonitis is often related to intra-abdominal pathology, and the prognosis may be poor. Aeromonas spp. have rarely been identified as the causative pathogen in PD-related peritonitis, and a very small number of cases has been reported in the literature. These rod-shaped, gram-negative microorganisms have been isolated from wastewater drainage systems, food, vegetables, and soil. Herein we report a case of polymicrobial peritonitis in a continuous ambulatory peritoneal dialysis (CAPD) patient with systemic lupus erythematosus (SLE), due to a combination of Streptococcus viridans and Aeromonas hydrophila infection. The patient was involved in gardening and was not compliant with her technique protocol. She did not wear a mask and omitted thorough hand washing. The patient was treated with i.p. vancomycin and ceftazidime and peritonitis was resolved. The patient's technique was reassessed, and she was retrained by our PD nurses.
Abstract: The vascular surface distribution of the subarachnoid space has not been studied extensively. The aim of our study was to develop a method of computer-assisted estimation of the distribution of the vascular network in the cortical leptomeninges and subarachnoid space and model it to aid the study of the physiology of brain surface dialysis. Nine sheets of leptomeningeal tissue were obtained from adult sheep. Fourteen image sample areas of 4 cm each were acquired and processed with ImageJ. The vascular and nonvascular areas of the cortical subarachnoid space were identified using a "projected surface" approach. The modeling equations were used to predict the behavior of brain surface dialysis processes. The mean surface area of identified subarachnoid vessels was 0.354 ± 0.02 cm per 1 cm of tissue. The mean meningeal area with unidentified vessels was 0.646 ± 0.02 cm/1 cm, and the difference between these surfaces was significant (p < 0.0001). The modeling equations used predict that modifying the vessel diameter of the subarachnoid space could alter the efficiency of brain surface dialysis. The computer-assisted modeling of the vascular surface of the cortical subarachnoid space may be a useful tool in depicting its morphology and assessing the physiology during brain surface dialysis.
Abstract: Chlorine (Cl(2)) gas exposure poses an environmental and occupational hazard that frequently results in acute lung injury. There is no effective treatment. We assessed the efficacy of antioxidants, administered after exposure, in decreasing mortality and lung injury in C57BL/6 mice exposed to 600 ppm of Cl(2) for 45 minutes and returned to room air. Ascorbate and deferoxamine were administered intramuscularly every 12 hours and by nose-only inhalation every 24 hours for 3 days starting after 1 hour after exposure. Control mice were exposed to Cl(2) and treated with vehicle (saline or water). Mortality was reduced fourfold in the treatment group compared with the control group (22 versus 78%; P = 0.007). Surviving animals in the treatment group had significantly lower protein concentrations, cell counts, and epithelial cells in their bronchoalveolar lavage (BAL). Lung tissue ascorbate correlated inversely with BAL protein as well as with the number of neutrophils and epithelial cells. In addition, lipid peroxidation was reduced threefold in the BAL of mice treated with ascorbate and deferoxamine when compared with the control group. Administration of ascorbate and deferoxamine reduces mortality and decreases lung injury through reduction of alveolar-capillary permeability, inflammation, and epithelial sloughing and lipid peroxidation.
Abstract: This study assessed the effect of corticosteroid treatment in the clearance of hydrothoraces in mice. Twenty-four C57BL/6 mice were divided into four groups and were injected intrapleurally with 500 microL sterilized PBS-BSA 1% to create isosmotic hydrothoraces. Two groups served as control and two groups were treated with dexamethasone. The control groups received intraperitoneally PBS, while the corticosteroid treatment groups received dexamethasone (1 mg/kg), both 5 min after the induction of hydrothorax. Control and treated animals were sacrificed 2 and 4 h after the induction of hydrothorax, and pleural fluid volume was measured. The pleural fluid volume 2 and 4 h after the induction of hydrothoraces was significantly lower in the dexamethasone-treated group compared to the untreated group. The rate of pleural fluid absorption 2 and 4 h after the induction of hydrothoraces was significantly higher in the dexamethasone-treated groups. The present study demonstrated that dexamethasone accelerates pleural fluid absorption in induced isosmotic hydrothoraces in mice. This newly reported property of dexamethasone may partly account for the clinical observation of faster resolution of pleural effusions when corticosteroids are administered in patients with pleural effusions of certain etiologies.
