Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0020639 (hypoproteinemia)
 1,134 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

We examined the influence of a peptide-based enteral formula and a standard (intact protein) enteral formula on intestinal transcapillary and transmucosal water and protein fluxes during hypoproteinemia induced by plasma volume expansion. In 15 Sprague-Dawley rats, net transmucosal water flux and net transmucosal and capillary albumin clearances were monitored in jejunal loops before and during intravenous infusion (2.5 ml/min/kg) of Tyrodes solution. This procedure resulted in a 60% reduction in plasma protein concentration and net water secretion into the bowel lumen. Luminal perfusion with the peptide-based formula did not modify the magnitude of the reduction in plasma protein concentration, yet dramatically reduced transmucosal and transcapillary albumin clearances (p less than 0.05). In addition, a net absorptive water flux was maintained with the peptide-based formula during volume expansion despite hypoproteinemia. The response to luminal perfusion with the intact protein formula were not different from controls. The results of this study are consistent with previous observations that enteral feeding with a peptide-based formula significantly attenuates the diarrhea associated with acute hypoalbuminemia in the critically ill patient.
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PMID:Intestinal absorption of elemental and standard enteral formulas in hypoproteinemic (volume expanded) rats. 313 61

We compared the effect of crystalloid to colloid fluid infusion on extravascular lung water (EVLW) in hypoproteinemic dogs. Plasmapheresis was used to decrease plasma colloid osmotic pressure (COP) to less than 40% of its base-line level. Five animals were then infused with 0.9% sodium chloride (saline), five with 5% human serum albumin (albumin), and five with 6% hydroxyethyl starch (hetastarch) to increase the pulmonary arterial occlusive pressure by 10 Torr in comparison to the postplasmapheresis level for a 5-h study interval. On completion of the procedure, the lungs were harvested and EVLW measured by the blood-free gravimetric technique. Three to six times the volume of saline compared with albumin or hetastarch (P less than 0.001) was infused. In the saline animals, COP was decreased to 3.3 +/- 1.3 Torr, whereas COP was increased to 18.1 +/- 1.4 Torr in albumin animals (P less than 0.001) and 20.1 +/- 1.6 Torr in the hetastarch group (P less than 0.001). The saline-treated dogs developed gross signs of systemic edema. The EVLW was 8.1 +/- 0.9 ml/kg in saline animals compared with 5.3 +/- 2.1 ml/kg in the albumin (P less than 0.05) and 4.1 +/- 1.4 ml/kg in the hetastarch (P less than 0.01) groups. These data indicate that crystalloid fluid infusion during hypoproteinemia is associated with the development of both systemic and pulmonary edema.
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PMID:Effects of crystalloid and colloid fluids on extravascular lung water in hypoproteinemic dogs. 361 Sep 36

Edema formation in nephrotic syndrome has been attributed to intravascular volume depletion resulting from leakage of plasma water into the interstitial space and activating secondary renal sodium retention. However, clinical studies indicate that edematous patients with nephrotic syndrome may have normal or expanded plasma volumes. We evaluated the relationship between plasma volume and edema formation in control rats and rats with chronic renal failure (CRF) produced by 7/8 nephrectomy. In each group, plasma volume and 22Na space were measured during the control period and after induction of hypoalbuminemia from passive Heymann nephritis. Rats with CRF had expanded plasma volume during the initial period (4.23 +/- 0.46 vs. 3.32 +/- 0.68 ml/100 g body wt) that became significantly more expanded (to 5.44 +/- 1.16 ml/100 g body wt) when they became nephrotic as 22Na space also increased. Plasma volume and 22Na space did not change in the sham-operated rats when nephrosis was produced. Plasma renin activity was lower in the CRF rats during the control period than in the sham-operated rats and fell significantly during the nephrotic period when edema developed. Nonnephrotic rats had a plasma colloid osmotic pressure (COP) of 17.8 +/- 4.3 mmHg compared with 8.5 +/- 2.9 mmHg when nephrotic. Despite this large difference in COP, both nephrotic and nonnephrotic rats exhibited the same relationship between plasma volume and extravascular sodium space, a measure of edema formation. Hypoproteinemia is not sufficient for edema formation in the rat with passive Heymann nephritis; concomitant plasma volume expansion resulting from CRF is a necessary additional component.
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PMID:Plasma volume expansion is necessary for edema formation in the rate with Heymann nephritis. 397 Feb 14

Four cases of left-sided pleural hydrothorax in connection with severe pre-eclampsia are reported. In addition an increased formation of ascitic fluid was observed in the patients. A long-lasting bed rest in the left lateral recumbent position preceded the discovery of the roentgenologically verified pleural changes. Hypoproteinemia caused by the excretion of large amounts of protein in the urine seems to be a partial etiological factor aggravated by the renal retention of sodium and water. Pleural transudate disappeared spontaneously within two weeks from the delivery. In such cases, immediate diagnostic procedures, e.g. the exclusion of tuberculosis, are unnecessary. The authors think that the phenomenon is common in similar cases but usually remains undiagnosed.
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PMID:Left-sided hydrothorax in connection with severe pre-eclampsia. Case reports. 615 19

