Neonates with Bartter syndrome have enormous fluid and sodium requirements.

AIM: Managing neonatal Bartter syndrome by achieving adequate weight gain is challenging. We assessed the correlation between weight gain in neonatal Bartter syndrome and the introduction of fluid and sodium supplementations and indomethacin during the first 4 weeks of life. METHODS: Daily fluid and electrolytes requirements were analysed using linear regression and Spearman correlation coefficients. The weight gain coefficient was calculated as daily weight gain after physiological neonatal weight loss. RESULTS: We studied seven infants. The highest weight gain coefficients occurred between weeks two and four in the five neonates who either received prompt amounts of fluid (maximum 810 mL/kg/day) and sodium (maximum 70 mmol/kg/day) or were treated with indomethacin. For the two patients with the highest weight gain coefficient, water and sodium supplementations were decreased in weeks two to four leading to a significant negative Spearman correlation between weight gain and fluid supplements (r = -0.55 and -0.68) and weight gain and sodium supplementations (r = -0.96 and -0.72). The two patients with the lowest weight gain coefficient had positive Spearman correlation coefficients between weight gain and fluid and sodium supplementations. CONCLUSION: Infants with neonatal Bartter syndrome required rapid and enormous fluid and sodium supplementations or the early introduction of indomethacin treatment to achieve adequate weight gain during the early postnatal period.

Uuttoprosessin suunnittelu

Teknologian kehitys ja prosessien tiukempi valvonta ovat alentaneet selluteollisuuden häviöitä tehden prosesseista suljetumpia. Valitettavasti nämä edistysaskeleet teknologiassa ovat lisänneet prosessiin kuulumattomien yhdisteiden määrää kemikaalien talteenottokierrossa. Näistä kemikaaleista haitallisimpia ovat kloridi- ja kaliumyhdisteet, jotka tulevat prosessiin raaka-aineiden ja prosessikemikaalien mukana. Kloridi ja kalium muodostavat emäksisissä liuoksissa epäorgaanisia liukoisia yhdisteitä, jotka rikastuvat lipeäkiertoon. Soodakattilassa kloridien läsnäolo alentaa tuhkan sulamislämpötilaa sekä tarttumispistettä, lisää korroosiota ja saostumien muodostumista kattilan pinnalle. Nämä seuraukset voivat vähentää vuosituotantoa ja nostaa korjauskustannuksia. Kaliumin ja kloridin rikastumista talteenottokiertoon voidaan estää poistamalla ne prosessista. Prosessiin kuulumattomat yhdisteet tulisi poistaa talteenottoprosessista ja säilyttää samalla korkea kemikaalien talteenottoprosentti. Koska kaliumin ja kloridin rikastumiskertoimet soodakattilan tuhkassa ovat korkeita, on tuhkan käsittely tehokasta. Kloridin ja kaliumin poistoon on kehitetty menetelmiä, joilla voidaan vähentää hyödyllisten kemikaalien häviöitä. Näitä menetelmiä ovat uutto, ioninvaihto, elektrodialyysi, jäähdytyskiteytys ja haihdutuskiteytys. Menetelmissä tuhka jaetaan kloridi- ja kaliumpitoiseen osaan ja natriumsulfaattipitoiseen osaan. Kloridi ja kalium poistetaan prosessista ja loput palautetaan lipeäkiertoon. Kloridin ja kaliumin poistoa tuhkasta tutkittiin uuttamalla tuhkaa vedellä. Parhaissa käyttöolosuhteissa natriumsulfaatin liukoisuus veteen on huomattavasti alhaisempi kuin kaliumkloridin liukoisuus veteen. Optimaalinen uuttolämpötila ja tuhka-vesisuhde määritettiin siten, että kloridi- ja kaliumpitoisuudet suodoksessa olivat mahdollisimman korkeat sekä natriumin ja muiden anioneiden pitoisuudet suodoksessa mahdollisimman alhaiset. Saatuja tuloksia käytettiin jatkuvatoimisen uuttoprosessin suunnittelussa.

Epithelial Sodium Channel-Mediated Sodium Transport Is Not Dependent on the Membrane-Bound Serine Protease CAP2/Tmprss4.