Abstract: Transmembrane resistance is a measure of ionic permeability. The occurrence of ionic permeability on the leptomeningeal tissue may suggest its contribution to the cerebrospinal fluid turnover. This property will support the background for a new in vitro model for the study of subarachnoid physiology. The aim of this study is to identify the occurrence and mean value of transmembrane resistance of leptomeninges in sheep at the basal state.
Abstract: To determine the effect of dietary supplementation with clinoptilolite on health and production as well as serum concentrations of fat-soluble vitamins, macroelements and trace elements, and activities of hepatic enzymes in dairy goats.
Abstract: Accumulating evidence confirms the presence of pan-airway inflammation in allergic rhinitis patients. Smoking is known to affect the asthmatic airway inflammation. However, no study has evaluated the impact of smoking on airway inflammation of allergic rhinitis patients.
Abstract: Aldosterone is a key component of the renin-angiotensin-aldosterone system, and spironolactone, an aldosterone receptor blocker, shows beneficial effects in patients with end-stage renal disease and heart failure. The aim of the present study was to investigate by means of Ussing chamber technique the effect of spironolactone on the transmesothelial permeability of visceral sheep peritoneum in vitro. Peritoneal samples from the omentum of adult sheep were collected immediately after slaughter in a cooled and oxygenated Krebs-Ringer bicarbonate (KRB) solution. Isolated intact sheets of peritoneum were mounted in an Ussing-type chamber. Spironolactone (10(-5) mol/L) was added apically and basolaterally to the KRB solution. The transmesothelial resistance (R) was measured before and serially for 30 minutes after the addition of the substances. Data present the mean +/- standard error of 6 experiments in each case. The control R was 19.8 +/- 0.36 omega x cm2. The addition of spironolactone resulted in a reduction in the R, which became significant on both sides of the membrane within 10 minutes and remained significantly different thereafter. The maximum reduction of R (deltaR%) reached 24.8% +/- 2.3% (p < 0.01) apically and 26.3% +/- 3.2% (p < 0.01) basolaterally. Our data clearly show that spironolactone increases the permeability of visceral sheep peritoneum in a lasting manner. Increased peritoneal permeability could result in increased sodium removal, which has acknowledged beneficial effects both in patients undergoing peritoneal dialysis and in patients with heart failure. Further clinical studies investigating the effect of spironolactone on sodium removal in peritoneal dialysis are justified.
Abstract: Thyroid hormones affect the function of almost every body organ, and thyroid dysfunction produces a wide range of metabolic disturbances. Severe hypothyroidism is associated with significant effects on the kidney. The pathophysiology is thought to be multifactorial, while the exact mechanism remains unclear. Hypothyroidism as a cause of renal impairment is usually overlooked, leading to unnecessary diagnostic procedures. We describe two patients with acute renal failure due to severe hypothyroidism in whom thyroid hormone substitution therapy led to a significant improvement in renal function.
Abstract: The effect of dexamethasone on the transmesothelial electrical resistance (R(TM)) of sheep pleura was investigated by Ussing chamber experiments. Our results show that dexamethasone decreases the R(TM) of sheep pleurae, in part by stimulation of glucocorticoid receptors. This finding may be of importance in regard to the faster resolution of corticosteroid-treated pleural effusions.