This paper is a study of 117 patients with endstage renal failure, treated by continuous ambulatory peritoneal dialysis (CAPD) over periods of 1-56 months. The study has shown CAPD to be an effective form of dialysis with a number of advantages over intermittent peritoneal dialysis and hemodialysis (better control of salt and water status, hypertension and anemia, steady state biochemistry and greater ease of self-dialysis). Peritoneal clearance and ultrafiltration have remained adequate in all but a few patients. Hypoproteinemia, poor nutrition, obesity and abdominal herniae have been problems in a small percentage of patients. Hyperlipidemia has developed in half the patients but improved with diet. Peritonitis remains the major barrier to the more widespread use of CAPD, although its incidence can be considerably reduced by use of better connectors, bacterial filters and choice of patients.
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PMID:Continuous ambulatory peritoneal dialysis (CAPD): an established treatment for endstage renal failure. 636 Jan 16

Infection with Mycobacterium intracellulare serotype 10 was diagnosed in 2 rhesus monkeys (Macaca mulatta) in a closed colony of 90 animals. The clinicopathologic presentation in 1 animal with advanced disease was characterized by a precipitous weight loss, therapeutically unresponsive diarrhea, anemia, weakness, prostration, refractory tuberculin tests (using mammalian old tuberculin and M bovis purified protein derivative tuberculin), and disseminated granulomas in the lungs, spleen, liver, kidneys, lymph nodes, salivary glands, and intestines. The lamina propria throughout the large and small intestines was infiltrated with mycobacteria-laden macrophages. Severe hypoproteinemia, hypoalbuminemia, hypoglobulinemia, mild hypocalcemia, and edema were compatible with a malabsorption-like syndrome. The 2nd animal was clinically normal, but a weak positive tuberculin reaction to M bovis purified protein derivative at 72 hours necessitated euthanasia. This animal's disease was characterized by microgranulomas in the lungs, bronchial lymph nodes, liver, and pancreas, without involvement of the gastrointestinal tract. There was no evidence of M intracellulare infection in the remaining 88 animals in the colony, as determined by mycobacterial cultures of tracheobronchial washings, additional tuberculin testing, thoracic radiography, and mycobacterial culture of the drinking water. Tuberculin testing and thoracic radiographs of personnel working with the nonhuman primates were also negative. These cases were considered to be important because both animals were infected with the same serotype and because there has been an increasing number of isolations of this organism in human infections throughout Massachusetts. Drug-sensitivity testing revealed the organism to be sensitive to cycloserine and resistant to isoniazid, rifampin, ethambutol, streptomycin, kanamycin, and pyrazinamide.
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PMID:Nontuberculous mycobacterial infection attributable to Mycobacterium intracellulare serotype 10 in two rhesus monkeys. 717 60

Human albumin is the most important oncotic-active protein (1 g albumin attaches 18 g water). It is essential for the water exchange between intra- and extracellular space and for homeostasis. The physiological distribution of albumin, its daily exchange and degradation are being discussed. At the example of normo- and hypovolaemic patients and acute blood-loss the stabilising effect on the blood-volume and the hemodynamic efficacy of human albumin are shown. Human albumin was infused into patients with hypoproteinemia and hypovolaemia as well as to surgical patients with normovolaemia. Volunteers received albumin after an acute blood-loss. Under and after the albumin-infusion the albumin disappeared partly from the blood-stream. The loss to the extravascular compartments was greatest among patients with hypoproteinemia. Among volunteers with experimental blood-loss the infused volume disappeared in an amount of 45 to 106 ml per hour. When human albumin is given over a longer period the synthesis of endogenous albumin and of globulins may be inhibited or at least depressed. Albumin has a positive effect on the hemodynamic. The cardiac-output and the stroke volume increased. The peripheral resistance fell in the same time. Renal filtration rate and the urine volume increased, in contrast renal resistance was lowered.
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PMID:Physiological aspects of the role of human albumin in the treatment of chronic and acute blood loss. 727 68