The membrane-bound serine protease CAP2/Tmprss4 has been previously identified in vitro as a positive regulator of the epithelial sodium channel (ENaC). To study its in vivo implication in ENaC-mediated sodium absorption, we generated a knockout mouse model for CAP2/Tmprss4. Mice deficient in CAP2/Tmprss4 were viable, fertile, and did not show any obvious histological abnormalities. Unexpectedly, when challenged with sodium-deficient diet, these mice did not develop any impairment in renal sodium handling as evidenced by normal plasma and urinary sodium and potassium electrolytes, as well as normal aldosterone levels. Despite minor alterations in ENaC mRNA expression, we found no evidence for altered proteolytic cleavage of ENaC subunits. In consequence, ENaC activity, as monitored by the amiloride-sensitive rectal potential difference (ΔPD), was not altered even under dietary sodium restriction. In summary, ENaC-mediated sodium balance is not affected by lack of CAP2/Tmprss4 expression and thus, does not seem to directly control ENaC expression and activity in vivo.

Post-translational modifications of voltage-gated sodium channels in chronic pain syndromes.

In the peripheral sensory nervous system the neuronal expression of voltage-gated sodium channels (Navs) is very important for the transmission of nociceptive information since they give rise to the upstroke of the action potential (AP). Navs are composed of nine different isoforms with distinct biophysical properties. Studying the mutations associated with the increase or absence of pain sensitivity in humans, as well as other expression studies, have highlighted Nav1.7, Nav1.8, and Nav1.9 as being the most important contributors to the control of nociceptive neuronal electrogenesis. Modulating their expression and/or function can impact the shape of the AP and consequently modify nociceptive transmission, a process that is observed in persistent pain conditions. Post-translational modification (PTM) of Navs is a well-known process that modifies their expression and function. In chronic pain syndromes, the release of inflammatory molecules into the direct environment of dorsal root ganglia (DRG) sensory neurons leads to an abnormal activation of enzymes that induce Navs PTM. The addition of small molecules, i.e., peptides, phosphoryl groups, ubiquitin moieties and/or carbohydrates, can modify the function of Navs in two different ways: via direct physical interference with Nav gating, or via the control of Nav trafficking. Both mechanisms have a profound impact on neuronal excitability. In this review we will discuss the role of Protein Kinase A, B, and C, Mitogen Activated Protein Kinases and Ca++/Calmodulin-dependent Kinase II in peripheral chronic pain syndromes. We will also discuss more recent findings that the ubiquitination of Nav1.7 by Nedd4-2 and the effect of methylglyoxal on Nav1.8 are also implicated in the development of experimental neuropathic pain. We will address the potential roles of other PTMs in chronic pain and highlight the need for further investigation of PTMs of Navs in order to develop new pharmacological tools to alleviate pain.

The role of the renal mineralocorticoid versus the glucocorticoid receptor in renal sodium and potassium transport