Abstract: The peritoneal mesothelium is a barrier to ion transport in peritoneal dialysis. Cimetidine is an H2 receptor antagonist and a potent inhibitor of Na+/H+ antiporter, which is found in the plasma membranes of various cell types, including mesothelial cells. Recent reports linked Na+/H+ antiporter stimulation with increasing peritoneal fibroblast proliferation. The aim of the present study was to investigate by means of Ussing chamber experiments the effect of cimetidine on the transmesothelial electrical resistance (R) of isolated visceral sheep peritoneum. Peritoneal samples obtained from adult sheep were collected from the slaughterhouse and transferred in oxygenated Krebs-Ringer bicarbonate (KRB) solution to the laboratory within 30 minutes of the animal's death. The peritoneal tissue was transferred in a cooled KRB solution (4 degrees C, pH 7.5) bubbled with 95% O2/5% CO2. A planar sheet of the visceral peritoneum was mounted in an Ussing-type chamber and cimetidine (10(-3) mol/L) was added to the solution on the apical and basolateral sides. The R was measured before and for 15 minutes serially after addition of the cimetidine. Results presented are the means +/- standard error of the mean of 12 experiments. Addition of cimetidine basolaterally induced, within 1 minute, an increase in the deltaR of 35.97% +/- 12.01% (p < 0.05), which returned to baseline after 15 minutes. The action of cimetidine on the apical side of the membrane was similar, with a rapid rise in the deltaR of 47.3% +/- 16.4% (p < 0.05) and a subsequent decline to control values. The R is inversely correlated with membrane permeability. The results of the present study indicate a rapid action of cimetidine on the permeability of visceral sheep peritoneum, probably through inhibition of mesothelial Na+/H+ antiporter. The increase in R observed after addition of the cimetidine clearly indicates the existence of Na+/H+ antiporter on both sides of visceral sheep peritoneum. The clinical implications of our results should be further investigated.
Abstract: Non-dipping pattern of circadian blood pressure in preeclampsia is associated with an increased risk of cardiovascular disease. The pathogenetic mechanisms of this relationship are still unclear. We investigated whether non-dipping in preeclampsia could relate to endothelial activation or damage.
Abstract: The peritoneal mesothelium is a biologic barrier to water and ion transport. Its functional and structural integrity is crucial for peritoneal dialysis treatment. In vivo studies have shown that corticosteroids increase transcellular water transport and ultrafiltration of the rat peritoneum. In the present study, we used Ussing chamber technique to investigate the effect of dexamethasone on the transmesothelial permeability of the visceral sheep peritoneum in vitro. Peritoneal samples from the omentum of adult sheep were collected in a cooled and oxygenated Krebs-Ringer bicarbonate (KRB) solution immediately after the death of the animals. Isolated intact sheets were mounted in an Ussing-type chamber. Dexamethasone (10(-6) mol/L) and its inhibitor mifepristone (10(-5) mol/L) were added apically and basolaterally, alone and in combination to the KRB solution. The transmesothelial resistance (R) was measured for 1 hour before and serially after the addition of the substances. Data are expressed as mean +/- standard error of 6 experiments in each case. The control R was 21.5 +/- 0.42 omega x cm2. Dexamethasone induced a significant reduction of R within 15 minutes, which continued for the entire experiment. The maximum effect (% deltaR) was observed at 30 - 60 minutes after the addition of dexamethasone apically 46.2% +/- 7.14% (p < 0.01) and basolaterally 35.3% +/- 7.76% (p < 0.01). Mifepristone acted as an agonist on both sides of the membrane and significantly inhibited the dexamethasone effect. Our findings clearly indicate that dexamethasone rapidly increases the transmesothelial permeability of visceral sheep peritoneum. The rapid effect implicates dexamethasone and probably mifepristone as being involved in a common nongenomic pathway. Further investigation is necessary to elucidate the underlying mechanisms and perspectives of these findings.