Respiratory failure after thermal injury is common, but the etiologic roles of high volume crystalloid resuscitation, hypoproteinemia, inhalation injury, or sepsis have not been specifically defined in human studies. We used the thermal-green dye double indicator dilution measurement of extravascular lung water (EVLW) to follow daily lung water changes in seven severly burned adult patients, resuscitated with only crystalloid solutions. An average weight gain of 21.3 kg, a 30% increase (p < 0.001), was present two to three days after admission. Admission EVLW for all patients was 7.9 +/- 1.2 ml/kg, (means +/- SD), and EVLW at the time of maximal weight gain was 5.9 +/- 1.4 ml/kg, a 25% decrease (p < 0.05). Admission pulmonary artery wedge pressure (PAWP) was 8 +/- 3 mmHG, which was not significantly different from PAWP of 13 +/- 4 mmHg at the time of maximal weight gain. In the three patients who died of sepsis, their terminal weight averaged 17.8 kg (27%) above their admitting weight (p < 0.01) and EVLW was 26.4 +/- 4.4 ml/kg, a 200% increase (p < 0.02) from admission. Their terminal PAWP averaged 22 +/- 2 mmHg, a 170% increase (p < 0.005). None of these patients had an increase in EVLW until clinical signs of sepsis occurred and the rise in EVLW preceded the rise in PAWP. Calculated mean plasma colloid osmotic pressure (PCOP) on admission was 20.7 +/- 4.9 mmHg; at the time of maximal weight gain, it was 8.6 +/- 1.7 mmHg (p < 0.001). The PCOP-PAWP gradient fell to -4 +/- 4 mmHg (p < 0.001) at the time of maximal weight gain and remained less than +4 mmHg throughout the study period in all patients. We conclude that massive crystalloid resuscitation while maintaining PAWP below 15 mmHg does not cause an increase in EVLW during the first four days after thermal injury. EVLW actually decreases slightly in all patients despite marked weight gain, hypoproteinemia and a negative PCOP-PAWP gradient. EVLW does not correlate with the PCOP-PAWP gradient in either septic or nonseptic periods. Three patients had severe inhalational injury and normal EVLW for the first four postburn days. It therefore appears that significant interstitial edema does not result from inhalational injury. There is also no evidence that thermal injury causes an early increase in pulmonary capillary permeability. The occurrence of sepsis, however, results in rapid accumulation of lung water, without any change in hydrostatic or osmotic forces. This study supports the primary role of sepsis in altering pulmonary capillary permeability with resulting pulmonary edema.
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PMID:Lung water changes after thermal injury. The effects of crystalloid resuscitation and sepsis. 742 95

It is well known that serum IGF-I concentrations are regulated endocrinologically since IGF-I has a growth-promoting action as a mediator of growth hormone. However, recent reports suggest that nutritional states influence serum IGF-I concentration because IGF-I shows anabolic effects like insulin. The aim of this study was to clarify the influences of maternal nutritional states or metabolism on the IGF-I concentrations in normal and abnormal pregnancy. In normal pregnant women, a significant positive correlation was indicated between serum IGF-I concentrations and maternal weight gain during pregnancy or serum triglyceride levels, and a significant negative correlation was observed between serum IGF-I concentrations and serum total protein levels. In the cases complicated with hyperemesis or hyperthyroidism during early gestation, a marked reduction of maternal body weight was observed, and serum IGF-I concentration was extremely low compared with that in normal pregnant women, but serum IGF-I levels gradually increased as the maternal body weight recovered after treatment by intravenous hyperalimentation or an anti-thyroid drug. In cases of severe toxemia of pregnancy, maternal weight gain and serum triglyceride levels were markedly increased, but serum IGF-I levels were significantly lower compared with those in normal pregnant women in the same gestational age. In severe toxemia of pregnancy, there was no significant correlation between serum IGF-I levels and maternal weight gain or serum triglyceride levels, and these results may be influenced by such abnormalities as water retention, hemoconcentration, severe hypoproteinemia and severe negative nitrogen balance not found in normal pregnancy. In conclusion, it is considered that IGF-I concentration is regulated not only by endocrinological factors, but also by metabolic factors in maternal circulation during pregnancy, and the measurement of maternal IGF-I concentration seems to be a useful parameter to evaluate the maternal nutritional states.
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PMID:[Maternal nutritional states and serum insulin-like growth factor-I (IGF-I) concentrations in normal and abnormal pregnancy]. 795 9

To determine whether hypoproteinemia slows the rate at which liquid is cleared from the lung lumen, we studied 36 lambs, 18 of which underwent repeated plasmapheresis, reducing plasma protein concentration by 37% and plasma protein osmotic pressure by 39%. We killed 29 lambs (14 hypoproteinemic and 15 normoproteinemic) and removed their lungs 1, 2, or 6 h after intratracheal instillation of isotonic saline (6 ml/kg body wt). We measured extravascular lung water and determined the percentage of tracheally instilled liquid that was cleared from the lungs by comparison with control lambs that did not receive saline into their airways. The percent liquid cleared from the lungs after 1 and 2 h was significantly less in hypoproteinemic than in normoproteinemic lambs (37 vs. 65% at 1 h, 58 vs. 75% at 2 h, respectively). By 6 h nearly all the liquid (> 92%) was cleared from the lungs of all lambs. Thus hypoproteinemia slows the initial rate of clearance of liquid from the lungs of lambs. To determine whether reduced plasma protein osmotic pressure might redirect this liquid into lung lymphatics, we measured lung lymph flow (Q1) in five lambs (7.7 +/- 1.4 kg, 19 +/- 4 days old) for > or = 2 h before and 6 h after tracheal instillation of saline. In each lamb, paired studies were done 3-6 days apart; between studies the lambs underwent plasmapheresis.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:Hypoproteinemia slows lung liquid clearance in young lambs. 844 86


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