Dans le néphron distal sensible à l'aldostérone, le récepteur aux minéralocorticoïdes (RM) et le récepteur aux glucocorticoids (RG) sont exprimés et peuvent être liés et activés par l'aldostérone et le Cortisol, respectivement. La réabsorption rénale de sodium est principalement contrôlée par le RM. Cependant, des modèles expérimentaux in vitro et in vivo suggèrent que le RG pourrait également jouer un rôle dans le transport rénal du sodium. Afin d'étudier l'implication du RG et/ou du RM exprimés dans les cellules épithéliales adultes dans le transport rénal du sodium, nous avons généré deux modèles de souris, dans lesquelles l'expression du RG (Nr3c1Pax8/LC1) ou du RM (Nr3c2Pax8/LC1) peut être abolie de manière inductible et cela spécifiquement dans les tubules rénaux. Les souris déficientes pour le gène du RM survivent mais développent un phénotype sévère de PHA-1, caractérisé par un retard de croissance, une augmentation des niveaux urinaires de Na+, une diminution de la concentration du Na+ dans le plasma, une hyperkaliémie et une augmentation des niveaux d'aldostérone plasmatique. Ce phénotype empire et devient létal lorsque les souris sont nourries avec une diète déficiente en sodium. Les niveaux d'expression en protéine de NCC, de la forme phosphorylée de NCC et de aENaC sont diminués, alors que l'expression en ARN messager et en protéine du RG est augmentée. Une diète riche en Na+ et pauvre en K+ ne corrige pas la concentration élevée d'aldostérone dans le plasma pour la ramener à des niveaux conformes, mais est suffisante pour corriger la perte de poids et les niveaux anormaux des électrolytes dans le plasma et l'urine. -- In the aldosterone-sensitive distal nephron, both the mineralocorticoid (MR) and the glucocorticoid (GR) receptor are expressed. They can be bound and activated by aldosterone and Cortisol, respectively. Renal Na+ reabsorption is mainly controlled by MR. However, in vitro and in vivo experimental models suggest that GR may play a role in renal Na+ transport. Therefore, to investigate the implication of MR and/or GR in adult epithelial cells in renal sodium transport, we generated inducible renal tubule- specific MR (Nr3c2Pax8/LC1) and GR (Nr3c1Pax8/LC1) knockout mice. MR-deficient mice survived but developed a severe PHA-1 phenotype with failure to thrive, higher urinary Na+, decreased plasma Na+ levels, hyperkalemia and higher levels of plasma aldosterone. This phenotype further worsened and became lethal under a sodium-deficient diet. NCC protein expression and its phosphorylated form, as well as aENaC protein level were downregulated, whereas the mRNA and protein expression of GR was increased. A diet rich in Na+and low in K+ did not normalize plasma aldosterone to control levels, but was sufficient to restore body weight, plasma and urinary electrolytes. Upon switch to a Na+-deficient diet, GR-mutant mice exhibited transient increased urinary Na+ and decreased K+ levels, with transitory higher plasma K+ concentration preceded by a significant increase in plasma aldosterone levels within the 12 hours following diet switch. We found no difference in urinary aldosterone levels, plasma Na+ concentration and plasma corticosterone levels. Moreover, NHE3, NKCC2, NCC

Sodium-dependent phosphate transporters in osteoclast differentiation and function.

Osteoclasts are multinucleated bone degrading cells. Phosphate is an important constituent of mineralized bone and released in significant quantities during bone resorption. Molecular contributors to phosphate transport during the resorptive activity of osteoclasts have been controversially discussed. This study aimed at deciphering the role of sodium-dependent phosphate transporters during osteoclast differentiation and bone resorption. Our studies reveal RANKL-induced differential expression of sodium-dependent phosphate transport protein IIa (NaPi-IIa) transcript and protein during osteoclast development, but no expression of the closely related NaPi-IIb and NaPi-IIc SLC34 family isoforms. In vitro studies employing NaPi-IIa-deficient osteoclast precursors and mature osteoclasts reveal that NaPi-IIa is dispensable for bone resorption and osteoclast differentiation. These results are supported by the analysis of structural bone parameters by high-resolution microcomputed tomography that yielded no differences between adult NaPi-IIa WT and KO mice. By contrast, both type III sodium-dependent phosphate transporters Pit-1 and Pit-2 were abundantly expressed throughout osteoclast differentiation, indicating that they are the relevant sodium-dependent phosphate transporters in osteoclasts and osteoclast precursors. We conclude that phosphate transporters of the SLC34 family have no role in osteoclast differentiation and function and propose that Pit-dependent phosphate transport could be pivotal for bone resorption and should be addressed in further studies.

Reference intervals for 24 laboratory parameters determined in 24-hour urine collections.