Abstract: The mesothelium is part of the peritoneal water and ion transport barrier essential for peritoneal dialysis (PD) treatment and has a central role in the pathogenesis of peritoneal fibrosis and ultrafiltration failure observed in many PD patients. We investigated the effect of amiloride on the transmesothelial electrical resistance (RTM) of isolated parietal human peritoneum. Intact sheets were obtained from seven patients (three men, four women; mean age, 64 +/- 8 years). Fourteen peritoneal planar sheets were transferred to the laboratory in oxygenated Krebs-Ringer bicarbonate solution at 4 degrees C within 30 minutes after removal and mounted in an Ussing-type chamber. Amiloride (10(-3) mol/L) added apically (n = 8) caused a rapid rise of the RTM to 24.15 +/- 0.76 [OMEGA]H cm2 and a subsequent value persistence (p < 0.05); added basolaterally (n = 6), it increased the RTM to 22.66 +/- 0.59 [OMEGA]H cm2 within 1 minute, which persisted throughout the experiment. RTM was measured before and serially for 30 minutes after addition of amiloride. Control RTM was 20.29 +/- 0.86 [OMEGA]H cm2. These results indicate a rapid inhibitory effect of amiloride on the ionic permeability of parietal human peritoneum. The increase in the RTM observed after addition of amiloride clearly indicates the existence of amiloride-sensitive sodium channels on the human parietal peritoneal membrane, which may play some role in the ultrafiltration process and sodium removal during PD.
Abstract: The mesothelium is part of the peritoneal barrier that manages the water and ion transport essential for peritoneal dialysis (PD) treatment. In addition, it has a central role in the pathogenesis of peritoneal fibrosis and the resulting ultrafiltration failure observed in many PD patients. Endothelin-1 (ET-1) is a potent vasoactive peptide originally described as an endothelial cell-derived factor In addition, ET-1 has been shown to stimulate fibrogenic activity in various organs by regulating the production and turnover of matrix components. The aim of the present study was to investigate, by means of Ussing chamber experiments, the effect of ET-1 on the transmesothelial electrical resistance (RTM) of isolated visceral sheep peritoneum. Intact sheets of visceral sheep peritoneum were obtained from 12 adult sheep. The samples were collected from the slaughterhouse immediately after the deaths of the animals and, within 30 minutes, were transferred in oxygenated Krebs-Ringer bicarbonate (KRB) solution at 4 degrees C to the laboratory to be mounted in an Ussing-type chamber. Endothelin-1 (10(-7) mol/L) was then added to the KRB solution apically or basolaterally, and the RTM was measured before and serially for 10 minutes after the addition of the ET-1. The control RTM (before addition of ET-1) was 22.8 +/- 0.56 Omega x cm2. Addition of ET-1 apically significantly increased the RTM by 63.82% +/- 16.93% (p < 0.05) within 1 minute. After addition of ET-1 basolaterally, the RTM also increased significantly by 90.91% +/- 57.31% within 1 minute (p < 0.05). In both cases, these values persisted throughout the experiment. These results clearly indicate an inhibitory effect of ET-1 on the ionic permeability of visceral sheep peritoneum. The rapid increase in RTM observed after the addition of ET-1 suggests the existence of endothelin receptors (ET-A or ET-B, or both) on visceral sheep peritoneum. Previous studies demonstrated that ET-1, acting on ET-B receptors, potently inhibits epithelial sodium channels in mammalian cell cultures. Nevertheless, the exact pathways that underlie these findings remain unclear; their elucidation requires further investigation.
Abstract: This article reports on the development of a simple and cost-effective bioassay for the detection of biotin in urine and serum, based on the very selective binding of avidin and biotin. Avidin was allowed to react without isolating it from egg white. Egg white was treated with the dye HABA, which binds to avidin. Upon subsequent treatment with biotin, HABA is released due to the high affinity of biotin to avidin. The amount of HABA released is proportional to the amount of biotin used.
Abstract: The peritoneal mesothelium is one of the main barriers to ion transport in peritoneal dialysis. In a previous study, we showed the existence of a micro-opioid influence on the in vitro ionic permeability of serosal membranes (specifically, pleura and pericardium), which become less permeable to ionic currents after the action of morphine. In the present study, we used Ussing chamber experiments to investigate the effect of morphine on the transmesothelial electrical resistance (RTM) of isolated parietal sheep peritoneum. Peritoneal samples from the diaphragm of adult sheep were isolated directly after the death of the animals and were transferred to the laboratory within 30 minutes in a cooled Krebs-Ringer bicarbonate solution (4 degrees C, pH 7.5) bubbled with 95% O2/5% CO2. A planar sheet of parietal peritoneum was mounted in an Ussing-type chamber and morphine (10(-9) mol/L) was added apically and basolaterally. The RTM was measured before and serially for 30 minutes after the addition of morphine. Because active ion transport is temperature dependent, the Ussing chamber was held at 37 degrees C. Results presented are the mean +/- standard error of 6 experiments. The control RTM (before the addition of morphine) was 20.26 +/- 0.57 Omega x cm2. Addition of morphine basolaterally induced, within 1 minute, an increase in RTM of 24% +/- 4.8%, which declined thereafter (p < 0.01). When morphine was added apically, the results were not similar, because no significant change occurred in the RTM. The RTM is an established surrogate of peritoneal permeability. The results of the present study indicate rapid action of basolaterally added morphine on the permeability of the parietal peritoneum. The observed increase in the RTM indicates the existence in the parietal peritoneum of micro-opioid receptors that seem to prevail basolaterally. The clinical implications of these results should be further investigated.
Abstract: The permeability for small solutes and the ultrafiltration capacity of the peritoneum are essential for effective peritoneal dialysis (PD) treatment. Elucidation of the factors that regulate these two properties is therefore of great importance. Ouabain, a potent inhibitor of the Na+-K+ pump has been shown to reduce fluid absorption in animal models of PD. In the present study, we used Ussing chamber experiments to investigate the effect of ouabain on the transmesothelial electrical resistance (RTM) of isolated visceral sheep peritoneum. Peritoneal samples from the omentum of adult sheep were isolated immediately after the deaths of the animals and were transferred to the laboratory in cooled Krebs-Ringer bicarbonate solution (4 degrees C, pH 7.5) bubbled with 95% O2/5% CO2. A planar sheet of visceral peritoneum was mounted in an Ussing-type chamber, and ouabain (10(-3) mol/L) was added apically and basolaterally. The RTM was measured before and serially for 30 minutes after the addition of ouabain. Because active ion transport is temperature-dependent, all measurements were taken at 37 degrees C. The results presented are the mean +/- standard error of 6 experiments. Before the addition of ouabain, the control RTM was measured as 21.26 +/- 0.57 Omega x cm2. Addition of ouabain basolaterally induced an increase in the RTM to 27.62 +/- 0.72 Omega x cm2 within 1 minute (p < 0.05), and this level persisted throughout the experiment. The effect of ouabain, when added apically, was similar, characterized by a rapid rise in the RTM to 24.66 +/- 0. 76 Omega x cm2 at 1 minute (p < 0. 05), with subsequent persistence at that level. A clear association between RTM and active ion transport has been shown in previous studies. The results of the present study, showing a rapid effect of ouabain on the RTM of visceral peritoneum, therefore clearly suggest that cell membrane Na+K+-ATPase is important for peritoneal ionic transport. In addition, ouabain was previously shown to reduce vasodilation and intraperitoneal sodium or to increase intraperitoneal volume, especially in the presence of conventional acidic solutions. Those findings, combined with the results of the present study, clearly indicate that intraperitoneal administration of digitalis glycosides may have some beneficial effect in PD patients; however the specific clinical implications need further investigation.