BACKGROUND: Reference intervals for many laboratory parameters determined in 24-h urine collections are either not publicly available or based on small numbers, not sex specific or not from a representative sample. METHODS: Osmolality and concentrations or enzymatic activities of sodium, potassium, chloride, glucose, creatinine, citrate, cortisol, pancreatic α-amylase, total protein, albumin, transferrin, immunoglobulin G, α1-microglobulin, α2-macroglobulin, as well as porphyrins and their precursors (δ-aminolevulinic acid and porphobilinogen) were determined in 241 24-h urine samples of a population-based cohort of asymptomatic adults (121 men and 120 women). For 16 of these 24 parameters creatinine-normalized ratios were calculated based on 24-h urine creatinine. The reference intervals for these parameters were calculated according to the CLSI C28-A3 statistical guidelines. RESULTS: By contrast to most published reference intervals, which do not stratify for sex, reference intervals of 12 of 24 laboratory parameters in 24-h urine collections and of eight of 16 parameters as creatinine-normalized ratios differed significantly between men and women. For six parameters calculated as 24-h urine excretion and four parameters calculated as creatinine-normalized ratios no reference intervals had been published before. For some parameters we found significant and relevant deviations from previously reported reference intervals, most notably for 24-h urine cortisol in women. Ten 24-h urine parameters showed weak or moderate sex-specific correlations with age. CONCLUSIONS: By applying up-to-date analytical methods and clinical chemistry analyzers to 24-h urine collections from a large population-based cohort we provide as yet the most comprehensive set of sex-specific reference intervals calculated according to CLSI guidelines for parameters determined in 24-h urine collections.

Complications following an accidental sodium hypochlorite extrusion: A report of two cases

Sodium hypochlorite (NaOCl) is the most commonly used solution in root canal treatments, as it is a low-cost method that displays a very effective antimicrobial activity against microbiota of infected root canals. However, this solution can cause complications especially due to its cytotoxic features. When this solution is injected into the adjacent tissues, the patient usually experiences intense pain, and an urgent treatment should be implemented in order to prevent a long-term sequelae. This paper describes the clinical features of two patients that experienced an accidental extrusion of NaOCl after endodontic treatment of varying severity and with different treatments. Furthermore, it shows the long-term neurologic injuries that this type of accidents may cause and a treatment protocol for these situations will be suggested.

Reagenssin pinta-aktiivisuuden hyödyntäminen sinkin uutossa

Työssä tutkittiin sinkin uutossa käytettävän di(2-etyyliheksyyli)fosforihappo (D2EHPA) -uuttoreagenssin faasikäyttäytymistä ja miten laimentimen koostumus, lämpötila ja orgaanisen faasin sinkkipitoisuus vaikuttavat faasitasapainoon. Laimentimen vaikutuksen havaittiin olevan pientä, kun taas lämpötilan nostaminen yli huoneenlämpötilan leventää faasidiagrammin yksifaasialuetta. Pienet orgaanisen faasin sinkkipitoisuudet eivät juuri vaikuta faasitasapainoon. Sinkin ja D2EHPA:n moolisuhteen ollessa välillä 0,1–0,2 kompleksin rakenne ilmeisesti muuttuu. Sinkkipitoisuuden kasvaessa yksifaasialue muodostuu pienemmillä ammoniakkimäärillä. Suurilla orgaanisen faasin sinkkipitoisuuksilla ja ammoniakkimäärillä muodostuu orgaanisen faasin ja vesifaasin välille kolmas nestefaasi. D2EHPA:n (40 p %) vesipitoisuuden ja viskositeetin pH riippuvuutta tutkittiin, kun laimentimena oli alifaattinen hiilivetyliuotin. Nostettaessa pH yli 3,5:n uuttoreagenssi alkoi muodostaa käänteismisellejä, jolloin orgaanisen faasin vesipitoisuus ja viskositeetti kasvoivat eksponentiaalisesti. Sinkin mukana uuttautuu epäpuhtauksia kuten Al3+, Co2+, Cu2+, Na+, Ni2+, Cl- ja F-. Takaisinuuton kautta epäpuhtaudet joutuvat talteenottoelektrolyysiin, jossa ne voivat vaikuttaa tuotteen laatuun ja laskea virtahyötysuhdetta. Tarkoituksena oli tutkia väheneekö epäpuhtauksien myötäuuttautuminen jollakin tietyllä sinkin latausasteella. Fluoridin ja kuparin uuttautumisen havaittiin vähenevän vasta, kun sinkin pitoisuus orgaanisessa faasissa oli yli 20 g/L lämpötilasta riippumatta. Fluoridi uuttautuu mahdollisesti alumiinikompleksina ja/tai fluorihappona. Koboltin ja nikkelin myötäuuttautumisen havaittiin vähenevän, kun sinkin latausaste oli yli 10 g/L. Natrium ja kloridi eivät myötäuuttautuneet.