Abstract: It is well-known that parapneumonic effusions lead to the formation of inflammatory exudates which contain an increasing amount of inflammatory cells, especially polymorphonuclear. At these pathological conditions characterized by oxidative stress, ascorbic acid (AA) plays an important role in quenching free radicals, so that it could protect neutrophils and mesothelial cells from oxidative damage. Besides that ascorbic acid and its metabolite dehydroascorbic acid (DHA) alters the sheep visceral and parietal pleura permeability. More specific ascorbic acid as well as dehydroascorbic acid decreases the permeability of pleura after addition on apical and basolateral side in both visceral and parietal pleurae. It seems that, AA and DHA have an opposite action upon pleura from that of the inflammatory mediators, like VEGF, which increases the permeability of pleura and causes mesothelial barrier dysfunction. The decrease of pleura permeability induced by AA and DHA suggest the hypothesis that AA and/or its metabolite DHA during inflammatory reactions not only protects mesothelial cells from oxidative damage, but also contributes to maintaining the mesothelial barrier function. Consequently, the inflammatory pleural fluid may be trapped in pleural space and the inflammation may be restricted, and have extension avoided.
Abstract: 1. Pleural permeability may contribute to pleural fluid turnover. The transmesothelial resistance (R(TM)), is an established surrogate of mesothelial permeability. The aim of the present study was to compare the electrophysiological properties of costal and diaphragmatic parietal pleura. 2. Specimens of the parietal pleura were isolated from 12 adult sheep from the chest wall and the diaphragm. Electrophysiological measurements were conducted with the Ussing system. Specimens of the parietal pleura of both types (diaphragmatic and costal) were compared histologically and total protein content measurements were also made. 3. The R(TM) of the diaphragmatic parietal pleura was significantly higher than that of the costal parietal pleura throughout the experiment. The diaphragmatic parietal pleura contains more cuboidal cells than the costal parietal pleura and its protein content was higher, however this difference was not statistically significant. 4. The costal parietal pleura consists of a more 'leaky' mesothelium than the diaphragmatic pleura. The morphological differences between the two types of parietal pleura may underline the electrophysiological findings.
Abstract: The effect of morphine (mu-opioid receptor agonist) on the transmesothelial resistance (R(TM)) of sheep's pleura and parietal pericardium was studied using the Ussing chamber technique. Basal transmesothelial resistance of parietal pleura was found to be 19.57+/-0.32 Omega cm2 and of visceral pleura was found to be 19.41+/-0.31 Omega cm2, whereas that of parietal pericardium was found to be 22.83+/-0.4 Omega cm2. Immediately after the addition of morphine (10(-9) M) both apically and basolaterally on the parietal pleura and parietal pericardium, these values were significantly increased (P<0.05). On the contrary, addition of morphine (10(-9) M) resulted in a rapid increase, only when placed basolaterally on the visceral pleura (P<0.05). In conclusion, our findings suggest that morphine, probably through mu-opioid stimulation, increases in vitro the transmesothelial resistance of the parietal pleura, of the visceral pleura when added basolaterally and of the parietal pericardium.
Abstract: The peritoneal mesothelium is a barrier to ion transport in peritoneal dialysis. In this study, we used Ussing-chamber experiments to investigate the effect of HgCl2, an aquaporin-1 inhibitor, on the transmesothelial electrical resistance (RTM) of isolated sheep parietal peritoneum. Peritoneal samples from the diaphragm of adult sheep were isolated immediately after the death of the animal and were transferred within 30 minutes to the laboratory in a cooled Krebs-Ringer bicarbonate solution (4 degrees C, pH 7.5) bubbled with 95% O(2)/5% CO2. A planar sheet of the parietal peritoneum was mounted in an Ussing-type chamber and HgCl2 (10(-4) mol/L) was added apically or basolaterally. The RTM was measured before and serially after the addition of the HgCl2. The entire experimental apparatus was held at 37 degrees C, because active ion transport is temperature-dependent. The results presented are the mean +/- standard error of 12 experiments. The control RTM (that is, before the addition of HgCl) was 19.3 +/- 0.38 omega x cm2. Addition of HgCl2 apically induced a decrease in the RTM to 16.25 +/- 0.86 omega x cm2 within 1 minute. When added basolaterally, HgCl2 action was similar, with a rapid reduction in the RTM to 18.1 +/- 0.51 omega x cm2 (p < 0.05). A clear association between the RTM and the active transmesothelial ion transport was shown in previous studies. In the present study, rapid action of HgCl2 on the permeability ofthe parietal peritoneum was observed, resulting in a reduction in the RTM Taken together, these findings indicate that inhibition of aquaporin-1 alters the ionic permeability of the parietal peritoneal membrane.