Avaliação de contaminantes inorgânicos e orgânicos em álcool combustível utilizando eletroforese capilar

This work reports the analysis of inorganic and organic contaminants in alcohol fuel samples using capillary electrophoresis. Chloride and sulfate were analyzed in nitrate/ monochloroacetic acid at 10 mmol L-1 concentration each under indirect UV detection (210 nm). The analysis of aldehydes is based on the 216 nm detection of 3-methyl-2-benzothiazoline hydrazone adducts. The running buffer consisted of 20 mmol L-1 tetraborate , 40 mmol L-1 sodium dodecyl sufate and 12 mmol L-1 beta-ciclodextrin. Both methodologies were applied to real samples indicating inorganic ion concentrations from 0.15 to 6.64 mg kg-1 and aldehydes from 32.0 to 91.3 mg L-1.

A Novel Missense Mutation, I890T, in the Pore Region of Cardiac Sodium Channel Causes Brugada Syndrome

Brugada syndrome (BrS) is a life-threatening, inherited arrhythmogenic syndrome associated with autosomal dominant mutations in SCN5A, the gene encoding the cardiac Na₊ channel alpha subunit (Naᵥ1.5). The aim of this work was to characterize the functional alterations caused by a novel SCN5A mutation, I890T, and thus establish whether this mutation is associated with BrS. The mutation was identified by direct sequencing of SCN5A from the proband’s DNA. Wild-type (WT) or I890T Naᵥ1.5 channels were heterologously expressed in human embryonic kidney cells. Sodium currents were studied using standard whole cell patch-clamp protocols and immunodetection experiments were performed using an antibody against human Naᵥ1.5 channel. A marked decrease in current density was observed in cells expressing the I890T channel (from -52.0 ± 6.5 pA/pF, n=15 to 35.9 ± 3.4 pA/pF, n = 22, at -20 mV, WT and I890T, respectively). Moreover, a positive shift of the activation curve was identified (V½ =-32.0 ± 0.3 mV, n = 18, and -27.3 ± 0.3 mV, n = 22, WT and I890T, respectively). No changes between WT and I890T currents were observed in steady-state inactivation, time course of inactivation, slow inactivation or recovery from inactivation parameters. Cell surface protein biotinylation analyses confirmed that Nav1.5 channel membrane expression levels were similar in WT and I890T cells. In summary, our data reveal that the I890T mutation, located within the pore of Nav1.5, causes an evident loss-of-function of the channel. Thus, the BrS phenotype observed in the proband is most likely due to this mutation

Effect of reducing and replacing pork fat on the physicochemical, instrumental and sensory characteristics throughout storage time of small caliber non-acid fermented sausages with reduced sodium content

The effect of pork fat reduction (from 44% to 20% final fat content) and its partial substitution by sunflower oil (3% addition) on the physicochemical, instrumental and sensory properties throughout storage time of small caliber non-acid fermented sausages (fuet type) with reduced sodium content (with partial substitution of NaCl by KCl and K-lactate) and without direct addition of nitrate and nitrite (natural nitrate source used instead), was studied. Results showed that sausages with reduced fat (10% initial fat content) and with acceptable sensory characteristics can be obtained by adding to the shoulder lean (8% fat content) during the grinding, either 3.3% backfat (3% fat content) or 3% sunflower oil, both previously finely comminuted with lean. Furthermore, sunflower oil showed to be suitable for partial pork backfat substitution in very lean fermented sausages, conferring desirable sensory properties similar to those of sausages with standard fat content. The sensory quality of the sausages was maintained after three-month cold storage in modified atmosphere.

Influence of the temperature and type of salt on the phase equilibrium of peg 1500 + potassium phosphate and peg 1500 + sodium citrate aqueous two-phase systems

The present work analyzed the effect of the temperature and type of salt on the phase equilibrium of aqueous two-phase systems (ATPS) formed by poly (ethylene glycol) (PEG) 1500 + potassium phosphate, from (278.15 to 318.15) K, and PEG 1500 + sodium citrate, from (278.15 to 298.15) K. The rise of the temperature normally increased the slope of the tie line (STL). With respect to the influence of the type of salt, sodium citrate showed better capability to induce phase separation, when compared to potassium phosphate.