Abstract: We present here the case of a continuous ambulatory peritoneal dialysis (CAPD) patient who developed sclerosing calcifying peritonitis with gross macroscopic calcification of the small bowel, a rare and life-threatening complication of sclerosing peritonitis. A 40-year-old female had been on CAPD for 7 years. A peritoneal biopsy during an open cholecystectomy for cholelithiasis showed sclerosing peritonitis, but the patient refused to change dialysis modality. She remained free of symptoms for 3 years, but then was admitted with cloudy effluent, abdominal pain, and referred pain to the left shoulder. A white blood cell count showed 25,000 cells/microL, and a peritoneal cell count showed 1000 cells/microL. An abdominal computed tomography scan was nondiagnostic. The patient was started on intraperitoneal antibiotics, but 3 days later she was taken for surgery because of acute abdomen. Laparotomy revealed a tanned and thickened peritoneum and a small bowel with significant fibrosis and foci of calcification on the antimesenteric surface. Enterectomy and primary anastomosis was performed. Pathology revealed extensive mural fibrosis, calcium deposition, and localized inflammatory infiltration of the small bowel. The patient developed an anastomotic leak and, despite a second operation, died in the intensive care unit from septic shock. Although some authors report successful outcomes in similar cases by using surgery or other treatments (parenteral nutrition, immunosuppression), or both, we urgently recommend that, if sclerosing calcifying peritonitis is diagnosed, the patient be switched promptly to hemodialysis.
Abstract: The effect of adrenaline on the transmesothelial resistance (RTM) of sheep's visceral and parietal pleura was studied using the Ussing chamber technique. Basal transmesothelial resistance of visceral pleura was found to be 20.71 +/- 0.31 Omega cm2, whereas that of parietal pleura was found to be 19.53 +/- 0.34 Omega cm2. Immediately after the addition of adrenaline (10(-7) M) both apically and basolaterally on the visceral and parietal pleura, these values were significantly increased (P < 0.05). Addition of the nonselective beta-receptor blocker, propranolol (10(-5) M), suppressed this effect in both visceral and parietal pleura, while addition of the nonselective alpha-receptor blocker, phentolamine (10(-5) M), partly suppressed the above-mentioned increase in the parietal pleura. In conclusion, our results show that adrenaline has a rapid effect on both pleurae. This rapid effect is mediated by the stimulation of beta-adrenergic receptors in the case of visceral pleura, while in the case of parietal pleura this effect seems to be due to a stimulation of alpha- and beta-adrenergic receptors. On the visceral pleura the effect of adrenaline vanishes after some minutes and on the parietal this effect is more permanent than the visceral's one, suggesting differences in the distribution of the adrenergic receptors between the visceral and parietal pleura.
Abstract: The peritoneal mesothelium is a barrier to ion transport in peritoneal dialysis. In the present study, we used Ussing chamber experiments to investigate the effect of amiloride on the transmesothelial electrical resistance (R(TM)) of isolated visceral sheep peritoneum. Peritoneal samples from the omentum of adult sheep were isolated directly after the death of the animals and were transferred to the laboratory within 30 minutes in a cooled Krebs-Ringer bicarbonate solution (4 degrees C, pH 7.5) bubbled with 95% O2/5% CO2. A visceral peritoneal planar sheet was mounted in an Ussing-type chamber and amiloride (10(-3) mol/L) was added apically and basolaterally. The R(TM) was measured before and serially for 30 minutes after the addition of amiloride. Because active ion transport is temperature dependent, the Ussing chambers were held at 37 degrees C. The results presented are the means + standard error of 12 experiments. The control R(TM) (before the addition of amiloride) was 21.86 +/- 0.46 omega x cm2. Basolateral addition of amiloride induced, within 1 minute, an increase in R(TM) to 27.26 +/- 0.39 omega x cm2, a level that persisted throughout the experiment. When amiloride was added apically, the results were similar with a rapid rise of R(TM) to 24.18 +/- 0.9 omega x cm2 and subsequent value persistence (p < 0.05). A clear association between R(TM) and active ion transport was shown in previous studies. The results of the present study indicate rapid action of amiloride on the permeability of the visceral peritoneum. The observed increase in the R(TM) indicates the existence of amiloride-sensitive sodium channels in the visceral peritoneal membrane. The clinical implications of these results should be further investigated.
Abstract: The peritoneal mesothelium constitutes an ion transport barrier that is taken advantage of in peritoneal dialysis. The aim of this study was to investigate the effects of epinephrine on the electrical transmesothelial resistance (R(TM)) of the isolated parietal sheep peritoneum by means of Ussing-type chamber experiments. Intact parietal (diaphragmatic) peritoneal samples were obtained from adult sheep immediately after sacrifice and transferred within 0.5 h to the laboratory in a cooled Krebs-Ringer bicarbonate solution (4 degrees C, pH 7.5), bubbled with 95% O2-5% CO2. A parietal peritoneal planar sheet was mounted in a Ussing-type chamber. Epinephrine (10(-7) M) was added to the apical and the basolateral side. The R(TM) was measured before and serially after the addition of epinephrine for 30 min. As active ion transport is temperature-dependent, all measurements were performed at 37 degrees C. The results were calculated as means with standard errors (x +/- SE) of six independent experiments. The control R(TM) was 20.05 +/- 0.61 ohm x cm2. The addition of epinephrine to the basolateral side within 1 min induced an increase of R(TM) to 21.8 +/- 0.45 ohm x cm2, which decreased thereafter progressively to reach control values again after 15 min. A similar effect of epinephrine on the apical side was apparent with a rapid rise of R(TM) to 22.5 +/- 0.66 ohm x cm2 and a subsequent decrease (P < 0.05). A clear association between the R(TM) and active ion transport was established from previous studies. The results of our study indicate a rapid action of epinephrine on the parietal peritoneum permeability.
Abstract: The peritoneal mesothelium is a barrier to ion transport in peritoneal dialysis. In the present study, we investigated, by means of Ussing chamber experiments, the effect of adrenaline on the electrical transepithelial resistance (R(TE)) of isolated visceral sheep peritoneum. Peritoneal samples from the omentum of adult sheep were isolated within 30 minutes of the animal's death and were transferred to the laboratory in a cooled Krebs-Ringer bicarbonate solution (4 degrees C, pH 7.5) bubbled with 95% O2/5% CO2. A visceral peritoneal planar sheet was mounted in an Ussing-type chamber and adrenaline (10(-7) mol/L) was added to the apical and the basolateral side in turn. We measured R(TE) before and serially for 30 minutes after addition of the adrenaline. Because active ion transport is temperature-dependent, all experiments were performed at 37 degrees C. All results are presented as mean and standard error (x +/- SE) of 6 experiments. The control R(TE0 (before adrenaline) was 20.05 +/- 0.61 omega x cm2. Within 1 minute after the addition of adrenaline to the basolateral side of the membrane, R(TE) increased to 21.8 omega x cm2, a rate that thereafter progressively decayed, returning to the control value. Adrenaline action on the apical side of the membrane was similar, with a rapid rise of R(TE) to 22.5 omega x cm2 and a subsequent decrease (p < 0.05). Previous studies provide evidence for a clear association between R(TE) and active ion transport. The results of the present study indicate rapid action of adrenaline on the permeability of the visceral peritoneum.
